Late last month we looked at whether the Government’s Green Paper ‘Transforming Children and Young People’s Mental Health Provision’ was right to focus solely on schools, colleges, and the NHS; concluding that the space for good mental health provision shouldn’t be so narrowly defined, and that youth workers should be considered for helping to work within those spaces.
It was encouraging therefore to see the Education and Social Care select committees criticise the report on various fronts just last week. Furthermore, a partial response from NHS Trusts to a Freedom of Information request from NSPCC has substantiated the need for the Green Paper to be broader by showing that schools are, at present, unable to cope with the levels of mental health issues they face, and are increasingly referring pupils to Child and Adolescent Mental Health Services (CAMHS); there were 123,713 referrals made by education settings seeking professional mental health help between 2014/15 and 2017/18.
That the NSPCC found that almost a third of these referrals were denied specialist treatment is concerning, and is placing pressure on community paediatricians who are instead dealing with those denied referrals. A different recent report placed the figure for unsuccessful referrals in 2106-17 at 26%. Shockingly, the most common reason for referrals not being accepted was due to ‘mistakes in the referral process’; suggesting bureaucratic and administrative complications may be denying these essential services for many.
Of course, even if a referral is successful it can often be a long wait till an initial appointment, and then a further delay until treatment begins. The average waiting time for assessment has dropped from 39 days in 2015-16 to 33 days in 2016-17 and for treatment from 67 to 56 days. Clearly some progress has been made, but nowhere near quickly enough; the average wait for treatment from referral is at 90 days.
The consequences of early non-intervention could potentially be more severe, as a study in Scotland has shown, which shows a positive correlation between incidences of non-suicidal self-harm and later prevalence of suicide attempts, especially amongst females, and those who are NEET. The figures suggest that as many as 1 in 9 children could be self-harming in Scotalnd. In Oldham, health chiefs estimate that 1 in 15 children deliberately self-harms. The connection between long waiting times and increased chances of self-harm were made in a Care Quality Commission (CQC) report last year. This may be partially behind the alarming rise in some parts of the UK in GPs prescribing children, as young as five in some cases, with anti-depressants. (It must be noted that anti-depressants can be prescribed for many other areas of medical need).
Youth workers may not be able to provide the level of specialist mental health care needed, but they can provide some holistic care and help within the period between referral and treatment; providing at least some comfort in the interim that the child isn’t being ignored totally. This would also help address one of the concerns of the CQC report last year which highlights the ‘fragmented’ nature of services and poor ‘experiences’ of service users. There may well also be the scope for youth workers to give an initial basic assessment that determines the urgency of the child’s needs, and thus to potentially ‘fast-track’ those who need the care most urgently; again building on the CQC Report’s calls for ‘timely’ intervention.
This would be a workable practice in the ethos of ‘Civil Society’ and inter-sector working.
As an aside; given that it is the final full week of the Civil Society Strategy consultation period, it is apt that there are calls for leading market brands to take the most immediate steps in providing safeguarding barriers, and producing products in an empathetic manner to help alleviate potential causes of mental health issues caused through such material and technological goods. After all, if a product or piece of technology is a cause or partial cause of mental health issues, then the earliest intervention comes with the product or technology itself.
The general consensus is that the uses or ownership of technology, social media, games, etc… are not in themselves sufficient factors to mental health issues; but rather that as the time spent on them increases, so the likelihood of mental health issues also increases. For a more full article on this point please see our previous piece here.
 https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/664855/Transforming_children_and_young_people_s_mental_health_provision.pdf [accessed 27 April 2018]
 https://publications.parliament.uk/pa/cm201719/cmselect/cmhealth/642/64210.htm [accessed 15th May 2018]
 https://epi.org.uk/wp-content/uploads/2018/01/EPI_Access-and-waiting-times_.pdf [accessed 16th May 2018]
 Ibid. p. 5.
 https://www.cambridge.org/core/services/aop-cambridge-core/content/view/D711AD4AFA2E25CB941814D6EDF90656/S2056472418000145a.pdf/suicide_attempts_and_nonsuicidal_selfharm_national_prevalence_study_of_young_adults.pdf [accessed 15th May 2018]
 https://www.marketingweek.com/2018/05/14/childrens-mental-health/ [accessed 15th May 2018]
 https://nya.org.uk/2018/04/research-roundup-how-young-people-are-interacting-with-technology/ [accessed 15th May 2018]