The Secretary of State for Health and I today welcome the publication of the final report of the independent review of child and adolescent mental health services. We would like to thank the CAMHS external review group for their report and recommendations. In particular, we would like to thank Jo Davidson, the chair and group director of children and young people's services at Gloucestershire county council and Dr. Bob Jezzard, the vice-chair.
This has been a challenging review. Children’s mental health is an area where there are strong views and perspectives. The external review group should, therefore, take great credit for having produced such a coherent and evidence-based report, which sets out a clear vision for how we can all take responsibility for promoting children’s mental health and psychological well-being, alongside clear recommendations for how we can best achieve the step change in the quality and consistency of services at all levels.
We asked the chair and vice-chair to investigate:
the progress that has been made, since the launch of standard 9 of the children’s national service framework and the publication of “Every Child Matters” in 2004, in delivering services to meet the educational, health and social care needs of children and young people at risk of and experiencing mental health problems, including those with complex, severe and persistent needs; and
the practical solutions that can be used by those developing policy and delivering, managing and commissioning services to address current challenges and deliver better outcomes for children and young people with mental health problems, and how these solutions can be monitored.
We welcome the fact that the review carried out its task in such a comprehensive manner, undertaking an intensive programme of investigation, including a national call for evidence and extensive consultation with children, young people and their families throughout the process. The fact that the review’s recommendations respond to the concerns of users of these vital services gives its report added weight and importance.
We agree with the review’s analysis that whilst considerable improvements have been made to the support and services delivered in this area, there is still a great deal of change that needs to take place at all levels of the system to support the delivery of integrated, child and family-focused mental health and psychological well-being services that are organised around children and young people’s needs.
The review’s report identifies the important changes that are required if we are to see real improvements in children’s mental health and psychological well-being. The review sets out a clear and ambitious vision of what this change would look like for children, young people and their families accessing universal, targeted and specialist services, highlighting the importance of:
everyone having a good understanding of what mental health and psychological well-being is, how they can promote resilience in children and young people and where children, young people and their families can go if they need more information and help;
children’s mental health and psychological well-being services being viewed and working as a single service that is organised around children, young people and their families’ needs, with staff working within these services having a clear understanding of their roles and responsibilities as well as those of others;
staff within universal services being trained and supported to provide effective mental health promotion, prevention and early intervention work and where necessary having the knowledge and skills that are needed to refer children and young people swiftly through to specialist services; and
staff within specialist services to have an appropriate range of skills and competences so that they can deliver support that is easy to access, readily available and based on the best evidence of what works.
The review makes 20 challenging recommendations to Government across all aspects of children’s mental health and psychological well-being services. The Secretary of State for Health and I are delighted to be able to demonstrate our commitment to the immediate implementation of a number of these recommendations. In particular:
we will set up a National Advisory Council for children’s mental health and psychological well- being. In line with the review’s recommendations, the council will act as a champion for children’s mental health and psychological well-being issues, advise Government on implementing the recommendations that have been set out in the review’s report, and hold Government to account on our successful delivery. We are delighted that Dame Jo Williams, former chief executive of Mencap has agreed to chair the review and Dr Lesley Hewson, consultant child and adolescent psychiatrist and director of CAMHS, Bradford District Care Trust, to act as vice-chair; and
we will improve support for practitioners delivering services for children and young people and drive culture change and consistency at national, regional and local levels, we will develop a National Support Programme. This will build on the work of the national CAMHS support service and field forces working in this area. The National Support Programme will co-ordinate these organisations to give everyone working in this area the support they need to achieve the aims of the CAMHS review.
We are committed to: taking forward key recommendations within the report on improving access for children, young people and their families to mental health support through universal services; improving the access, quality and impact of mental health services for vulnerable children and young people; and ensuring that parents and carers have access to high quality advice and support when they are concerned about their children’s mental health.
For example, legislation to strengthen Children’s Trusts is already in train. Revised statutory guidance will highlight that Children’s Trusts should consider the mental health and psychological well-being needs of children and young people in their area as part of their wider joint strategic needs assessment and respond to this through effective joint-working between primary care trusts, local authorities and other strategic partners.
Today we want to further demonstrate our commitment by announcing:
the roll-out of phase two of the targeted mental health support pathfinder programme (TaMHS) in an additional 55 local authority areas. This will enable a further 100 to 150 secondary schools and their feeder primary schools to deliver additional support in school to promote all children’s psychological well-being and additional help in and through the school for those children and their families at risk of problems. It will also provide additional funding for schools to forge closer working links with specialist CAMHS. Children will benefit from schools’ increased ability to identify risks to mental health at an early stage and ensure that they receive prompt access to the help and support that they need;
additional funding for local authorities already delivering the targeted mental health in schools pathfinder, so that they can build on their work in pupil referral units and special schools in order to meet the needs of this very vulnerable group of children and young people; and
additional funding for organisations who are delivering vital telephone helpline support for parents who are concerned about their children’s mental health.
We are pleased to accept most of the review’s recommendations in principle, with a view to implementing these as soon as is practical. Overall, we share the review’s conclusions on the need to promote greater consistency in access, quality and impact of children’s mental health services. In order to deliver these improvements, we identify four priority areas to be addressed by the National Support Programme and National Advisory Council. These are:
awareness of and access to services through the provision of local information in every area that clearly sets out the support that children, young people and their families can expect to receive in their local area;
the diffuse leadership and responsibility for children’s mental health and psychological well-being that currently exists at a national, regional and local level, for example through the strengthening of Children’s Trusts;
waiting times, where we are aware of the significant negative impact that having to wait a long time to receive treatment can have on children and young people’s recovery, so look to the national support programme to drive further improvements in this area; and
transitions to adult services, where we agree with the review that urgent work is required to identify, understand and overcome the barriers to smooth transitions between mental health services for young people and services for adults.
We will give further consideration to the remaining six recommendations from the review in conjunction with the National Advisory Council in order to develop an appropriate response and effective solutions that reflect local and national priorities.
The Secretary of State for Health and I have set out our initial response to each of the review’s 20 recommendations in a summary document that has been made available on the DH and DCSF websites and in the Libraries of both Houses of Parliament.