Children and Adolescents
We need to address the shortfalls in resources
and skills in the workforce to secure real change for our
children's future – to improve their mental wellbeing which will in
turn impact on the next generation.
Mental health problems in childhood and
adolescence are sadly very common and yet the available mental
health workforce is insufficient to tackle these problems in
anything but a superficial way. Multiple indicators point to
higher rates of psychosocial problems amongst our nations’ young
than most of our European neighbours . (Unicef 2007) Indeed 10%
of 5 to 15 year old children at any one time have a mental
health disorder (ONS 200) But only a quarter of these have seen a
mental health professional of any kind in the last year.
We are increasingly knowledgeable about the
impact of mental health problems that remain unaddressed and the
treatments that can make a big difference. Mental health problems
in children and young people not only cause distress to the
sufferers and their families but are directly economically costly
to society at the time and also in adult life. This is
because of lost productivity and because of the direct costs of the
damage they do to themselves, their children and society as a
whole. With treatment significant improvement is evident, for
instance, for 50 – 70% of cases with conduct problems and moderate
to severe depressions.
Although progress has been made in relation to
meeting the objectives set out in the National Service Framework
for Children, Young People and Maternity services there were still
serious shortfalls, particularly in relation to specialist CAMHS
services; with on average services being approximately 33% below
the staffing numbers recommended in the NSF.The threshold to be
accepted for treatment by specialist CAMHS services is in many
cases too high due to insufficient capacity to meet the demand
resulting in children and young people with milder problems being
unable to access treatment which can lead to a lost opportunity for
early intervention.
In addition, treatments recommended by the
National Institute of Clinical Evidence and the Scottish
Intercollegiate Network guidelines for the assessment and treatment
of some mental disorders in children and young people are not
sufficiently available in the NHS.
Older people
Early intervention is also critical for the
prevention and treatment of mental illnesses, particularly
depression among the older population, particularly those with
chronic physical health conditions
It is just as true for older people as it is
for younger adults that the earlier conditions are recognised and
treated the better the outcome for patients.
Specifically, evidence shows that early
treatment for depression improves prognosis and a pillar of the
National Dementia Strategy is early identification based on a spend
to save principle as it has been shown to delay transition to more
expensive forms of care. The existence of early intervention
for psychosis services show the benefit for younger adults and
while these have been denied to older people there is no reason to
believe they would not derive similar benefits. Early
identification creates the opportunity to prevent chronic and
disabling morbidity which will cause protracted suffering and
usually greater costs. Delays simply removes that
opportunity.
Further resources