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Fifth of all children referred to specialist mental health services rejected for treatment

This includes those whose problems are linked to abuse or neglect, says NSPCC

Caroline White

Monday, 12 October 2015

Local specialist NHS mental health services are rejecting a fifth of all children referred to them for treatment, including those whose problems stem from abuse, says children’s charity NSPCC.

This is creating a “time bomb” of serious mental health conditions if vulnerable children don’t get the help they need early, says the charity.

Figures from 35 mental health trusts across England obtained by the charity show that of a total of 186,453 cases referred by GPs and other professionals, 39,652 children did not receive help.

And in six mental health trusts who provided a breakdown of outcomes for children whose problems were associated with abuse and neglect, 305 of the 1,843 – 1 in 6 – cases were rejected by Child and Adolescent Mental Health Services (CAMHS).

Children who have been abused or neglected could face serious long-term mental health problems because of a lack of support, says the charity. 

Where reasons were given for not offering a service to children affected by abuse or neglect, it was often because they did not meet the high clinical threshold to qualify for treatment at a CAMHS.

Not all children who have been abused will have a diagnosable mental health problem, but many will still need therapeutic support to help them deal with their trauma, says the NSPCC.

Strict access criteria, both for assessment and treatment, have been identified as significant issues in some areas.

Peter Wanless, NSPCC Chief Executive said: “There’s been a huge increase in awareness about all forms of abuse in recent years. If children don’t receive the right kind of help and support following a disclosure, the damage can last a lifetime and include post-traumatic stress disorder, depression or suicidal thoughts in adulthood.”

He added: "Children and Adolescent Mental Health Services are just one part of the jigsaw, and it’s clear the current range of support available doesn't meet the needs of many abused and neglected children.”

The NSPCC’s ChildLine service recently revealed it had received nearly 100 contacts a week last year from children who have been abused and whose mental health and wellbeing are suffering as a consequence.

The NSPCC’s state of the nation How Safe are our children? 2015 report, revealed the number of sexual offences against children recorded by police in England and Wales rose by more than a third last year (2013-14), with the number of children referred to social services also soaring.

"More and more victims of abuse are speaking out and we need to match their bravery with more specialist therapeutic support that is age-appropriate and there for children and young people, for as long as they need it,” said Wanless.

Dr Max Davie, a consultant community paediatrician from the Royal College of Paediatrics and Child Health (RCPCH), said the findings corroborated their concerns.

“This adds further evidence to the concerning picture of the state of child and adolescent mental health services (CAMHS) in the UK. With 1 in 10 children in the UK having a diagnosable mental health disorder and 75% of mental illness in adult life starting before the age 18, prevention and early intervention is critical. If help is not given early, the lifelong impact can be catastrophic,” he said.

He added that it was encouraging to see the government prioritising mental health, as well as the appointment of a shadow health minister for mental health.

But he said: “Politicians need to do more than talk a good talk. We know there is a shortfall in resources, and effective CAMHS can only be delivered by addressing workforce and training issues to plug the growing gap between physical and mental health services.”

He continued: “We know that there are problems with transition services; so there must be joint commissioning between mental health services for children and adults and shared commissioning approaches at a regional level to ensure a seamless pathway.

“And we know that factors such social deprivation and disability can have an effect on mental health which in turn can have a negative impact on health and educational attainment  – which is why we want to see the development of a unique identifier for children and young people across sectors so vulnerable young people do not fall through the gaps.”

The scale of the problem was increasingly being recognised, but he emphasised: “The challenge now is to put the effort, money and resources into solutions that will make a real difference.”

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