Calls for review into why mental health services reject some children

Date: 3rd April 2017
Category: Health and health services, Mental health

1 in 5 referrals to child and adolescent mental health services (CAMHS) are rejected. Calls for a full review of the referral and assessment process for mental health services for children and young people have been partly answered by upcoming Mental Health Strategy.

NHS figures show that around one in five referrals was rejected in 2015, with the number affected totaling around 17,000 children and young people over the last three years. Organisations such as Barnardo's Scotland said there were "serious issues" with the process of referral to CAMHS. Local health boards are supposed to help those referred access CAMHS specialists within 18 weeks of being their referral but many have continuously missed the waiting time target.

The charity said it supported Scottish Labour's campaign for an investigation into the issue, saying it had become "increasingly concerned" after carrying out a review of its own services which support around 3,000 children and young people. Half were found to have mental health issues but three quarters of those were receiving no service from CAMHS. Barnardo's Scotland said children and young people "described losing trust in CAMHS because of the fear that they would not be seen".

Director Martin Crewe said: "Although waiting times for CAMHS continue to be an issue, it is increasingly worrying that there are significant numbers of children and young people who are not being seen at all.

These children and young people either go without support or receive limited or inappropriate help. In our experience this can be the result of something as simple as insufficient information being included on a referral form."

The charity also highlighted new research from The University of Stirling showing that the odds of being rejected were significantly higher if a child or young person was referred by a teacher or had emotional or behavioural difficulties.
Scottish Labour's Monica Lennon MSP said: "It's shocking enough that one in five children in Scotland are having to wait far too long for mental health treatment, but this new research indicates that many children and young people are not able to access specialist treatment at all.

"Many children across Scotland in need of mental health care are clearly not able to access the help they need, and I urge the SNP Government to listen to Barnardo's Scotland's call for a complete review of the referral process."

Following pressure from charities and a parliamentary question asked by Conservative MSP Graham Simpson, First Minister Nicola Sturgeon has announced an audit of rejected referrals would now be commissioned as part of the Scottish Government's 10-year mental health strategy.

"All children who are referred to specialist child and adolescent mental health services are assessed on an individual basis," Sturgeon told MSPs. "If, as a result of an assessment, a clinician did not believe that CAMHS was the best course, we would expect the child to be referred to an appropriate service.

"As the chamber is aware, the minister for mental health will next week bring forward our new 10-year mental health strategy. I am able to tell the chamber today that an early action of that strategy will be to commission an audit of rejected referrals.

"Its findings will help to ensure that children are being referred to the right services and that those services can provide the help that children need."

Reacting to the first minister's announcement, the Scottish Children's Services Coalition said it was pleased. A spokesperson for the coalition, which includes charities such as Who Cares? Scotland and Action for Sick Children Scotland, said:

"The findings from this audit will help to ensure that children and young people are being referred to the right services and that those services can provide the help that they need, when they need it.

"It is estimated that 50% of mental health problems are established by the age of 14 and 75% by the age of 24, so the sooner we can identify these mental health problems the sooner we can prevent them developing further and also assist in the key Scottish Government strategy of closing the educational attainment gap."