Last week, figures from YoungMinds revealed that the majority of clinical commissioning groups (CCGs) and local authorities have cut or frozen their spending on child and adolescent mental health services (CAMHS) – to me, this can only create problems in both the short and longer-term.
YoungMinds’ research found that 77% of CCGs froze or cut their CAMHS budgets between 2014/2015 and 2013/2014, while 55% of local authorities in England that supplied data cut, froze or only increased budgets, below inflation . In addition, 60% of local authorities in England have cut or frozen their CAMHS budgets since 2010/2011.
Perhaps most shockingly, it was revealed that Birmingham City Council – which isn’t renowned for the quality of its children’s services at the best of times – had cut its CAMHS budget by a whopping 94.6% since 2011. I would suspect that more children than ever are missing out on vital support in the city due to this – which will pile yet more pressure on its already over-stretched children’s services department.
Given that children’s mental health services are, and perennially have been, chronically underfunded, it means that many young people are not receiving the help they need when they need it, which will only exacerbate and prolong their problems.
It is well known that more than half of all adults with mental health problems were diagnosed in childhood, yet more than half of those did not receive appropriate support at the time.
Likewise, the evidence suggests that early intervention with young people who have mental health problems can stop those difficulties developing into something more serious and improve their health and life chances.
But what is going to happen to change things and enable better care and earlier intervention? Care Services Minister Norman Lamb’s response to YoungMinds’ findings wasn’t exactly reassuring. While saying that it was vital that children get the right support at the right time – he would say that, wouldn’t he? – he added “I would urge everyone to put pressure on local commissioners to make sure children’s mental health gets its fair share.”
Surely it is the government’s role to put pressure on local commissioners as well? Rather than leaving it to people on the ground – who often put pressure on commissioners to no avail – those in positions of power should be exerting their influence.
The government may say it is prioritising children’s mental health but this doesn’t seem to have percolated down to spending in local areas – in fact, quite the opposite appears to be happening. If the aims of the Mental Health Strategy – remember that? – are to be realised, it has to be backed with funding from central government. And we know that when the government really wants to do something, funds can be found.
It is clear that urgent investment is needed in CAMHS services from CCGs and local authorities. Cuts to services need to be reversed and then spending needs to be increased – not only on early intervention services, but also on specialist services, such as those for eating disorders, which are known to be on the rise.
Cutting CAMHS services is simply a false economy. While it might bring short-term savings for commissioners, in the medium to longer-term, costs will only grow , with the increased use of acute services, and a with longer times spent in secondary services – much of which could be prevented with effective CAMHS services.
But more than the financial cost, the real worry is the cost to the young people, who will not get the services they need, and as a result will be at greater risk of long-term mental and physical health problems and poorer life chances.
That is the true cost and should dictate all our thinking when discussing the future funding of children’s mental health services.