This Mental Health Awareness Week, why don’t we begin at the beginning? After all, around half of all the mental health problems that dog the adult population dig their claws in by the time the person is 14. So before they’ve sat an exam or driven a car, there is a shadow over their lives that they may struggle with forever. Yet we spend so little time thinking about children’s mental health and even less time (and fewer resources) making sure it’s OK.
There’s no denying that schools these days are diligent about promoting emotional wellbeing and giving children the language and context to talk about mental health – these are things that just didn’t happen a generation ago and it can only be a good thing. But what about when a child needs specialist support?
Anything from bereavement or abuse to a disorder like autism or ADHD can leave youngsters struggling and we know that one in 10 children and young people has a clinically diagnosable issue. And yet a survey of GPs last year found that more than half of their referrals to child and adolescent mental health services (CAMHS) were rejected.
There are other routes into CAMHS, it’s true, but all those rejected referrals? Surely no child, young person or parent who goes to their GP with a mental health worry should be rejected for specialist treatment. And yet here we are.
As a parent, I was one of the lucky ones. My daughter’s referral to CAMHS for anxiety and suspected autism and ADHD when she was seven years old was accepted. We’d been warned of long waits and sure enough, by the time the autism diagnosis arrived we were more than four years into our CAMHS journey.
Autism is a tricky diagnosis. There’s no scan or blood test doctors can do. It’s a hugely complex condition, not yet fully understood. And the assumption that it’s mostly a male disorder is starting to be questioned. It could be that girls are affected just as much as boys but are better at watching other children and copying ‘normal’ behaviour. You can see how that could be a ticking time bomb for mental health.
Then on the other hand it’s not really tricky at all. It’s just that services are horribly underfunded. Health spending varies across the country, but CAMHS receives about six per cent of the mental health budget – just 0.7 per cent of the NHS’s total spend.
We’ve had appointments cancelled at short notice, and on one occasion turned up at the hospital to be told the psychiatrist had been called away to an emergency. I could see the nurse thought we might kick off. But really, I was just trying to process this. A child mental health emergency.
These are people trained in vital skills, doing one of the toughest jobs imaginable and they’re stretched to breaking point and starved of the funding their colleagues practising other specialisms get. ‘Parity of esteem’ is a pretty phrase, loved by politicians, but it’s not true and just saying it won’t make it real. We need to make it real.
This is never more vital than in the case of children. While suicide rates rise, while it continues be the biggest killer of men under 50, while drug deaths spiral out of control in parts of the country – these and so many other social ills aren’t being viewed through the prism of child mental health.
But the struggling children of today might be the desperate adults of tomorrow. And we’re not doing nearly enough to help them.
Amy Smith is a pseudonym.