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You can find the current article at its original source at https://www.theguardian.com/society/2017/aug/06/were-failing-our-young-people-on-mental-health-provision
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| We’re failing our young people on mental health provision | We’re failing our young people on mental health provision |
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| The failure to find a specialist bed for a suicidal and vulnerable young woman leaving youth custody is at the heavy end of a much wider problem facing mental health services for young people (Senior judge warns of ‘blood on our hands’, 4 August). | The failure to find a specialist bed for a suicidal and vulnerable young woman leaving youth custody is at the heavy end of a much wider problem facing mental health services for young people (Senior judge warns of ‘blood on our hands’, 4 August). |
| First, there are territorial injustices in young people’s access to child and adolescent mental health services (Camhs) when problems arise. This often results in long delays in receiving preventive services, sometimes to the point where they just give up hope and suffer in silence while their problems get worse. | First, there are territorial injustices in young people’s access to child and adolescent mental health services (Camhs) when problems arise. This often results in long delays in receiving preventive services, sometimes to the point where they just give up hope and suffer in silence while their problems get worse. |
| Second, there is evidence some vulnerable young people moving on from Camhs at 18 are unable to access the adult mental health services they desperately need, often until a crisis occurs. This is a consequence not just of staff shortages but also differences between adult services and Camhs in their thresholds for services: whereas the former is based on meeting a strict clinical diagnosis, for the latter, the threshold is usually general “wellbeing”. This reflects a failure to have a seamless link between child and adult care services during young people’s transitions to adulthood. | Second, there is evidence some vulnerable young people moving on from Camhs at 18 are unable to access the adult mental health services they desperately need, often until a crisis occurs. This is a consequence not just of staff shortages but also differences between adult services and Camhs in their thresholds for services: whereas the former is based on meeting a strict clinical diagnosis, for the latter, the threshold is usually general “wellbeing”. This reflects a failure to have a seamless link between child and adult care services during young people’s transitions to adulthood. |
| Finally, the increasing levels of mental health problems and suicides among young people must raise difficult questions about their emotional and material status in families, schools, communities and society. In the words of Sir James Munby: “Have we a right to call ourselves civilised?”Mike SteinEmeritus professor, University of York | Finally, the increasing levels of mental health problems and suicides among young people must raise difficult questions about their emotional and material status in families, schools, communities and society. In the words of Sir James Munby: “Have we a right to call ourselves civilised?”Mike SteinEmeritus professor, University of York |
| • In 1996 I edited a book, “Childhood” in “Crisis”? We exposed the systemic demonisation of children and young people alongside the lack of support for families in communities, the erosion of child and youth provision, and the rise of ever-more draconian regulatory responses to children in conflict with the law. Yet the following year the Asbo mantle was eagerly grasped by Jack Straw whose tenure as home secretary tightened the vice. | • In 1996 I edited a book, “Childhood” in “Crisis”? We exposed the systemic demonisation of children and young people alongside the lack of support for families in communities, the erosion of child and youth provision, and the rise of ever-more draconian regulatory responses to children in conflict with the law. Yet the following year the Asbo mantle was eagerly grasped by Jack Straw whose tenure as home secretary tightened the vice. |
| We warned that the relationship between “austerity” – meaning poverty – social exclusion and harsh measures failed to address one of the most obvious and prevalent issues of the time: mental ill-health in childhood and early youth manifesting in self-harm, alcohol and drug dependency and young people taking their own lives. | We warned that the relationship between “austerity” – meaning poverty – social exclusion and harsh measures failed to address one of the most obvious and prevalent issues of the time: mental ill-health in childhood and early youth manifesting in self-harm, alcohol and drug dependency and young people taking their own lives. |
| During the 2000s the work addressed specific tensions within communities transitioning from generations of conflict to peace. Again, our research demonstrated the devastating impact of economic marginalisation and structural conflict on the mental wellbeing of our children. | During the 2000s the work addressed specific tensions within communities transitioning from generations of conflict to peace. Again, our research demonstrated the devastating impact of economic marginalisation and structural conflict on the mental wellbeing of our children. |
| It is commendable Sir James Munby has spoken out unambiguously in the case of the risk faced by a young woman if appropriate care is unavailable on her release from youth custody. Less acceptable is the parade of politicians, senior health professionals and academics who have responded so swiftly to an issue that has burned in full view for 20 years. | It is commendable Sir James Munby has spoken out unambiguously in the case of the risk faced by a young woman if appropriate care is unavailable on her release from youth custody. Less acceptable is the parade of politicians, senior health professionals and academics who have responded so swiftly to an issue that has burned in full view for 20 years. |
| As so many children and young people took their own lives, were incarcerated in a range of soul-destroying institutions or were left homeless and hopeless, many community-based, independent and local authority essential services were depleted by draconian cuts, their outstanding workers forced out from their dedicated essential support. That it has taken a senior judge to headline the suffering of our children and young people is an indictment of the lack of political will to fully resource essential, community-based services.Prof Phil Scraton School of law, Queen’s University, Belfast | As so many children and young people took their own lives, were incarcerated in a range of soul-destroying institutions or were left homeless and hopeless, many community-based, independent and local authority essential services were depleted by draconian cuts, their outstanding workers forced out from their dedicated essential support. That it has taken a senior judge to headline the suffering of our children and young people is an indictment of the lack of political will to fully resource essential, community-based services.Prof Phil Scraton School of law, Queen’s University, Belfast |
| • The care and support we provide our vulnerable children reflects on us as a society. We score highly on awareness and willingness to act. The government has put in the resources to deliver more staff on the ground over the next four years. Where criticism is valid is on our ability to use these resources effectively to enact change that makes a difference. | • The care and support we provide our vulnerable children reflects on us as a society. We score highly on awareness and willingness to act. The government has put in the resources to deliver more staff on the ground over the next four years. Where criticism is valid is on our ability to use these resources effectively to enact change that makes a difference. |
| The government cannot just put money into the system and sit back and hope that it reaches the front line. There needs to be concerted political leadership to deliver change. The prime minister should establish an implementation taskforce pulling together ministers across government – including health, education, justice and work and pensions. It should focus on ensuring children and young people in crisis receive appropriate care and support, but also that we invest in early intervention and prevention. The tragic plight of this young woman could be added to the long list of similar stories or it could represent a watershed moment in bringing about real change. Let’s make sure it’s the latter. No child should ever be condemned to the “too difficult to help” box.Prof Sue BaileyChair of the Children and Young People’s Mental Health Coalition | The government cannot just put money into the system and sit back and hope that it reaches the front line. There needs to be concerted political leadership to deliver change. The prime minister should establish an implementation taskforce pulling together ministers across government – including health, education, justice and work and pensions. It should focus on ensuring children and young people in crisis receive appropriate care and support, but also that we invest in early intervention and prevention. The tragic plight of this young woman could be added to the long list of similar stories or it could represent a watershed moment in bringing about real change. Let’s make sure it’s the latter. No child should ever be condemned to the “too difficult to help” box.Prof Sue BaileyChair of the Children and Young People’s Mental Health Coalition |
| • A distressed and suicidal young mother who had just split up from her boyfriend killed her two-year old daughter last October (Report, 27 July). She then sent a picture of the child to her ex-boyfriend, and called 999 for help. She said the dead child was not breathing. She wrote a note saying, “There’s nothing for me or Macey, life’s shit.” She was found making attempts to revive the child and she, Cody-Anne Jackson, had superficial chest, neck and wrist injuries. At first she denied suffocating the child but later changed her plea. She was sentenced to life imprisonment. | • A distressed and suicidal young mother who had just split up from her boyfriend killed her two-year old daughter last October (Report, 27 July). She then sent a picture of the child to her ex-boyfriend, and called 999 for help. She said the dead child was not breathing. She wrote a note saying, “There’s nothing for me or Macey, life’s shit.” She was found making attempts to revive the child and she, Cody-Anne Jackson, had superficial chest, neck and wrist injuries. At first she denied suffocating the child but later changed her plea. She was sentenced to life imprisonment. |
| The judge, Michael Chambers QC, said: “This is not a case where you suffered from mental illness” and that the killing was “an expression of utter self-absorption”. We are not told what the evidence for these statements was. Is this the best we can do for a distressed and vulnerable young woman, her family, her boyfriend and his family? Where, also, is the concern to prevent such tragedies?John Gunn Emeritus professor of forensic psychiatry, Kings College London | The judge, Michael Chambers QC, said: “This is not a case where you suffered from mental illness” and that the killing was “an expression of utter self-absorption”. We are not told what the evidence for these statements was. Is this the best we can do for a distressed and vulnerable young woman, her family, her boyfriend and his family? Where, also, is the concern to prevent such tragedies?John Gunn Emeritus professor of forensic psychiatry, Kings College London |
| • The Five Year Forward View for mental health recognised child and adolescent mental health services as being particularly under-resourced in comparison with other psychiatric services (Judge’s verdict exposes a rapidly growing scandal, 4 August). Yet all mental health services receive only 13% of the NHS budget, despite mental illness accounting for 23% of the UK’s total burden of disease. | • The Five Year Forward View for mental health recognised child and adolescent mental health services as being particularly under-resourced in comparison with other psychiatric services (Judge’s verdict exposes a rapidly growing scandal, 4 August). Yet all mental health services receive only 13% of the NHS budget, despite mental illness accounting for 23% of the UK’s total burden of disease. |
| The February 2017 follow-up report, One Year On, speaks in relation to Camhs of having conducted a “consultative review to consider the local requirements for in-patient beds and make recommendations on how the availability and use of beds can be improved”. New beds will be opened, but there is no indication of the timescale, the number of beds, their tier level or their funding. Many boroughs and counties have no Camhs beds after decades of “efficiency savings”. NHS England bears full responsibility for this lack, and the resulting harm caused to the most vulnerable children and adolescents in our society.Morris BernadtLondon | The February 2017 follow-up report, One Year On, speaks in relation to Camhs of having conducted a “consultative review to consider the local requirements for in-patient beds and make recommendations on how the availability and use of beds can be improved”. New beds will be opened, but there is no indication of the timescale, the number of beds, their tier level or their funding. Many boroughs and counties have no Camhs beds after decades of “efficiency savings”. NHS England bears full responsibility for this lack, and the resulting harm caused to the most vulnerable children and adolescents in our society.Morris BernadtLondon |
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