Why is access to specialist mental health support denied to so many teenagers?

10^th December 2015

Our recent report at The Children’s Society’s, Access Denied: a teenager’s pathway through the mental health system, shows that last year out of 200,000 teenagers referred to specialist mental health services around 30,000 were turned away without any offer of support. In this blog, I will be exploring our key findings showing why more needs to be done to ensure that children in need of mental health support do not find they face access being denied.

The current state of children and young people’s mental health

The latest national data available on children and young people’s mental health estimates that 1 in 10 experience mental health problems[i].  But not only is this data more than a decade old, it does not even cover all children, given 16 and 17 year olds were excluded from the survey. Therefore it is very likely to misrepresent the scale of the problem, whilst recent hospital data points also to a worrying rise in self-harm episodes and eating disorders among young people.

While a child of any age may require help with mental health issues, the research shows that teenagers are particularly at risk of developing mental health issues. Many long-term mental health issues, including self-harm and eating disorders, first emerge during adolescence. Recently concerns have also been raised by parents and teachers about the impact of social media on mental health and wellbeing of children and young people, particularly with regards to emotional distress caused by cyber-bullying. Many teenagers, as the most active users of internet and social media, are likely to be affected.

Yet, despite the ever increasing number of children and teenagers requiring mental health support, Child and Adolescent Mental Health Services (CAMHS) have been underfunded and have experienced cuts in recent years. Only 6% of national spending on mental health went to CAMHS in the year 2013. A Health Committee report[ii] concluded there were ‘serious and deeply ingrained problems’ in CAMHS, a sentiment echoed in the 2015 ministerial taskforce report Future in Mind[iii], which called for a ‘complete overhaul’ these services.

With mounting political and public pressure calling for improved mental health services for children and young people, the Government finally committed in spring 2015 to invest £1.25bn over the next 5 years to improve access to mental health support for children and young people. This announcement has been welcomed by many, including ourselves.

What issues need to be addressed?

Every day at The Children’s Society’s, we work directly with some of the most vulnerable teenagers, such as those with safeguarding needs such as domestic abuse, neglect, sexual exploitation as well as those who have run away from home or care. Many of them require counselling and therapeutic support to help them overcome their traumatic experiences. Access to CAMHS for these young people is a grave issue of concern.

Based on data collected from 36 NHS mental health trusts, we examine the barriers preventing the most vulnerable adolescents accessing the support they need.

Acceptance rates

We estimate that that approximately 200,000 young people aged 10 to 17 across England are referred to specialist mental health services each year and around 30,000 of these are turned away without getting any support at all. For the most vulnerable teenagers, we believe the reason may be that some professionals believe that responding to safeguarding concerns alone is sufficient to meet their mental health needs. The access and referral processes are often too complicated.

Variations in Waiting times  

When referrals are accepted, young people on average are waiting 66 days for an initial assessment. But there are great variations between areas with some trusts offering appointments within 13 days and others worryingly up to 140 days – almost five months. The recent policies on improving waiting times standards for conditions such as eating disorders by the Government is crucial but our research demonstrates that these standards needs to be introduced to all specialist CAMHS.

Inconsistent policies

We also reviewed policies enabling vulnerable groups of young people such as children in care, those who are victims of physical or sexual abuse and older adolescents access services they need. Our analysis reveals inconsistent policies about access to services for vulnerable young people. We found that 64% of mental health trusts identify looked-after children as a vulnerable group in the initial stages of their referral, yet only 40% offer priority access and less than a third (28%) have policies in place to support them when they transition to adulthood. Furthermore, less than half of trusts have clear pathways in place for children who have experienced sexual abuse.

CAMHS services across the country have been developing transformation plans on how they will spend some of the promised funding over the next five years. The Children’s Society believes that  this presents an opportunity for the Government and local commissioners to improve access to mental health support for young people who are most at risk – including children who have experienced traumatic experiences, such as sexual abuse or those children leaving care.6

Read Access Denied: A teenager’s pathway through the mental health system.

Read more about The Children’s Society’s mental health work.

[i] ^{Green H, McGinnity A, et. al. Mental health of children and young people in Great Britain. 2004. Basingstoke: Palgrave Macmillan; 2005.}

[ii] ^{Health Committee. Children’s and adolescents’ mental health and CAMHS, Third Report of Session 2014–15. 2014. http://www.publications.parliament.uk/pa/cm201415/cmselect/cmhealth/342/342.pdf}

[iii] ^{The Children and Young People’s Mental Health and Wellbeing Taskforce. Future in Mind. 2015. Department of Health, London. https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/414024/Childrens_Mental_Health.pdf}