All children needing NHS mental health services must have a guarantee to be seen within four weeks, or the next day for those at risk of self-harm and suicide, according to a new report.
The study, from the Commission on Young Lives, which is chaired by former children’s commissioner for England Anne Longfield, said the current system is buckling under pressure and called for a huge cash injection.
It criticised the fact NHS services often reject referrals for help, including for children who have self-harmed, tried to commit suicide or have eating disorders, while there are long waits for those who do make the list.
It called on the Government and the next Prime Minister to sign up to a five-to-10-year strategy with an immediate £1bn cash injection to improve support for youngsters with “guaranteed appointment and treatment times”.
This means a national guarantee that all children and young people requiring NHS Child and Adolescent Mental Health Services are seen within a four-week period, “with guaranteed next-day emergency appointments for children at risk of serious self-harm and suicide”.
The report said access to mental health services remains a “postcode lottery”, with a recent survey from YoungMinds finding 76% of parents saying their children’s mental health deteriorated while waiting for help.
Furthermore, in 2020/2021, just 23% of children referred to NHS services actually started treatment within four weeks, it added.
This is against a huge rise in the demand for help, with areas such as eating disorders among those seeing a surge.
In March 2022, 90,789 young people were referred to NHS children and young people’s mental health services, the highest figure since records began.
The report said: “YoungMinds told us of two particularly harrowing examples of young people who had attempted suicide but had still not been able to access NHS children and young people’s mental health services (CYPMHS).
A young woman was admitted to A&E by ambulance following a suicide attempt but was discharged 12 hours later. Her family contacted mental health services every day for over a week but did not receive any follow-up appointment or phone call
Commission on Young Lives report
“We heard about one teenage boy who was discharged from hospital after trying to take his own life, but after 10 days nobody from mental health services had been in touch.
“A young woman was admitted to A&E by ambulance following a suicide attempt but was discharged 12 hours later. Her family contacted mental health services every day for over a week but did not receive any follow up appointment or phone call.”
Overall, one in six children aged six to 16 has a probable mental health problem – a “huge increase” from one in nine in 2017, the report said.
It highlighted those who are more likely to suffer poor mental health, with half of all children in care meeting the criteria for a possible mental health disorder, compared with one in 10 outside the care system.
Children from LGBTQI+ groups are also “disproportionately affected”, as are those with special educational needs and disabilities, and children from black, brown and minority ethnic backgrounds.
Furthermore, children in poverty are more likely to suffer and “feel as though no one and/or no service cares about them”.
In a foreword to the study, Ms Longfield described “a very profound crisis in children and young people’s mental health in England.”
She said the Covid pandemic had a major impact, and school leaders, youth workers and people working in children’s services “have told me that dealing with students who self-harm and make suicide attempts is now a regular part of their professional lives”.
Among the recommendations are a guaranteed mental health assessment for children and young people at points of vulnerability, such as those entering care, and a bigger focus on increasing staffing across all services.
There should also be a national implementation programme to embed a “whole school and college approach to mental health”, with a Government commitment to provide a funding package for mental health support teams beyond 2023/24.
The study warns that failing to support young people with mental health problems could lead to more behavioural incidents at school, a rise in exclusions, and more children becoming at risk of grooming and exploitation.
The children’s mental health emergency in England is so profound that we face a generational threat to our country’s future national prosperity and success
Children's commissioner for England, Anne Longfield
The report also called for a “national social prescription scheme in every area that enables GPs and health professionals to pay for sports, arts, music, drama, activities, youth clubs, volunteering, and outlines to improve young people’s confidence and self-esteem.”
Ms Longfield said: “The children’s mental health emergency in England is so profound that we face a generational threat to our country’s future national prosperity and success.
“The overall response from the Government to this children’s mental health crisis has so far been too slow and inadequate, and we are failing to support hundreds of thousands of children with mental health problems.”
Dr Trudi Seneviratne, registrar at the Royal College of Psychiatrists, said it was unacceptable so many children were waiting for treatment due to the “overwhelming pressure on specialist services”.
She added: “Without significant investment and urgent action to tackle the workforce crisis, many more young people could end up at the point of crisis.”
Shadow health minister Rosena Allin-Khan said: “Our children’s futures can’t be put at risk because the Government continues to ignore the rising demand for mental health services, leaving many areas without the access to services that are so desperately needed.
“This is why the next Labour government will eradicate the postcode lottery, guaranteeing mental health treatment within a month for all who need it.”
A Government spokeswoman said: “We are committed to ensuring children can access the support and resources they need, as early as possible.
“We’re continuing to take action to support their mental health – including £79 million to ensure 22,000 more children and young people can access community mental health services, as well as to expand mental health support teams in schools to reach three million pupils by 2024.
“This is on top of our record investment to expand and transform services giving an additional 345,000 children access to support by 2024 and expanding the children’s mental health workforce by more than 40%.”