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May's prescription for more children's mental health misery

Not only do the Prime Minister’s plans for mental health services fall short, but the major contributing factors of poverty and unemployment are only exacerbated by her government’s austerity agenda, writes STEVEN WALKER

THE NHS Long Term Plan announced by Theresa May includes yet more promises to improve services for child and adolescent mental health (CAMH). We have heard it all before. And the ambition is pathetic as they only aim to increase treatment from one in four to one in three of those suffering by 2021.

The latest data shows a rising number of young people being diagnosed with anxiety, depression, psychosis, self-harm and eating disorders.

So by 2021 any investment will be overtaken by more demand on the CAMHS system. Recent figures from the Office for National Statistics highlighted a recent jump in the annual number of suicides among people aged 15 and over — 6,188 deaths in 2015, compared to 5,608 in 2010. An extra 580 suicides, over 10 per week. Further analysis shows that the suicide rate increased significantly in the past few years from 11.1 deaths per 100,000 people to 11.8. For 15 to 19-year-olds there was an average of four suicides every week, while for 19 to 25-year-olds it was 14 per week. Historic analysis shows that the total number of young people who killed themselves between 1981 and 2011 was 21,006 — over 700 a year.

The stats also show that during the peak years of unemployment — 1983-4, 1992-3 and 2009-10 — there were higher than average numbers of suicides among young people. That is one of the starkest prices of austerity with youth unemployment currently over 12 per cent — well above the rate in Germany, the US, South Korea, the Netherlands and Canada. The number of young people who kill themselves each year is a sobering reminder of the human cost of government failure to invest in children’s wellbeing and prevent the onset of mental illness.

Cuts to local authority budgets reduce preventative services delivered by their staff in social care or charities commissioned to do the work, meaning vulnerable children are not getting help they need to stop their problems deepening and becoming harder to tackle in the long run. Children who cannot get access to help and support early on will grow up to become troubled and unwell adults costing money, time and resources as well as potentially harming others or disrupting family relationships. If ever there was a false economy, this is one of the biggest and costliest. While young people wait for help and support, teachers and parents or carers find they are on the front line trying to cope with dangerous and often frightening behaviour.

The government recently decided that schools would receive some funding to create mental health leaders within schools and training to manage problems as they arise within schools.

Teachers’ unions and headteachers are very lukewarm about this idea as it pushes more work onto already stretched staff without any depth of knowledge or clinical capacity to diagnose and least of all treat effectively.

Last week attention was focused on the potential negative impacts social media and excessive “screen time” has on children’s well-being. The mainstream media fixated on the role of parents’ management of their children’s use of screens, rather than the multibillion-pound companies who rake in profits while divesting themselves of any responsibility to monitor harmful content, trolling and abuse which can trigger mental health problems.

What Theresa May has not addressed are the underlying social and economic causes of poor mental health in young people, preferring to treat the symptoms. Poverty, unemployment, domestic violence, drug misuse, child abuse and poor housing are implicated in developing mental health problems. Mainstream CAMH services are not user-friendly and young people tell us they need accessible services open at weekends and evenings where they could drop in, with staff who are qualified to work in a variety of creative, innovative therapeutic ways and who are fully trained to empathise with and understand young people.

Ten years ago the last national CAMHS report from the NHS in 2008 demanded increased training for all staff working with young people, more specialist resources and extra investment in early intervention services to prevent problems arising in the first place. Ten years later, the situation is worse. Staff vacancies are high, morale is at rock bottom, budgets are slashed and demand for help and support is increasing. Early intervention services have been cut back in a classic example of a false economy. As a result Britain has the unhappiest children in the European Union according to research by the World Health Organisation and charity the Children’s Society. A terrible indictment for one of the richest countries in the world.

Steven Walker is former Head of Child and Adolescent Mental Health, Anglia Ruskin University, and author of the forthcoming: Supporting Troubled Young People: A practical guide to helping with mental health problems.

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