In June this year, the UK government pledged a long term settlement for the NHS, and chose mental health as one of the key priority areas to receive sustained funding. Since this announcement, NHS England have approached many organisations with expertise in mental health, including the Centre for Mental Health, inviting them to share their views on what should be prioritised in the upcoming long-term plan for mental health.
This response is based on research the Centre for Mental Health has carried out in recent years, and builds on the report to the Mental Health Taskforce, Priorities for Mental Health.
The Prime Minister has this week announced a comprehensive plan that aims to transform mental health services with a particular focus on children and young people.
Speaking at the Charity Commission in London, she addressed the stigma attached to mental health stating that the Government aims to “transform the way we deal with mental health problems right across society, at every stage of life.”
Secretary of State for Health Jeremy Hunt has also announced new suicide prevention measures which includes initiatives to better support people at risk of self-harm.
The announcement from the Prime Minister included key areas that will impact on children and young people:
The Government will launch a major thematic review into Children and Adolescent Mental Health Services (CAMHS) across the country to find out what is, and what isn’t, working.
Every secondary school will receive ‘mental health first aid’ training and extra training for teachers in order to better support students experiencing mental health problems.
The Government aims to strengthen the links between schools and local NHS mental health staff.
The Government will be investing in new digital tools for mental health alongside the suicide prevention strategy.
This report focuses on progress in transforming services since the publication of the Coalition Government’s children and young people’s mental health strategy, Future in Mind. It explores what progress has been made in the first year of the programme and the barriers and risks which could hinder the process of transformation.
Objectives: The impact of policy and funding on Child and Adolescent Mental Health Service (CAMHS) activity and capacity, from 2003 to 2012, was assessed. The focus was on preschool children (aged 0–4 years), as current and 2003 policy initiatives stressed the importance of ‘early intervention’.
Settings: National service capacity from English CAMHS mapping was obtained from 2003 to 2008 inclusive. English Hospital Episode Statistics (HES) for English CAMHS was obtained from 2003 to 2012. The Child and Adolescent Faculty of the Royal College of Psychiatrists surveyed its members about comparative 0–4-year service activity and attitudes in 2012.
Participants: CAMHS services in England provided HES and CAMHS mapping data. The Child and Adolescent Faculty of the Royal College of Psychiatrists are child psychiatrists, including trainees.
Outcome measures: CAMHS mapping data provided national estimates of total numbers of CAMHS patients, whereas HES data counted appointments or episodes of inpatient care. The survey reported on Child Psychiatrists’ informal estimates of service activity and attitudes towards children aged 0–4 years.
Results: The association between service capacity and service activity was moderated by an interaction between specified funding and age, the youngest children benefiting least from specified funding and suffering most when it was withdrawn (Pr=0.005). Policy review and significant differences between age-specific HES trends (Pr<0.001) suggested this reflected prioritisation of older children. Clinicians were unaware of this effect at local level, though it significantly influenced their attitudes to prioritising this group (Pr=0.02).
Conclusions: If the new policy initiative for CAMHS is to succeed, it will need to have time-limited priorities attached to sustained, specified funding, with planning for limits as well as expansion. Data collection for policy evaluation should include measures of capacity and activity.
Thousands to benefit from kick-start of mental health services transformation
NHS England has published Implementing the five year forward view for mental health. This report details how new funding, pledged in response to the Five Year Forward View for Mental Health, rising to £1bn a year by 2020/21 in addition to the cumulative £1.4bn already committed for children, young people and perinatal care, will be made available for CCGs year on year.
It also shows how the workforce requirements will be delivered in each priority area and outlines how data, payment and other system levers will support transparency.
House of Commons Library. Published online: 22 June 2016
House of Commons Library briefing on children and young people’s mental health policy and services.
One in four people on average experience a mental health problem, with the majority of these beginning in childhood. A report by the Chief Medical Officer in 2014 found that 50 per cent of adult mental health problems start before the age of 15 and 75 per cent before the age of 18.
The Coalition Government committed to improving mental health for children and young people, as part of their commitment to achieving “parity of esteem” between physical and mental health, and to improving the lives of children and young people. The Government’s 2011 mental health strategy, No Health without Mental Health, pledged to provide early support for mental health problems, and the Deputy Prime Minister’s 2014 strategy, Closing the Gap: priorities for essential change in mental health, included actions such as improving access to psychological therapies for children and young people. The Department of Health and NHS England established a Children and Young People’s Mental Health and Wellbeing Taskforcewhich reported in March 2015 and set out ambitions for improving care over the next five years. The Coalition Government also pledged funding for children and adolescent mental health, detailed in the briefing.