Limited mental health services leaving many children in England without support
In some parts of England, 1 in 3 children's acute hospital beds are currently occupied with children in distress, some of whom cannot access specialist mental health treatments because of limited beds
As the psychological impact of the Covid-19 pandemic comes into sharp focus, an increasingly clear picture has emerged of the current state of mental health services across the UK.
Growing numbers of mental health issues across the country has led to ever-extending waiting lists to access professional help, from talking therapy sessions through to designated psychiatric beds for more severe cases, in turn revealing just how stretched mental health services are.
This is particularly accentuated for children, among whom 1 in 6 are now believed to be living with a diagnosable mental health issue (up from 1 in 8 in 2018). Included in this figure are a doubling of cases of anxiety and depression among teenagers, as well as record levels of referrals for eating disorders, due to the pandemic.
According to a survey in July, the pandemic has resulted in 1 in 3 children possibly needing mental health support. But in specific parts of England, extended waiting lists and services shortages mean many children aren't getting the support they need.
Reported by The Guardian, 1 in 3 acute hospital beds are currently occupied by children in 'extreme distress', some of whom qualify for a psychiatric tier 4 bed –which are reserved for treating people with severe mental health issues – but can't access one either due to waiting lists or a lack of availability. As a result, many of these children remain without appropriate support for months at a time.
A significant proportion of these children are also in care, but have lost their placement due to their behaviour, leaving them with nowhere else to go.
“It is estimated that roughly a third of acute hospital beds at the moment are full of these vulnerable young people, many who are subject to child protection plans, or they are already children in care, living in a residential placement that’s falling apart,” Dr Emilia Wawrzkowicz, a paediatric consultant and assistant officer for child protection at the Royal College of Paediatrics and Child Health (RCPCH) told The Guardian. "...usually, we’re not providing any acute medical care. The way we understand it, as acute paediatricians, we are babysitting, fundamentally. And the children are stuck.
“When I first started as a paediatrician, you might have one case like this once a month or maybe even once every three months. Now it’s on a nightly basis.”
"A whole-societal issue"
Making the situation even more complex is the involvement of authority figures like the police. In some cases, distressed children can become violent and disruptive toward other children on their wards. Dr Peter Green, chair of the National Network of Designated Health Professionals, said that in these cases, police involvement often makes things worse.
“If you sit down, shut the door and keep the police officers out of the way and have a caring, relational approach, then suddenly all the anger disappears and the tears start because they are very, very unhappy, and very tragic characters. And they need all the love and care and support we can give them,” said Green.
Consultant paediatrician Dr Vicki Walker, who also acts as the looked-after children’s representative on the RCPCH’s safeguarding committee, described these scenarios as the result of failings across the care system:
“It is the end point of a very traumatic life," said Walker. 'We need to look at what has happened in the run-up to see what support they and their family received. This is a whole-societal issue, and it ends up with these very vulnerable children feeling that no one else wants them.”
The government has made pledges to address the growth of mental health issues in children. In March, a £79 million investment package was announced to improve support services in schools and colleges for young adults. A further £40 million was then announced in June with the specific goal of addressing rising cases of eating disorders.
Written by Marco Ricci
Editor and contributor for Talking Mental Health