Regulator warns of ‘ticking time bomb’ in youth mental health services

Mental health services for children and young people are a “ticking time bomb” due to understaffing, funding and long delays in treatment, the health regulator has warned.

The Care Quality Commission (CQC) estimates that in November 2023, the number of children and young people waiting to access or receiving mental health treatment in England will reach a record high of almost 500,000, reaching 496,897. announced that it would rise to

The regulator’s Mental Health Act Monitoring Report said these children faced an average waiting time of 40 days from referral to treatment, citing data from the Children’s Commissioner for 2021/22.

Chris Zikiti, CQC’s director of mental health, said: “Half a million children are receiving or waiting for mental health care, and it takes an average of 40 days to receive care, but it takes longer than that. “Many children are reporting worsening mental health.” Some people’s mental health deteriorates while they wait, and some even try to take their own lives.

“When children with mental health needs do not receive appropriate and timely care, they are at increased risk of harm and, in some cases, suicide. This problem is a ticking time bomb and must be addressed if left unaddressed. We will face the consequences.”

The report, which was produced after conversations with 4,515 patients and 1,200 carers, found that many children are housed in facilities such as adult wards and general pediatric wards, which causes their suffering. He said it was making things worse.

Staff shortages were found to cause isolation, reduced quality of care, reduced access to activities and treatments, increased risk of inappropriate restraint, and mistreatment of both patients and staff.

Increased reliance on agency staff to fill vacancies not only negatively impacts the therapeutic relationship and the delivery of individualized care to patients, but is also seen as detrimental to the mental health and well-being of permanent staff. Ta.

In June 2023, NHS England set out plans to increase the number and proportion of NHS staff working in mental health, primary care and community care by 73% by 2036/37.

It also aims to increase the number of mental health nursing training locations by 93% to more than 11,000 by 2031/32.

Health regulators were “encouraged to consider initiatives to improve staffing levels” but were “concerned that this is not sufficient to address current shortages”.

Mr Gikiti said: “Our staff are working hard, but staff shortages can make it extremely difficult to provide personalized, high-quality care.

“A larger permanent workforce is needed to alleviate pressure on overburdened health care workers, and this will require improved community support and support for struggling health care providers. Supported by ongoing funding to:

“Without these measures, people will not be able to access the mental health support they need and the impact could be devastating, especially for children and young people.”

Lack of suitable accommodation also means that people, particularly those with autism and learning disabilities, are unnecessarily detained in hospitals, with a significant number of patients being placed far from home and In some cases, people were isolated for years at a time.

The report interviewed people who had been detained and said racial disparities continue to exist in care.

The rate of detention of black or black British people under the Mental Health Act was more than 3.5 times higher as a proportion of the population than white ethnic groups, down from four times the previous year.

The Mental Health Act 1983 is a legal framework that allows hospitals to detain and treat people with mental illnesses.

Community treatment orders, where supervised treatment takes place in the community, were also eight times more likely to be issued for black or black British people than for white ethnic groups.

The report also said: “During our visits, we observed examples of a lack of respect for LGBT+ patients, including services not respecting patients’ pronoun choices.”

Additionally, “using (or assuming) the wrong pronouns or names can make people feel unsafe, distrust staff, and have a negative impact on care.” he added.

Mr Zikiti said: ‘Black people are still far more likely to be detained under the Mental Health Act.

“This is a long-standing inequity that everyone involved in the delivery and oversight of mental health services needs to take steps to address, starting with implementing the Patient and Carer Race Equality Framework (PCREF).

“Without this effort, nothing will change and black people will continue to be overrepresented among people in custody.

“CQC will continue to monitor, raise and work to reduce issues of unequal and inappropriate treatment.”

More people than ever before are using NHS services for mental health support, with around 5 million people including 1.1 million children and young people expected to increase in 2022/23, according to the latest NHS England data. of patients are receiving the service.

An NHS England spokesperson said: “The NHS is treating more young people than ever before, with evidence showing a 48% increase in children and young people receiving mental health support since 2019/20. “We have the latest data and the health service is expanding this provision as quickly as possible across the country.” Her current five-year funding arrangement is designed to meet increased demand.

“We know there is still work to do, which is why plans are also in place to ensure that more than one in two pupils in schools and colleges are covered by NHS mental health support teams. “We will provide early support by spring 2025, our original goal.”