NSPCC: One in five children referred to local mental health services are rejected for treatment

More than a fifth of all children referred to local specialist NHS mental health services, including children whose problems stem from abuse, are rejected for treatment, the NSPCC reveals today.

New statistics from 35 Mental Health Trusts across England show that of a total of 186,453 cases referred by GPs and other professionals, 39,652 children did not receive help.¹

A worrying picture also emerged from six Trusts who provided a breakdown of outcomes for children referred to Child and Adolescent Mental Health Services (CAMHS) who had problems associated with abuse or neglect. In these Trusts 305 of the 1,843 - one in six - cases were rejected.²

Children who have been abused or neglected could face serious long-term mental health problems because of a lack of support, the NSPCC says. The charity says a 'time bomb' of serious conditions is being created by children not getting appropriate early help. The findings come as reported abuse across the UK soars.

Where reasons were given for not offering a service to children affected by abuse or neglect it was often because did not meet the high clinical threshold to qualify for treatment at a CAMHS. Not all abused children will have a diagnosable mental health problem but many will still need therapeutic support to help them deal with their trauma.

Some evidence has raised concerns around access to this kind of support for children and young people following abuse. Strict access criteria, both for assessment and treatment, have been identified as significant issues in some areas.³

NSPCC Chief Executive, Peter Wanless said: "There's been a huge increase in awareness about all forms of abuse in recent years. If children don't receive the right kind of help and support following a disclosure, the damage can last a lifetime and include post-traumatic stress disorder, depression or suicidal thoughts in adulthood. Not addressing their needs early on is just creating a time bomb of mental health problems. Sadly, the availability of specialist services that meet the needs of abused children, when they need it, do not appear to have kept pace with this growth in understanding of the crime. There is a vacuum that needs to be filled and it needs to be a national and local priority.

"Children and Adolescent Mental Health Services are just one part of the jigsaw and it's clear the current range of support available does not meet the needs of many abused and neglected children. Often children who are suffering with the consequences of what's been done to them won't necessarily meet a medical threshold but the emotional and psychological fallout of their abuse can snowball and get more severe in years to come. Desperate and frightened about their feelings, but unable to access services, some of these children call ChildLine. More and more victims of abuse are speaking out and we need to match their bravery with more specialist therapeutic support that is age-appropriate and there for children and young people, for as long as they need it."

The NSPCC's ChildLine service recently revealed it had received nearly 100 contacts a week last year from children who have been abused and whose mental health and wellbeing are suffering as a consequence. Previous research by the charity has found huge gaps between the estimated need for services by victims of sexual abuse for example and service availability.⁴

The NSPCC's state of the nation How Safe 2015 report, revealed the number of sexual offences against children recorded by police in England and Wales soared by more than a third last year (2013-14), with the number of children referred to social services also soaring.⁵

Response from Royal College of Paediatrics and Child Health (RCPCH)

Responding to the NSPCC findings on the number referrals of children and young people to local specialist NHS mental health services, Dr Max Davie, a consultant Community Paediatrician from the Royal College of Paediatrics and Child Health (RCPCH), said:

"This adds further evidence to the concerning picture of the state of child and adolescent mental health services (CAMHS) in the UK. With 1 in 10 children in the UK having a diagnosable mental health disorder and 75% of mental illness in adult life starting before the age 18, prevention and early intervention is critical. If help is not given early, the lifelong impact can be catastrophic.

"It is encouraging to see Government put mental health high on the agenda and commit to a refresh of the BCAMHS prevalence survey - and it's also good to see for the first time a shadow health minister dedicated to mental health. But politicians and need to do more than talk a good talk. We know there is a shortfall in resources, and effective CAMHS can only be delivered by addressing workforce and training issues to plug the growing gap between physical and mental health services. We know that there are problems with transition services; so there must be joint commissioning between mental health services for children and adults and shared commissioning approaches at a regional level to ensure a seamless pathway. And we know that factors such social deprivation and disability can have an effect on mental health which in turn can have a negative impact on health and educational attainment - which is why we want to see the development of a unique identifier for children and young people across sectors so vulnerable young people do not fall through the gaps. "There is clearly a growing recognition that the scale of mental ill health amongst children and young people is spiralling. The challenge now is to put the effort, money and resources into solutions that will make a real difference."