Children in care ‘too often denied mental health treatment’


Children in care are being denied access to mental health services in some cases because they have not got a stable placement, according to a report.

One 16-year-old in foster care had to wait more than two and a half years to access Child and Mental Health Services (Camhs) because she was moved 13 times during that period.

Other children and vulnerable young people are turned away because they do not reach the high thresholds required for treatment, and schools say they are having to contact emergency services in severe cases because of the difficulties of getting children specialist help.

The report by the House of Commons education committee, published on Thursday, accuses “a significant number” of local authorities and health services of failing to identify mental health issues when children enter care.

It calls for changes to current practice, which has led to children and young people being turned away because mental health services are unwilling to begin treatment until a child is in a permanent placement.

According to the report, almost half of children in care have a diagnosable mental health disorder, with looked-after children four times more likely than their peers to have a mental health condition, yet access to Camhs may be even more difficult for them because placements can be very unstable, with multiple moves.

Neil Carmichael, Conservative chair of the education committee, said: “Local authorities have a special responsibility for the welfare of looked-after children. In spite of this duty, it’s clear that many looked-after children in England are not getting the mental health support they need.

“At present, Camhs are not assessing or treating children in care because these children do not have a stable placement. Given children in care may have unstable family lives and are frequently moving foster or residential placement, this inflexibility puts vulnerable children in care at a serious disadvantage in getting the support they deserve. This must change.”

He called for children in care to be given priority access to mental health assessments and said they should never be refused care “based on their placement or severity of their condition”.

The report also calls for initial assessments of those entering care to be more thorough and consistent, and highlights “inadequate” support for vulnerable young people with mental health conditions when they leave care – a time of disruption and upheaval.

Among its recommendations, the report says care leavers should be able to access Camhs up to the age of 25, rather than 18 as it is now, and calls for improvements in mental health training for teachers, foster carers and residential carers.

The Local Government Association’s community wellbeing spokeswoman acknowledged the need for improvement in mental health services for looked-after children, but called for increased funding.

Izzi Seccombe said: “We recognise that improvements urgently need to be made to the mental health services available to all children, in particular those in care. Early intervention is key, and it is not right for any child to have to wait a long time for treatment.

“However, to provide the level of support required, we need a joint approach with every organisation involved in a young person’s life, such as schools, carers and health services, as well as councils.

“But this vision needs to be backed with proper funding, which at the moment is around just 6% of the NHS mental health budget and 0.7% of its overall budget. Clearly more investment is needed if we are to deliver the mental health support our children and young people need and deserve.”

Malcolm Trobe, interim general secretary of the Association of School and College Leaders (ASCL), said many schools were reporting difficulties in obtaining specialist care from local services for students in need.

“This reflects severe cutbacks over the past five years to Camhs. In our evidence to the education committee, ASCL pointed out that long waiting lists for Camhs means schools are forced to call emergency services in severe cases.

“We recognise that the government has pledged greater investment in mental health services. However, we are extremely concerned about a rising tide of mental health issues among young people.”

Responding to the report, Matthew Reed, chief executive of the Children’s Society, said some of the most vulnerable young people in the country were being let down by “overstretched and underfunded” mental health services.

“When children come into the care system they are at their most vulnerable and yet, as this report shows, their mental health and wellbeing is too often overlooked until they reach crisis point,” he said.

“There is a way forward but urgent action is needed now – children in care must be guaranteed access to specialist assessments and the support they need to help them overcome trauma or mental health problems.”

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