Child and adolescent mental health services need a tangible commitment | Letters

Jeremy Hunt is right when he says that too many young people are being let down by the NHS (Hunt says mental health services for young are biggest NHS failing, 21 October). As a school counsellor in secondary schools for 14 years I have seen a steady decline in our young people’s mental health. Child and adolescent mental health services (Camhs) have suffered budget cuts of £85m since 2010, rendering them now unfit for purpose and there has been a gradual disappearance of many other support agencies. The children’s commissioner for England states that a quarter of children referred for specialist mental health treatment do not receive a service. This has serious repercussions in their education and mental wellbeing, and will put an ever increasing burden on adult mental health services.

Mr Hunt says schools should work more closely with Camhs teams and more should have counsellors on the premises. Faced with severe budget cuts themselves, many schools are cutting counselling services. Furthermore, it has become increasingly difficult for schools to refer pupils on to Camhs as the waiting lists become longer and the threshold for referral is continually raised. Priority cases can wait months for an initial assessment and schools are advising pupils in crisis to present at A&E, where the mental health team is obliged to give some immediate psychological support. Providing funding for counselling in all English schools would show a tangible commitment to improving our children’s mental health.

The UK consistently comes towards the bottom of Unicef’s ranking of child wellbeing in the 21 most economically advanced countries. Jeremy Hunt might look at the reasons behind our children’s mental health problems rather than overburdening schools, the NHS and counselling professions when mental health reaches crisis point.
Catrina Goundry
Leamington Spa, Warwickshire

• We welcome Jeremy Hunt highlighting the need to more effectively help children and young people with mental health issues by intervening early, and the emphasis he puts on schools and Camhs teams working together.

The secretary of state refers to the need for Camhs workers in schools, and that is important, but as in many areas of healthcare, you need to consider the whole system. You can’t just put a Camhs worker into a school and think everything is fixed. Schools need better trained staff, who can identify and signpost children who might have mental health problems, a curriculum where children and young people learn how to look after their own mental health, and a culture that addresses wellbeing. A Camhs worker or a counsellor in schools can help with all of this, but there will inevitably be those who need more specialist support, so there have to be appropriate services in the community as well. We already have a blueprint from government about how to do this, in the form of Future in Mind.  It now needs to be implemented properly across the country so no child is left behind.

Many schools already see the importance of supporting children and young people’s mental health and wellbeing. For instance, Schools North East, which is UK’s only regional network of schools, has recently launched their schools-led mental health commission, which Prof Sue Bailey is privileged to chair.
Prof Sue Bailey and Dr Pooky Knightsmith
Chair and vice-chair, Children and Young People’s Mental Health Coalition

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Child and adolescent mental health services need a tangible commitment | Letters

The NHS is at breaking level challenging perform and commitment alone won"t conserve it

A occupied ward reception area in an NHS general hospital. Photograph: Pulse Picture Library/PA

The NHS has coped properly at a time of unprecedented monetary stress thanks to the hard function of one.three million staff across England. Physicians, nurses, therapists, managers and numerous others have ensured that most individuals most of the time acquire higher-good quality care without obtaining to wait longer than needed. They have also squeezed far more worth out of each and every offered pound to enhance care and stay within budget.

But speaking to these workers virtually each day, as I do in my occupation, I hear men and women wonder out loud how a lot longer they can proceed to work at this degree of intensity to safeguard and protect the service they know and adore.

More hospitals are in deficit or expecting to be so. Other people are struggling to hit waiting time targets and provide timely and practical appointments. Psychological overall health providers, community companies and GPs are also all affected. There is often scope to enhance efficiency in public solutions and the NHS is no exception. Smarter procurement of items and solutions, better use of staff to reduce the fees of high-priced company and locum workers, and greater coordination of care could all support the £100bn yearly well being budget go even more. Jeremy Hunt is also correct to argue that lowering errors and strengthening patient security will totally free up sources to assist deal with the pressures employees are beneath.

The snag is that time is running out. In April 2015, an further £2bn will be transferred from the NHS price range to the Far better Care Fund, to help councils perform more closely with the NHS to meet their population’s requirements. This is cash that would have been invested funding GPs, hospitals and psychological wellness providers and its transfer implies that employees in these companies will have to perform even more difficult to locate the efficiency financial savings necessary to balance the books and improve care.

NHS leaders speak openly of what will occur when they reach the edge of the fiscal cliff in 2015. Some hospitals are in the fortunate position of getting reserves to draw on to cover the shortfall in revenue they can see arriving. Other people will have to consider cutting their fees at the finish of this 12 months to have any chance of staying inside budget in 2015. Since most of their costs are accounted for by employees, this implies not filling vacancies and taking into consideration redundancies.

The difficulty is that the top quality of patient care will be compromised by there not getting sufficient physicians and nurses on the wards and in surgeries and clinics. The properly-publicised failures of care at Mid Staffordshire NHS Trust had been brought on by precisely this sort of value-cutting, with tragic consequences for the families concerned.

The dilemma for the government is where to discover additional income to stay away from a repeat of this, given the parlous state of the public finances and the safety previously afforded to the NHS in contrast with other public companies that have experienced deep cuts. Navigating a safe route amongst the Scylla of added public spending and the Charybdis of public anger at failure to give sufficient sources for the NHS will demand skills of the highest purchase.

It is also the challenge for a Labour party at pains to stay away from getting accused of returning to the undesirable outdated days of tax and commit and as a result anxious about engaging with the reality that the NHS needs far more sources. The risk this creates is of collusion between the main events and a failure to have a debate that is turning out to be more and more urgent. The public and the NHS deserve greater.

Chris Ham is chief executive of the King’s Fund

The NHS is at breaking level challenging perform and commitment alone won"t conserve it