The Royal Colleges of GPs (RCGP), Paediatrics and Child Health (RCPCH), and Psychiatrists (RCPsych) have committed to five shared principles that they hope will lead to tangible actions to improve the care and support of children and young people (CYP) with mental health problems.
The three Colleges say that as well as the commissioning of specialist treatment, an effective CYP mental health system requires:
- Acknowledgment that CYP mental health is everybody’s business, and should be supported by a shared vision for CYP mental health across all government departments, particularly health, education and justice.
- A preventative, multi-agency approach to mental health across all ages, incorporating attention to education for young people and families, social determinants, and health promotion. This should focus on public mental health and early intervention in CYP, including minimising the need for admission and effective crisis services to maintain CYP in their homes.
- A system of national and local accountability for population-level CYP mental health and well-being, delivered via integrated local area systems.
- Training and education for the whole children’s workforce in their role and responsibilities for CYP mental health.
- More support, both from specialist services and other sectors, for professionals dealing with CYP who do not meet referral threshold to a Child and Adolescent Mental Health Service (CAMHS).
Following the development of the joint principles, the three Colleges have committed to a number of ongoing actions. These include ensuring the highest quality training and standards in CYP mental health; supporting the development of evidence based models of care that are focused on integration of care; and calling for greater investment and resources to be focused on developing services in CYP friendly settings that promote early intervention and resilience.
Dr Faraz Mughal, Clinical Fellow for Mental Health for the RCGP, said: “An estimated 850,000 children and young people have mental health problems in the UK, yet only a quarter receive specialist intervention they need. We desperately need more, and more varied, mental health services in the community, where they can be of most benefit for our patients – and GPs need to have better and quicker access to these services for our patients.
“NHS England’s GP Forward View pledged for every GP practice to have access to one of 3,000 new mental health therapists. We need this, and its other promises – including £2.4bn extra a year for general practice and 5,000 more GPs – to be delivered as a matter of urgency, so that we can continue to provide the best possible mental health care to our young patients.”
Dr Max Davie, Mental Health Lead at the RCPCH, said: “We are failing children and young people and condemning them to a potential lifetime of mental ill health if we don’t acknowledge that mental health is everybody’s business and requires a coordinated approach across many agencies. It is shocking that 75% of children and young people with mental health problems aren’t receiving the specialist interventions they need – and it’s a problem that’s only set to get worse.
“Getting it right for young people’s mental health means putting resources into early intervention and prevention; building resilience amongst young people, ensuring the children’s workforce as a whole is trained to spot the signs of mental ill health and refer to appropriate services, and crucially making sure local areas have robust plans and adequate resource to provide appropriate local support.”
Dr Bernadka Dubicka, Chair of the Child and Adolescent Faculty at RCPsych, said: “Too many children and young people are falling through the gaps. Our NHS is so overstretched, they are unable to access care. Patients either aren’t getting the help they need, when they need it, or they are being sent hundreds of miles from home and family for treatment – a practice we know hinders their recovery.
“We know that money isn’t reaching the frontline for CAMHS – our analysis of NHS England Mental Health Dashboards found that 10 CCGs were planning to spend less than £10 a head on children’s mental health. This is simply unacceptable.
“To meet the increasing demand for child and adolescent mental health services in our country, we need a greater workforce. The RCPsych is calling for 350 more child psychiatrists, and welcomes the government’s forthcoming green paper as a further opportunity to invest in CAMHS.”