Concerning children's mental health

A recent government task-force review sheds some rather disturbing light on the state of child mental health services in England. The review focuses on concerns highlighted by a survey of Clinical Psychologists working across 43 separate specialist Child and Adolescent Mental Health Services (CAMHS) in 2014.

According to the Psychologists, in the last three years some 62% of services have decreased their staffing levels, with a bias towards the loss of more highly skilled professionals. In addition, further cuts are being planned for 42% of services.

Other findings showed that:

• 71% of services have tightened their acceptance criteria and raised severity thresholds for being seen
• 54% of respondents were concerned about the deterioration in provision for young people in crisis
• 66% of services reported a decrease in the quality of treatment provision
• 56% said the availability of psychological therapies had decreased in the last three years
• 53% had noticed a more medicalised approach to treatment

On this last point, Professor Jamie Hacker-Hughes, President-Elect of the British Psychological Society commented:

"We are seriously concerned that over half the respondents reported a move to more diagnosis-led, medicalised approaches given the significant weight of evidence in favour of psychological interventions for the majority of child mental health issues."

He has a point. There is a substantial and growing body of outcome research from the UK and abroad demonstrating the efficacy of child and adolescent psychotherapy, which is one of the reasons why the National Institute of Clinical Excellence (NICE) clearly recommends it. And while medical treatment has its place, it would be a tragedy to see it become the mainstay of treatment for conditions such as childhood depression.

Corroborating the survey findings, figures released last month showed that NHS spending on children's mental health services in England has fallen, in real terms. by 6% since 2010. The charity Young Minds has also recently found that over half the councils in England cut or froze budgets for child and adolescent mental health spending between 2010-2011 and 2014-2015.

These are troubling times for mental health services in general, but it is especially upsetting to think that our children, who are our future, are being let down in the critical area of mental health service provision. And as the culture around them becomes increasingly dysfunctional, we can only expect the crisis to deepen.

Do you have thoughts on this important topic? If so, we'd love to hear them.


Written by Jacqui Hogan

Children and mental health in the digital age

A recent report issued by the Commons Health Committee paints a grim picture of the situation on the ground for the mental health of children in the United Kingdom.

The report notes a radical increase in the number of children seeking help for mental health problems (25% to 30% a year) and links it to a rise in the number of violent video games, sharing of indecent images on mobile phones, bullying on social media and proliferation of websites for teenagers advocating self-harm.

The cross-party group acknowledges that social media and online communications are now integral to the fabric of life for the under-18s, but recommends a government enquiry into the effects, because of the potential for harm to this and future generations.

Sarah Wollaston, Chair of the committee, commented that so-called 'sexting' (sharing of indecent photographs) could be traumatic for vulnerable young women, who are persuaded to pose for intimate pictures then find that shots are widely shared. She also expressed unease about the impact of violent videos now being watched by young people.

Mental health services are under such pressure with this growing problem that, in some parts of England, children are only seen by a Psychiatrist once they have tried to take their own lives.

A Consultant Psychiatrist with the Cornwall Partnership NHS Trust, Liz Myers, told the committee that they were receiving four thousand referrals per year, but are only funded for two thousand.

One wonders at the need for a government enquiry when pure common sense suggests that if you expose children to concepts and imagery they are too young to process, of course you will harm their mental health. Arguably, exposing anyone to the same kind of material might cause problems.

But the juggernaut of 'progress' takes no hostages - rather it seems hell-bent on destroying all those who stand in its path. Admittedly, such an issue is way more complex than can be addressed here (like what can parents do to control access to this stuff when we are literally steeped in it?) but a first step must surely be to recognise its pernicious effect.

Something tells me it's not just a matter of controlling access, but looking underneath to the states that drive our youngsters to sink so very low. It is surely a sign of deep disillusionment and despair.

Do you have experience of working with children adversely affected by social media? Maybe you think the positives outweigh the negatives? Whatever your thoughts, we'd love to hear from you.

Written by Jacqui Hogan