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Child mental health services are a postcode lottery, finds study

Children who need ‘low level’ mental health services for conditions such as depression and anxiety or eating disorders face a significant postcode lottery, a report has warned.

An investigation by the Children’s Commissioner into spending on prevention and early intervention services in 2018/19 found while a quarter of areas are spending £1.1 million or more, the bottom quarter spent £180,000 or less.

Figures collected for the report from local authorities, public health bodies, children’s services and CCGs found funding for services had dropped in real terms in a third of areas.

And 60% of local authorities had cut their funding in real terms in recent years.

Overall £226 million – or £14 per child – was spent last year on programmes including support provided by school nurses or counsellors, drop-in centres, or online counselling services.

CCGs had allocated roughly £103m of the total spent on services designed to stop mental health conditions developing into more serious illnesses, the report found.

But while some CCGs were spending £680,000 or more on low level mental health services for children others had only allocated around £140,000 or less.

In the North of England CCGs spent £12.76 per child compared with Midlands and the East which spent £5.83 per child.

Anne Longfield, the Children’s Commissioner for England, warned that despite more funding being made available nationally for children’s mental health the system continues to fail to help until they are so unwell they need specialist intervention.

‘This report reveals for the first time the postcode lottery facing the increasing number of children suffering from low-level mental health conditions like anxiety and depression.

‘It is extremely worrying that a third of local areas in England are actually reducing real terms spending on these vital services.’

She added that while the NHS Ten Year Plan made children’s mental health a top priority, ‘it won’t succeed unless children with low-level mental health problems are offered help quickly and early’.

‘Local authorities are under huge financial pressure and many are doing a good job, but those who are spending barely anything on low-level mental health cannot continue to leave children to struggle alone.’

BMA GP committee chair Dr Richard Vautrey said: ‘This is a major area of concern for GPs, who are often faced with trying to provide support for children and their parents or guardians, but all too often the services to refer to are limited or with long waiting lists before assessment.

‘There can also be confusion in some areas relating to whether mental health support is delivered through school-linked services or NHS services.

‘With many schools under significant financial pressure, this can lead to budget squeezes on what is essential mental health care.’

He added: ‘It’s vital to invest in mental health services for children, as early intervention can make all the difference, not just for the child but the wider health, social care and justice systems.’

Dr Nick Waggett, chief executive of the Association of Child Psychotherapists, said: ‘We welcome the Children’s Commissioner’s report that provides further evidence that children suffering anxiety, depression and other mental health conditions face a postcode lottery when seeking treatment. There are great disparities in local spending to meet the needs of children, young people and families both in the early intervention services highlighted in this report, and also in more specialist provision.

‘We would however caution against the use of the phrase “low-level” in relation to the difficulties that are being seen in primary care. Many children and young people seen in the community will have complex needs and complicated networks of care that require skill and experience to manage. “Mild” presenting symptoms, whether emotional, relational or behavioural, may mask some very troubling underlying problems.’


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