The postcode lottery means on average some children in one part of the country are seen within a week of their referral; others in a different part of the country are waiting nearly four months. Some are forced to wait nearly three years. This is scandalous and wouldn’t be tolerated if kids were waiting that long for physical health treatment, but because it’s mental health it’s somehow deemed acceptable.
One of the reasons for the postcode lottery is the lack of consultant psychiatrists. The Royal College of Psychiatrists’ recent census found that 10 per cent of these posts in England are vacant.
Like waiting times, there’s huge variation across the country with some areas having vacancy rates of 5 per cent, while others are at 15 per cent. However, the problem is more acute in child and adolescent mental health services where 15 per cent of posts are vacant.
Those psychiatrists who are in post have been working tirelessly throughout the Covid-19 pandemic, but it is difficult to sustain this work in the face of such high demand. This workforce crisis is one reason why children are waiting so long for treatment and is why the Royal College of Psychiatrists is calling for an additional 7,000 medical school places by 2029, and an additional 120 core psychiatry training posts in 2022.
Early intervention is crucial to making a recovery or learning to live with a mental illness. Waiting times have worsened over the course of the pandemic because record numbers of children are being referred to mental health services, and more than ever before are becoming so unwell that they need crisis care. Undoubtedly school closures, disruption to friendships, and deep uncertainty about the future have all contributed to this.
Vulnerable children have also slipped through the cracks as they’ve had much less contact with others outside of their home, such as teachers and support workers, who’re likely to notice if something’s amiss with the children in their care. If children cannot access early help many will struggle to access education, to do as well as they can in their exams, make friends, and live full lives as adults.
Children are frequently forgotten when services are being commissioned and Covid has exposed the extent and impact of years of neglect. The pandemic gives the government and local commissioners the opportunity to do things differently.
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The Royal College of Psychiatrists is calling for the urgent rollout of a national network of mental health support hubs, so that every child or young person can access early support with their mental health, should they need it. Investing in these hubs would ensure young people have rapid access to help, without the need of a referral and close links with specialist mental health services can facilitate additional care and treatment if needed.
This needs to happen alongside the rollout and strengthening of mental health support teams in schools, so that no child will miss out on the early support and intervention they need.
The mental health fallout of the pandemic is going to long outlive the threat of the virus, so the government and local commissioners need to act now. Waiting times must be tackled, the psychiatric workforce crisis resolved, and funding given to mental health services to ensure no child goes untreated.
Dr Elaine Lockhart is chair of the child and adolescent mental health services faculty for the Royal College of Psychiatrists