The increased funding promised for children’s mental health by the government is not making it through to frontline services, which is putting the planned transformation of services at risk, a report has said.
The Education Policy Institute’s Independent Commission on Children and Young People’s Mental Health’s new report, Time to Deliver, found that in the first year of the government’s plan for increased funding, of the expected £250 million, only £143 million was released, and of that only £75 million was distributed to clinical commissioning groups (CCGs).
While it is unclear how much of this has reached frontline services, mental health providers have indicated that they have not yet seen this increased investment. For 2016-17, £119 million has been allocated to CCGs, but this has not been ring-fenced – with the risk that it will be spent on other priorities.
The report also calls for a new ‘Prime Minister’s Challenge’ on children and young people’s mental health. Time to Deliver sets out a number of new findings, and proposes a series of recommendations which it urges the government to adopt through the Challenge. This includes a programme of changes covering research and prevention, early intervention and improving access to quality services.
This adds to the evidence that the promised money is not getting to the frontline. In October, a King’s Fund report, which analysed the accounts of mental health trusts in England found that 40% of trusts saw their income fall in 2015/16.
The Commission’s report found evidence of a ‘treatment gap’ when it comes to local mental health transformation plans. For instance, 66.9% of young people aged 16-34 who had attempted suicide had not subsequently received medical or psychological help.
In addition, specialist mental health services are on average turning away 23% of the young people referred to them for treatment.
Research supports previous findings that workforce difficulties are a key barrier to the implementation of the vision set out in Future in Mind. Of the trusts that responded, 83% said they had experienced recruitment difficulties, with a similar number saying they have had to advertise posts on multiple occasions to fill roles, with mental health nurses being the most difficult profession to recruit, followed by consultant psychiatrists.
A significant hindrance to progress is the lack of engagement between health services and schools. The report highlights the difficulties faced by health staff in attempting to work with the education sector – with schools similarly expressing frustration at obtaining support for their pupils from specialist mental health services.
Prime Minister’s challenge
The Commission calls for a new Prime Minister’s Challenge on Children’s Mental Health, which should be adopted as a key priority for the government. This would set out an ambitious reform programme covering research and prevention, early intervention, and improving access to quality services.
Research and prevention measures would include establishing a Mental Health Research Institute to fund research into understanding mental health and new treatments, producing an easy to understand web-based parenting guide for all parents, and a strategy to empower young people to live safe digital lives. This should focus on developing young people’s resilience and critical thinking skills in the face of online threats, given the impossibility of eliminating all online risk.
For early intervention, the report recommends setting up kite marked, easily accessible, early-intervention services in every area. In education it recommends a national programme on mental health and wellbeing within schools – with trained teachers and a trained mental health and wellbeing lead guaranteed in every school, college and university – and high quality statutory PSHE in all schools and colleges with dedicated time for mental health.
Finally, to improve access to high quality services, the Commission said areas should not receive their annual share of the additional £1.4 billion unless they can demonstrate that they have robust plans to improve care and all the additional funding is being spent on children’s mental health and not offsetting cuts elsewhere. Also, there should be a new goal that no one should wait more than 8 weeks for routine treatment and an end to the practice of making a young person leave their support services to move onto adult services on their 18th birthday.
Time to deliver
Bev Humphrey, chair of the Mental Health Network, said: “We support the Commission’s challenge to the Prime Minister, which follows ongoing concern about the Government’s failure to come close to fulfilling its existing promises on mental health funding.
“This situation means underfunded NHS and social services are struggling to help the growing number of children experiencing serious mental health problems.
“With many services almost at breaking point the Commission is right – it really is time to deliver.”