Mental health services for young people in Stoke-on-Trent are being overwhelmed due to funding cuts to early intervention, councillors have been told.
Scrutiny committee members at Stoke-on-Trent City Council heard that as many as 140 referrals a week are coming into the area’s NHS crisis centre, partly due to the underfunding of prevention work.
The shortage of tier one and tier two services means that tier three CAMHS (Children and Adolescents Mental Health Services) provision is effectively acting as a ‘front door’ for troubled young people, which NHS provider Combined Healthcare says ‘is not the intended or most effective and efficient use’ of such a service.
The budget for tier three CAMHS is £12 million, whereas the prevention budget for lower level support is just £1 million.
Members of the children’s and young people’s overview and scrutiny committee, who carried out a review of mental health provision, have now called for a ‘rebalance’ of funding in favour of early intervention and prevention services.
According to the committee’s report, this will result in cost savings through reduced demand for more expensive clinical treatment, as well as better outcomes for the young people themselves.
The report states: “The issue for CAMHS services at the higher tiers, is therefore not a lack of funding, but the increase in demand for these services because of the lack of prevention funding and the lack of more specialised staff, for example, educational psychologists to meet the increasing demand.
“Combined Healthcare do not have enough specialist staff to cope with the demand, which is not their fault – if there is not the specialist skill available, they can’t recruit. The committee heard evidence that in one particular week, 140 referrals came in to the crisis centre and the team were not set up to manage this level of demand.”
Tier one and two services, provided by schools, GPs and the voluntary sector, are commissioned by the city council and clinical commissioning groups.
Tier three services are commissioned by the CCGs, while the tier four inpatient units – such as the 15-bed Darwin Centre in Penkhull – are funded by NHS England.
Committee members heard that young people at the Darwin Centre were using Whatsapp to share self-harm techniques. Combined Healthcare, which runs the centre, acknowledged that it is ‘not an ideal environment for a young person’.
The Combined Healthcare representative told the committee that mental health provision for young people should be expanded.
They said: “Considering that 50 per cent of all diagnosable mental health conditions are diagnosable by the age of 14 years, there isn’t really enough funding or resource to meet this need and consequently, children wait longer until they meet services and adult services are strained as a result because they then have to treat years of ingrained mental health symptoms and disorders, which takes longer and needs more intense care, that treating the condition early on in presentation.”
The committee also heard evidence from service users and their parents.
One young person was complimentary about the Changes mental health service, but said it was ‘being eroded by year on year funding cuts’.
The parent of a child with mental health issues criticised CAMHS, saying ‘children are being failed because they are bounced around the system like a ping pong ball’.
Combined Healthcare explained that this happened because referrals from GPs and schools sometimes lacked sufficient detail for an effective assessment to be carried out. The committee heard it could take up to two hours to fill in a referral form.
Committee members agreed to refer their conclusions and recommendations to the city council’s cabinet for a formal response.
They will also carry out a separate piece of work focusing on the transition from young people’s to adult’s services.