Briefing: Children’s Mental Healthcare in England

1. Our analysis shows just over 200,000 children received CAMHS treatment last year, 2.6% of the age 5-17 population. Comparing this to recent research on the number of children with a mental health condition we estimate that between 1 in 4 and 1 in 5 children with a mental health condition received helped last year.

2. The overwhelming majority of NHS mental health spending goes towards those with the most severe needs. Our analysis shows that:

• 38% of NHS spending on children’s mental health goes on providing in-patient mental-health care. This is accessed by 0.001% of children aged 5-173.
• 46% of NHS spending goes on providing CAMHS community services, these are accessed by 2.6% of children aged 5-17.
• 16% of NHS spending goes on providing universal services. This need to support the one in ten children who are thought to have a clinically significant mental health condition but are not accessing CAMHS. It also needs to support a – currently unknown – number of children with lower level needs, who would be less likely to develop a more serious mental health condition if they were provided with timely support.

3. This is despite the fact that early intervention is much cheaper to deliver:

• £5.08 per student – the cost of delivering an emotional resilience program in school
• £229 per child – the cost of delivering six counselling or group CBT sessions in a school
• £2,338 – the average cost of a referral to a community CAMHS service
• £61,000 - the average cost of an admission to an in-patient CAMHS unit=

And highly cost-effective in preventing conditions escalating:

The Department of Health estimate that a targeted therapeutic intervention delivered in a school costs about £229 but derives an average lifetime benefit of £7,2525. This is costbenefit ratio of 32-1.

4. Our research shows that the Government’s much vaunted prioritisation of mental health has yet to translate into change at a local level. The current system for providing children’s mental health care is neither transparent nor accountable and the Government have failed both to put clear expectations onto local NHS areas as to what should be provided or to monitor what is provided. In particular, the NHS are still failing to identify:

• How many children are referred to CAMHS but don’t receive treatment
• How long children wait from the date they are referred to the date they entertreatment
• How many children drop out of treatment
• Whether the treatment is effective at improving children’s mental health

5. There is a massive discrepancy between children’s and adult’s mental health. Our analysis shows local areas spend an average of 6% of their mental health budget on children, despite children making up around 20% of the population. NHS England monitors 39 local measures for adult mental health but only nine for children’s mental health.

6. Most local areas are failing to meet NHS benchmarks for improving services and providing crisis care.

• Nearly 60% of local areas are failing to meet NHS standards on improving services
• Over 55% of local areas are failing to meet NHS standards on providing crisis care in A&E and other settings