As my radio alarm clock clicked on this morning, it caught the tail-end of one of today’s headlines: “…investing in children’s mental health services is a priority”. Time and again, working in children’s social care over the past five years, the sufficiency of Children and Adolescent Mental Health Services (CAMHS) has been cited as a major source of frustration by frontline social workers through to senior managers. Did this titbit mean it was finally getting the spotlight and – perhaps most importantly – funding that it deserves?
Unfortunately, it turns out that the short answer is no. The news item was reporting that Children’s Commissioner Anne Longfield – following her excellent work raising the profile of the extremely concerning practice of schools ‘off-rolling’ pupils with Special Educational Needs, which has also been a focus of our work at IMPOWER recently – has completed research showing that in over a third of ‘local areas’ (meaning Clinical Commissioning Group and Local Authority spending combined) spending on low-level mental health services dropped in real terms between 2016/17 and 2018/19.
Our Valuing Care programme, currently running across five local authority areas, uses a needs and outcomes profiling approach to track children’s needs in a way that can be used across agencies, with Looked after Children’s placement providers, and with carers and children and young people themselves. The results of this work have shown – in every single local authority area – that the highest level and most prevalent needs of Looked After Children relate to their emotional and mental health.
And yet, everywhere we work, we hear that CAMHS is difficult to access, with a sense that the threshold is ‘too high’. What this really points to – just as Ms. Longfield has found – is that there is insufficient lower level, preventative support available. Social workers have anecdotes about children being turned away from CAMHS ‘because they aren’t suicidal’ – because that is around where the threshold for CAMHS proper lies – or about children having to wait months on end for their referral to reach the top of the list, when trying to deal with the serious consequences of early childhood trauma in the context of moving home, school and family.
What children and young people need is meaningful, lower level support that is easy to access and destigmatised – and in the long run, this will help ease those lengthy waiting lists as those crisis cases become less frequent. While funding is of course tight, there are examples of fantastic work being done – for example, when working in West Yorkshire in 2017 we encountered the excellent Future in Mind strategy developed by Leeds CCG, working closely with schools to ensure support is close to children and young people as they need it.
The current distraction away from this systemic failing of our most vulnerable children and young people is nothing short of a national scandal, and the throwaway response from a nameless official quoted in some of today’s media reports was breath-taking in its dismissiveness. While funding has increased in cash terms in recent years, proper direction needs to be given nationally on how it is to be spent, and local authorities have to recognise how vital preventative services are, for those children and young people they are directly responsible for as well as for the wider population. Without this, our Valuing Care approach will only record needs headed the wrong way, rather than demonstrating the progress that practitioners are so desperate to be able to deliver.