News: Urgent improvements needed in mental health services for children and young people in Wales
24 November 2009Mental health services in Wales are still failing many children and young people, despite some improvement in recent years. That is the conclusion of a report published jointly today by Healthcare Inspectorate Wales, the Wales Audit Office, Estyn, and Care and Social Services Inspectorate Wales.
The report acknowledges the recent improvements that have been made. These include new funding streams to develop parenting and family intervention services, expanding school based counselling and the introduction of primary mental health workers who support professionals, such as GPs and school nurses, working with children and young people.
However, it highlights the barriers that are currently preventing further improvement – such as the way services are planned and provided, and issues around workforce development, staff training and performance management. The report makes 16 recommendations to the Assembly Government, health boards and local authorities in Wales.
The report highlights that there is too much variation across Wales in the availability and quality services. For example:
- Unlike other parts of the UK there are no specialist mental health services in the community for children under five;
- In parts of Wales some groups of young people do not have access to the specialist mental health services that are in place ;
- Specialist community services, including services for young people with eating disorders are too variable;
- Transition arrangements for the transfer of young people to adult services when they get older are not good enough;
- Services are often not child friendly and many children and young people are not involved enough in planning their care;
- The access to care and support for young people varies substantially across localities in Wales;
- A number of practices are putting children at risk including placing significant numbers of children inappropriately, on paediatric or adult mental health wards.
The report also states that it is unclear how policy should be implemented, with only limited support and guidance provided by the Assembly Government to organisations arranging and providing services locally. The overall approach to planning and providing services is one of assessing whether a child or young person's needs meet a service's criteria, rather than building services around the specific needs of the individual. And joint working between the health, local authority and voluntary sectors is very variable, resulting in some children and young people receiving services that are poorly co-ordinated.
The report's recommendations call for:
- The Assembly Government to develop an action plan within six months of the report being published to address the issues identified around the availability and quality of services.
- Health Boards and Local authorities to develop local multi agency plans for implementing the priorities and targets in the national action plan.
- The Assembly Government to commission the development of information for children, young people and their parents on their rights relating to child and adolescent mental health services and what they should expect from these services.
- The Assembly Government and other public bodies to introduce effective arrangements for managing and scrutinising performance, ensuring results are widely available.
The Auditor General for Wales, Jeremy Colman said today:
"There have been some improvements in recent years in mental health services for children and young people. However, additional investment alone will not deliver the further improvements needed, and the Assembly Government should take the lead in ensuring that changes to the design and delivery of services, as recommended in this report, are fully implemented."
Chief Executive for Health Inspectorate Wales, Peter Higson said today:
"There is still a considerable challenge ahead for those providing mental health services to children and young people. We hope that this landmark report will assist them in meeting this challenge and Healthcare Inspectorate Wales, along with the Wales Audit Office, Estyn and CSSIW, will continue to monitor the progress made across Wales in developing comprehensive, effective and safe services."
Chief Inspector for Estyn, Bill Maxwell said today:
"It's evident that there is still a lot of work to be done to ensure that all children and young people with mental health problems have equal access to a good range of support from specialist Educational Psychology, Welfare and School Nursing services. Recent guidance issued by the Assembly Government will hopefully help to address some of these issues. I would urge schools and early year settings to read and actively use this guidance to help improve the role that their education staff can play in providing preventative services and improving the emotional wellbeing of children and young people."
Acting Chief Inspector for Care and Social Services Inspectorate Wales, Jonathan Corbett said today:
"Children and young people with emotional and mental health problems often have complex and wide ranging needs that require a co-ordinated response from different professionals and services in the fields of health, social care and education. This report should help those tasked with meeting these challenges."
Source: Wales Audit Office