Progress on child mental health

The 2017 green paper Transforming Children and Young People’s Mental Health set out plans to improve links between community mental health provision and schools, tackle high waiting lists for children to see a clinician and promote more partnership working to address the causes of poor mental health.

Nearly three years on from the plans being finalised following a public consultation, the health and social care committee has launched a parliamentary inquiry to assess the progress in putting the measures into action.

Measures in the green paper the committee is to focus on include the progress towards:

Ensuring every school and college appoints a designated mental health lead by 2025

The roll out of mental health support teams (MHST) in schools to offer help to individuals and groups of young people with mild to moderate mental health issues and that link with specialist provision

Reducing waiting times for children to see a specialist from months to four weeks.

Other issues it will look at include standards of in-patient care, measures to tackle self-harm, prevention services and how the government is learning from best practice.

Former Health Secretary Jeremy Hunt, who chairs the committee, said the inquiry will examine progress made against the ambitions of the green paper, and “consider the case to prioritise early intervention, and for those who need in-patient care, how the stress can be reduced.

“We will ask what more can be done to reduce the growing numbers who turn to self-harm or suicide.”

The deadline for submissions is 26 February.

• More from https://committees.parliament.uk/

Invest in local drop-in centres

Emma Thomas, chief executive, Young Minds:

We have seen progress since the green paper, and the government is more-or-less on track to meet some of the commitments in it. But the needs have grown since the proposals were published – one in six children and young people now have a diagnosable mental health problem, compared with one in nine in 2017 – and we need greater ambition to meet the challenges presented by Covid-19.

For example, MHSTs need to be rolled out across the country, not just in a quarter of schools. There are also some specific areas where there has been very limited progress, such as the plan to train designated senior leads on mental health.

One area that was not sufficiently covered in the green paper was early intervention. We need to learn from countries like Australia, where there is a network of open-access mental health hubs. We need places where young people can go locally, where they can talk informally to a volunteer, a youth worker or a counsellor, without having to go through a medicalised assessment or face long waits.

Early intervention to complement schools but within communities, where local charities, youth clubs and drop-in centres can play a critical role, is a huge missing piece of the jigsaw. This is where the government must turn its attention.

Too much focus on schools

Cassandra Harrison, chief executive, Youth Access:

When we consulted young people on the government’s green paper, they told us that the targets seemed slow and this has been borne out in

subsequent years as many parts of the country are still waiting for MHSTs.

Initiatives have also often been too focused on educational settings. There are significant barriers to accessing support in schools, including stigma, confidentiality and accessibility issues. The pandemic has highlighted the need to look beyond educational and clinical settings as points of support, giving young people different options to access services in a way that suits them.

We already have a model that we know can address these challenges. The youth information, advice and counselling services that make up the Youth Access network support young people with a range of social welfare and mental health issues, with a focus on providing open-access local support.

The foundations for more government investment are already in place: the Future in Mind report recommended a “one-stop shop” model, and the NHS Long Term Plan calls for more collaboration with the voluntary sector to deliver a mental health offer – but progress on these fronts has been patchy. There’s a lot more work to do.

Staff shortages hinder progress

Dr Bernadka Dubicka, chair of the child and adolescent faculty at the Royal College of Psychiatrists:

The green paper should have heralded a new dawn for children’s mental health services. While the ambition is there, much more needs to be done.

Years of chronic underinvestment left services ill-equipped to treat the growing numbers of children and young people with a mental illness. One in six five- to 16-year-olds now live with a mental illness – up from one in nine three years ago – but resource-starved services mean only a third of those get help.

Those wait on average 53 days – that will only get worse as the consequences of the pandemic take hold. It isn’t just surging demand behind waiting times. Shortages in specialists means there aren’t enough staff to promptly treat those needing help. There are six per cent fewer consultant child and adolescent psychiatrists than there were 10 years ago.

Frontline staff are already grappling with the record number of referrals to children’s mental health services, a number that will undoubtedly rise in the months ahead. The government must urgently assess the likely effects on demand and how this will impact the delivery of the NHS Long Term Plan. Without this, they will not be able address the workforce crisis meaning many more children will not get the help they need.