10.03.15
Young people with mental health problems ‘falling through the gaps’
Commissioners must improve mental health services for young people who are getting ‘stuck in the gap’ between inpatient and community care, according to the Royal College of Psychiatrists.
The college’s Child and Adolescent Faculty says a lack of access to acute mental health beds is putting children and young people at risk to themselves and others – a problem made worse by stretched community services.
The recommendations are based on a survey of in-patient admissions for children and young people with mental health problems, which found that almost 80% of child and adolescent psychiatrists who responded had safeguarding concerns about their patients waiting for beds.
It urged the government to prioritise investment in crisis care services for children and young people, and for NHS England, CCGs and social services to ensure adequate emergency care pathways are in place “as a matter of urgency”.
Faculty chair Dr Peter Hindley: “It is unacceptable that children and young people are stuck in this gap between community and inpatient care. This survey shows just how devastating the consequences can be.
“We need urgent action to support these individuals and their families. Ensuring the safety of children and young people should be the number one priority. Failure to improve both inpatient and community care will mean they will continue to be at risk to themselves and others.”
Of the psychiatrists who responded to the survey, three-quarters said they had diagnosed a young person as being at ‘high risk’ when it came to their own safety and others, thus needing a bed, but who were being managed in the community anyway. More than half of respondents (61.9%) reported young people were being held in inappropriate settings such as paediatric wards, police cells, Section 136 suites and A&E departments.
The survey showed that 14% of respondents cited cases of children and young people who had attempted suicide while waiting for a bed.
The lack of beds was blamed on an increase in referrals, decreased community CAMHS capacity, decreased capacity of social care and decreased in-patient capacity. New commissioning arrangements had resulted in “less control and accountability”, they said.
Dr Max Davie of the Royal College of Paediatrics and Child Health (RCPCH), said: “We know that children and young people’s mental health services are in turmoil with disinvestment in early help services, increased pressure and cuts to CAMHS and a shortage of specialist services.
“With 850,000 children and young people in the UK having a mental health problem, provision as it currently stands is simply not sustainable – and today’s stark survey findings only highlight this further.
“We simply cannot let children and young people fall through the gaps. They need support at the earliest opportunity because if left unsupported, mental health problems can lead to alcohol and drug misuse, self-harm and in extreme cases, can lead to suicide – a devastating reality which has been flagged as a major concern in this survey.
“We welcome many of the recommendations outlined by the RSPsych, particularly giving careful thought to services for vulnerable and high-risk children and young people, strengthened multi-agency working and, to avoid hospital admittance and targeted resource investment to strengthen community mental health services.
“In addition, it’s crucial that we know how many children are likely to need CAMHS support so we must collect regular data on the prevalence of mental health conditions to ensure service demand does not outstrip supply.”
The full report and list of recommendations is here.