Young With Mental Health Issues ? Sorry , We're In Meltdown !

For issues specific to caring for someone with mental ill health.
It gets worse :

https://www.theguardian.com/society/201 ... in-england

Fall in number of NHS psychiatrists treating children in England.

Latest figures are second lowest since NHS Digital began keeping records in 2009 and come as demand surges.
The number of NHS psychiatrists treating troubled children and young people is falling, despite a surge in demand among under-18s who need urgent mental health care.

NHS workforce statistics show that the number of full-time equivalent psychiatrists working in child and adolescent mental health services in England fell to 942 in July – its second lowest number on record, down from 970 in January this year .

The drop has occurred despite high-profile pledges, made by Theresa May and NHS chiefs, to expand and improve the mental healthcare under-18s receive, and to put more money into it.

The 942 psychiatrists who were employed in England in July represented the second lowest figure since NHS Digital began keeping records in 2009, and only seven more than the record low of 935 working in July 2017.

Barbara Keeley, the shadow cabinet minister for mental health, who highlighted the fall in workforce numbers, said: “These figures are a severe blow to the government’s plans for children and young people’s mental health, which will come to nothing unless the NHS trains and recruits more child psychiatrists.”

NHS mental health trusts are already having to delay or limit patients’ access to care because their staffing numbers have not kept up with the rise in demand, which experts have linked to academic pressures, social media and other factors. Some children wait as long as 18 months before being treated, the Care Quality Commission regulator found last year.

“Children in need of mental health services are being turned away in their droves despite showing evidence of self-harm, while many have to wait six months for treatment to start – all because of a shortage of key clinical staff,” Keeley added.

Ministers have pledged to increase the mental health workforce in England by 21,000 by 2021. But last month the National Audit Office, the Whitehall spending watchdog, warned ministers that slow progress so far on delivering that promise posed a major risk to their ability to improve CAMHS care. The overall NHS mental health workforce increased by just 915 people in the year to March, ministers admitted recently.

There are doubts as to whether Health Education England, the NHS agency that educates and trains new staff, will be able to recruit the 100 extra CAMHS consultants it has promised to hire by 2021.

The Royal College of Psychiatrists estimates that, with demand for care from troubled children likely to keep rising, the number of CAMHS psychiatrists the NHS needs will have to go up by 463, almost 50% more than the present number.

“With the country facing a crisis in children’s mental health, we need a big expansion of the number of doctors … It is deeply frustrating that the number of child and adolescent psychiatrists is falling,” said Dr Bernadka Dubicka, chair of the college’s faculty, whose members care for under-18s.

The prime minister has identified improving mental healthcare for children as a priority for the NHS’s forthcoming long-term plan, which is expected at the start of December. But critics fear that growing understaffing will undermine that ambition.
UK teenagers turn to mobile apps to help with mental ill health.

Usage of apps that help cope with anxiety, self-harm and depression has soared recently.


Tens of thousands of young people in Britain who are struggling with their mental health are seeking help online for problems such as anxiety, self-harm and depression.

Soaring numbers of under-18s are turning to apps, online counselling and “mood diaries” to help them manage and recover from conditions that have left them feeling low, isolated and, in some cases, suicidal.

A generation of young people are attracted by being able to receive fast, personal care and advice using their phone rather than having to wait up to 18 months to be treated by an NHS mental health professional.
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The shift comes as ministers brace themselves for publication on Thursday of the first new figures for 13 years showing how common mental heath problems are in the young.


Experts believe they will show a big rise from the one in 10 schoolchildren who were identified as having a diagnosable mental health condition when the last research was done in 2005, partly as a result of the emergence of social media and its use in cyberbullying and fuelling feelings of inadequacy.

The number of under-18s using Kooth, a free online counselling service, has shot up from 20,000 in 2015 to 65,000 last year, and is forecast to rise further to 100,000 this year.

One hundred NHS clinical commissioning groups across England, more than half the total, have now commissioned the service. It helps young people suffering from anxiety, low mood, poor self-worth or confidence, self-harm and loneliness.

“Young people like the fact they can talk to a counsellor either instantly, or within 10 minutes, for up to an hour in the evenings. They love that immediacy”, said Aaron Sefi, the research and evaluation director at XenZone, the company behind Kooth.

“They also love the anonymity involved, because they can sign up without giving their personal details. Plus, they’re in control, because they are choosing to contact us rather than being told to do so.”

Its use of video counselling and supportive text messages also help young people feel less alone, he said.

In addition, 123,138 people in the UK downloaded Calm Harm, an NHS-approved app that helps people self-harm less often or not at all, between April 2017 and this month. Of those, 56% were aged between 10 and 18 and 82% were girls or women.

“Users tell us that Calm Harm helps with suicidal thoughts and intent,”, said Dr Nihara Krause, the consultant clinical psychologist who developed the app. “Currently 92% of our users, who are mainly female and often aged 15-21, say the urge reduced.”

The app, which launched in 2015, also helps people who have impulse control problems, such as obsessive compulsive disorder, eating disorders and problem drinking, she said.

Calm Harm is among 18 apps that NHS England has endorsed to help tackle mental ill-health. They also include BlueIce, which helps young people manage their emotions using a mood diary, techniques to reduce feelings of distress and automatic routing to emergency help numbers if their urges to self-harm continue.

Experts welcomed the trend but warned that online help must complement, not replace, face-to-face appointments with therapists, psychologists and psychiatrists.

“Most young people spend much of their time online, and it can feel easier for them to communicate through messaging and online services than face-to-face,” said Tom Madders, campaigns director at Young Minds, which helps people under 26.

“Evidence-based mental health apps and online support services can be really beneficial in helping young people to look after their own mental health, develop strategies for coping with difficult emotions, and get accessible information and advice when they need it.”

Claire Murdoch, NHS England’s national mental health director, said: “Technology is constantly evolving and young people are usually at the forefront, so it’s no surprise increasing numbers are turning to services like these which can certainly play a part, particularly when backed up by face-to-face support.”

The NHS’s forthcoming long-term plan, due next month, will “harness all of the benefits these advancements can bring”, she added.

Meanwhile, 37% of the young people referred to NHS child and adolescent mental health services (Camhs) in England last year were refused help, the children’s commissioner has revealed.

In an analysis of Camhs care published on Thursday, the children’s commissioner for England, Anne Longfield, says that despite promises by politicians and NHS bosses to improve access, “a vast gap remains between what is provided and what children need”.

While she found improvements in several areas of care, including care for eating disorders, new mothers and under-18s in the criminal justice system, overall “the current rate of progress is still not good enough for the majority of children who require help but are not receiving it”.

Of more than 338,000 children and young people referred to Camhs last year, 31% were treated within a year. But 37% got no help at all and another 32% were still waiting for treatment to start at the end of the year, she found.



For many , what other alternative do they have ?

The support , as such , is simply not out there.
Lack of NHS mental health services puts under-18s at risk, say GPs.

Survey shows young people struggle to access treatment and face long delays.

Online CBT is not a therapy substitute but a step to help manage anxiety.


Nearly all GPs worry that young people with mental health problems will come to harm because of difficulties in accessing treatment on the NHS, according to a survey.

The poll of UK family doctors found that 99% said they feared that under-18s would come to harm as a direct result of facing long delays to see a specialist and vital care being rationed.

Nine in 10 GPs said health and social care services for young people who have anxiety, depression, eating disorders and other conditions were either “extremely inadequate” (37%) or “very inadequate” (53%), and only 10% said they were adequate or good.

Many family doctors who took part in the survey, commissioned by the youth mental health charity stem4 and undertaken by MedeConnect Healthcare Insight last month, said that in their experience NHS child and adolescent mental health services (Camhs) often could not respond to a recent sharp increase in demand for care. Experts believe that social media, exam stress, poverty and family circumstances lie behind the rise.

Camhs providers were “overwhelmed”, delays could last as long as 18 months, and many denied treatment to young people, who had to be potentially suicidal in order to be seen, GPs said.

One said: “The delay is awful. Only the very severely affected are seen and then too little, too late. Patients are usually left to suffer, self-harm, or just get worse. They go to their local emergency department [A&E], get patched up and sent home and may get a referral to Camhs. But Camhs will find a reason why they are not bad enough to be seen, and the cycle continues. It’s an unfolding, heartbreaking tragedy.”

Another said: “It’s extremely frustrating. There is a lack of [treatment] options for most mental health issues affecting young people. Suffering for the patient and family is increased and in some cases deterioration to more severe problems is inevitable.”

The survey also found :

78% of GPs are worried that too few of their young patients can get treatment for mental ill-health.

86% have seen a rise in the last two years in the number of 11- to 18-year-olds with anxiety.

88% say it is impossible or very difficult for young people to get help with anxiety.

68% are seeing more under-18s who have self-harmed.

This year the government has made mental health a key priority, with Theresa May pledging to improve NHS care for troubled young people. Campaigners say patients who are left without treatment are more likely to deteriorate and may be at greater risk of harming themselves, having suicidal thoughts or trying to take their own life.

Norman Lamb, the Liberal Democrat former health minister, said young people were suffering because NHS services for troubled teenagers in many places were “dysfunctional”.

He said: “This survey lays bare just how broken children’s mental health services are in much of the country. Families are left in a state of acute anxiety, desperately hoping no harm will come to their child whilst they wait.

“It is a disgrace that so many children are turned away from services after a referral from their GP. Most disturbing of all is the finding that 99% of GPs fear that young people may come to harm whilst waiting for treatment.”

Labour’s Luciana Berger, said the “deeply troubling” findings showed that repeated pledges by ministers, including May, to improve mental healthcare for under-18s were “nothing more than vacuous warm words”. Delays in accessing care could have a “devastating” impact on young people, she said.

“In no other part of our NHS would you find 99% of GPs admitting that young people may come to harm while waiting for treatment – if they can access any help at all. The long-term consequences for every young person affected can be devastating. It’s socially, morally and economically illiterate for government to have made the choice not to properly fund these services.”

Dr Nihara Krause, a consultant clinical psychologist who founded stem4, said a lack of talking therapies for teenagers meant GPs were forced to refer young people to Camhs, which are meant to treat those with the most serious illnesses, despite knowing they may be rejected as ineligible.

“Where we once had access to highly trained therapists in the community, able to deliver evidence-based treatments such as cognitive behaviour therapy, in many areas these services have been cut, denying people access to expert treatment. GPs faced with limited referral pathways are being forced to refer patients to Camhs, knowing they are unlikely to meet the treatment criteria,” she said.

Almost two in five GPs (38%) said that, given the problems accessing Camhs care, they would recommend that patients whose families could afford it pay for private treatment.

Lamb said this was unacceptable. “Increasingly we are witnessing a growing divide between those with money who can pay for treatment and others who are just left waiting.”

NHS England sought to play down the findings. “This survey is ultimately based on the view of a tiny fraction of GPs – roughly just 3% – but the number of Camhs referrals is rising and the NHS is gearing up to meet that demand, with more children and young people seen than ever before, 22% more staff in services than five years ago and mental health front and centre in the NHS’s long-term plan,” a spokesperson said.

It has committed to ensuring that by 2020/21 35% of all under-18s seeking help get it, and it is adding another 150-180 inpatient beds for that age group and improving care for young people in crisis.

May has promised that further improvements to services, including giving schools a key role and introducing a new four-week waiting time for treatment, will be central to the NHS long-term plan, which is due to be published in early January.

A spokesperson for the Department of Health and Social Care said: “Supporting the mental health of our children and young people is a key priority for this government. We are ensuring that 70,000 more children a year have access to specialist mental health care by 2020/21. And we’re training a brand new, dedicated mental health workforce for schools to make expert mental health support available to a population of almost half a million young people.”
May to promise NHS mental healthcare boost for under-18s.

Campaigners wary of pledge to expand treatment to more children and teenagers.

Theresa May is to promise a major expansion of NHS mental healthcare for children and young people in an attempt to tackle the “scandal” of most under-18s not receiving treatment.

Health service managers said they hoped the move would end the persistent criticism that only a minority of young people receive help for debilitating conditions such as depression, eating disorders and psychosis.

The pledge will be included in the NHS long-term plan to be launched by the prime minister and the chief executive of NHS England, Simon Stevens, at a hospital on Monday.

For years MPs, psychiatrists, mental health charities and families have accused the NHS of letting down troubled teenagers by not ensuring that more of them received treatment.

The NHS responded by agreeing to increase the proportion of those with a diagnosable mental health condition who get treated from 25% to 35% by 2020-21. However, key people, such as the children’s commissioner, Anne Longfield, said that even the revised ambition was inadequate and cast doubt on the NHS’s commitment to ensuring “parity of esteem” between mental and physical health.

The long-term plan – which will set out how the NHS plans to spend the extra £20.5bn a year it will receive by 2023-24 – will make clear that many more under-18s will receive care over the next few years.

Stevens has been considering pleas from Claire Murdoch, NHS England’s national mental health director, and Paul Farmer, the chief executive of the mental health charity Mind, to increase the treatment target from 35% to 50%.

When questioned by MPs in October about the 35% figure, Stevens assured them the target would rise as part of the plan to deliver “a more ambitious set of service expansions and reforms in mental health, as well as in other areas”.

He said improvements in access to treatment meant 30.5% of under-18s were already being helped by specialist NHS child and adolescent mental health services (Camhs), and the NHS was “on track” to meet the 35% target by 2020-21.

May has pledged to dramatically improve NHS mental healthcare for people of all ages as part of her personal agenda to address the “burning injustices” in British society she identified when she took office in July 2016.

The prime minister has made better help for under-18s a key priority, and unveiled plans to give schools a key role and introduce a maximum four-week waiting time for young people to start receiving help, although initially only in some parts of England.

Stevens has cautioned that serious staffing problems across mental health services limit the NHS’s ability to expand Camhs care to deal with the growing number of under-18s affected by mental ill-health.

He told the public accounts committee of MPs: “We want to get to a position where ultimately every child who needs a specialist NHS mental health service is able to get it, but that might not be the same as every child with a diagnosable mental health condition, which at the moment is what the 30% or 35% is tracking.”

May will reveal key elements of the plan on The Andrew Marr Show on BBC One on Sunday morning, with the health and social care secretary, Matt Hancock, giving further details on Sophy Ridge on Sunday on Sky News.

Mental health campaigners made clear the plan must significantly increase the number of children and young people who receive help. They said that, just as NHS bosses would not allow under-18s with a serious physical condition, such as cancer, to go untreated, the same should apply to those with psychological or psychiatric conditions, some of which can lead to self-harm and suicide.

“The previous target of treating just a third of under-18s with a diagnosable mental health condition simply isn’t good enough, particularly given that the most recent statistics on the number of young people experiencing mental ill health showed there has been a significant increase in the last decade,” said Dr Bernadka Dubicka, the chair of the child and adolescent faculty at the Royal College of Psychiatrists.

“If they were waiting months or even years for cancer treatment there would be an outcry, which is why we’ve repeatedly asked the government to address this issue.”

The college has lobbied Stevens to commit in the plan to treating at least 45% of children in need by 2023-24, and wants to see that increased again to 70% by 2028-29.

Anne Longfield, a vocal critic of the delays and rationing of care families face when seeking help for their child from Camhs, said all young people with mental health problems should get help.

“I’ll welcome any progress being made to improve services, but any system that does not provide Camhs support to every child who needs it will still be failing thousands of children. I can’t ignore that. Nor would any of us if it were physical illness under discussion.

“The government must aim higher and provide clear targets and timetables so that by 2023 no child who needs help is turned away.”


Emma Thomas, the chief executive of the charity YoungMinds, said: “We’re facing a mental health crisis for young people, with more than a million having diagnosable mental health problems and the vast majority not able to access NHS support.

“Parents and young people tell us every day that they have been left to cope on their own while their problems have got worse, with some dropping out of school and becoming suicidal.”


• Childline in the UK can be reached on 0800 1111, or by confidential email via its website.

• In the UK, Samaritans can be contacted on 116 123 or email jo@samaritans.org.
Young people " Turned away " from NHS mental health support left to hit crisis point, MPs warn.

Intervening early could prevent serious mental health risks and save NHS money but lack of funding and staff present major barriers.


The NHS is “failing” children and young people with mental health conditions by rejecting them for not having “severe enough” symptoms and then leaving them to reach crisis point, MPs have warned.

Currently only three out of 10 children are getting the treatment they need, and those that do access support face “unacceptably long waits”, a report by the Commons Public Accounts Committee (PAC) said.

The committee found that children who are denied NHS support are currently not kept track of and are not routinely directed to other services that could help them.

“NHS services are turning away many children and young people because their condition is not considered severe enough to warrant access to overstretched services, even though it can later deteriorate to a point of crisis,” the report warns.

NHS plans set out in the Forward View for Mental Health committed to boost treatment by 2022 but would still leave two thirds (65 per cent) of those with a diagnosed mental health condition unsupported, MPs said.

On Monday the NHS published its long-term plan for revolutionising services over the next decade, including a commitment for an additional 350,000 young people to access counselling.

However, the report warn action is needed immediately and these ambitious plans are hamstrung by a workforce “roadblock” and the “inability” to recruit mental health nurses – made worse by the removal of the nursing bursary.

“Children and young people with mental health conditions are being failed by the NHS,” Labour’s Meg Hillier, chairwoman of the PAC, said.

“Provision is far below required levels and many people who do get help face long waits for treatment. This can be devastating for people’s life chances, their physical health, education and work prospects.

“We will be keeping a close eye on the real-world impact of the measures proposed in the government’s 10-year plan for the NHS.”

Anne Longfield, Children’s Commissioner for England, said the government must be “more ambitious” about mental-health funding because “too many children are failing to receive any support at all”.

She added: “The NHS 10 year plan will improve access to CAMHS (child and adolescent mental health services) for more children, but until the government can guarantee that all children will get the specialist help they need, every year thousands of children will still miss out on treatment.”