When Norman Lamb is able to reach the conclusion that children’s mental health services ‘are not fit for purpose’ you know that it is time to wake up and smell the bacon.
While it is encouraging to, finally, see dialogue about the future of our mental health services, it is astonishing it has taken politicians of all parties this long to come to their senses.
Despite increasing demand, mental health services receive just 13 per cent of the NHS budget, only six per cent of which is allocated towards child and adolescent mental health services. Alongside this disparity, over the past five years, Child and Adolescent Mental Health Services and other support services have seen a reduction in resources. In England 34 out of 51 local authorities have severely reduced their funding for CAMHS since 2010, with at least one council reporting a reduction of 41 per cent.
When we know that half of all diagnosable mental health problems begin before the age of 14 and three-quarters before the age of 18 this just does not make sense.
Cuts to services mean that only the most unwell children and adolescents are eligible to access the ever-shrinking pot of resources. By cutting the resources available we are putting ourselves at risk of losing a generation of young people. That is a generation of young people who will drift into adulthood without the support that they need to avoid reaching crisis level. Failing to tackle mental health problems early results in poor life chances. Those affected may struggle to access education, employment and housing or they may find themselves in prison, as well as poor outcomes for physical health.
There is not just a social cost to these failings. There is an economic one too. The combined economic and social cost of poor mental health is already £105bn a year in England alone. This is without the long-term repercussions of the shortsighted cuts that I mentioned above.
In an age where we are asking our local authorities and healthcare services to streamline and provide more for less, we find ourselves with the perfect opportunity to change the way that mental health services are offered and to tackle the crisis facing our mental health services.
Rather than taking the easy option and reducing funding, which inevitably results in a reduction of resources and a steady increase in the threshold at which children and adolescents access services, we should be increasing it. Investing in these services now alongside a shift in focus from treatment to early intervention and prevention could, potentially, improve the life chances of thousands of young people.
Early intervention and prevention is hardly a revolutionary idea. If you take psychosis for example, Early Intervention in Psychosis currently support 10,000 young people per year. Their support not only reduces the risk of relapse and suicide; it also saves the NHS £44m each year through the reduced use of hospital beds.
If one project can improve outcomes in such a monumental way, and save the state valuable resources, surely exploring a holistic approach to early intervention and prevention is worth exploring? Of course, these kinds of projects could not be rolled out on a large scale without a long-term strategy that includes the introduction of maximum waiting times and the muscle of central government.
I fully appreciate that shifting the focus to early intervention and prevention creates a level of uncertainty and risk, but any big change to the way we run our services does this.
In short, while improving the quality and quantity of our child and adolescent mental health services may seem costly in the short term, in the long term the benefit to our society is immeasurable. Our services are at breaking point and we cannot afford to stand still.
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Kerrie Gilbert is a member of Progress. She tweets @KerrieAGilbert
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I totally agree with Kerrie but we should go further. When a person reaches 18yrs old they ‘fall off a cliff edge’ and plunge into adult health services which in some circumstances are completely inadequate. I would propose an interim service say from 16 to 25 years old because at this age progression into adulthood is different for each individual.