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Independents' Day

GP practices failing to spot mental ill health in children, claims CQC

GPs sometimes lack skills or capacity to identify mental health problems in children and young people, the CQC has warned.

The health inspector’s in-depth inquiry into Child and Adolescent Mental Health Services (CAMHS) found that on the whole, these are ‘complex and fragmented’ throughout England.

The review, ordered by Prime Minister Theresa May in January, concluded that:

  • Availability of services varies vastly in different areas depending on what was commissioned locally;
  • Children in vulnerable circumstances, including those in care or with learning difficulties, ‘can find it particularly hard to access care’;
  • There are ‘significant challenges’ in accessing intensive and specialist care where needed;
  • Children and young people are sometimes admitted far from home because inpatient bed demand outstrips supply; and
  • There are ‘long waiting lists’ for specialist mental health services in the community.

Regarding the input of GPs, the report said workload and workforce problems, as well as knowledge gaps, sometimes affected detection of mental health problems in children and adolescents.

The report said: ‘Those who work with children and young people – in schools, GP practices and A&E, for example – do not always have the skills or capacity to identify mental health problems or help children and young people access the right support at the right time.

‘Heavy workloads, difficulty in recruiting and retaining staff, and gaps in knowledge and skills all contribute to a situation where services miss opportunities to support children and young people’s mental health and detect mental health problems.’

The CQC will now launch a second phase of its review of CAMHS, which will explore ‘barriers and enablers to improving quality and access in children's mental health services'. It said this will result in a final report next spring with recommendations for improvement.

This comes as GPs were earlier this year accused by a think tank of referring 'too many' patients to already oversubscribed CAMHS services.

It also comes as a Pulse investigation revealed last year that 60% of child mental health referrals by GPs to English trusts did not lead to any treatment.

And in Scotland, one in five referrals made by GPs to children’s mental health services is bounced back according to official figures.

Readers' comments (4)

  • Vinci Ho

    Interested to read your comments on this....

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  • OK I'll start.
    CQC continue to fail to spot own significant failings.

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  • Maybe the funding set aside for these interminable and solutionless CQC reviews could be diverted towards developing a few more CAMHS inpatient units or even improving staffing and funding for front line CAMHS. Where I work, there is no CAMHS inpatient unit less than two hours' drive away, and I can't conjure one up if one of my patients needs admission and their family has other challenges that make travelling that far from home to visit impossible.

    Furthermore, once upon a time I chose not to do child and adolescent psychiatry for a living because I accepted that I was temperamentally unsuited to it, and I suspect it would do troubled children no good at all if I "recognised" them and, in the absence of sufficient CAMHS resources, blundered around trying to treat their mental health problems myself. I'm not sure whether that's being suggested here, but I'm not sure WHAT is being suggested apart from "more studies".

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  • as with any other specialities, there is no reason to expect us to instantly develop 'skills and capacities' for a specialty just because the specialist services no longer have the capacity.Training GPSIs ?
    Might help but means taking GPs away from things they should be doing and this is certainly not an area which should default to GPs Without a Special Interest!

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