As a Government-commissioned CQC research report announced on 27 October finds children are waiting up to 18 months for treatment, many professionals are calling for a change in approach to make more service provision possible.
Jon Goldin, vice chair of the child and adolescent psychiatry faculty executive committee of the Royal College of Psychiatry commenting on the report on Linked In said “Concerning report. We must do better as a nation in supporting our young people with mental health difficulties.”
Another cause for concern is the question some are asking – are waiting times for eating disorders linked with self-harm among children? Statistics have risen in both and many professionals think they are related. UK GP Practice statistics announced in October showed a 68% increase in self-harm among girls aged 13 to 16. To read more on this, see the article recently published on The Guardian. Commentators on the research are linking the fact that children are diagnosed, but not receiving treatment and during this time of unmet need are self-harming and dropping out of education. As a specialist inpatient service dealing with eating disorders among children in the UK, Ellern Mede sees the impact of delayed treatment in this particular type of illness as particularly damaging to the long term prognosis for recovery. Eating disorders are on the one hand, most responsive to early treatment; on the other, most dangerous to physical health if left untreated.
Claire Murdoch, the mental health director for NHS England told The Guardian that NHS funding for children’s services had been increased but that: “NHS England has been explicit about the scale of unmet need, which recent improvements have inevitably only been able to begin to tackle.”
True, the NHS has increased funding for community based services, however its’ funding of new and specialist inpatients services remains restricted. The emphasis of the NHS on avoiding inpatient admissions in favour of providing outpatient services risks patients missing the level of intervention they need at the right time. Therefore some of the new and most advanced specialist eating disorder beds are only accessible to patients and their families through private self-pay and private medical insurance funding.
How the NHS will move to close the evident gap in children’s needs and mental health service provision is a debate that is raging this Autumn at high level. On the 15th October, the Observer printed an article reviewing the public debate between Anne Longfield, Children’s Commissioner for England and Simon Stevens, chief executive of NHS England. Research publicised by Longfield claimed only between one quarter or a fifth of children who needed help had received NHS treatment last year. She said: “children’s inability to access mental health support” was leading to a range of extra problems, “from school exclusions to care placements breaking down to children ending up in the youth justice system”.
Jo Hardy, the head of parent services at Young Minds added to the waiting times debate. She told The Guardian: “Some parents tell us that their children have started to self-harm during the wait or that they’ve dropped out of school, which not only has a big impact on their own education, but also means that one of the parents has to give up their job to look after them.”
The threshold for entry to at least some form of eating disorder care should not be a physical crisis point. It should be as soon as possible upon diagnosis. Delayed treatment for eating disorders costs more in the long term. As chronic illness sets in, instead of one hospital admission there is an increased risk of multiple admissions and usually for longer periods. All services are familiar with the fact that some people with eating disorders need to return again and again for treatment, prompting the phrase ‘revolving door’.
Ellern Mede believes the earlier a patient accesses treatment the shorter the term of inpatient care they are likely to need. Research evidence shows that a model of care that focuses on early-stage short-term inpatient care with post discharge support allows patients to reintegrate back into the community faster provided there is appropriate post discharge support. Ellern Mede works with the NHS in providing eating disorders care and also work with Clinical Commissioning Groups and Local Authorities. We offer a range of services and we prefer to tackle eating disorders at the earliest possible stage. We believe health sector policy needs to recognise the vital role that the independent sector plays. It is the key to reducing mental health treatment waiting times and to meet children’s needs which the NHS currently find impossible within its existing resource.