“..a brutal and potentially fatal form of healthcare rationing”. It should be the politicians with “an inability to face the outside world” rather than the patients..

The Times leader refers to “..a brutal and potentially fatal form of healthcare rationing”. It should be the politicians with “an inability to face the outside world” rather than the patients.. We can raise as much money as is needed for cancer, which is also rationed (Viz: there are hospices in richer areas, but not in poorer ones), and children normally evoke much sympathy. Unfortunately the children with mental health needs come from families that are seen as least deserving. If we wish to have fewer children in care as offending as teenagers, we need to challenge the right to parent badly, and this would also help prevent some of the psychiatric problems. At the same time we do need to provide more child psychiatry services and if this means co-payments for other services – so be it. Without reference to means is meaningless…

NHS Perverse Incentives

Rosemary Bennett reports 28th May 2016: NHS refuses to treat children with life-threatening mental illnesses

Children who attempt suicide, suffer from psychosis, severe anorexia and other life-threatening mental illnesses are being refused specialist treatment by the NHS despite being referred by their GP, a report by the Children’s Commissioner for England has disclosed.

Anne Longfield called the situation desperate and described services as unresponsive as she revealed that one in eight classified as having a “life-threatening condition” was turned away by their mental health trust last year. Even those with the most serious illnesses who did secure treatment faced long delays, with the average waiting time 110 days for children in this category…..

The Times leader of the same day reads: Mind the Gap – Promises to improve mental healthcare for young people are not being kept

There is a “gaping black hole” in mental health services for young people. These were the words of John Partridge’s parents at an inquest into his death last month. He took his life after discharging himself from hospital without being seen by specialists whose help he clearly needed. His parents’ blunt analysis is borne out today by the Children’s Commissioner’s finding that one in eight children with life-threatening mental illness are being denied specialist treatment even after being referred for it by their GPs.

Overall, more than a quarter of youngsters referred to the overstretched Children and Adolescent Mental Health Services (CAMHS) do not get the help it is supposed to provide. The average waiting time for those who do get it is 110 days.

The government has rightly set itself the target of putting mental healthcare on the same footing as physical, but the goal remains elusive. Money has been earmarked for young people’s mental health, but not enough of it is being spent. The number committing suicide is rising and the number being hospitalised is rising faster.

There is a widening gap between ministers’ rhetoric on this most distressing of public health emergencies, and concrete action to tackle it. The former reflects a growing awareness of the problem thanks partly to efforts such as this newspaper’s Time to Mind campaign. The latter is in- adequate, and children are paying with their lives.

The latest official figures show 201 suicides by people aged 10-19 in 2014, a 10 per cent increase in a year. Each is a tragedy. Together they are the tip of an iceberg. According to the YoungMinds charity, three children per classroom have a diagnosed mental illness and the number admitted to hospital for self-harm or eating disorders has doubled in three years.

In all, 248,000 young people were referred to CAMHS last year. Some GPs are quicker to refer than they were, but this counts for little when specialist clinics are so swamped that waiting times in four areas average more than 100 days. In the West Midlands it is double that. In several, the Children’s Commissioner reports that specialist treatment is being withdrawn if a child misses a single appointment. This is a brutal and potentially fatal form of healthcare rationing that ignores a common symptom of acute anxiety or depression — an inability to face the outside world.

Shortly before John Partridge’s death he was admitted to hospital in Devon with a history of mental illness and with blood on his clothes having cut himself with a razor blade. In a comparable case Edward Mallen, 18, took his own life after being referred to mental health services as an acute suicide risk but receiving, in his father’s words, “a strip of pills and couple of website addresses”.

The system failed them both. An extra £1.25 billion has been put aside in principle for mental healthcare for young people for the five years to 2020. In practice £143 million has been allocated for this year. The money is not ringfenced and there are fears it is being funnelled elsewhere because of budgetary pressures. Such fears are compounded by the fate of Natasha Devon, the first children’s mental health “tsar”, sacked after singling out exam stress as a cause of depression. Ministers must examine the origins of this epidemic more dispassionately, and tackle its symptoms more aggressively. When young people are contemplating suicide, there is no time to wait.

Children in care six times more likely to have a criminal record

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This entry was posted in A Personal View, Rationing, Stories in the Media on by .

About Roger Burns - retired GP

I am a retired GP and medical educator. I have supported patient participation throughout my career, and my practice, St Thomas; Surgery, has had a longstanding and active Patient Participation Group (PPG). I support the idea of Community Health Councils, although I feel they should be funded at arms length from government. I have taught GP trainees for 30 years, and been a Programme Director for GP training in Pembrokeshire 20 years. I served on the Pembrokeshire LHG and LHB for a total of 10 years. I completed an MBA in 1996, and I along with most others, never had an exit interview from any job in the NHS! I completed an MBA in 1996, and was a runner up for the Adam Smith prize for economy and efficiency in government in that year. This was owing to a suggestion (St Thomas' Mutual) that practices had incentives for saving by being allowed to buy rationed out services in the following year.

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