Laura Power Wharton highlights the mental health crisis experienced by children in the UK and argues that the solution lies in public services working together in new and innovative ways.
Our Children and Young People’s Mental Health Services are in crisis. 1 in 6 children and young people aged 6 to 16 years were identified as having a probable mental health problem in 2021 (up from 1 in 9 pre-Covid), but less than 1 in 3 young people with a mental health condition get access to NHS care and treatment.
Growing demand, lengthy waiting times and staff shortages, all signify the scale and complexity of the challenges facing services. Mental health charity YoungMinds says that ‘no matter how you measure it, times are undeniably tough.’
Efforts to tackle these challenges have included reviews of waiting lists to improve understanding of needs and develop appropriate strategies to respond, increased use of digital to support access and improved signposting to other services while families wait. What seems clear to me, however, is that we need to do more than tweaking around the edges to respond to this surge in demand for help. The focus must be on collaboration, drawing on the range of agencies and resources across an area to address these complex problems together.
Whilst the challenges facing children’s mental health services are complex, there are ways in which partners can work together to improve understanding within the system and lead the way to more effective collaboration.
For example, in Portsmouth, the introduction of a neurodiversity profiling tool has helped to reduce the number of children waiting for assessments in their area. The tool is carried out with families by trained professionals from a range of agencies and professions (with over 200 trained so far) moving it away from a single provider response and unlocking capacity in the system.
Similarly, three adoption agencies in the North East and North Cumbria are working with their Integrated Care Board to create a new team of social workers, clinical psychologists and therapists. This team will speed up assessments and provide quicker access to support for adopted children with behaviours which may be indicative of neurodiversity, attachment and trauma issues and are likely to escalate in severity and complexity without support.
Barnardo’s Foundation has recognised the challenges health systems are experiencing to meet the needs of children, young people and families and as a result is investing in a three-year programme working with Integrated Care Systems. These partnerships will include work to develop a dynamic measurement tool which areas can use to gather the right information and focus resource in the right place to develop emotionally, mentally and physical healthy children.
While innovative approaches are clearly out there, how we can make collaboration widespread and deliver the scale of change required at the pace families need?
Following the passage of the Health and Care Act 2022, the 42 Integrated Care Systems (ICSs) across England are now formalised as legal entities with statutory powers and responsibilities. ICSs are partnerships that bring together NHS organisations, local authorities and others partners to take collective responsibility for planning services, improving health and reducing inequalities across geographical areas. A key priority for their development over 2023-24 is to mature their ways of working, providing an opportunity to put children’s mental health front and centre and encouraging collaboration.
The King’s Fund warns of the limitations of what this legislation can realistically achieve. Collaboration and co-ordination of local services requires changes to behaviours, attitudes and relationships among staff and leaders right across the system which can’t be legislated for. Real collaboration also requires commitment over the long term at both a national and local level with all the key players having a seat around the table.
Regardless of how it is achieved, until we see more collaborative examples in children’s mental health services, children and young people will continue to struggle to get the support they need. This will impact their life, both at home and at school, and put additional strain on their families.
To make collaboration a reality, local leaders need to work together to agree the right approach to meet the needs of families and find ways to make it happen – however challenging that might prove to be.
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