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Child mental health bed boost

NHS England to make more beds available following sustained criticism of child mental health services

Mark Gould

Monday, 18 August 2014

NHS England says that it has a five year plan to revamp child and adolescent mental health which includes providing more beds and skilled case managers. NHS England is making 50 more beds available nationwide to boost child and adolescent mental health services and hiring 10 to 20 new case managers following mounting criticism of standards of care and treatment for young people. Last week it was revealed that young people in psychiatric crises are regularly detained in police cells due to a lack of suitable mental health beds.

Dr Sarah Wollaston, the new chair of the Commons health select committee, is the latest public figure to join a chorus of criticism of the care of young people with mental illness. In an interview with The Guardian she said it was "wholly unacceptable" for under-18s who are picked up by the police because they are having a breakdown to be taken into cells rather than to a specialist medical unit.

"It would be unthinkable for someone who had a broken leg, for whom there was no place to assess them in casualty, to be taken to a police cell. It should be unthinkable for someone who's having an acute mental health crisis to be seen in a police cell. That's inexcusable, but it's happening," Wollaston told The Guardian. "That's wholly unacceptable for an adult, much less for a child."

Wollaston, who was a GP for 24 years before becoming Conservative MP for Totnes in 2010, added: "We won't have true parity of esteem [between mental and physical health in the NHS] unless we end the scandal of section 136 assessments".

Anyone detained under section 136 of the Mental Health Act 1983, which often happens if someone appears mentally disturbed in a public place, should be assessed in a "place of safety". That is meant to be a mental health unit, but a lack of them in many parts of England means one in three assessments takes place in a cell in a police station.

Figures from the Care Quality Commission, the NHS care regulator in England, show that 21,814 assessments of adults or children took place in 2012-13 under section 136, of which 7,761 involved the use of a police cell. According to the Association of Chief Police Officers, a disproportionate 45% of under-18s detained under section 136 that year were assessed in police cells.

Wollaston accused the NHS of treating mental health as "a Cinderella service" and seriously underfunding it. NHS bosses had failed so conspicuously to deliver the coalition's landmark pledge of "parity of esteem" between mental and physical health that the health secretary, Jeremy Hunt, may be forced to intervene, she said.

Wollaston said the NHS had given mental healthcare low importance for decades.

"Mental health has always been a Cinderella service within the NHS, underfunded and given nowhere near enough priority. There's never been a time when mental health services have been funded equitably with physical health and received a fair share of the cake, especially child and adolescent mental health services," she said.

The last Labour government's decision not to set maximum waiting times for patients to access mental health treatment, despite introducing them for key physical health services such as A&E units and planned operations, was an example of the inferior status psychological illness has received from Whitehall and the NHS, she added.

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