Mental health services for children and young people risk backward slide, warn MPs

A Report from the Health and Social Care Committee calls for urgent action to prevent mental health services slipping backwards as a result of additional demand created by the pandemic and the scale of unmet need prior to it. 

MPs found that despite progress in numbers of young people receiving treatment, it was unacceptable that more than half with a diagnosable condition pre-pandemic do not receive the mental health support they need.  

The Report notes that half of mental health conditions become established before the age of 14, while data from NHS Digital showed that in 2020 potentially one in six young people had a diagnosable mental health disorder up from one in nine three years earlier, placing a huge additional strain on already stretched children and young people's mental health services. 

New Mental Health Support Teams in schools offered a valuable opportunity to identify those beginning to experience problems with their mental health. However, MPs note there was no funding to roll them out nationally in the recent Spending Review settlement and that current plans lack ambition. 

The Report also found that too many children and young people were placed in inpatient units far from home, without adequate understanding of their rights, and subject to restrictive interventions. 

Health and Social Care Committee Chair Rt Hon Jeremy Hunt said: 

“Partly because of the pandemic, we are seeing demand for mental health treatment pushing NHS services to breaking point. Whilst we recognise that capacity to provide such services is increasing, we are not convinced it is happening at a fast enough rate. 

“There is a growing risk that elective and emergency care pressures will mean mental health services once again become the poor relation.  

“Our report uncovers good progress in schools provision but a continuing failure to find community care for too many young people who end up in inappropriate secure provision that makes their illness even worse." 

ENDS 

The Report found that young adults between 18 and 25 face some of the widest gaps in support. While welcoming an NHSE&I commitment to base a new model of care on provision for those aged 0-25, progress was slow. The inquiry heard from a young person who had self-harmed from 13, struggled with suicidal thoughts and faced a two-year wait for treatment. Now aged 21, his case was a ‘stark reminder’ that the transition to adult services remains poor for many children and young people, with high rates of drop-out from services. 

Key recommendations from Children and young people’s mental health report: 

·       NHS England & Improvement must accelerate the implementation of the 0-25 offer in every local area as a national priority so that young people do not continue to face a cliff edge in accessing the care they require as they transition from children to adult services. 

·       Department of Health and Social Care should fund and roll out open access models to every area across the country so that there is a consistent, comprehensive community offer to complement available school-based and clinical support across England. 

·       Further action should be taken with all inpatient providers to minimise restrictive practice by sharing best practice from programmes such as the SafeWards approach with all children and young people's inpatient units nationally.   

A full list of conclusions and recommendations can be found in the attached embargoed Health and Social Care Committee Report on Children and young people’s mental health 

Separate Report by Expert Panel finds Government progress to improve mental health services ‘requires improvement’ 

The Committee is publishing a report by its Expert Panel to evaluate Government progress to deliver commitments on a wider range of mental health services in England. Its overall rating against progress on nine commitments in four policy areas is ‘requires improvement’. The areas evaluated are: workforce; children and young people’s mental health; adult common mental illness; and adult severe mental Illness. The Panel gives further CQC-style ratings against nine individual commitments in the policy areas.  

The Panel’s Report on the Evaluation of the Government’s progress against its policy commitments in the area of mental health services in England has examined a broader remit than the Committee’s inquiry, however its findings and ratings in relation to commitments made to improve services for children and young people have contributed to the Committee’s inquiry on this topic.    

Please see table on page 11 of the Expert Panel Report for further details 

Professor Dame Jane Dacre, Chair of the Expert Panel, said:  

“Our Expert Panel has assessed to what extent commitments on improvements to mental health services for adults and children, and the expansion of the workforce have been met. Our overall verdict is that the Government’s progress requires improvement.  

“On growing the workforce, every aspect of the Government’s commitment to do so requires improvement. Despite an overall increase in staff, in some important areas, such as psychiatry and mental health nursing, targets have not been met. This is a wake-up call because shortages represent the single biggest threat to national ambitions to improve mental healthcare, with an impact on delivery across all mental health services. 

“On commitments to services for adults with severe mental health illness, there are a number of aspects where we have rated progress as inadequate.  

“Throughout our work a prominent theme of inequality emerged on outcomes, provision and access to mental health services with striking differences between regions and ethnic groups. This failure to ensure equality reflects a lack of overall progress within the commitments we have evaluated.” 

ENDS  

The Expert Panel is chaired by Professor Dame Jane Dacre, Professor of Medical Education at University College London, a consultant physician and rheumatologist at Whittington Health in London, and former President of the Royal College of Physicians.  

Core members:  Sir Robert Francis QC; Dr Charlotte Augst; Meerat Kaur; Professor John Appleby; Anita Charlesworth; Professor Stephen Peckham.  

Mental health specialist members: 

·       Professor Kamaldeep Bhui, Professor of Psychiatry & Hon. Consultant Psychiatrist; 

·       Dr Ananta Dave, Consultant Child & Adolescent Psychiatrist and Medical Director at Lincolnshire Partnership NHS Foundation Trust; 

·       Professor Peter Fonagy, Head of the Division of Psychology and Language Sciences at UCL, Chief Executive of the Anna Freud National Centre for Children and Families, London; 

·       Karen Turner, Lay Trustee, Royal College of Psychiatrists