HEALTH

No child should be at the mercy of a postcode lottery

We need a national conversation about the way our mental health system fails too many children and a review of CAMHS is required, says the new president of the ADCS, Steve Crocker.

Many lifetime mental health conditions begin in childhood. Yet support for children's mental health and wellbeing is simply not yet good enough.

Too many children end up in care as a result of their poor mental health, a care system that was never designed to be a backstop for child and adolescent mental health services (CAMHS).

Yes, there are pockets of good practice, and this is certainly not a criticism of the many dedicated professionals who are working hard to support children's mental health. This is about a mental health system which is failing too many children. We need to have a national conversation about this which is why I am advocating a national review of CAMHS.

Several inquiries, reports and research have come to the same conclusions; overstretched services with children facing long waits to access the right support. In waiting so long, the needs of some children reach crisis point. Services are too rooted in clinical diagnosis, and for children in care access is often dependent on them being ‘stable' even though many children will not be ‘stable' until they receive therapy.

For children in extreme distress, crisis care responses vary, there can be mismatch between available services and actual needs and risks, with some children being told they're too ill for local services, or not ill enough.  This often means a trip to A&E, which is a sticking plaster - the findings of a recent survey of GPs, by the charity stem4, echo this. We need to be able to meet the needs of children, in the right way, at the right time and in the right place. It is vital that we support children to become healthy, happy, independent and productive adults.

Future in Mind sadly didn't prove a turning point for CAMHS and the NHS's Long Term Plan is neither comprehensive nor sufficiently ambitious for children and young people's mental health. However, the Government is developing a new 10-year Mental Health Plan which presents an opportunity. Mental health is shaped by a range of factors, from household finances and poor-quality housing to poverty and so much more so it is right that this will be a cross government strategy. The introduction of mental health support teams in schools has been welcome but is not nearly ambitious enough in supporting only 35% of pupils by 2023.

Now more than ever, the Government must be ambitious for children's mental health. We are seeing a huge increase in poor mental health and wellbeing amongst children because of the pandemic. Many Ukrainian, Afgfhani and other refugee children arriving in the UK will also need mental health support to overcome trauma and loss.

The mental health plan must have early intervention and prevention at its heart, include comprehensive strategies to pro-actively promote lifelong good mental health and wellbeing, closer working and integration with local authority early help services and it must be backed by a sustainable long-term funding strategy for children and young people's mental health that leaves no child at the mercy of a postcode lottery.

Steve Crocker is president of the Association of Directors of Children's Services (ADCS)

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