Let’s make the next step on CAMHS count

7th February 2020

By Carolyn Lochhead, SAMH Head of Communications and Public Affairs

This week is Children’s Mental Health Week (3rd – 9th February 2020).

For several years, SAMH has been calling for urgent action on children and young people’s mental health; so we were interested to see the Scottish Government start the week by publishing new Child and Adolescent Mental Health (CAMHS) National Service Specifications.

A year and a half ago, the Scottish Government published an audit of rejected referrals to CAMHS, which included 29 recommendations for improving the experience for children, young people, and their families. Responding to the report at the time, the Cabinet Secretary for Health and Sport described the current system of rejecting referrals as “completely unacceptable”, accepting all recommendations and announcing £5 million of investment for a new CAMHS Task Force.

Since then, it’s been frustrating to see that despite the promises, there’s been a lack of real action on the ground. We continue to see 21 young people turned away from CAMHS every day in Scotland – that’s a shocking 9,131 since the audit was published. We don’t know what, if any, support these young people have received since.

The new CAMHS National Service Specifications therefore offer an opportunity for meaningful change, and indicate an important step forward – however we don’t think they go far enough. In particular we were disappointed to see no mention of rejected referrals, and no commitment to ending them. For something that is “completely unacceptable”, this feels like a missed opportunity.

One of the issues we have heard time and time again is of young people being told that CAMHS isn’t the right service for them, but that they haven’t been referred elsewhere. CAMHS isn’t, and shouldn’t be, the only answer, but we do need a more joined up approach so that no young person is left behind. The audit recommended introducing a ‘multi-agency assessment system’ – a central referral hub in which young people are guaranteed an initial, face-to-face, assessment in the first instance. This will help determine the most appropriate support for that person’s needs – whether it’s CAMHS or something else. Although this recommendation was accepted, there’s no reference to it in the service specifications, and we haven’t received an update on its progress.

The service specification also continues to make reference to ‘tiers’, something which the audit reported children, young people and their families found confusing and want to see reconsidered. We think it’s really important that young people understand the services available to them, so that they feel in control of their options, and would like to see this language changed accordingly.

Importantly, real change needs resourced, so we were disappointed not to see mention of this. We can’t just place more expectations on CAMHS teams without substantial resourcing, and we would like to see clarity on this.

However, we were also pleased to see some really encouraging commitments in the service specifications. It’s great to see that the service will now be extended to cover all children from birth to the age of 18. And we know from our work with young people that there’s a real need for a 24/7 crisis service for children and young people, so we are also happy to see this expectation included.

As Children’s Mental Health Week draws to a close, it’s important to recognise and appreciate the progress that’s being made – but also to renew our efforts to continue campaigning for every child and young person, to make sure that when they ask for support, that they receive it.