Child and Adolescent Mental Health Services (CAMHS) are in a state of near-collapse across much of the UK according to a shocking new report by mental health charity stem4, publicised in The Guardian.

The report draws on a survey this spring of 1001 GPs, and finds 95% of respondents believe CAMHS services are either in crisis of very inadequate, revealing a deterioration over the past six years.

Almost two thirds of GPs fear their young patients may come to harm through lack of access to treatment, with half reporting that 60% of their referrals are rejected because young people’s symptoms of anxiety, depression or self-harm are not seen as severe enough. Almost one in five (18%) say a patient has attempted to or taken their own life due to lack of access to treatment over the past 12 months.

One GP in 20 said the services were so inadequate they had stopped trying to refer to them, and told young people in crisis to go to A&E instead, even though this was not the right place for them.

One GP in Yorkshire & Humber told the survey: “It is so appalling in our area – it may as well not exist.  Patients only get support if their parents can afford to pay for it, or they are drinking bleach…. even then its touch and go whether a referral to CAMHS will be accepted.”

Another GP in the North east summed up: “Woefully underfunded and understaffed, not fit for purpose. A disgrace for a first world country.”

Dr Nihara Krause, Consultant Clinical Psychologist, founder of stem4, said:

“For the past six years Child and Adolescent Mental Health Services have been described as a ticking time bomb, the Cinderella service of the NHS, a postcode lottery, and the list goes on.  Yet despite successive governments’ promises to improve mental health services for children and young people, with extra boosts of cash, including the additional £1.4bn investment made between 2015 and 2021, services have neither improved, nor been maintained.  In fact, as these GP describe, CAHMS is not much more than a raffle, and one that is currently in crisis.”

However adult services, too are in a continual state of crisis, with NHS England admitting last November that at least at least 1.4 million people “have been accepted for or are eligible for care but are yet to receive it, with an additional eight million who would benefit from care, if access barriers were reduced.”

The problems are far from recent. In Essex the first ever Public Inquiry into mental health care, belatedly set up last year after years of protests and demands by bereaved relatives, is finally investigating a long catalogue of service failures that led to the deaths of a staggering 1,500 people on mental health wards between 2000 and 2020. Last year the Essex Partnership University Partnership Trust that since 2017 covers the county was fine £1.5 million for failures of care committed by the former North Essex Partnership trust between 2004 and 2015 that led to the deaths of 11 patients.

The Inquiry has a long way to go: on March 28 its chair Dr Geraldine Strathdee issued a statement pointing out that “Right now, we have very limited information on the 1,500 deaths we’ve been made aware of. Our investigations are ongoing, and we expect to be able to provide a fuller breakdown of this number in the future. But as it stands, for example, we have only been given the cause of death for around 40% of these deaths.”

In Norfolk and Suffolk campaigners have also been complaining for many years over the poor quality of services and management failures of the Norfolk and Suffolk NHS Foundation Trust. In March the Trust admitted to an inquest that its own investigation had revealed failures in the assessment and treatment of a 19-year old student who took her own life in December 2020, who was “in the system but not flagged as urgent” despite a series of attempted overdoses after returning to Norwich in September 2020. The Trust’s lead consultant psychologist argued that the Covid pandemic had led to cases deemed “routine” not being prioritised.

Meanwhile the vigorous Norfolk & Suffolk Mental Health Crisis campaign has slammed the Trust’s plans for a £45m redevelopment of Hellesdon Hospital, which does not provide the increased number of local beds needed to prevent a continual stream of out of area referrals to distant private hospitals, asking “How can you invest £45m and still not have enough beds?”

“These plans will institutionalise the transportation of patients to private hospitals outside the trust – a practice they promised to end in 2014 and again by 2017 but which continues to this day.”

Lat year one Trust patient, 81-year old Peggy Copeman died in a minibus on the hard shoulder of the M11 in transit back to Norfolk after being sent 280 miles to Taunton in Somerset for treatment for lack of local beds.

In February it was revealed that 29 adults were waiting for mental health beds, 15 were in private beds in the region, and 15 more had been dispatched to beds outside Norfolk and Suffolk. The discharge of 14 patients was delayed by lack of suitable social care.

Rollesby ward, the Trust’s psychiatric intensive care unit has been closed for over a year, allegedly for refurbishment costing £700,000, but even now the work completed the ward has not reopened, apparently for lack of staff.

But lack of capital has also restricted the scope of the Hellesdon hospital refurbishment, slashing the initial plan for five new wards back to three, offering just 15 extra beds. Since even the reduced funding is not yet in place, no work has yet begun, so the additional beds will not be in place for another two years. Campaigners warn that unless more staff are recruited these could be “the most expensive empty beds ever.”

The staffing problems are not helped by the trust’s poor rating from the CQC and its reputation for bullying from a management that lurches from one failure to another, and seem more than ready to blame staff rather than take responsibility for any failures in care.


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