May's rhetoric on CAMHS must deliver improvements for children

Nobody, from government ministers to experts and families, needs proof that when it comes to mental health, children and young people's needs are regularly going unmet.

NHS England's guidance on transforming child and adolescent mental health services (CAMHS) makes clear: "More of the same is simply not an option. Unless we make some real changes right across the whole system… opportunities to build resilience in our children and young people, promote good mental health and intervene early when problems first arise will continue to be missed."

The evidence on the rising prevalence of mental health problems in children and young people and the trouble accessing appropriate services is overwhelming.

NCB's research last year with the Association of School and College Leaders showed a rising tide of schoolchildren with mental health problems. More than half of educational leaders said there had been a large increase in anxiety or stress over the last five years, and 40 per cent reported an increase in the problem of cyberbullying. Seventy-nine per cent reported an increase in self-harm or suicidal thoughts among students. Schools and colleges had access to a variety of support, but more than half of leaders who referred students to CAMHS (53 per cent) thought these services were ineffective.

NSPCC research confirms how widespread mental illness is among the young: 19,000 children were admitted to hospital last year after self-harming - a 14 per cent rise over three years. NSPCC chief executive Peter Wanless emphasised the constant pressure felt by young people, connected 24/7 by digital technology, which means they can never switch off and are always in competition with each other. This is a valid indication of the general causes of mental illness, but specific groups are particularly at risk: those who suffer abuse or trauma, those in care, those who have been bereaved, in the criminal justice system or those with learning disabilities.

The government has promised to invest £1.4bn to deliver the Future in Mind strategy, designed to improve services for children and young people. Local Transformation Plans enable services and commissioners to ensure children's needs are at the centre of service design.

The intent is clear, but it is not yet providing adequate services to meet growing needs. A report by YoungMinds last year showed that in the cash-strapped NHS, the money intended to improve mental health services for children and young people was not getting through.

Frontline staff we speak to have said the extra funding, when it does get through, is making a difference. But after years of neglect, there is still a long way to go before CAMHS do more than provide crisis support for children and young people in the most acute need, and reach out to those with emerging problems in the early stage of poor mental health.

Initial findings from our survey of the sector, to be published later this year, show that improvements at a strategic level, and consultation activity, are yet to lead to real change in support for individual children.

Those working at various levels of the system reported having to turn children away. This echoes findings from the Children's Commissioner for England that out of 3,000 young people suffering from life-threatening mental health conditions, 14 per cent were not allocated any provision, while in one CAMHS, the average wait to access services for young people with these conditions was 112 days.

As well as promoting children's emotional wellbeing, and being ready to support them when they are in crises, we also need to secure proactive support, present at the times when challenges to mental health are most likely to arise. For children in care, this problem is particularly pressing. The child's journey is likely to have undermined their mental health, and yet they do not have routine access to an assessment by a qualified professional, let alone access to the therapeutic support they need.

Thankfully, the government has now committed to pilot an improved approach to assessment, following work over many years by NCB and others through the Alliance for Children in Care and Care Leavers. But piloting an assessment is only the first step.

Rhetoric matters, and the PM's intervention may well help tackle stigma, raise awareness, and galvanise decision makers around the country to take action. But the government must go further to ensure that the £1.4bn is used to help those who need it most. The stakes are high. If we don't act now, CAMHS will continue to fail children and young people.

Anna Feuchtwang is chief executive at National Children's Bureau