Better Care for Children and Young People – the UK has been failing Families and Young People for Decades

“The Child is Father to the Man”, expressed by Wordsworth in 1802 must have been a commonplace thought even earlier than that, despite “breeding” having long been almost universally held as the dominant factor in the development of young people and in fixing patterns of behaviour throughout their subsequent years. But
Wordsworth certainly popularised this thought, which speaks so uccinctly to the importance of early experience in setting trends for adolescent and post-adolescent development and behaviour.

it is difficult, controversial and posssibly futile to prescribe an optimal development path for every child’s journey from child to adulthood, but it is somewhat easier to recognise negative treatments, adverse circumstances and cognitive or psychological disadvantages that can hinder their social, emotional or intellectual development.

However, there are lots of situations where society can recognise problems that, through timely diagnosis, treatment, counselling and advice, can be mitigated. Poor emotional wellbeing and mental health in children, for example, can often be improved by timely intervention. Distressed and bewildered young persons and their families can benefit from sympathetic explanations, diagnoses and coping strategies. Even more importantly, they can often be helped to recognise talents and benefits sometimes hidden within the person’s personality by superficial behavioural and motivational difficulties.

Early interventions like this can usually reduce much distress, frustration, unhappiness and the sheer misery which can so often blight a young person’s family and damage their own personal future.

As former or present county councillors many of us feel that the kindest way we can describe Hertfordshire’s perfomance in caring for children and young people is that it has spent many decades in barely producing an average performance within a country notorious for its lack of interest in, and provision of specialist help for, cognitive and mental health problems in the young.

With this in mind, in early 2020, the Herts County Councillors Ron Tindall and Nigel Quinton proposed and seconded a motion to Hertfordshire County Council commenting on the early responses to an improvement plan and committing the authority to further improvement to its own service delivery and to working through the Local Government Association to raise the government’s awareness of the importance emotional wellbeing and mental health services for children and young people.

This motion, which was carried, read as follows:

” 1. This Council notes:

(i) The CAMHS Provision Update report was considered by the Children, Young People & families Cabinet Panel on 12th November, 2019;

(ii) That the CAMHS Transformation Plan programme has been in place since 2015 and in some performance areas has had difficulty in meeting its targets;

(iii) That in 2018/19, CAMHS Specialist Services accepted only 4147 out of 9365 referrals and the current wait for assessment is 7 weeks compared to a target of 4 weeks. Ratios for other children’s mental health services, Step 2 and PALMS, were equally challenged. In 2017/18 and 2018/19, Hertfordshire met the NHS targets for access to all NHS funded provision, 30% and 32% respectively;

(iv) That NHS targets remain low so that only 34% of children who would benefit from help will get access, and that Hertfordshire will meet this, but will not exceed it. The NHS Long Term Plan sets out to provide support to 100% of those who need it:

(v) That schools are increasingly concerned about the strain that the poor mental health of students is plcing on their resources;

(vi) That the delivery of emotional wellbeing and mental health services for children and young people in Hertdfirdshire is undertaken by several NHS bodies, the County Council itself and third sector providers; and

(vii) That the emotional wellbeing and mental health services follows a Thrive Model, looking across the whole system from Early intervention and prevention to the top tier of CAMHS sevice bprovided by the Herts Partnership Foundation Trust (HPFT).

2. This Council is concerned that children and young people with mental health needs are currently having to wait many weeks for treatment and, in many cases, often not receiving any treatment at all.

3. Therefore this Council

(i) Calls for the Health Scrutiny Committee to include in its Work Programme an examination of how mental health services are commissioned and organised. This scrutiny could include consideration of approaches used by other council and NHS clinical commissioning group areas, for example the Lambeth Living Well collaborative and the cornwall Children’s Services’ HeadStart Kernow Partnership;

(ii) Acknowledges that Hertfordshire schools are under increasing financial and workload pressures and calls for greater NHS support to schools in respect of CAMHS;

(iii) Recognises that the challenges of addressing children’s, young people’s and family emotional wellbeing and mental health services, including Early Intervention and prevention, requires appropriate resourcing; and

(iv) Will continue to work with the Local Government Association to ensure that the importance of the wellbeing of children and young people is recognised by the incoming government.”

Background

1. 10% of children and young people (aged 5-16 years) have a clinically diagnosable mental problem (ONS 2004)

2. 20% of adolescents may experience a mental health problem in any given year. (WHO 2015)

3. 50% of mental health problems are established by age 14 (USA research, 2005)

4. 75% of mental health problems are established by age 24 (USA research, 2005)

5. 70% of children and adolescents who experience mental health problems have not had appropriate interventions at a sufficiently early age (Children’s Soc., 2008)