A growing number of children and young people in Brighton and Hove are showing signs of being mentally ill, according to a report being discussed by health chiefs today (Tuesday 26 May).
Hospital admissions for self-harm have risen and are significantly higher than the national average.
And thousands of children in Brighton and Hove have had a mental health condition diagnosed.
Health chiefs are carrying out a review over the next few months with the aim of bringing in improvements from September.
A report to the Brighton and Hove Clinical Commissioning Group (CCG) board said: “All services demonstrate an increase in demand from children and young people for mental health and wellbeing support, assessment, treatment and intervention.”
Criticism has been levelled locally and nationally at Child and Adolescent Mental Health Services (CAMHS).
The CCG report said that while CAMHS “appear to be achieving their access targets, namely, urgent referrals within 24 hours, 4 weeks from referral to assessment and 18 weeks from referral to treatment, this does not reflect the feedback we have received from users and stakeholders who feel it is difficult to access the service”.
It added: “The CCG recognises that this is not acceptable in terms of early support, availability of evidence-based treatments, good outcomes and potential for children and young people to ‘fall through the net’.”
The report said: “Locally we have specific needs around mental ill-health in Brighton and Hove.
“The population (0-19 year olds) of Brighton and Hove is 58,600 with an estimated 3,095 children (5-16 years) with a mental health disorder such as conduct disorders and 1,195 children (5-16 years) with emotional disorders.
“We have higher levels of mental ill-health in young people in Brighton and Hove. In 2012-13
- There are significantly higher rates of hospital admission for self-harm for young people aged 10 to 24 in Brighton and Hove. Over the three years from 2010 to 2013 the rate per 100,000 young people rose from 423.6 to 454.7 compared to 352.3 for England.
- 13th highest looked after children per local authority in the UK.
- Nearly 50 per cent children in local authority care and nearly 70 per cent living in residential care have a diagnosable mental disorder.
“Until October 2014 Brighton and Hove Clinical Commissioning Group (CCG) delegated the commissioning responsibility to Brighton and Hove City Council for children’s mental health and wellbeing services. The CCG has now taken on full commissioning responsibility.”
The CCG spent about £2.5 million on CAMHS locally last year and a further £756,000 on early intervention work.
It was unsure how much was being spent by schools and GPs who tend to be in the frontline in dealing with children who are or seem mentally ill.
Nor did the CCG know how much was being spent on local patients with more serious problems.
Traditionally mental health has been regarded as something of a “Cinderella service”, receiving a disproportionately low level of funding.
The former Care Minister Norman Lamb, a Liberal Democrat member of the coalition government until earlier this month, set about tackling the disparity.
The CCG report said that the budget for dealing with mothers suffering from post-natal depression would double in the current financial year.
And it added: “There is a 12 month pilot starting in September 2015 changing the way that (the) community Child and Adolescent Mental Health Service team interacts with schools.”
The report also said: “Over the last seven months the CCG has become aware of multiple stakeholder and patient feedback in Brighton and Hove that reflects the national picture by outlining
- A system that is difficult to access, such as waiting times, criteria and thresholds
- The desire for a more coordinated multi-disciplinary approach closer to home
- Better/clearer information about services available
- More emphasis on early intervention
- A clear pathway for crisis and out of hours
- A clear pathway for transition to adult services
Nationally, there is a great deal of focus on children’s mental health services, recognising this is an area where improvements need to be made. National themes included
- Significant gaps in data and information and delays in the development of payment and other incentive systems;
- The treatment gap – less than 25 to 35 per cent accessing treatment they need
- Difficulties in access such as waiting times, criteria and thresholds, and includes difficulties in accessing “tier 4” inpatient beds
- Complexity of current commissioning arrangements, a lack of clarity on accountability;
- Variable access to crisis and out of hours care
- Specific issues for more vulnerable groups of children and young people
“Brighton and Hove has fairly few children and young people in out of area inpatient beds – nine in 2014-15.
“Improving the mental health and wellbeing of children and young people in Brighton and Hove is a CCG priority.
“While there are fantastic services in pockets across the city, they are working in isolation and in a fragmented way, not necessarily together as a whole system
“The services are often reactive rather than proactive and not always able to respond to need.
“The CCG, therefore, plans to carry out a joint strategic needs assessment (JSNA) and a whole system review and service redesign of children and young people’s mental health and wellbeing services.
“The JSNA should conclude in September 2015. The recommendations from the JSNA and review will inform commissioning intentions in 2016-17 and beyond.”
Forgive me at treating this cut-and-pasted press release with a pinch of salt. I would like to know what these thousands of 5 year olds have actually been diagnosed with before branding them as “mentally ill”. Call me a cynical old git, but are we sure we’re not “medicalising” various types of behaviour and personality that in previous decades would not have been classed as an illness? And how are these mental illnesses being treated? Are 5 year old being prescribed with psychiatric drugs?