The hon. Lady is absolutely right. Trauma in young people’s lives is often the trigger, whether it is sexual abuse, domestic abuse, violence perpetrated by other young people, or bereavement. All those triggers set off a train of deterioration in young people’s mental health that is often lifelong. It is so important that they get the access they need.
Several hon. Members have mentioned waiting times for CAMHS. I have certainly found that my constituents cannot get on Facebook quick enough to tell me about their CAMHS experiences. I do not want to denigrate CAMHS, which have great people doing great work; the problem is that there are just not enough of them and they are under too much pressure. As Rachael Maskell noted, CAMHS are turning away nearly a quarter of children who are referred to them. In 2017-18, they turned away 24.2%, meaning that at least 55,800 children were not accepted for treatment. Of those who were referred, the average waiting time was 34 days for an initial assessment and 60 days for treatment—significantly longer than the four-week standard set out in the Government’s Green Paper. We can all point to examples of much longer waiting times in our constituencies.
One constituent contacted me to say that her son had been self-harming for years. It took them months to get an appointment with CAMHS, and when the appointment happened, her son suffered a meltdown. That is not unusual, due to the pressures that those appointments put on young people. Because he is 15, their GP cannot prescribe anything for him. My constituent has had to watch her son throughout the night to make sure he does not do any permanent damage to himself. Another parent told me how her daughter was discharged from CAMHS, with it saying there was nothing more it could do to help with her anxiety.
Young people have told mental health charity Mind—I am very lucky to have Burton and District Mind in my constituency, which does a great job—that the wait for support is one of the most difficult issues they face. They say that sometimes, they find that their mental health deteriorates while they are waiting; the wait actually makes it worse. In England as a whole, half of those accepted for treatment during 2017-18 were still waiting for treatment at the year’s end. That proportion was lower in my area, east Staffordshire, where it was just over one third. However, that is still a substantial figure.
A school counsellor from my constituency contacted me to say that the waiting lists for referrals to child services outside of school can be months long. She believes that when it is established that a child needs help, a counselling session needs to happen within 48 hours. She goes on to say that too much red tape is preventing children from getting the help they need. I think we all recognise, as the Government have done, that support in school, delivered in a way that is accessible to young people—they feel comfortable asking for it, and know of other young people who have accessed it—is a real help.
One parent told me that she decided to fight to get her son’s care commissioned outside of the county they lived in because of her disappointment with the support she had received. She says that early intervention is key, and that there have been too many endless reports and not enough action has been taken. Another parent in my constituency said that she took her daughter to the GP two years ago. She was referred to That Place in Burton, which is a fantastic facility; she took her for assessment, only to be told that her daughter was not old enough to be accepted. Yet another constituent told me that after a referral for her daughter, aged nine, it took three years for them to see a psychiatrist. That kind of wait is difficult, and all the time, the young people are getting worse.
There is also a problem with the transition from childhood to adulthood. According to the British Psychological Society, about one in six 17 to 19-year olds have a mental health disorder; according to the Children’s Society, 16 to 17-year-olds are the biggest service users of mental health services. However, young people often face barriers to accessing support, and end up falling through the cracks of adult and children’s services as they transition. Some young people who are discharged from children and young people’s mental health services at 18 find it can be very difficult to get a referral to adult mental health services at all, and can end up completely isolated. In some circumstances, young people are not accepted into either children and young people’s or adult mental health services, due to them falling between the gaps.
Again and again, I hear that CAMHS discharges young people on their 18th birthday, and that there is no provision at all for them. The challenges those young people are facing do not magically disappear when they become adults. Just last Friday, I met with a constituent who was getting ready to leave CAMHS and had been left to organise her future on her own. She was not automatically transferred to adult services, and had to organise a private therapist in order to get the ongoing treatment that she needs.
One of my constituents sums the problem up better than I could:
“All the time the kids are getting no support, becoming suicidal, becoming adults with even more complex issues, families are breaking up because of the pressure, parents quitting work to do the job of education/social care/health, and all of this causes more and worse financial pressure later on. No one sees the bigger picture because they can’t afford to. No one sees long term because that’s too expensive. Early interventions are crucial but they aren’t funded. We will reap the whirlwind then wring our hands and say ‘how could we have prevented this’”.
That is absolutely pertinent.
The Government have set a five-year forward view for mental health, which is for one in three children and adolescents with a mental health disorder to access NHS mental health community services by 2020-21. In the new long-term plan, they have set a target that 100% of children and young people who need specialist care will be able to access it by 2028-29. However, that is so far down the track.