Let’s talk. As a mental health professional, I am becoming increasingly concerned about the health and welfare of our young people at this moment in time. You might think that this is going to be another discussion about Covid19, or about the creeping tide of obesity, or the sharp increase in alcohol consumption during lockdown. No, what terrifies me most is the ever-increasing tidal wave of mental health crisis facing our upcoming generation of young adults.
Currently, waiting lists for child and adolescent mental health services on the NHS are lengthening by the second, exacerbated by the closure of many frontline services during the Covid19 lockdowns. Prior to March 2020’s lockdown a six-month wait time for mental health treatment was typical, but now the waiting lists are years, rather than months long.
Never before has mental health support been more needed either. Children have spent significant periods of 2020 isolated from friends and extended family. They have missed essential socialisation, and some have been babysat by the internet or TV. And sadly, some have been in homes, from which school is their only place of escape.
Now that schools have reopened there is the opportunity to see friends and teachers again, albeit in bubbles, socially distanced, and wearing facemasks in the corridors. But this school contact does not adequately replace the normal playdates and activities that should be a part of any child’s life.
I run a private child and adolescent therapy centre in Suffolk. I opened this centre because I saw a real need and a gap in the current provision. It also came from my own family experience. Eight years ago, my son had a mental health breakdown at the age of 19. As a family we tried to access appropriate care for him, but he was being passed from one waiting list to another in the NHS mental health system. We were shocked at how little support was available for him and how hard it was to access that provision. It became an impossible task and it became increasingly detrimental to his already fragile mental state. We were fortunate in that we had private health insurance and using that in addition to self-funding, we were able to get good support in place for him. But it still broke us financially.
At the time I was working as an industrial psychologist, but I gave up my job to retrain as a child and adolescent psychodynamic counsellor. My motto is “don’t complain, do something”, so I did. After four years of post-graduate training, I started working in schools through a charity and to my horror in that intervening time whilst training, the state of the mental health system had got worse, not better. By now mental health provision for young people was so limited, that at best I would be able to see a child for a maximum of 12 counselling sessions which was not nearly enough for most of my patients. Furthermore, the threshold criteria for which patients could be seen were also rising.
Desperate parents would contact me directly asking me to help their children, but I was restricted in my employed role as to who I could speak to. So, I started my own not for profit practice and started taking self-referrals and working from my office at home. We then opened the Teenage Mental Health Centre in Ipswich, in December 2019.
This first year has been an interesting and challenging time for our practice. We need to think about practical concerns around financing the work we do and how we navigate Covid19 compliances in these unprecedented times of a global pandemic. However, our biggest worry has been the stories we hear on an almost daily basis from parents and children who have become exhausted, frustrated, and let down by the state system, which is supposed to help them, and yet fails them at their time of greatest need.
One child was becoming increasingly suicidal, his parents phoned the GP every week for two months, and each time they were told they could not have an appointment but would be forwarded to the emotional wellbeing hub, who in turn never returned their calls.
Another child made three suicide attempts and each time they would be admitted to hospital for a few hours and then discharged without support. When her parents asked whether their child could access any mental health treatment, they were told that she did not meet the threshold for care. The underlying message they got was that three suicide attempts is not sufficient to be deemed suicidal. Many of our parents have struggled to get a GP appointment and when they finally do ask for help for their child, they are referred to wellbeing services who they are told will call them in a few days. These parents often wait weeks to only receive a letter directing them to a website or to only be told that their child is not sick enough. I have lost count of the number of times a parent has attended our centre with a child who is barely eating and who lost a significant amount of weight but when referred for mental health assessment they have been told that their child’s weight isn’t low enough to receive treatment.
If a child is very lucky, they may be offered services from a local charity however it is usually often limited to just six counselling sessions and whilst they may be offered a place it can be another six months before their treatment can begin.
I have also met numerous children in assessment sessions who present indications that they have autism. I might recommend to the parents to ask their GP about an autism assessment referral, only to then find out that the GP refuses to refer them and bases their decision on a brief phone call with a wellbeing team. They are then recommended to attend parenting classes instead. In the private referrals for autism assessments that our parents have taken their children to every child has been diagnosed as autistic.
What we are witnessing in this field of child and adolescent mental health is a ticking timebomb. Without adequate mental health support for our young people now, these problems and this suffering will continue and follow them into adulthood.
Celebrities and members of Royalty have recently been promoting mental health awareness, urging those who suffer to speak to someone or talk to their GP. But the reality is that if you are suffering from mental health issues, the services that you are referred on to are overwhelmed and have limited capacity to take on new clients. I am concerned that these celebrity messages are detached from the reality. Child services are chronically underfunded and failing our children’s generation miserably.
There is some access to mental health support in schools, but in primary schools much of this is through charities and very few senior schools have mental health professionals working in them to support children and bring about timely interventions. But once again, even if these schools make a referral it is frequently knocked back as the child is not considered “ill enough”. If this was a referral for cancer this would be a national scandal. Imagine a doctor saying, “You have cancer, but it is not bad enough yet. Come back when it is more advanced” or “You have cancer but the waiting list to be seen is eight months long” or even worse “You have cancer but the only treatment is six chemotherapy sessions with a local charity, and you will have to wait six months before you can start” or “Why not download our cancer app to find out how you can treat yourself?” It is just not good enough. So, I am scared. I am scared that if things continue as they are in children’s mental health services it won’t be Covid19 that devastates our children’s futures, it will be that we did not prioritise their emotional and mental health needs. We need to ensure that we secure happy and healthy futures for our young people through good, appropriate, timely mental health provision, and for this to be put in place by those in positions of authority who are charged with providing it for our children’s generation.