Posted 9th October 2015
Surely we can’t go on ignoring the data? It has long been known that “half of lifetime mental illness (excluding dementia) have already developed by the age of 14”[i]. Our adult mental health services are overflowing, and large numbers of the ill are ending up in police custody or in prison, where the suicide rate is 15 times higher than in the general population[ii]. “Too many vulnerable young people are slipping through the net of mental health and welfare services and ending up behind bars. Very many of the tragic deaths could have been prevented by thorough assessment and intervention at an earlier stage in these young peoples’ lives. Time and again this is what bereaved families say after struggling for years to get the help they need.”[iii]
But simultaneously, child and adolescent health services have been cut, with schools and other services having to step into the gap. Following the swingeing cuts of 2010, two thirds of local authorities reduced their CAMHS budgets. Early intervention services and voluntary sector were especially badly hit. In 2014, one Head wrote: “There is so much more pressure on schools and teachers to deal with children’s mental health and behavioural problems. We provide as much support as we can but, with fewer resources available and a massive increase in need … the pressure has been incredible.”[iv]
Both Bridge in Schools and The Bridge Child and Family Service are registering the impact. The level of risk and complexity of the cases seen in both services has shot up, because it has got so hard for families to get specialist NHS help, when services have to be ring-fenced for those already in crisis.
Working with our colleagues in CAMHS, we see early intervention as a key priority for the future. This means a return to serious commissioning of Tier 2 services for children in the younger age range. There is a worrying gap opening up now between services for under 5s and services for 11 – 16s. Unless this is bridged with good mental health support for children of primary school age, we can expect more or our 14 year olds to be on track for a lifetime of mental illness.
[i] Dept of Health, 2012
[ii]Dept of Health 2014
[iii] Juliet Lyon, Director of the Prison Reform Trust, 2015 – in response to Changing Prisons, Saving Lives: Report of the Independent Review into Self-inflicted Deaths in Custody of 18-24 year olds
[iv] Joan Cunningham, cited in The Guardian 15 April 2014.