The Challenges of Children and Adolescent Mental Health Services (CAMHS) during COVID-19

 

Despite children and adolescents being considerably less affected by the virus itself compared to older members of the population, the associated Public Health measures in response to COVID-19, such as social distancing, school closures, and isolation, have all substantially impacted their mental health. Directly correlating with an increase in mental health issues is a spike in demand for CAMHS, leaving the services severely underequipped to match needs.

Whilst some CAMHS in the UK have been able to act more swiftly in providing support, the majority have fallen short of the level of care required for children and adolescents struggling with their mental health. A huge disparity of care between certain areas has also become increasingly apparent, with the lengthy waits certain young people are subjected to only increasing the likelihood of crisis.

 

Why are children and adolescents not receiving the help they need?

With one in six children reporting a mental health disorder in 2020 and 2021, rising from one in nine in 2017, the pandemic has been a key contributor to the deterioration of children and adolescent’s mental health, through factors such as strained family relationships, academic stress, reduced social contact, and anxieties surrounding the virus itself. Indications have pointed towards the fact that, compared to adults, children and adolescents may suffer prolonged, adverse effects to their mental health as a result of the pandemic. The understandable rise in demand has not been met with an increase in care provision; CAMHS have been described as inaccessible, unapproachable, and lacking organisation.

Six Trusts have supposedly recorded patient wait times of over a year within their CAMHS; one example is 476 days at Norfolk and Suffolk, but this comes as little surprise when considering the sheer demand for NHS Mental Health services following the pandemic. 420,000 children and adolescents were treated in 2020-21, with record demand for eating disorder services also seen. However, despite COVID-19 contributing to the insufficient capacity of CAMHS and subsequent shortages and delays, the service was in crisis years before the pandemic; COVID-19 has simply acted as a catalyst for an already omnipresent issue.

 

What are the NHS doing to tackle the rising demand for CAMHS?

Efforts to improve CAMHS were underway prior to COVID-19; it was during the pandemic that these efforts were derailed, though. However, in 2020, the NHS continued to try and improve services with a number of implementations, notably:

  • Investing nearly £120m extra funding in CAMHS.
  • Implementing mental health crisis lines.
  • Providing more support to schools in order to deal with mental health issues.
  • Proposing new standards, which mean children and adolescents with mental health issues should start receiving care within 28 days of their referral.

 

The NHS are still in the midst of a staffing crisis, though, which needs resolving for waiting times to reduce, and ultimately, the quality of care to improve. Until then, CAMHS patients are more likely to receive sub-standard treatment; one mother of a child in need of the service mentions “begging” for help, but instead were made to feel “ashamed”. With the promises of a care plan and fortnightly appointments they had received failing to be met, this is just one example of CAMHS’ ability (or lack of) to match capacity with demand.

 

The disparity of care across the UK within CAMHS

The “postcode lottery”, as some have described it, of access to CAMHS in the UK, is inconceivable. Waiting times for CAMHS are heavily area-dependent; for example, the average waiting time for an initial appointment with Oxford Health NHS Foundation Trust is 75 days, while for Bradford District Care NHS Foundation Trust, it is a comparatively mere 15 days. Obviously, differences in staffing levels between Trusts are bound to arise; however, when these differences are resulting in such disparities of care for children and adolescents which are based entirely on where they live, the situation is nothing short of scandalous.

With the burden of multiple stressors, children and adolescents’ mental health has taken a considerable hit over the past two years, which is predicted to affect them for years to come. The consequent spike in CAMHS referrals has further perpetuated difficulties faced by these underequipped services, with children and adolescents continuously failing to receive the care they so desperately need. Despite efforts to improve CAMHS in the UK, more needs to be done to address the services’ shortcomings, particularly the lingering issue of chronic understaffing. Until this is done, the mental health of children and adolescents in need of support is at increasing risk of further decline.

 

Written by Charley Peacock, Bid Writer 

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