This report by the Education Policy Institute (EPI) examines new data on access to specialist treatment for children and young people with mental health problems, and the waiting times they face. This new data was obtained by EPI through a Freedom of Information request.
You can download the full report here.
Key findings
Access to mental health services
Children with mental health problems face barriers when seeking access to mental health services:
- Over a quarter (26.3 per cent) of children referred to specialist mental health services were not accepted in 2016-17. This figure has scarcely changed since last year, and represents a significant rise since 2012-13, when 21.1 per cent of young people were turned away.
- Applying this 26.3 per cent to the number of children currently being treated nationally, EPI estimates that it represents over 50,000 children.
- There is considerable variation between providers, with some turning away less than 5 per cent of referrals, while others turn away over half of young people. Providers in the South of England rejected the highest proportion of referrals (34.0 per cent), with London the lowest (19.3 per cent).
- The five providers with the highest proportion of unaccepted referrals were: Norfolk and Suffolk (64.1 per cent); Hertfordshire Partnership (63.5 per cent); Nottinghamshire Healthcare (61 per cent); Cambridgeshire and Peterborough (58.3 per cent); and South Staffordshire and Shropshire (58.7 per cent).
- The five providers with the lowest proportion of unaccepted referrals were: Birmingham Children’s Hospital (0.0 per cent); Derbyshire Healthcare (0.1 per cent); Tavistock and Portman (1.7 per cent); Shropshire Community Health (2.0 per cent); and Bradford District Care (3.0 per cent).
Waiting times
Over the last year, overall waiting times (including both assessment and treatment) have fallen – yet there remains substantial variation across England:
- The average of all providers’ median waiting times for assessment has fallen from 39 days in 2015-16 to 33 days in 2016-17.
- A similar trend exists for young people waiting for treatment, with average waiting times falling from 67 to 56 days. Such progress could be the result of additional government funding targeted at children’s mental health services.
- Young people in London waited the longest time for mental health treatment to start (66 days), while those in the Midlands and East of England waited the shortest (50 days).
- Median waiting times for treatment range from just 5 days in South Staffordshire and Shropshire, to 112 days in Dudley and Walsall, indicating significant variation across the country.
- Providers with the longest median waiting times (days) for mental health treatment were: Dudley and Walsall (112); Homerton University Hospital (110); Whittington Hospital (102); Coventry and Warwickshire Partnership (98); and Berkshire Healthcare (86).
- Providers with the shortest waiting times were: South Staffordshire and Shropshire (5); Worcestershire (14); Norfolk and Suffolk (14); Isle of Wight (14); and Northumberland, Tyne and Wear, Leicestershire Partnership, and Hertfordshire Partnership (all 21).
Policy recommendations
- Government information on access and waiting times for children should be published in a comparable format. At present, figures must be obtained through an FOI request, rather than routinely published as with most NHS indicators.
- Standardisation of data collection and publication would increase transparency and allow for better evaluation of NHS performance on child and adolescent mental health.
- The high thresholds applied by providers for accepting children highlights the need to expand overall capacity for specialist services in England.
- The forthcoming government Green Paper on mental health and schools should include measures to provide early intervention more consistently at a local level.
- To avoid the unnecessary rejection and subsequent delay for children and young people, teachers must be equipped with sufficient training and skills.
- In light of the wide regional variation for young people in waiting for access to mental health treatment, there is a strong case for the establishment of national waiting time standards.
