Euan Cook explores how extended waiting lists for mental health services have affected children’s wellbeing during the pandemic.
Photo by Juan Pablo
The Covid-19 pandemic has been extremely damaging for everyone’s mental health, particularly our younger generation. Forty-nine per cent of young people seeking mental health support waited more than four weeks to be seen between April 2020 and March 2021, leaving many feeling abandoned by the system. The longer the wait times, the more vulnerable children will be.
The NHS has historically struggled with limited funding and soaring waiting times. Increasingly longer periods between referral and treatment can be attributed to the legacy of the Conservative-Liberal Democrats coalition government in 2010, which instigated a decade of austerity funding for the NHS.
With a squeeze on capital funding and consequent staff shortages, the NHS today is short of approximately 100,000 nurses and doctors, contributing to limited access to mental health services.
For every 100,000 patients in England, there are just 246 hospital beds available. Compare this to Germany’s health care system, for example, where there are 800 beds per 100,000 patients, and the deficiency is evident. How can we expect our public health service to adequately refer and treat “distressed” children who suffer from mental health disorders, especially when they end up in A&E with nowhere else to go?
Buckling Under Pressure
The Child and Adolescent Mental Health Services (CAMHS), run by the NHS, offered treatment to 420,000 young people during 2020-21, despite 1.5 million under 18-year-olds suffering from mental health disorders.
Lockdowns and proto-online education have led to children struggling with “isolation, loneliness, and concerns about the future”, inducing a cascade of referrals to mental health services. With limited funding and limited workers to fight this battle, the NHS simply cannot survive in the current climate.
Half of those who were seen by CAMHS waited longer than four weeks, while a fifth waited more than 12 weeks. Although the average waiting times floated around 2 months across the nation, some cases topped the 8 month mark, which is simply unacceptable.
According to a CareQuality Commission, it is “unusual to rate a service as good” if the national standard of waiting times—between referral and treatment—exceeded 18 weeks. Currently, Regulation 17 of the Commission has been breached, as the “provider is not managing the waiting list well [and] does not operate an effective system”.
Unhappiness Amongst the Young
If children are not receiving desperately needed treatment for their mental health, there are fears that our younger generation will continue to struggle with their wellbeing as they grow into adolescence.
According to a survey sampling more than half a million children, orchestrated by England’s children’s commissioner Dame Rachel de Souza, 57 per cent of children aged 9-17 are happy with their mental health, while one in five young people are unhappy. De Souza’s survey concluded that 40 per cent of girls aged 16 to 17 are unhappy with their mental health, more than double the statistic for boys.
The severity of young people’s mental health has been highlighted by the headteacher of Moon Hall School in Surrey, Michelle Catterson. One of her students attempted suicide earlier this year, but they could not be seen by a professional. The student’s family was unfortunately cornered into paying for private healthcare due to excessive waiting times. Families that are already experiencing financial inequalities will, therefore, be “disproportionately affected” by this waiting time crisis, emphasising the dire need for accessible services to tackle the exponential rise of unhappiness in our younger generation.
A Three-Year Resolution Plan
Despite Regulation 17 being breached, the government arguably has an “effective plan to resolve the problem”. NHS England has promised it is investing in existing mental health services, which, by 2023, would support an additional 345,000 children. Although 735,000 children are excluded from this scheme, pumping an additional £40m into CAMHS is a step in the right direction. Staff will be provided with adequate mental health training, including the implementation of necessary support networks to prevent children from being directly admitted to hospital.
Education has also not been forgotten. De Souza has endorsed a “comprehensive” three-year catchup package for schools, calling for improved services for children struggling with attendance, faster implementation of tutoring support and a voluntary “third session” for the school day incorporating catch-up lessons and extracurricular activities. Ultimately, de Souza has called for upwards of £5.8bn to tackle children’s mental health disorders across the country.
De Souza praises the younger generation who has grown up during a global pandemic. They have “seen how colossally frightening life can be”, and deserve the very best health care to thrive in the future. This is certainly “not a ‘snowflake generation’”, she concludes, but rather a “heroic generation”. Pragmatic, civic-minded, yet vulnerable.
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