Health Service Focus

14.02.20

CAMHS: The state of play for children and adolescent mental health

National Health Executive’s Matt Roberts spoke with Whitney Crenna-Jennings, a senior researcher in mental health, wellbeing and inclusion at the Education Policy Institute (EPI) about their recently released CAMHS report.

 

Forming a key cornerstone of mental health provision in this country, access to children and adolescent mental health services (CAMHS) is a vital area of care which has found itself underfunded and with patchy coverage in recent times.

Steps are being taken to improve funding and close regional inequalities in the provision of services, but as the Education Policy Institute (EPI) uncovered in their annual report for 2019, using information gained through Freedom of Information (FOI) requests, there is still some distance to go to in order to attain ambitious government targets.

Speaking with Whitney Crenna-Jennings, one of the authors of the report at the EPI, we get a better understanding of what the report uncovered.

Q: You recently co-authored the EPI’s Annual Report into access to child and adolescent mental health services and it produced some rather damning statistics on the state of mental health provision available to children and young people around the country.

Could you talk us a through your findings a little bit more?

“We’ve been collecting this data through Freedom of Information (FOI) requests for the past three years, and year on year this is what we’ve found. We’ve found a quarter of referrals to specialist services are not accepted into treatment.

“In a way it’s not surprising, but in another, as time goes on and we know there has been a significant amount of money committed to improving access to and quality of services, it was surprising to us [that] we’re not seeing that filter down and have any kind of impact on the data we’re collecting.”

Q: We’ve seen an extra £1.4bn committed by Government for CAMHS services, yet seen no improvement in the last four years in the rate of rejections. Do you think this represents funds being misspent or larger underlying factors?

“It’s hard to say, [but] I think it’s a combination of factors.

“Firstly, we’re just coming out of years, decades really, of underinvestment in child and adolescent mental health services so we’re starting from a really low baseline.

“The £1.4bn that was committed was in 2014, so not that long ago, but I think there are a lot of systemic issues. It could be that funding is not reaching the frontline of all areas because its not ring-fenced, so clinical commissioning groups and other agencies could be hypothetically using it to plug other holes in health services.

“Another indicator we looked at was wait time and we do see a decrease in waiting times over the [period of our research] so it could be that money is being funnelled into reducing waiting times rather than expanding access to more referrals.

“We’re really still at the beginning of this transformation of CAMHS but it is concerning that it has been four years and we don’t see a huge amount of change or a mass rise in the level of need that is being met.”

Q: As said, we are seeing an improvement in waiting times but the average still remains some way off the government targets of four weeks. How realistic of a target do you feel these are?

“The Government is currently piloting the four weeks waiting time in a handful of areas and there are questions to when or how they would roll this out across the country. Based on the data we’ve been collecting over the past few years and what we know, it is likely to be a long way off for the country as a whole.

“There is massive local variation in terms of ease of access to services and how long you wait to start treatment and that’s likely to continue.

“We might see these four week waiting times happen in the next few years, in a few areas such as the pilot areas or some areas who are just doing a better job of delivering services, but it is unlikely we will see [these targets met] across the country in the near or medium term.”

READ THE FULL ANNUAL REPORT BY THE EDUCATION POLICY INSTITUTE HERE

Q: Good provision of mental health services doesn’t just rely on healthcare bodies, but local authorities too. Do you feel

there is enough collaboration between these at present?

“I think it’s a problem area and not something only we have found. The Care Quality Commission has repeatedly, in their reports and assessments of CAMHS, talked about this fragmentation of the service offer as a whole.

“The concern is when you have a quarter of referrals not being accepted by specialist services, some of those may not need specialist intervention or not meet the threshold, but for whatever reason they probably require some sort of support.

“As a result, the concern is that those alternative services are not in place, and not in an even way around the country. [In previous research] we carried out FOI asking what services were being offered to support the mental health and wellbeing in young people. We know local authority budgets have been reduced significantly and a lot of [these services] have been decommissioned over the past decade.

“It’s really a black hole as the government doesn’t collect data on these alternative services so we don’t know if children who can’t access specialist CAMHS or who have lower level need but require some sort of intervention are able to access those services.”

Q: Mental health services can provide a key backbone to the care of those under their services, but those who enter the system as children and young people often find there isn’t support when transitioning from these services into adult mental health services.

Is this something your data correlates with, and what can local authorities and health bodies do to improve this transition period?

“We know not just from our own research but from others, and from young people themselves, that this is a huge area of provision. We see a number of young people

dropping out of care at that point despite ongoing need.

“I think the fact we found there was not a specific service or role or specific support for children transitioning into adult mental health services in a lot of areas is a concern.

“There is expert consensus around the fact that CAMHS should be offered up to age 25, but again that is only happening in a minority of areas, with only a small number further who have plans to extend the offer. For a lot of places this still isn’t happening.”

Q: What are the EPI’s aims with carrying out this research?

“We haven’t been successful yet in engaging with NHS England on this but that is the goal and we are working towards this on that goal.

“They came out quite strongly against some of our findings this year, but we want to work constructively with them. We have plans to meet with them and present our suggestions based on the research we’ve done.

“We’re not trying to be combative, we’re just reporting the data as it comes to us. Yes, there are issues around FOI data quality, but until NHS England collects and publishes this data this is the only way we have of finding out this information.

“In an ideal world, they would be collecting, validating and publishing this data and we wouldn’t have to collect this data. That’s our position and we do have hopes and plans to engage with them in the future.”

 
This article first featured in the Jan/Feb 2020 edition of NHE

Comments

There are no comments. Why not be the first?

Add your comment

 

national health executive tv

more videos >

latest healthcare news

Digital prescribing and records introduction boosted by funding

18/09/2020Digital prescribing and records introduction boosted by funding

More patients and healthcare staff are set to benefit from single electronic patient records after the UK Government announced £8.7m fundin... more >
NICE’s support for rebuilding capacity in non-Covid health services

18/09/2020NICE’s support for rebuilding capacity in non-Covid health services

Paul Chrisp, Director of the Centre for Guidelines, NICE When the Covid-19 pandemic hit the UK’s shores earlier this year, the NHS res... more >
New Lighthouse Labs established to boost testing capacity

17/09/2020New Lighthouse Labs established to boost testing capacity

Testing capacity is set to be significantly boosted through the creation of two new Lighthouse Labs in Newcastle and Bracknell. The announce... more >

editor's comment

26/06/2020Adapting and Innovating

Matt Roberts, National Health Executive Editorial Lead. NHE May/June 2020 Edition We’ve been through so much as a health sector and a society in recent months with coronavirus and nothing can take away from the loss and difficulties that we’ve faced but it vital we also don’t disregard the amazing efforts we’v... read more >

last word

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad: ‘We all have a role to play in getting innovations quicker’

Haseeb Ahmad, president of the Association of the British Pharmaceutical Industry (ABPI), sits down with National Health Executive as part of our Last Word Q&A series. Would you talk us th... more > more last word articles >

the scalpel's daily blog

NICE’s support for rebuilding capacity in non-Covid health services

18/09/2020NICE’s support for rebuilding capacity in non-Covid health services

Paul Chrisp, Director of the Centre for Guidelines, NICE When the Covid-19 pandemic hit the UK’s shores earlier this year, the NHS responded quickly, diverting and devoting resources to make sure patients facing this new and unknown pathogen received the best possible care. But in doing so, many other health services were reduced or paused. Far fewer people consulted their family doctor or used urgent and emergency care servi... more >
read more blog posts from 'the scalpel' >

comment

NHS England dementia director prescribes rugby for mental health and dementia patients

23/09/2019NHS England dementia director prescribes rugby for mental health and dementia patients

Reason to celebrate as NHS says watching rugby can be good for your mental health and wellbeing. As the best rugby players in the world repr... more >
Peter Kyle MP: It’s time to say thank you this Public Service Day

21/06/2019Peter Kyle MP: It’s time to say thank you this Public Service Day

Taking time to say thank you is one of the hidden pillars of a society. Being on the receiving end of some “thanks” can make communit... more >
Nurses named as least-appreciated public sector workers

13/06/2019Nurses named as least-appreciated public sector workers

Nurses have been named as the most under-appreciated public sector professionals as new research reveals how shockingly under-vauled our NHS, edu... more >
Creating the Cardigan integrated care centre

10/06/2019Creating the Cardigan integrated care centre

Peter Skitt, county director and commissioner for Ceredigion Hywel Dda University Health Board, looks ahead to the new integrated care centre bei... more >
Helpforce to launch training programmes for NHS volunteers

10/06/2019Helpforce to launch training programmes for NHS volunteers

Kay Fawcett OBE, clinical advisor and education lead at Helpforce, and Lynn Twinn, talent development consultant, outline the new national traini... more >

interviews

Organ Donation Week: Having the conversation

11/09/2020Organ Donation Week: Having the conversation

As part of Organ Donation Week, NHE’s Matt Roberts spoke with our Managing Director Roy Rowlands about the importance of raising aware... more >
Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

24/10/2019Matt Hancock says GP recruitment is on the rise to support ‘bedrock of the NHS’

Today, speaking at the Royal College of General Practitioners (RCGP) annual conference, Matt Hancock highlighted what he believes to be the three... more >
NHS dreams come true for Teesside domestic

17/09/2019NHS dreams come true for Teesside domestic

Over 20 years ago, a Teesside hospital cleaner put down her mop and took steps towards her midwifery dreams. Lisa Payne has been delivering ... more >
How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

24/10/2018How can winter pressures be dealt with? Introduce a National Social Care Service, RCP president suggests

A dedicated national social care service could be a potential solution to surging demand burdening acute health providers over the winter months,... more >
RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

24/10/2018RCP president on new Liverpool college building: ‘This will be a hub for clinicians in the north’

The president of the Royal College of Physicians (RCP) has told NHE that the college’s new headquarters based in Liverpool will become a hu... more >