Mental health crisis: One in four children are rejected by Scottish mental health services

One in four children in Scotland are being rejected by mental health services, new figures have revealed.

NHS Scotland provides mental health services for children and young people with a wide range of mental health conditions, including attention deficit hyperactivity disorder (ADHD), anxiety, behaviour problems, depression and early onset psychosis. This treatment is provided through Child and Adolescent Mental Health Services (CAMHS).

These services, which are mainly outpatient and community based, are provided by a range of staff, including psychiatrists, mental health nurses, clinical psychologists, child psychotherapists, occupational therapists and other allied health professionals.

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Fresh figures from Public Health Scotland show in the first half of this year, 4,640 cases were refused help by CAMHS after being referred by healthcare professionals.

A mother stroking the back and comforting a little girl at home
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Between January and June, an average of 24.5 per cent of referrals to CAMHS were rejected each month, with monthly rejections peaking at 27.4 percent in May.

In 2018, the Scottish Government completed an audit of rejected referrals to CAMHS, but more young people are being rejected now than before the audit. The aim of the audit was to investigate why so many children were denied help from CAMHS in the three years to 2017.

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Between 2014 and 2017, 19.6 per cent of children were rejected from CAMHS, but so far this year 24.5 per cent have been rejected.

The 2018 audit found “most decisions are made on the basis of paper referrals, without a face-to-face assessment”, and “some young people whose referral has been rejected report a belief that they will not be seen by CAMHS unless they are suicidal or at immediate risk of harm”.

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The audit’s authors also stated their belief that “in a well-functioning system, there should be no need for rejected referrals”.

Despite this, the number and percentage of rejected referrals to child mental health services have increased since the report was published in 2018.

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Scottish Conservative drugs policy and mental well-being shadow minister Sue Webber said: "It’s absolutely heart-breaking that one in four children in need of mental health support are being rejected for CAMHS services.

“The SNP knew rejections were too high in 2018, when the rate was one in five, yet instead of improving the service they’ve allowed things to get even worse.

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“Often children and families have reached a desperate point by the time they contact CAMHS for help, so the fact that a quarter of them are then being denied vital help is deeply wrong. And even when children are accepted for CAMHS services, waiting times are far too long.

“This service is failing too many of our children and leaving worried parents and families with nowhere to turn. The SNP must heed the recommendations of their own 2018 review and take urgent action to ensure every child in Scotland can get the mental health support they need.”

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A Scottish Government spokesperson said: “Decisions on referrals are for healthcare professionals. We have high expectations for mental health services – supported by additional £40 million in funding. This means under-18s should be guided to a suitable service nearby if a referral is not accepted.

“We have published a National Service Specification for CAMHS, which sets out the levels of care that can be expected.”

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