Even people under the age of 18 with an eating disorder or psychosis do not receive treatment from overly stressed CAMHS services, who insist they are not ill enough to justify treatment. In one case, a CAMHS crisis team in Wales would not immediately assess the mental health of an actively suicidal child who had stopped jumping from a building earlier that day unless the GP made a written referral. In another, a CAMHS service in the east of England refused to deal with a 12-year-old boy who was found with ligation in his room because the lack of marks on his neck meant that his referral criteria were not met. The shocking state of CAMHS care is revealed in a survey by the mental health charity of 4,001 young doctors across the UK who have sought emergency help for people under the age of 18 with mental health problems. CAMHS teams, which can no longer cope with the growing need for treatment before Covid strikes, are even more overwhelmed by the effects of the pandemic on young people’s mental health. The findings, which the 4 hs shared with the Guardian, also show that in some areas children and young people need two years after being referred by their doctor to start receiving help. Mental health experts say the widespread inability of young people to access CAMHS care is exacerbating their already fragile mental health and further self-harm, dropping out of school, feeling neglected and needing to seek help from A&E. “As a clinician, it is particularly worrying that children and young people with psychosis, eating disorders and even those who have just attempted suicide are doomed to such long waits,” said Dr Nihara Krause, a clinical psychologist who specializes in treatment. children and young people and who is the founder of stem4. “It’s really shocking to learn from this survey of doctors’ experiences working with CAMHS that so many vulnerable young people in desperate need of emergency mental health care are forced to wait so long – up to two years – for care. that are needed immediately. “Delayed treatment increases the risk and you can expect problems applying to study or work, relationship issues, other emerging comorbid mental health issues, for example depression, increased vulnerability to self-harm, anxiety with panic attacks and so on.” Many GPs were angry about providing CAMHS in their area. Some have said that access to services means they are not safe or even dangerous, because many under the age of 18 get worse as they wait and may feel angry, neglected and frustrated as they are left without expert help. Almost one in five (18%) of the doctors who participated in the study knew a patient who tried or took his own life after being denied care. A handful of doctors said the situation was so bad that they had stopped referring young people to CAMHS and instead instructed them to go to A&E, although this was not appropriate. A family doctor in Yorkshire and the Humber said: “It’s so horrible in our area that it may not exist. “Patients only receive support if their parents can afford to pay for it or drink bleach, and even then it is unknown whether a referral to CAMHS will be accepted.” The findings are “deeply troubling” and show the enormous additional pressure Covid has put on CAMHS, said Tom Madders, campaign manager at YoungMinds. “What these doctors tell us reflects what we hear every day from parents, young people and professionals. Despite signs of progress in parts of the country, support thresholds are alarmingly high, with thousands of young people moving away or entering long waiting lists. “Without timely support, the needs of young people will often deteriorate, with many injuring themselves, dropping out of school or turning to A&E services in the event of a crisis.” Madders called for a network of “timely support hubs” across the UK, so that GPs could have somewhere where they could send people under the age of 18 to the emergency room. In one case, CAMHS in the Northwest rejected a doctor’s referral to a child with anorexia because it contained insufficient information, even though his body mass index was just 16. MedeConnect Healthcare Insights surveyed 1,001 physicians, salaried or local physicians about stem4 between March 4 and April 1, and the survey was regionally representative. He also found that: 95% of GPs say that CAMHS services are either in crisis (46%) or very inadequate (49%) – up from 90% when stem4 conducted the same survey in 2018 and 85% in 2016 Half say that at least six in 10 referrals to anxiety, depression, behavioral disorders and self-harm are usually dismissed because young people’s symptoms are not considered serious enough, although they are reported only in cases where they are most at risk. One in four say 60% -100% of referrals for eating disorders and addictions are rejected 63% fear that young people will be affected due to lack of treatment, while 58% have seen patients’ symptoms worsen, forcing them to go to A&E Professor Martin Marshall, president of the Royal College of GPs, said the findings were “both alarming and disturbing”. He added: “It is of the utmost importance that if general practitioners refer these patients to specialized mental health services, these referrals should be taken seriously and not rejected without good reason.” The Ministry of Health and Social Welfare did not immediately comment on the findings. A spokesman said: “We recognize the impact of the pandemic on everyone, especially children and young people who have had problems in their lives and upbringing at home. “We have committed an additional εκατο 500 million in 2021-2022 to support those most affected, including 79 79 million for child mental health services, to accelerate the development of mental health support groups and to expand community services. This is above our commitment to expanding and transforming mental health services in England, with an additional 3 2.3 billion a year by 2024, allowing hundreds of thousands more children to access support. “We will launch a national debate to inform the development of a new long-term mental health plan later this year.” In the UK and Ireland, you can contact the Samaritans at 116 123 or email [email protected] or [email protected] In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, Lifeline Crisis Support is 13 11 14. You can find other international helplines at www.befrienders.org.
