The Education Policy Institute’s Independent Mental Health Commission published its final report of the year. It is the culmination of research into exploring challenges and transformation of children and young people’s mental health care and support.
One in every ten children between the ages of five and sixteen have a diagnosed mental health problem. And yet, children’s mental health services receive only a mere 0.7% of the total NHS budget. This equates to just 6% of the overall spending on mental health.
The commission found that, on average, 23%, that one in four, are being turned away. It also revealed a postcode lottery of waiting times, from two weeks in Cheshire or nineteen in Staffordshire. The average wait is two months for treatment, but that conceals the hidden wait times for ten months or more held by some areas of the country.
March 2015 saw the government publish a strategy, Future in Mind, with aims of transforming Children’s services, alongside an investment of £1.25 Billion over the next five years.
The Education Policy Institute analysed the progress. Every area was asked to develop a plan as part of the conditions of receiving the funding. The EPI found a wide variation in the quality of these plans. Of the 121 published plans, a mere 18 areas (15%) had “good plans”. 58 (48%) required “improvements”, and 45 (37%) required “substantial improvements”.
The EPI also identified significant barriers. 83% of trusts had stated that finding experienced staff members was difficult. They stated that they needed to advertise on multiple platforms and occasions to fill the roles. Mental health nurses were notoriously the most difficult position to recruit for, followed by consultant psychiatrists. These issues led to an 82% increased output of temporary staffing. 20016-16 almost £50 million was spent on agency staffing by 32 trusts.
Moreover, not all the investment has reached the frontline. Only two-thirds of allocated funds were distributed in the first year, and only half of that (£75 million) was distributed to clinical leads. It is not clear how much has been spent on frontline services, but reports show mental health providers indicate they have not yet seen this increased investment. For 20016-17, £119 million has been allocated to clinical commissioning groups, but this has been included in general budgets, so the risk that it will be spent elsewhere is high.
It is important to consider the wider picture when it comes to funding the NHS system. Cuts to both local and early intervention services will have a significant impact on child and adolescent mental health because these specialist services are contained within the wider system which includes local funded early intervention support. When those services are cut, the specialist referrals increase. The CQC (Care Quality Commission) found that reductions in funding, including those non-NHS services, contributed to increased waiting lists.
Therefore, the Commission is calling for a new Prime Minister’s challenge on young people’s mental health. Based on David Cameron’s Dementia Challenge, this would include research, prevention, early intervention and increased access to high-quality services.
Research and prevention
The recommendations include the establishment of new Research Institute to research into the understanding of mental health and empowering young people to live safe digital lives.
The recommendation of a national programme on mental health and well-being to be placed within schools. Inclusive would be training for teachers and an inclusive curriculum as part of an updated PSHE lessons.
To increase access to quality care, the Commission urges the government to withhold funding for those areas who cannot demonstrate a robust plan of improvement. Proof should also be attained showing that the funding is being used in children’s mental health and not in offsetting cuts elsewhere. The commission also calls for a nationalised waiting time: that no one person should wait longer than two months to receive treatment.
Mental health can seriously affect a young person’s life chances, it can hold them back in education and development, and increase the risk of unemployment and ill health in their adult lives. These recommendations aim to ensure that this issue remains top of the agenda for at least the next five years.