Last week, the Care Quality Commission (CQC) released a statement reviewing the current state of mental health care for children and young people.
Between June and July 2021 the CQC carried out a series of reviews to investigate how services have been working to support children and young people’s mental health during the pandemic. In order to do this in the most effective way, they chose seven areas in England and followed a number of individuals as they moved through the system from social care to health and mental health; this also involved working with and hearing from young people, their families and those who work in the services being reviewed.
Improvements within services
During the course of their reviews, the CQC witnessed a notable improvement in cross-service and system collaborative work, noting in one area instances where more than 60 ‘system partners came together, including people working in the voluntary sector, to coordinate care for children and young people as well as identify gaps in provision.’
This improvement then also bridged across to the sharing of information between services, as well ensuring information is being shared with service users and their families, however the CQC notes ‘this was not the case everywhere and siloed or disjointed working was a concern’.
The experience of young people accessing services
The shift to virtual support and digital work for children’s health and social care services was, unsurprisingly, every bit as complex as it was for schools, the criminal justice system and other public sector work. The CQC noted that in some cases there was an improvement in access to day services and crisis support.
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One of the major concerns was of digital exclusion, an issue likely very prevalent with those accessing children and young people’s health and social care. Across the services reviewed by the CQC a number of tactics were used to address this issue. This included: date packages and digital devices for those in need of them, as well as continuing to offer face-to-face appointments for the most vulnerable children and young people where appropriate and possible.
“Demand has soared over the last 18 months and children and young people should not have to reach a crisis point before they get proper mental health support.” Said Dr Rosie Bennyworth, Chief Inspector of Primary Medical Services and Integrated Care.
CQC reported hearing numerous concerns from children and young people that ‘they had to become very unwell before they could access care, and that they waited long times to receive help.’ As we have reported on before, the number of young people seeking help for eating disorders has increased drastically over the past 18 months and in their statement, the CQC confirmed that people ‘were waiting longer to access care than would have been the case before the pandemic.’
The impact of the pandemic has been acutely felt by staff working in services too, expressing worry about stress and burnout. Many services employed wellbeing measures such as ‘wobble rooms’ where staff could escape to when they needed a break, as well as creating wellbeing clinics and counselling sessions.
The pandemic has, in health and social care as with many other sectors, highlighted the ‘deepened health inequalities’ facing some children and young people
The CQC eluded to the fact that many of the issues affecting children and young people today, and throughout the pandemic have been long standing, and although may have been exacerbated by the extenuating conditions of the past 18 months, have not appeared unexpectedly. CQC also suggested that many of the largest concerns for those living in the most deprived areas in England now, echo those found in the 2018 CQC review ‘Are we listening? A review of children and young people’s mental health services.’
Dr Rosie Benneyworth spoke on some of the improvements seen in the CQC review: “As systems begin to move towards recovery, we need to hold onto and share the hard-won developments that have driven better care for children and young people, and their families. Examples like improved data sharing, joint commissioning of roles between CAMHS and social care and improved mental health training for non-mental health staff have huge potential to help tackle issues we have sadly seen in this area for too long.”
It is important to note that, although the improvements found in the series of reviews from the CQC reported here are promising, this is still only a snapshot of the reality facing services for children and young people’s mental health, nationwide.
Out of these unprecedented times, here we see some examples of the kind of work necessary to address the crisis facing children and young people’s mental health, especially the cross-service collaborative work. Responding to the fact that many children and young people believe they have to reach crisis point before they might receive help, Dr Benneyworth finished saying, “We have to take this opportunity to learn from this incredibly challenging time and do better for them.”