Last week, the government published a Green Paper outlining plans to increase funding and provision for young people’s mental health.
Among the proposals, to be delivered over a time period between now and 2022, was an additional £300 million of funding, some of which will be given to schools. £95 million of the funding will be set aside for “senior mental health leads”, who will work with schools to develop a “whole-school approach” from 2019. The remaining £215 million is for support teams who will apparently improve the link between schools and CAMHS (Children and Adolescent Mental Health Services).
The Green Paper also calls for mental health discussions in the classroom and a cap on waiting times for CAMHS of four weeks.
The response has been, to put it mildly, mixed. Welcomed as a “huge step forward” by some, others have declared it “too little too late”, interspersed with more than a few cries of “I’ll believe it when I see it”.
My own view is that £300 million over five years is a drop in the ocean. To put it into context, we spent £5 billion every single year on Trident. We currently spend fourteen times more on adult mental health services than we do for young people, despite the commonest onset age for mental illness being adolescence. Local authorities spend an average of 1 per cent of their health budgets on mental health, despite one in three GP appointments relating to a mental health issue.
It is, however, as my Nan (somewhat inexplicably) says “better than a smack in the face with a wet kipper”. Before we get all excited, however, here’s six questions we should be asking our politicians:
Is it ringfenced?
In 2015, the government promised £1.5 billion to be invested in young people’s mental health before 2020. However, a 2016 investigation by the former shadow minister for Mental Health, Luciana Berger, revealed that despite £76 million having already reportedly been “invested” by that point, only half of local authorities had increased their spending on mental health in real-terms.
This is because the money was not ringfenced, meaning that while it was in theory allocated for mental health, local authorities had the option to spend it on other “more urgent” projects.
This time, we need assurance that the promised funding is guaranteed to reach the people it was intended for.
Does the four-week target represent the waiting times for the start of treatment or “initial consultation”?
“Waiting lists” usually represent the time spent in anticipation of an initial assessment, after which an appropriate course of treatment is agreed upon and the patient is placed on another waiting list until an appointment becomes available. It’s important to distinguish between the time spent waiting for the consultation and for the commencement of treatment.
Where are the healthcare providers going to come from?
There is already evidence to show that the Brexit vote will lead to a decline in staffing for an already stretched NHS, with 1 in 5 doctors reportedly planning to quit after we leave the European Union. Applications for nursing training are also in steep decline.
So, have the government accounted for all of these additional medical practitioners? If so, will they have the qualifications, skills and experience necessary for such a momentous task as implementing a “whole-school approach”?
Will CAMHS criteria be lowered?
A smoother transition between school and CAMHS is an appealing idea, but one of the most pressing issues is that, owing to funding and staffing shortages in CAMHS, the thresholds are incredibly high. Children and young people in huge amounts of emotional distress, some with addiction issues, some who are undertaking highly dangerous self-harming behaviours, are being denied treatment on the basis that they don’t meet the criteria, leaving teachers attempting to play therapist. This is one of the factors that is in turn leading to a crisis in teacher recruitment.
How do we define “young people”?
The handover between CAMHS and adult mental health services is notoriously difficult to navigate, with many young people dropping off the radar at this point. There are discrepancies as to the appropriate age to make the handover. Furthermore, university has been identified as a time when young people can be particularly vulnerable to
mental health issues, yet, because most university students are over 18, presumably this funding won’t benefit them.
What about prevention?
We can’t keep merely firefighting the worst instances of mental illness without acknowledging the wider contributory factors to poor mental health. Lack of funding for school subjects known to improve wellbeing (arts, music, drama, sport), academic pressure, testing regimes, teacher stress, child poverty, concerns about future prospects, student debt, lack of quality family time due to increased working hours - these all play a part in the spiralling mental health crisis among young people.
Ultimately, the government’s job is to fix our broken society and, in that context, £300 million over five years isn’t going to cut it.
Natasha Devon MBE is the former government mental health champion. She is a writer and campaigner and visits an average of three schools per week all over the UK. She tweets @_natashadevon. Find out more about her work here
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