Over a quarter of referrals to specialist children’s mental health services were rejected in 2018-2019, according to research by the Education Policy Institute.
Despite an extra £1.4bn bring invested in children's mental health between 2015-16 to 2020-21, approximately 133,000 children and young people were turned away from specialist help usually because children’s conditions were deemed not suitable for treatment, or because conditions did not meet eligibility criteria.
"There is considerable regional variation in England. On average, providers in London rejected 17% of referrals, compared to 28% in the South, the Midlands and the East, and 22% in the North," said the report.
The research is based on data from freedom of information (FOI) requests to mental health providers and local authorities over a year.
It warns that the majority of lifelong mental health problems develop early on, during childhood or adolescence, while the wider economic costs of mental ill health in England are estimated at £105bn each year.
The report highlights that nationally, the average median waiting time to begin treatment has fallen by 11 days since 2015, but children still waited an average of 56 days to start treatment in 2019 – which is double the government’s four-week target.
The report adds that the government is unlikely to meet its target of four weeks by 2022-23.
The longest median waiting times to receive treatment were in London at 65 days whereas the shortest waiting times were in the Midlands and East of England at 49 days. The report says this is likely to be related to the high number of referrals accepted for treatment in London.
There were also great disparities across local Child and Adolescent Mental Health Service providers, with many children facing "unacceptably long waiting times".
Median waiting times for treatment across mental health providers varied from one day to 182 days.
Providers in England with the longest median waiting times for mental health treatment are:
West London Mental Health Trust – 182 days
South Tyneside and Sunderland – 129 days
Alder Hey – 124 days
Leeds Community Healthcare – 117 days
Northumberland, Tyne and Wear – 116 days
"Local commissioners and providers of mental health support services often fail to engage with the most vulnerable children and families. Local provision is patchy and lacks accountability, being dispersed across several organisations. Support for children with less acute, common mental health conditions, such as conduct disorders, as well as those in social care, is insufficient," said the report.
The report also cites a lack of support from local authorities for young people transitioning from CAMHS to adult mental health services. In fact, only a minority of local authorities have specific services dedicated to supporting this vital transition.
The EPI calls on all mental health providers to be required to report regularly on their services and says there are multiple flaws in the current system for reporting and disclosing basic data on CAMHS in England, raising serious questions about transparency and accountability.
Providers continue to give inadequate information on access to treatment, obscuring any understanding of the state of services and ability to monitor progress.
"A universal system for reporting data on access to CAMHS, including a clear definition of children who are eligible for treatment, is urgently required. Failure to introduce stronger accountability measures may hinder the government’s plans to improve services," the report concludes.
Access to child and adolescent mental health services in 2019