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Alison Michalska: A storm is brewing in children’s mental health

Alison Michalska
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Around one in 10 children in the UK have a diagnosable mental health condition.

Early access to support will help secure better outcomes for children across the course of their lives but children’s mental health services are too often unavailable and inaccessible, children face unacceptable delays and children in care can even be refused help due to issues with their placement. This can cause the mental health of many children and young people to deteriorate and reach crisis point.

A raft of reports in recent years have highlighted well-known issues in the current mental health system but we have not yet seen a radical improvement in the accountability of the system and the effectiveness, availability and reach of services which support children’s emotional health. The need is clear for a shift away from focusing on diagnosing mental health problems towards early help and prevention, as is the need for flexible services available when and where children and young people need them. We are losing vital opportunities to transform services and, fundamentally, to improve outcomes for children.

In October, the Care Quality Commission published findings from its review of the children’s mental health system. The report evidences ‘good’ and ‘outstanding’ services where the system is working well but recognises that there is too much variation in the quality of care children and young people receive. More recently, the Expert Working Group (EWG) on children’s mental health published its report on improving the mental health of children in care. The EWG’s focus on this cohort of children is most welcome as is the report’s strong focus on children being at the centre of decisions made about their care. The EWG also described areas of good practice and found disparity in the quality of and access to these services.

The Institute for Fiscal Studies estimates the number of children living in poverty will be 5.1 million by 2022 and evidence suggests children living in poverty are several times more likely than their wealthier counterparts to suffer from poor mental health by the age of 11. This is a perfect storm waiting to happen if we do not radically improve the system now.

Whist we welcome the government’s commitment to tackling poor mental health, the Association of Directors of Children’s Services hopes the government’s forthcoming green paper on children’s and young people’s mental health sets out a clear, child-focused strategy on how mental health will be improved now and in the future. This must result in transformative action on the ground, consider the need for sufficiently funded services and address challenges in accessing specialist in-patient placements for children and young people with the highest level of need, otherwise known as tier 4. Without this, we will be doing our children and young people a great disservice.

Alison Michalska, 2017-18 president, ADCS and corporate director children and adults, Nottingham City Council

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