Children and young people must be at the heart of the mission to achieve a revolution in mental health and wellbeing. One in ten children between the ages of 5 and 16 suffer from a diagnosable mental health condition(1). These can escalate into serious problems in later life if left untreated, and we know that three quarters of mental health problems in adult life start by the age of 18(2). So there is an overwhelming moral and pragmatic case for ensuring that young people get the right help, in the right place, at the right time.
As a minister, however, I became increasingly of the view that children and adolescent mental health services are dysfunctional and ineffective. Too many children are let down by poor access to care. 75% of children and young people do not get access to the treatment they need(3), and many don’t receive any care at all. The system is too reactive, geared around treating mental illness rather than promoting mental health and well-being in the first place.
Children’s mental health services are at the front of the queue for funding cuts by CCGs and local authorities trying to cope with tighter budgets. Research by Young Minds in 2014 found that the early intervention services (Tier 1 and Tier 2) have suffered the most. And because specialist CAMHS services (Tier 4) are commissioned nationally by NHS England, there is a perverse incentive for local areas to push children into acute care settings to absolve themselves of responsibility for payment. All too often, children unnecessarily end up in hospital when this is the least therapeutic option.
That is why I set up a taskforce to identify the barriers that prevent us from providing excellent mental health care for young people, and set a clear direction for change. It brought together professionals, academics and other experts, working with charities and community organisations as well as young people and their families. The result was the ‘Future in Mind’ report, a blueprint for the modernisation of CAHMS services in England, backed up by an extra £1.25 billion in funding secured by Nick Clegg to help spark this revolution.
The response to ‘Future in Mind’ has been extremely positive, and its recommendations were endorsed by the Mental Health Five Year Forward View. However, I want to make sure that we act on this vision and develop our thinking further. So I am delighted to be chairing the Education Policy Institute’s Children’s Mental Health Commission to assess progress on a national and regional level following the publication of the report.
The Commission will look at local variation in the implementation of Future in Mind transformation plans, identify the main barriers to service improvement, and highlight areas of promising practice and key success factors in transforming care.
It will cover the range of support from prevention to crisis care, look at the role of schools and new technology in combating mental illness, and identify innovation in primary care, acute care and specialised services. There are already some inspiring examples of good practice in different parts of the country. I recently visited the CAMHS service at Boundary Brook House in Oxfordshire, and was really impressed by their vision to take mental health support into schools.
This work will enable the Commission to make recommendations for change to government, policymakers and commissioners. But it is important to stress that the Commission will seek to build on rather than duplicate the excellent work that has been done so far. While ‘Future in Mind’ set a roadmap for transforming services, the Commission will take a closer look at the practical changes that can be made to achieve our ultimate objective: timely access to effective, evidence-based children and young people’s mental health services for all who need them.
This is an extremely exciting initiative. There is a real sense that the winds are changing in mental health, but we must continue the fight to make sure that this momentum continues. I am grateful to the Education Policy Institute for their commitment to this project, and look forward to providing an update on our progress.