Parents and mental health professionals are reporting that young people are unlikely to receive inpatient care unless they have reached a serious point of crisis, such as attempting “suicide multiple times”, finds a report published by Look Ahead Care and Support.
Based on in-depth interviews with service users, family members, and NHS and social care staff, the report has found that increasing demand from children and young people requiring crisis support is creating serious challenges for service provision.
Interviewees reported that A&E departments have become an ‘accidental hub’ for young people experiencing a point of crisis; however, these places are often unsuitable or ill-equipped to offer the treatment they need. Accounts from patients and experts indicate that young people are frequently placed in general paediatric wards alongside younger children for ongoing medical monitoring.
In addition, because of the high demand, private sector providers are increasingly delivering the majority of support (55%) for hospitalised young people with mental health difficulties at an “exceptionally high” cost for British taxpayers.
Families are increasingly relying on ambulances and police services to deliver mental health support
Data shows that the number of children and young people contacting mental health services rose by nearly a third from 2020 to 2021. Additionally, families increasingly rely on ambulance and police services to deliver mental health support, particularly for those young people aged 16-17.
Chris Hampson, Chief Executive of Look Ahead, responded to the report’s findings. He said: “The deep challenges in mental health care crisis provision for young people [are] setting up a ticking timebomb for mental health services in the future – as young people become vulnerable adults.”
“The NHS is doing all it can in impossible circumstances, but the result is a service that both costs more than it should and helps too few of those in crisis […] This research shows how much more needs to be done to redirect funds towards early intervention and prevention, in particular through intensive supported housing as an alternative to hospital. These are the community services that can help people before they reach crisis point.”
A new community-based model is needed to support young people in crisis and those who do not meet the threshold for CAMHS treatment
In addressing these issues, the report makes a series of recommendations to policymakers and local commission groups for new residential, community-based crisis services outside of the hospital setting, which Look Ahead projects could cost over half (52%) less than existing services. Such new community-based organisations would be an alternative for those in a mental health crisis or those who did not meet the current very high threshold for admission.
An example of this new services model, detailed in the report, includes The Hope Service, run by Surrey and Borders Partnership NHS Foundation Trust.
The service provides intensive community support to young people aged 11-18, preventing or shortening their admission to inpatient units. The Extended Hope Service also gives out-of-hours support to young people in crisis, offering mental health assessments and a unit to provide residential care for those in crisis for up to 7 days.
The Hope Service is staffed by social workers, nurses, teachers, psychologists, art and drama therapists, psychiatrists, family therapists and activity workers. The team works with young people, their families and carers to co-produce a care plan to prevent the escalation of mental ill health or intensive social care support.