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Two-thirds of GP referrals for child mental health lead to no treatment

Exclusive An increasing number of vulnerable children are being refused vital mental health treatment that is recommended by their GP, finds a major Pulse investigation.

Figures obtained from 15 mental health trusts reveal that 60% of GP referrals to child and adolescent mental health services (CAMHS) lead to no treatment and a third are not even assessed.

The situation for young people with mental health issues appears to be worsening, with the numbers of referrals that progress to treatment decreasing from 44% in 2013 to 39% in 2015.

GPs told Pulse that CAMHS were refusing to treat patients unless they had attempted suicide or self-harmed. Many cases are being sent to school counsellors or charity services, when GPs have requested specialist input.

The figures come despite Government promises to increase access to mental health services for children, with an increase in funding of £1.4bn and a call to all regions to produce plans on how they are going to work together to improve CAHMS services.

The freedom of information requests to mental health trusts found that in Norfolk and Suffolk NHS Foundation Trust the number of CAMHS referrals progressing to treatment was 20%, down from 46% in 2013. At Leeds and York Partnership NHS Foundation Trust the proportion treated fell from 42% to 26%.

Dr Karen Cox, a GP in Bristol, said: ‘Recently all referrals seem to get bounced. They’ve included children who self-harm, a child who was physically abusing his mother and a child with severe night terrors after the loss of his father. All of them were advised to contact local charitable organisations.’

Dr Dominique Thompson, a GP in Bristol with special expertise in young people’s mental health, said the findings show the system is ‘failing the next generation’.

She added: ‘We risk our CAMHS becoming a source of national shame if they continue to be so poorly resourced.’

Dr Faraz Mughal, RCGP clinical fellow for young people’s mental health and a GP in Solihull, told Pulse that often charities and school counsellors are not the right people to be treating these children.

He said: ‘GPs are at the frontline of the NHS and treat so many young people with mental illness, and are trained to identify their needs. If they think further expert input is required then GPs really need to be supported in that.’

NHS England chief executive Simon Stevens last month told the NHS Confederation conference that CAMHS was the ‘most creaking’ part of the NHS mental health sector.

A Department of Health spokesperson said: ‘No child who needs help should be refused it. That is why we have introduced the first-ever mental health access and waiting time standards and are putting in a record £1.4bn to transform support for young people.

‘This investment is just beginning, so will be making an increasing difference in the years ahead – every area in the country has produced plans on how they are going to work together to make sure young people get support before they reach a crisis point.’



Readers' comments (11)

  • As revelations go, the idea that CAMHS reject lots of referrals is up there with Papal Catholicism. We've now got a form letter we send to parents, the CCG and back to CAMHS explaining our impotence in the face of "computer says no" rejections before the child is even seen. We get a nice colourful flowchart explaining what they will and won't see with our reply. I usually tell patients to book in with their MP. I thought this would stop when GPs were put in charge of services via CCGs. I see no difference. Thank god I have eight months to go till I'm done. Real harm is being done here. Still, as long as my ladder protocol is up to date, all is right with the world. Joke.

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  • The only reason this isn't terrible news is that sadly it isn't news. Every GP I know has this experience with CAMHS on a regular basis. I've had calls from CAMHS following referrals for very serious issues asking ME or my colleagues to downgrade the referral because they cannot see the patient in time to meet the timeframe required, or they have decided that they don't think it's that serious...without seeing the patient. Interestingly when other specialities downgrade a referral they just do it themselves, they don't ask us to take responsibility for their decision. Either way the patient often still gets bounced. CAMHS is all about workload management, not work.

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  • “Being turned away or not listened to when seeking help, only reinforces patients’ feelings of rejection and hopelessness and can drive them to suicide.” (Quote)

    The following 10 minute feature involving a Psychiatrist and a GP, will provide you with an alternative medical perspective on this serious problem.

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  • Mental Health Trusts are only doing what the rest of us should be doing. They defined what they can do with the funding they receive and dropped the rest. I too would like a private jet but my wallet says no.

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  • More than half the referrals are bounced back to GPs.At other times the parents are directed to online parent classes provided by private contractors.Basically the mental health services up and down the country are in a state of complete collapse.I was talking to a CPN recently who has a caseload of 72 patients!That's how bad things are and not surprisingly they're quitting in droves

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  • Most of my referrals are refused and do not meet citeria.

    When seen is not by a specialist doctor but is triaged and never appropriately assessed or followed up . Mr Hunt this Not acceptable.

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  • Vinci Ho

    Vinci Ho | GP Partner04 Jul 2016 7:34pm

    Despite what the coalition and pre-referendum governments(my new terminology)have been bragging about 'investment of attention' on mental health and more specifically in children and young people , probably only frontline GPs can really see the true meaning of this fallacy . The same old story ('they will only be seen if they are really psychotic , not just low in mood' and more contemporary , how hard you can refer to adult follow up services for these teenagers with ADHD or Austistic Spectrum Disorders grown older ) is highly prevalent in the whole country.
    We know better because we know the child and the family long enough to see how heart sinking when the referral is 'bounced back'. Yes , I am 'exploiting' the virtue of continuity of NHS General Practice only because those in the hierarchy specifically the SOS and DoH are simply arrogant and ignorant. We cannot blame our mental health colleagues who have been working their socks off to sustain the services but this forthcoming post referendum government has ten thousand questions to answer .....

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  • The situation is dire but it's not the fault of the people who've been tasked with providing the service. We shouldn't blame psychiatrists for the fact there aren't enough of them. It's down to the fact the service is totally underfunded at a time when public attention and interest in 'mental health' problems is rocketing. There is a vast and seemingly inexhaustible demand for mental health support for young people. Stoacked by who knows what.

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  • The running down of the ChildAvoidanceMHS is a national disgrace. I've long since given up referring these poor children, the false hope in the desperate parents' eyes dashed when their referral is rejected is just cruel. And even if by some miracle one storms the gates into the Promised Land of CAMHS they are always discharged after first consultation. I only wish the harassed staff at CAMHS would be more honest about their plight, but they still claim to offer a full service despite the obvious evidence to the contrary.
    Sadly it will take many more childrens' "successful" suicides to hit the headlines before this dangerous, dire and depressing disgrace will be properly addressed.

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  • The investment, if and when it happens, will be too late for my eldest grandchild, failed by the system, school and CAMHS, with ADHD behavioural problems. Seen once by a psychiatrist in 5 years, useless unqualified support workers, unhelpful social workers.A bright lad who has had to be home schooled because of the confrontational methods at his school.

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