There is strong and detailed evidence of the deterioration of youth wellbeing in the UK. According to the Commons Health Select Committee, the number of young people receiving treatment has risen from 25% to 40% from pre to post pandemic.
It has also been reported by the BBC, that since 2019 at least 20 patients under the age of 18 have died in NHS or privately run Child and Adolescent Mental Health Services (“CAMHS”) units. 18 of these deaths were in England, with 14 in NHS units and four in private units. This is more than a 200% increase in deaths per year from data gathered between 2010 and 2014 in England and Wales, which reported only nine deaths. Further, after being released from these units another 26 patients were reported to have died within a year, according to date from NHS Trusts.
State of Youth Mental Health Crisis
It has been estimated that 1.5 million under 18’s will need extra help with their mental health because of the pandemic.
According to data from the Children’s Society, 7% of all 10-15 year olds are unhappy. Some key causes have been noted and include; school, appearance, damage by social media, friends, bullying, problems at home, and sexual assault. The NHS has also seen a 77% rise in children needing specialist treatment for mental health. It seems that the pandemic has only acted as a catalyst for these issues due to the nature of the lockdowns and forced social isolation as part of nationwide public health measures.
The NHS Digital’s survey, which was published in September 2021, revealed that the number of under 18’s who were in touch with mental health services rose by just over 20% to 650,000 after the pandemic. It also found that the rates of mental health disorders in 6 to 16 year olds increased from 11.6% in 2017 to 17.4% in 2021. It further found that 39.5% of that same age group experienced a downturn in their mental health with only 21.8% reporting and improvement.
Pressures on the Resources
CAMHS units look after 4000 patients with the aim of assisting recovery by offering specialist care. However, it appears that these units cannot keep up with demand and that patients are often in and out of these units for many years.
Patients are often rejected from CAMHS units on the basis that they are ‘ill enough’ and there are delays as long as 81 days for potential patients, meaning the mental health issues they experience become more entrenched by the time they receive treatment and support.
First-hand accounts from patients and their families detail how they have experienced lack of proactive engagement from providers in care decisions, failure to follow and read care plans, and minimal psychological support. This culminates in an overall reactive approach to these problems and the risks they pose as opposed to a preventative approach to discover the root causes of these behaviors and help mitigate them.
There are also fears that patient safety is more at risk due to heavy reliance on temporary staff. Recent BBC data shows that in 32 out of 41 areas with NHS run CAMHS wards, spending on agency nurses rose by 72% from 2017 to 2021.
The BBC has also heard claims of unsafe discharge from CAMHS including incidents of serious self-harm incidents or attempted suicide within days of being released. Parents have also reported having to resort to ‘suicide watch’ to ensure the safety of their children.
Dr Bernadka Dubicka, Editor in Chief of the Journal of Child and Adolescent Mental Health, has stated that post discharge is one of the most risky periods in a young person’s life, however there is not enough intensive support from community CAMHS teams in large parts of the country for patients returning home. Dr Dubicka also attributes this rise in need to the pandemic and states that chronic underinvestment throughout the years coupled with the pandemic has created the perfect storm for such a crisis.
At the heart of this, as with many other issues currently affecting the health and social care sector in general, is underfunding and understaffing.
According to Dr Dubicka a good standard of care will provide positive outcomes for people in the inpatient system. However, this is contingent upon proper funding to provide the staff and resources necessary to effectively treat and support these young people.
CAMHS beds cost £230,000 on average – Dr Dubicka says this would be better spent on community provisions. Thus, a more proactive approach as opposed to the reactionary approach we are used to. The Department of Health and Social care is also working to recruit 27,000 new mental health professionals by 2024.
More money is going into children’s mental health services and NHS England is making progress using new support teams to provide help in schools and colleges, so not all hope is lost. However, there are still care gaps and it would be naive to think that the NHS is able to cope, without further support and with the increased demand in light of the effects the pandemic has had.