The scandal of underfunded child and adolescent mental health services laid bare in new research from RCPsych

Press release
17 November 2016

Some local NHS areas are spending less than £10 a head on the mental health of children and young people in their communities

Researchers from the Royal College of Psychiatrists have estimated the amount of money being spent per head by NHS commissioners on child and adolescent mental health services for the 2016/17 financial year.
They found that 25 of the Clinical Commissioning Groups in England have planned to spend less than £25 a head on mental health services for the children in their communities. Commissioners in ten areas will spend less than £10 per head.*
1. Luton (£2.01)
2. Enfield (£2.33)
3. Tower Hamlets (£4.45)
4. North Somerset (£5.89)
5. Ealing (£6.39)
6. Central London (Westminster) (£7.65)
7. Tameside and Glossop (£8.61)
8. High Weald Lewes Havens (£8.73)
9. Walsall (£9.04)
10. West London (£9.17)
11. Stockport (£10.80)
12. Shropshire (£10.96)
13. Solihull (£11.02)
14. Hastings and Rother (£11.07)
15. Hounslow (£11.55)
16. Eastbourne, Hailsham and Seaford (£11.59)
17. North Derbyshire (£11.76)
18. Blackpool (£12.83)
19. Hardwick (£13.76)
20. Bristol (£14.74)
21. Halton (£18.32)
22. Hillingdon (£20.66)
23. South Gloucestershire (£21.86)
24. Brighton and Hove (£23.11)
25. Horsham and Mid Sussex (£23.79)
The Government has pledged to invest in child and adolescent mental health services, with £119 million of NHS funding allocated to clinical commissioning groups for this financial year and another £140 million promised for 2017/18, with an additional £30 million for eating disorder services. But it is up to local clinical commissioning groups to ensure that money is passed to the front line based on their assessment of local need.
The RCPsych figures show that children and adolescents’ mental health is still underfunded when it comes to the share of NHS spending in many areas of the country. There are 52 Clinical Commissioning Groups in England that are allocating less than 5% of their total mental health budget to services for children and young people. That’s despite the fact that one in every ten children aged 5-16 years has a diagnosable mental health disorder and children under 18 make up a fifth of the population (21.3%).
The President of the Royal College of Psychiatrists, Professor Sir Simon Wessely said:
“Our analysis shows that in many areas of the country, the proportion of money that NHS clinical commissioning groups are planning to spend on the mental health of our children and young people is negligible. We know that more than half of all adults with mental health problems were diagnosed in childhood and less than half were treated appropriately at the time. It is a national scandal that opportunities to prevent mental illness from occurring in childhood are being missed because of unacceptably low investment”
The Chair of the RCPsych Faculty of Child and Adolescent Psychiatrists Peter Hindley, said:
“This research confirms the stories I hear from colleagues every day; that desperately needed money, promised to child and adolescent mental health services is not getting through to local services in many parts of the country. Without this investment, it will be nigh on impossible to deliver the best outcomes for children, young people and their families, let alone achieve the national target of ensuring 70,000 more children receive treatment for their mental illness by 2021. The College calls upon commissioners to revisit their planned spend in this vital yet chronically underfunded area.”
The Royal College of Psychiatrists has created an interactive map showing the planned spend on children and adolescent mental health services across the country. * excluding eating disorder spend as not all 209 CCGs were able to extract costs for specific services they commission. Please see Notes to Editors for further info.

Notes to editors

1. The RCPsych analysis draws on information that all 209 CCGs gave to NHS England on total 2016/17 planned spend for children and young people's mental health, excluding eating disorders. Eating disorder spend has been excluded in RCPsych analysis because the NHS England data set is incomplete in this area. This is the first time CCGs have been asked to report mental health spend at programme level, meaning some CCGs have had difficulties extracting costs for specific services they commission because of block contract arrangements. As a result there are some CCGs that show zero spend for mental health programmes in the eating disorder category, which is being reported as N/A in the dashboard. Full results of the dashboard are available on the NHS England website.
2. The Royal College of Psychiatrists welcomes transparency on Child and Adolescent Mental Health spending by clinical commissioning groups. Following the publication of the College analysis of the NHS official dashboard on CCGs, a number have come forward with revised data. Luton CCG reports that its total planned spend for 2016/17 will be £3,892,000 and per head spending on under 18s will be £58.60. Enfield reports that spending per head will be £5.2 million in 2016/17 or £17 per head. We urge CCGs with new or revised data to inform NHSE who collate and publish the official data upon which policy makers and service providers must depend. The Royal College of Psychiatrists must rely on the official published data.
3. All figures on the NHS England Dashboard exclude spend on learning disabilities.
4. The Royal College of Psychiatrists is the professional medical body responsible for supporting psychiatrists throughout their careers, from training through to retirement, and in setting and raising standards of psychiatry in the United Kingdom.
5. The College aims to improve the outcomes of people with mental illness, and the mental health of individuals, their families and communities. In order to achieve this, the College sets standards and promotes excellence in psychiatry; leads, represents and supports psychiatrists; improves the scientific understanding of mental illness; works with and advocates for patients, carers and their organisations. Nationally and internationally, the College has a vital role in representing the expertise of the psychiatric profession to governments and other agencies.
6. The Royal College of Psychiatrists is an independent professional membership organisation and registered charity representing over 18,000 psychiatrists in the UK and Internationally. The core purposes of the Royal College of Psychiatrists are to:
Set standards and promote excellence in psychiatry and mental healthcare
Lead, represent and support psychiatrists
Work with patients, carers and other organisations interested in delivering high quality mental health services

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