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Regulator Warns of Potential Crisis in Children’s Mental Health Services

A record high 496,897 children in England were waiting to access or were receiving mental health treatment in November 2023.

Treatment delays, staff shortages, and a lack of appropriate accommodation have made mental health services in England for children “a ticking time bomb,” the health regulator has warned.

The Care and Quality Commission’s (CQC’s) report, “Monitoring the Mental Health Act in 2022/23,” published on Thursday warned that despite additional investment, rising demand means that children are facing “long waits” for mental health care.

The CQC said that in November 2023, nearly half a million—496,897—children were waiting for or were undergoing mental health treatment, a record high.

Chris Dzikiti, director of mental health at the CQC, said: “Half a million children are receiving or waiting for mental health care and are having to wait on average 40 days to access care, but often much longer – with many reporting a deterioration in their mental health while waiting and some attempting to take their own life.

“Without access to good, timely care, children with mental health needs are at increased risk of harm and in some cases suicide. This issue is a ticking time bomb, and we will face the consequences if it’s not resolved.”

According to the latest data from NHS England, almost 5 million patients were in contact with the health service in 2022–2023 for their mental health, including 1.1 million children.

Lack of Suitable Accommodation

The CQC produced the report following conversations with 4,515 patients and 1,200 carers. The regulator said that owing to “high demand and a lack of specialist beds,” many children had been placed in “inappropriate environments” such as general children’s wards or adult wards and sometimes far from home.

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“Whether on a general children’s ward, adult ward or in acute admissions, the care given to children and young people is compromised by the fact that these wards are not designed for children and young people who have mental health needs,” the report said.

The commission said that placing children with such needs in inappropriate settings can exacerbate their distress, particularly those with sensory needs.

“For example, often noisy and bright wards can create a particularly difficult sensory environment for autistic people and people with a learning disability. Services must determine each patient’s unique sensory profile and preferences to ensure they receive care that meets their needs,” the report said.

Staff Shortages

The commission also cited staff shortages as an issue that can make it “extremely challenging” to deliver appropriate care to children and young people.

Staff shortages had contributed to poorer quality of care, an increased risk of inappropriate restraint, and reduced access to therapy and activities.

The report noted that staff treating children placed in adult wards “are often used to treating adults [and] may not tailor the care they provide to meet the needs of younger patients.”

A reliance on agency staff was also highlighted as detrimental to care. At an eating disorder service, patients told report authors that some staff—“especially agency staff”—were “too rough” when administering nasogastric feeding tubes, which caused them distress.

NHS Treating More Children

In response to the report, an NHS England spokesperson said, “The NHS is treating more young people than ever before with latest figures showing 48% more children and young people accessing mental health support since 2019/20, and the health service is expanding this provision as quickly as possible within the current five-year funding arrangements to meet rising demand.”

“We know there is more to do to which is why plans are also in place to ensure more than one in every two pupils in schools and colleges are covered by an NHS mental health support team offering early support by spring 2025 – significantly ahead of the original target,” they added.

A spokesperson from the Department of Health and Social Care also said the department was “committed to expanding community mental health services so children and young people can access the services they need.”

“Over the 12 months to January 2024, 758,000 people aged under 18 were supported through NHS-funded mental health services — a 32% increase on the 12 months to March 2021.”

Children Experiencing ‘Uniquely Challenging Times’

Last week, Children’s Commissioner Dame Rachel de Souza warned that there was a growing group of children struggling with their mental health.

“This generation of children has experienced uniquely uncertain and challenging times,” Dame Rachel said. “Some have spent some of their most formative years isolated and indoors, fearful they or their loved ones may catch a deadly virus. They have felt the squeeze of a cost-of-living crisis, and are keenly aware of the pressure their parents are under.”

She also pointed to children being “constantly bombarded by negative news, of wars and climate catastrophe,” and the risks they faced from the “harmful impact of social media, cyber bullying, and online exploitation.”

“Against this backdrop, it is not surprising that we continue to see the number of children experiencing poor mental health at persistently high levels,” she added.

PA Media contributed to this report.

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