With a big injection of government funding, and a new NHS programme to improve services launched, it has been said that children’s mental health care is on the brink of a “new dawn” – but the rhetoric must result in action.
Dr Jacqueline Cornish, NHS England’s national clinical director for children and young people, certainly talks a good game. Speaking at the recent launch of the first stage of a new programme to improve children’s mental health services, she said: “We are on the brink of a new dawn for young people’s mental health and these are the first steps towards a new and more secure place with a brighter and more hopeful future.
“Unless we make real changes across the whole system, opportunities to build resilience, promote good mental health and intervene early when problems first arise, will continue to be missed and the opportunity to build a stronger youth for future generations lost.”
That all sounds great, on the face of it. As everyone knows, children’s mental health services have been crying out for reform for years. The aims of the NHS England programme, such as ensuring that by 2020 95% of patients are seen within four weeks of being referred, or within one week for urgent cases, are welcome. And, having a national improvement programme in place is a significant move forward over previous years.
These developments, coupled with the promised £1.25 billion package of spending on children’s mental health services, over the course of the next Parliament, provide source for genuine optimism.
But anyone who has worked in children’s mental health services in recent years will be forgiven for a touch of cynicism. There has been talk of new dawns before, but they have generally turned into false dawns.
The scale of the challenge of reforming children’s mental health services should not be underestimated. As research by YoungMinds last year found, local authority CAMHS services have seen major cutbacks over the past five years, and other services, such as inpatient care, lag behind their adult equivalents. The majority of clinical commissioning groups have also cut, or frozen, their CAMHS budgets in recent years.
It should also be remembered that demand for CAMHS is increasing. As it stands, many young people do not get support when they need it or, where they need it– given the number sent out-of-area for treatment. There are also anxieties over the standards of a number of CAMHS services across the country – the National Autistic Society recently went public on its concerns about services in Cumbria, for instance.
So, NHS England’s new programme has to be driven from the top to ensure that its aims are realised. If they are, they will go some way to addressing the problems in CAMHS. However, those aims cannot be achieved without the promised extra investment from government. So far, £143 million of that has come through – less than the expected £250 million. But, the government has reiterated its commitment to spending the full amount over the next 5 years.
That money is desperately needed and must be deployed in frontline services – including bolstering the flagging local authority sector and reinstating some services that have been cut in the past few years.
The funding also needs to cover the whole range of services – from early intervention through to acute crisis care.
This is a crucial time, especially for CAMHS – if change is got right, then it really could represent a new dawn for services and generations of children and young people will benefit. Get it wrong, and the effects will be felt for many years to come.