Analysis of 71,000 records from a large NHS trust found that children on child protection plans were two-times more likely to have their referral for support rejected by CAMHS, while children with social care involvement were more than three times more likely to be rejected.
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In addition, children from the most deprived areas were around two times more likely to be rejected than those from the least deprived areas.
Researchers say further analysis indicates that this may be because these children’s circumstances are considered too “unstable” for mental health support.
However, children in care were less likely to be rejected by CAMHS, with this thought to be because the trust studied has dedicated mental health services for looked-after children.
The findings have emerged from the Coaches study, a four-year collaboration between the University of Cambridge, Kingston University, King’s College London, the National Children’s Bureau (NCB), the British Association of Social Workers and the Care Leavers Association.
The analysis considered young people ‘accepted’ by CAMHS if they were offered an appointment; this is distinct from whether young people are able or willing to attend.
Anna Feuchtwang, chief executive of NCB, said: “Mental health services often require young people to be in a ‘stable place’ to receive support. But these young people’s lives can be highly unpredictable, whether that’s because of poor parental mental health or being at risk of harm or abuse, or because of more practical issues like lacking the funds to take public transport to appointments. The net result is that these children may never get the support they need – a system that accepts this as an answer is clearly one in need of reform.”
Professor Robbie Duschinsky from the University of Cambridge, said the “sad" findings may surprise many people.
“However, they may not be a surprise to children and families who need and use these services,” he added. “Our research was prompted by discussions with people with lived experiences, who urged us to look at inequalities in access to mental health services for the most vulnerable groups of children. Their concerns have been borne out in the results described in this report.”
The report authors have put forward a series of recommendations for addressing the problem including creating a dedicated CAMHS pathway for children with social work involvement, a mental health assessment tailored to their needs, and co-location of social workers and CAMHS professionals.
They also recommend that CAMHS could adapt their approach to children living in poverty by giving practical support such as travel vouchers to attend meetings and by offering a wider range of therapies that do not require a young person to have “stability”.
The study follows a report last month by a group of children’s mental health charities that found there is a ‘dual crisis’ of mental health and poverty affecting families, with the poorest children four times more likely to have mental health difficulties by the age of 11.
