Cuts to mental health services putting young people at risk, say experts

In an article published today in the Journal of Public Mental Health, the team discuss the policy implications of their study published earlier in the year, which found that young people who have contact with mental health services in the community and in clinics are significantly less likely to suffer from clinical depression later in their adolescence than those with equivalent difficulties who do not receive treatment.

Young people’s mental health problems are associated with an increased risk of problems later on in adulthood, including poor mental health, lower income, unemployment, inability to maintain a stable cohabiting relationship, and greater contact with the criminal justice system. However, the team’s previous study suggested that access for adolescents with mental health problems to intervention in schools and clinics reduces mental health problems up to three years later and would therefore yield personal, economic, and societal benefits over an individual’s lifespan.

In the study, Sharon Neufeld and colleagues from the Department of Psychiatry at the University of Cambridge used data obtained between 2005-2010 – prior to funding cuts to Child and Adolescent Mental Health Services in the community and in NHS clinics. Between 2008 and 2013, funding for the services dropped by 5.4 per cent in real terms so that in 2012/2013, only 6 per cent of the NHS’ total mental health budget was spent on these services. The knock-on effect of this was that while in 2005/2006, 38% of 14-year olds with a mental disorder had made contact with mental health provision for young people in the past year, in 2014/2015 only 25% of all children and young people with a mental disorder had made such service contact.

One consequence of this has been that the number of young people attending A&E due to a psychiatric condition had doubled by 2014/2015, compared with 2010/2011.

“It’s important to improve young people’s mental health services in schools and strengthen the care pathway to  specialist Child and Adolescent Mental Health Services, in order to meet the NHS target of returning contact back up to 35% by 2020/2021,” says Mrs Neufeld.

“We need to acknowledge the mental health suffering in our young people that has only been increasingly apparent in recent years, and resolve to improve young people’s access to effective mental health services.”

She and her colleagues argue that as well as protecting funding for specialist Child and Adolescent Mental Health Services, funding for school-based counselling is also important as their study found that this was the second most used service for young people with a mental health disorder.

“The current government has promised to provide funding for mental health first aid training for teachers in secondary schools, which should enable them to better identify those with mental health issues and connect students to the appropriate support services,” says Professor Peter Jones. “But this is against a backdrop of freezing school budgets, the very budgets that typically fund school-based counselling.

“Funding for school-based counselling must be ring-fenced, whether it be funded through the education sector or NHS, to ensure young people have adequate service access prior to specialist mental health services.”

The researchers also argue that GPs could use more training in identifying mental disorder. The Royal College of General Practitioners reports that nine out of ten people with mental health problems are managed in primary care. However, even in the recent past, most GPs do not include a rotation in mental illness as part of their training. Such gaps in training, say the researchers, mean that GPs correctly identify less than a half (47%) of depression cases.

“This is a huge missed opportunity,” adds Professor Ian Goodyer. “GPs will encounter a large number of individuals with mental disorders, but have insufficient background knowledge to appropriately identify such cases.”

Reference
Sharon AS Neufeld, Peter B Jones and Ian M. Goodyer. Child and adolescent mental health services: longitudinal data sheds light on current policy for psychological interventions in the community.  Journal of Public Mental Health; Date; DOI 10.1108/JPMH-03-2017-0013