Over half a million young people might miss out on mental health support. Reform would be a worthwhile legacy
“I’ve contemplated killing myself a few times.” Sensing the pause in my throat the 19-year-old young man quickly followed: “But obviously I didn’t, I self-harmed instead. It was the only way they’d take me seriously.”
This young man went on to explain to me how, from an early age, his parents had suspected he was autistic but hadn’t taken him to be tested. At school, his emotional and mental health began to rapidly deteriorate. Bullying led to severe panic attacks, which meant rarely leaving the house. Throughout all this he had bounced from one counsellor or support service to another. Finally the panic attacks became so bad he was admitted to hospital. At first he felt “relieved” at the attention, but when he found out the waiting time for a specialist appointment would be three months his condition regressed. He felt he had no option left but to self-harm to get the right help.
Related: ‘Shattering stigma starts with simple conversations’: tackling the child mental health crisis
I was driven to the brink by the poor care my friend received. I finally left over pointless tasks
The first time I thought I should leave the NHS and never return was at my friend’s inquest. After struggling with mental health issues for many years he had taken his own life. At his inquest, I learnt that in the period leading up to his suicide his mental health appointments had all been with support workers and he had not once seen a qualified mental health nurse. I also discovered that his last five appointments had been with four different members of staff. The coroner asked about the level of the service he had received. The manager of the service cited difficulties with a large geographical patch and described the service he received as usual practice. As an NHS manager myself, I could see it may have been usual practice, but it was far from good enough.
As I drove home from the inquest my head was spinning with dissonant thoughts and questions. I was angry and upset. I was concerned for the service manager. I was furious with government cuts. I was worrying about the service I managed. I needed the noise in my head to stop. I found myself contemplating killing myself. I did not sleep that night. I knew I was unwell and so the next day I saw my GP. I needed three months off work for severe depression and anxiety. I had excellent talking therapy via my GP surgery and my counsellor continued to support me through and beyond my return to work.
Related: The NHS sets leaders up to fail – and then recruits more in the same mould
The Tories betray wilful ignorance in refusing to acknowledge that some adults need support all their lives – asking them to pay care costs is wrong
Much has been said about the Conservative manifesto pledges on social care and Theresa May’s subsequent U-turn, but one issue that has so far escaped scrutiny is the Tories’ strange assumption that social care is all about older people. This is despite the fact that around a third of those who need social care services are of working age [pdf].
Social care affects all adults who need support because of a disability or long-term health condition. This might include a learning disability, a physical disability or severe and enduring mental ill-health. The failure of the Conservative manifesto to acknowledge any of this gives the impression of a party that is wilfully ignorant of the nature of adult social care and its beneficiaries.
Related: The ‘dementia tax’ mess shows how little May thinks of disabled people | Frances Ryan
Related: Forget money – we need to rethink what social care should look like
From online counselling to a texting service offered by school nurses and free wellbeing courses, providing support for young people needn’t break councils’ budgets. Sarah Johnson reports on a roundtable discussion
Public concern around child and adolescent mental health is at an all-time high. The prime minister, Theresa May announced in January her intention to better identify and help the growing number of young people in schools who are at risk of developing mental health issues. Prince Harry and the Duke and Duchess of Cambridge, meanwhile, are using their profiles to convince the public that “shattering stigma on mental health starts with simple conversations”.
And yet, despite growing awareness of the issue, child and adolescent mental health services (Camhs) are under an increasing amount of pressure. Healthcare professionals bemoan a lack of resources and staff while health secretary Jeremy Hunt has described Camhs as the “biggest single area of weakness of NHS provision”.
Related: Quarter of a million children receiving mental health care in England
Related: Psychiatrists attack ‘scandal’ of child mental health spending
The mental wealth of the nation is critical to our future – young people’s mental wellbeing should be paramount
The mental health of the nation is built on foundations laid in the early years of our lives. Yet our mental health system is designed and funded to pay the price of our failure to act on the evidence and invest in the right family support in those childhood years.
We go through many life changes and transitions in our childhood and teenage years. It’s why the age of 18 is the wrong time for child and adolescent mental health services (Camhs) to “hand over” to adult services. A joint report by the health and education select committees has turned the spotlight on the role schools can play.
Related: We’re working with children in care to improve mental health | Tony Hunter
Related: Mental health services won’t help children in temporary care settings
Small community organisations and social enterprises could form an efficient, cost-effective support system for adults
An unexpected effect of cuts to council budgets, and the ensuing crisis in support services for adults and older people, is that the public is starting to understand for the first time what social care for adults actually is. The challenge now is for us to imagine what it could be.
In March, the government announced a green paper in response to the overwhelming evidence that the way we support older and disabled people is neither working nor affordable. Fewer people are getting support, care providers are leaving the sector and handing back contracts to councils, and hospitals are filling up with older people who have no medical reason to be there.
Related: Social care green paper is an opportunity too important to be missed | Peter Beresford
Related: How we can start a social care revolution in seven easy steps | Katie Johnston
Voters in six regions are to elect mayors, who could provide the biggest surprise when it comes to health policies
While Labour will be desperate to push the NHS to the centre of the general election campaign, and the Liberal Democrats will be emphasising their commitment to mental health services, it is the six regional mayors being elected for the first time in May who could provide the biggest surprise when it comes to health policies.
The exact powers of the six – covering Tees Valley, Greater Manchester, Liverpool city region, West Midlands, West of England and Cambridgeshire & Peterborough – vary depending on the deal each region reached with the government, but none of them will control the NHS.
Related: Are we ready for a grown-up election debate on the NHS and social care? | Niall Dickson
Mayors could easily derail STP plans without any obligation to provide a coherent alternative
More than 70% of children in care have mental health problems; an expert panel is drawing up an action plan
It’s good news that mental health in general, and children’s mental health in particular, is being given increasing attention by the media and greater consideration by policymakers. Yet the mental health and wellbeing of children in care is too often marginalised in these debates. More than 70% of children in care have been diagnosed with mental health problems. Perhaps you just assume that it goes with the territory and there’s not much that can be done about it. This is absolutely not the case.
The Social Care Institute for Excellence (Scie) has started a new project, commissioned by the departments of health and education, to ensure that children in care have access to high-quality services, based on a clear assessment of need, from a range of professionals working across different agencies. The project is likely to suggest significant changes to the way assessments are conducted for children in care, which could have a big impact on up to 70,000 care-experienced children and young people.
Related: Mental health services won’t help children in temporary care settings
Related: Children’s mental health in crisis – readers share their stories