Number of children in A&E with serious mental health issues jumps 50 per cent since start of pandemic

·7-min read
Emma Shepherd was so afraid for Lila's health that she felt she had no recourse other than to beg staff at Sheffield Children’s Hospital A&E to admit her - Paul Cooper
Emma Shepherd was so afraid for Lila's health that she felt she had no recourse other than to beg staff at Sheffield Children’s Hospital A&E to admit her - Paul Cooper

The number of children who go to A&E with serious mental health issues has jumped by more than 50 per cent since the coronavirus pandemic began, after school closures pushed youngsters to crisis point, a Telegraph investigation has revealed.

More than 2,243 children in England were referred for specialist mental health care from emergency departments in May this year, compared with just 1,428 in May 2019.

Experts say children have struggled with schools being closed and without face-to-face interaction with their peers.

Robert Halfon, the Conservative MP and the chair of the education select committee, called for schools to remain open to stave off a mental health “catastrophe”.

NHS data reveal that nearly 27,000 children are being prescribed antidepressants each month, up more than eight per cent from 2019. While most are teenagers, 25 a month are aged six or under, and more than 1,000 are aged seven to 11.

Waiting lists for Child and Adolescent Mental Health Services (CAMHS) have jumped by more than a third in some regions, according to NHS England Trusts.

The number of children admitted to acute wards with eating disorders more than doubled in the three months to June 2021, when compared with the same period in 2019.

Dr Anna Conway Morris, a consultant child and adolescent psychiatrist, said the increase in A&E referrals “shows that the things that are likely to need CAMHS input, like eating disorders, or like more serious self-harm or suicidal thoughts, have increased.”

Paul Farmer, the chief executive of the mental health charity Mind, has written to the Health Secretary, Sajid Javid, calling for extra funding in order not to “betray the next generation”.

An NHS England spokesman said its mental health services were looking after record numbers of children “with over 420,000 treated since April last year”.

The Lila Veasey case study: a far from uncommon occurrence
The combined pressure of remote learning and isolation from her peers made 13-year-old Lila Veasey increasingly stressed. - Paul Cooper
The combined pressure of remote learning and isolation from her peers made 13-year-old Lila Veasey increasingly stressed. - Paul Cooper

Lila Veasey was a perfectly happy child before the pandemic took hold, but over the course of last year the combined pressure of remote learning and isolation from her peers made the 13-year-old increasingly stressed.

Shortly after Christmas (as the third national lockdown loomed) Lila’s mother, Emma Shepherd, noticed that alongside violent mood swings, she was rapidly losing weight. By Easter Monday, she had not eaten anything for several days.

Ms Shepherd, 33, was so afraid for Lila's health that she felt she had no recourse other than to go to A&E at Sheffield Children’s Hospital, and beg staff to admit her. There she was diagnosed with anorexia, anxiety, and depression.

Lila was referred to the Child and Adolescent Mental Health Services for specialist care, but with no beds available the teenager remained at Sheffield Children’s Hospital until this month.

During that time, Lila deteriorated considerably, refusing water so that she had to be fed by a tube. She self-harmed and made daily attempts to abscond.

Sheffield NHS Children’s Trust says it has a team of specialist mental health staff available to help children who present in A&E, and that it puts “appropriate support” in place for patients after carrying out an assessment of risks, including that of running away.

None the less, in July, Ms Shepherd received a horrifying call from a nurse to say that Lila had escaped. She was eventually found three miles away, barefoot and frightened. Ms Shepherd feared that Lila was so dehydrated she would collapse.

Looking back, she is also clear that Lila’s mental health problems were exacerbated by her difficulties in accessing specialist care. “If they had got her a bed in a specialist hospital in April, she wouldn’t be in this position,” she says.

A spokesman for Sheffield NHS Children’s Trust said that it worked closely with NHS England and families to “secure a suitable place for patient care as soon as possible”.

Sadly, however, Lila’s situation is far from uncommon.

A mental health pandemic

NHS chiefs have warned of a mental health pandemic among children, which they predict will unfold over years rather than months, as the effect of successive lockdowns take their toll.

The numbers of children self-harming and becoming preoccupied with thoughts of suicide have risen sharply, according to research by the mental health charity, Place2Be.

NHS officials have warned of children as young as five having panic attacks about playdates. Cases of children being admitted to hospital with acute eating disorders have more than doubled.

While there was a sharp drop off in referrals to CAMHS from A&E during the first lockdown, they started rising rapidly last autumn, according to data from 55 out of 127 NHS Trusts in England.

Dr Conway Morris said: “There has been a massive spike of presentations, especially in crisis.”

Waiting lists are growing

In some cases, youngsters who had been diagnosed with mental health disorders before the pandemic have relapsed or found themselves getting worse. In other cases, like Lila’s, children who have never previously displayed any major mental health problems are now in need of urgent treatment.

Meanwhile, waiting lists for some CAMHS treatments have started to grow across most of England.

Data obtained under the Freedom of Information Act shows that waiting lists for treatment for conditions including anxiety and depression have jumped in almost every part of England. In the South West and South East they are up by over a third.

Less than a third of youngsters who require mental health treatment are being seen, according to analysis by Mind, the mental health charity.

NHS England said that it treated 420,000 children and young people last year and has laid out plans to increase that capacity by 345,000.

“While there is more to do given the effect of the pandemic on young people, the NHS has already put mental health crisis lines in place, more support in schools so that help is available at an earlier stage,” a spokesman said.

Enough time has been lost

On Sunday night, the Conservative MP Robert Halfon, chairman of the education select committee, called for all children who did not attend school during lockdown to have their mental health assessed, and for the Government to fund specialist mental health staff in every school. “We have wasted enough time as it is,” he said.

However, for those stuck on CAMHS waiting lists, long delays can have a substantial impact on their health – and on that of other family members.

Nicola Jenkin and her son, Logan, at home in Oxfordshire. Logan needs specialist mental healthcare, but the family has been told they will need to wait two, possibly three years, because of the pandemic. - Geoff Pugh
Nicola Jenkin and her son, Logan, at home in Oxfordshire. Logan needs specialist mental healthcare, but the family has been told they will need to wait two, possibly three years, because of the pandemic. - Geoff Pugh

In Oxfordshire, the family of eight-year-old Logan Jenkin have been told that he will have to wait two- to three years for a CAMHS assessment, and “possibly more now because of Covid”.

He is due to be assessed for ADHD and autism after he suddenly became “very violent” during the first lockdown, and was physically lashing out in a way that felt out of character.

“He’s usually the kindest little boy. Out of all my kids, if he sees that I’m looking a little bit sad, he’s the one who comes over and gives me a hug,” says his mother, Nicola Jenkin.

She was advised that there was nothing they could do in the meantime to help curb her son’s violent behaviour. In desperation, Ms Jenkin was forced to call the police three times, “because I couldn’t control him”.

“On one occasion I had him beating me because I was trying to get in the way of him and his sisters.”

“I sat down a few days later and was just like, ‘Jesus, did that actually happen?’. The police can’t do anything, they aren’t trained either."

Oxford Health NHS Foundation Trust said that while waiting for a neurodevelopmental assessment, children and their families "have access to a duty clinician, and there is also additional support available via our website and mental health helpline”.

But Jenkin is exasperated that there is not more.

“Children’s mental health is the next pandemic,” she says. “I am 100 percent sure it is.”

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