BASW response to green paper on CAMHS

The British Association of Social Workers (BASW) is the professional association for social work in the UK, with offices in England, Northern Ireland, Scotland and Wales. With over 20,000 members, we promote the best possible social work services for all people who may need them, while also securing the well-being of social workers. 

This response should be read in conjunction with the original consultation response from BASW based on a survey of BASW England’s membership.

BASW sees significant shortfalls in the government’s response to the consultation ahead of the Green Paper: Transforming Children and Young People’s Mental Health Services, not least the near absence of the role of the social worker.

As the professional association for social workers, we have frequently highlighted serious flaws within the context of inadequate mental health system that systematically fails children, young people and their families. These flaws hinders social workers from providing the high-quality advice, support and interventions they are trained to give.

These failures must be seen within the context of the Government’s decision to reduce spending in children’s services nationally against ever increasing ‘assessed needs’.  Another significant factor is the ongoing failure to establish a modernised system that prioritises and meets the needs of the most vulnerable children in society.

Social Workers occupy many different roles within the child and adolescent mental health services and deliver essential, skilled services in this specialist area of work across the statutory, private and voluntary sector. 

The Government response to ‘Transforming Children and Young People’s Mental Health Provision’, again fails to mention the role of social worker and the positive role they play in improving children and young people’s mental health. This is incomprehensible, as social workers are coordinators, practitioners and often the point of delivery for these services.

It is encouraging to see the government’s latest response now acknowledges the significance of early years mental health provision, the need for input and partnership from all relevant sectors and underlines the importance of annual reviews. 

However, we remain concerned there is still a total lack of planning for specialist services to refer children and young people to; particularly for those with more complex needs, including but not limited to children and young people subject to immigration control, separated children seeking asylum, children in the secure estate or children with disabilities. Some of these children and young people will not be in mainstream schools and often their needs are not prioritised by mainstream services.

The government’s response seems to only consider children who are engaging with statutory services, such as a school or a GP.  However, children who are looked after, in gangs or experiencing sexual exploitation are less likely to engage with these statutory services.  This current plan does not set out how children’s needs will be met in the community or in spaces where they feel most comfortable. 

This can be rectified by considering the role of social workers and community children’s health workers, in the green paper.  These workers often will visit children in their own home.  This is a vital, and yet often undervalued resource, that would strengthen any mental health support and cannot be reasonably met by schools or GP services which are already stretched by existing responsibilities.

The government’s response asserts that access to NHS services should be given based on clinical needs as opposed to a characteristic such as being a ‘looked after child’. The paper does refer to the additional needs and stresses that looked after children are subject to and has put forward ‘personal budgets’ as an additional support service for ‘looked after children’.

However, it is not clear how this will be integrated into the new system and so ‘looked after children’ may still fail to have their needs met.  The state has a caring responsibility for these children enshrined in law; following a traumatic experience of being removed from their home most children will suffer significant harm and distress and often need support because of complex needs.

The government appears reluctant to target funding for mental health support to areas of social disadvantage and inequality, as the existing NHS allocations formula already considers relative need when allocating resources. 

BASW argues that for the plan to be truly transformative it needs to consider investment in local authority funding for both universal and targeted services (including for example children centres) that are evidenced to promote good mental health and wellbeing. Research evidence including Paul Bywaters (2017) report (state title) highlights how the most deprived local authorities are adversely impacted by lack of adequate funding.

BASW recommends:

• Greater recognition and inclusion of the role(s) of the social worker in meeting the mental health needs of children and young people. This includes clearly defining the role of the social worker, and training and recruiting more social workers to work specifically in the new mental health support teams. Social workers need to be empowered to focus on child centred relationship-based social work which they are professionally trained to undertake.
• The inclusion of ‘looked after children’ at every stage of the Green Paper process by registering their needs as a core part of the new training programs and implementing the recommendations of the SCIE Expert Working Group on Improving Mental Health Support for Children in Care.
• Expand the remit of the mental health support teams to cover early years provision and providing incentives for nursery staff to undertake tailored mental health awareness training. This should be delivered against a backdrop of halting further closures to children’s centres and conducting a joined-up audit of where provision is currently falling short.
• Provide ring-fenced funding for local specialist services to ensure that once a mental health problem is identified, the services exist to refer that child or young person to. The existing postcode lottery is unsustainable and unfair.