National action required to ensure local services work together to support children and young people’s mental health needs

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Too many children and young people find themselves at ‘crisis point’ before accessing mental health services because health care, education and other public services are not working together as effectively as they could to protect and support their best interests, a report from the Care Quality Commission (CQC), published today, has found.

Government proposals – such as establishing dedicated mental health support teams in schools – are welcome, and the commitment of funding in the NHS’s The Five Year Forward View for Mental Health has been a significant intervention and an important signal that this is a priority for the whole system to address. However, unless the pace of delivery is accelerated, these commitments will not be enough to achieve the scale of change that is required to protect children and young people from unnecessary distress and avoidable deterioration in their mental health

Among its recommendations, CQC is calling for the Secretary of State for Health and Social Care to use the inter-ministerial group on mental health to guarantee greater collaboration across Government departments in how their policies prioritise the mental health needs and wellbeing of children and young people in England.

CQC has examined care, how needs were identified and how services worked together, in ten local areas across England. CQC also spoke with more than 1,300 people through focus groups and one-to-one interviews, including young people, carers and professionals, and looked at how individual children and young people moved through mental health services to understand their journey.

Based on this, CQC is calling for changes to how local bodies work together to support and care for children and young people with mental health needs and for national bodies to champion and enable this change by ensuring their work does not reinforce the boundaries between services, which can lead to people’s care and access to services feeling fragmented. CQC has recommended:

• The Secretary of State for Health and Social Care to drive joint action across government through the inter-ministerial group on mental health, to ensure children and young people’s mental health becomes a higher priority across government departments.

• National bodies including the Department of Health and Social Care, Health Education England, NHS England and NHS Improvement must recognise and build on the examples of good, person-centred care that exist, and to support people working locally so they can develop innovative approaches to high-quality care based on local need.

• Those leading regional sustainability and transformation partnerships (STPs) and Integrated Care Systems (ICSs) to reach out and collaborate with organisations beyond traditional health and social care services including schools, police and probation services, and charities.

• Commissioners and providers across education, local authorities and the NHS to work with NHS Digital to drive cross-sector improvement in the quality and availability of data, information and intelligence.

• Ofsted and inspectorates of independent schools to recognise and assess how schools support children and young people’s mental health.

CQC has committed to working with other regulators on joint inspections (such as Ofsted, Her Majesty’s Inspectorate of Constabulary and Fire and Rescue Services and Her Majesty’s Inspectorate of Probation) so they take full account of children and young people’s mental health and consider the quality of care across whole systems.

Speaking about the report, Dr Paul Lelliott, Deputy Chief Inspector of Hospitals (lead for mental health) at the Care Quality Commission (CQC), said: “Children and young people deserve to have their mental health needs and wellbeing put at the heart of every decision, be that planning, commissioning or resourcing. Currently, this is not the reality everywhere and we heard from too many young people who felt they could only access care at a crisis point because local services are not working together, or are not able to work together effectively to support their mental health and wellbeing.

“Despite the pressure the system is facing, we saw dedicated staff across the country who embodied this vision and whose work presents an opportunity to transform and improve the experience of children and young people with mental health needs. With children’s mental health a high priority for Government, we must grasp this opportunity. The Five Year Forward View for Mental Health sets out the right ambition for service improvement in mental health, but national bodies must work together and champion creative and effective solutions that go beyond the traditional boundaries of health and social care.

“Our report provides clear recommendations based on listening to children and young people, as well as looking at all the organisations with a role to play in this area. We all need to act now and to act together. If we do not, we risk letting down children and young people across the country and undermining their potential in adult life.”

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