The report is the first phase of a major thematic review requested by the Prime Minister in January 2017. The CQC has drawn on existing reports, research, its inspections of children and young people’s mental health services, as well as conversations with young people to identify the strengths and weaknesses of the current system.
The report confirms many of the issues raised in the Five Year Forward View for Mental Health published in 2016 and in particular, comments on the difficulties children and young people face in accessing appropriate support for their mental health concerns from a system that is fragmented and where services vary in quality.
- A study from Public Health England suggested that less than 25% – 35% of those with a diagnosable mental health condition accessed support.
- The Royal College of Psychiatrists has noted difficulties in finding specialist inpatient beds close to a young person’s home.
- The CQC has rated 39% (26 services) of specialist community child and adolescent mental health services (CAMHS) as requires improvement and 2% (1 service) as inadequate against CQC’s ‘responsive’ key question, which looks at whether people access care and treatment in a timely way.
- When concerns are identified, children and young people, and their families, often struggle to navigate the complicated and fractured system of services.
- Too many organisations are involved in planning, funding, commissioning, providing and overseeing support and care for young people with mental health problems. Poor collaboration and communication between these agencies can lead to fragmented care, create inefficiencies in the system, and impede efforts to improve the quality of care.
When young people are able to access specialist services, they can often expect to receive good quality care. CQC has rated 59% of specialist community services as good and 9% as outstanding, and 73% of specialist inpatient services as good and 7% as outstanding.
Speaking about the report, Dr Paul Lelliott, Deputy Chief Inspector (lead for Mental Health) said: “This review has given CQC an important opportunity to not only consider the quality of care as found in our inspections, but also take a step back and look at the system as a whole.
“There are many people out there working to make sure that children and young people who experience mental health issues are offered caring support. Their dedication is to be celebrated. However, we must also address those times when a child or young person feels let down or not listened to and make sure the same level of support is available to each and every one of them.
During phase two of the thematic review, CQC will undertake fieldwork to identify what helps local services to achieve, or hinders them from achieving, improvements in the quality of mental health services for children and young people, as set out in the NHS’s Five Year Forward View for Mental Health.