Improving mental health services must be our goal

Since the early 2000s, the need for improved mental health services for young people has been a main part of the national policy context, and there has been a raft of polices and strategies in response. It is also why the Scottish government launched a new mental health strategy in August 2012, which identified child and adolescent mental health as one of its four "key change areas" - and rightly so.

As a result, over the past three years, there have been significant efforts to improve access to specialist child and adolescent mental health services (CAMHS) by reducing the time young people have to wait between referral and treatment.

The current target, in place since December, is for at least 90 per cent of young people referred to start CAMHS treatment within 18 weeks, by the first quarter 2015.

During the final quarter of last year, 4,100 children and young people started treatment in Scotland and 79 per cent were seen within 18 weeks. While nine boards met the 90 per cent target, five did not. Some managed only 50 per cent. While performance has improved generally, such inconsistencies can mean ongoing anguish for children, families and carers involved. Delays for children accessing services are just as significant as for adults, arguably more so because of their stage of development.

The Mental Welfare Commission for Scotland reported recently that admissions to non-specialist in-patient settings rose for the second year in 2013/14, with 202 admissions involving 179 young people. Twenty-eight admissions were to paediatric wards, which are still non-specialist wards for treatment of mental illness. The main rise has been in the 16-plus age group.

Cross-border support

In a few complex cases, there was an identified need for a cross-border transfer to specialist units in England because there were no suitable beds available in Scotland.

Moreover, the commission found that only 50 per cent of young people had a responsible medical officer who was a CAMHS psychiatrist.

Attaining the appropriate treatment is one thing, but it also needs to be recognised that young people very often need close support across a number of inter-linked areas to ensure ongoing mental health. Disrupting education to undergo treatment, for example, might inflict further difficulty. Poverty or lack of parental care, too, have an impact on mental health.

On young people in secure accommodation, a recent joint report by the Care Inspectorate and Mental Welfare Commission indicated that these services are, overall, providing very good or excellent care for this very complex group of young people. That is a welcome advance from a few years ago when too much was left to chance in the arrangements secure units have with their local health boards.

The focus on child and adolescent mental health is much needed, as it is a very complex area. It has been identified as an issue of concern across the UK and will form part of the UK Children's Commissioners' report to the UN Committee on the Rights of the Child, to be published later this year.

This is a children's rights issue. Many of the areas of concern for Scotland are relevant in other parts of the UK. We owe it to all of our children to make improvements in mental health services for timely and appropriate provision.

Tam Baillie is children's commissioner for Scotland