CQC highlights concerns over young people’s mental health services

The State of Care - the Care Quality Commission's (CQC) annual assessment of health and social care provision in England - identifies children and young people’s mental health as an area of specific concern.

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The CQC reviewed seven areas in England in June and July 2021, and carried out activities with young people directly, to identify the key challenges for children and young people’s mental health services and gather examples of best practice.

One major challenge the commission identified was the increased demand for services following the Covid-19 pandemic, citing the NHS Confederation’s report Reaching the Tipping Point, which found that 1.5 million children and young people may be in need of new or additional mental health support as a result of the pandemic.

This report also notes a significant increase in the number of young people accessing urgent support for eating disorders following the pandemic, with a rise of 141 per cent between January to March 2020 and April to June 2021.

During the commission’s own review, most areas reported a rise in demand for eating disorder services. A mental health trust in one area reported a 45 per cent rise in eating disorder referrals, causing an 80-person waiting list.

The report also finds challenges relating to health inequalities, stating: “The COVID-19 pandemic has shone a light on, and in some cases exacerbated, inequalities faced by some children and young people with mental health needs.”

Groups found to be affected by these inequalities included children from deprived areas, those from black and minority ethnic backgrounds, those identifying as LGBTQ+, and children with physical or learning disabilities.

According to the report, there had been an increase in children and young people from deprived areas being referred to mental health services during the pandemic, and one area told the commission that large numbers of black and ethnic minority young people were missing appointments or not attending school during the pandemic.

The report calls for more to be done to tackle health inequalities, stating that “while we saw some evidence of this in action, there was a lack of long-term and cohesive strategic planning focusing on children and young people with mental health needs who experience inequalities”.

The report also notes that following the provision of online support throughout the pandemic, mental health support became more accessible for some young people.

However, some young people told the commission that face-to-face services were still preferable, with one 17-year old saying: “Face-to-face appointments still felt more private and more sincere from professionals struggling with tech.”

The report says there needs to be a balance of remote and face-to face appointments based on clinical presentation and risk, as well as other factors such as individual preferences and access to technology.

Other challenges which the report outlines include identifying children and young people in need of support before they reach a crisis point, improving collaboration between system partners as well as between providers and families, and ensuring that children has adequate support to transition from CAMHS to adult services.