Of course we want to help but we’re in a recruitment crisis
Soaring demand, insufficient capacity and a recruitment crisis are the factors that all add up to a waiting list of up to eight months for at- risk children and young people who need help for mental ill health.
Referrals to NHS Lanarkshire’s Child and Adolescent Mental Health Service (CAMHS), which provides a wide range of high-quality support to children across the region, rose by an alarming 46 per cent between 2012 and 2018.
CAMHS’ clinicians are calling for increased capacity for frontline services to help ease the pressure on their own service and enable them to reduce waiting times and reach more children and young people who need their help.
As well as asking health visitors, school nurses, GPs and A&E units, to “do their bit at their level” to help reduce the burden on CAMHS, they are appealing to parents and families to be vigilant and play their part in supporting sons and daughters who may be troubled or anxious.
CAMHS’ services, which include the provision of early intervention for young people with emotional distress through to specialist services for patients with more severe and complex mental ill health, are under more strain than ever in Lanarkshire.
Jim Murray, service manager children’s services: CAMHS and paediatrics, says the service is recruiting constantly but currently has nine vacancies for clinical psychologists and children’s mental health nurses which they are struggling to fill.
“We are in a recruitment crisis because the government has invested in all boards to increase capacity,” he explained.
“The unintended consequence is we are all fishing in the same pool. Lanarkshire is wedged between Glasgow and Edinburgh and the bigger cities find it easier to recruit than we do.”
He says if NHS Lanarkshire CAMHS could fill the vacancies, he is confident they could meet the Scottish Government’s target of 90 per cent of referrals being seen within 18 weeks.
He and Dr Eileen Boyes, consultant/ lead clinical psychologist with CAMHS and clinical manager of the early intervention service, Tracy Stephen, want to see increased capacity among universal services to create a structure in which CAMHS is the final destination in a mental health support journey.
And they want youth counsellors to be embedded in every school as permanent members of staff.
A new attainment team is focusing on mental health needs of primary school children with a view to “getting in early in preventative mode”.
School nurses are also being helped to develop pathways for children presenting at an early stage with lowintensity anxiety.
“Families can play a role,” insists Dr Eileen Boyes.
“It is not always about psychological intervention. There can be trauma in families – maybe a death. Life is not straightforward. There are lots of challenges for us as humans and we should manage it rather than pathologise it.
“Parents are important people and should not underestimate the roles they play in their sons’ and daughters’ health and wellbeing.
“There are young people who self harm and go on to complete suicide who may not have had a recognised mental illness and may not have demonstrated their intention.
“It can be impulsive with no prewarning. It does not mean mental illness or long-term distress.”
In North Lanarkshire, three specialist locality CAMHS teams are staffed by consultant psychiatrists, clinical psychologists, specialist nurses and social workers, all of whom have advanced level training and skills in a variety of specialist evidencebased psychological interventions.
There are also sub-specialist teams for looked-after and accommodated children, Reach Out for children whose parents experience mental illness, and an award- winning CAMHS intensive treatment team.
Working together to support young people living in the community who have an increased risk of suicide or self-harm, the nurse-led team uses a range of approaches to build engaging relationships.
In Lanarkshire, 66.7 per cent of people who started their treatment between October and December last year were seen within 18 weeks compared to the Scotland average of 71.1 per cent.
The average wait in Lanarkshire was 11 weeks compared to 10 weeks across Scotland.
If a child or young person is at risk of self harm or suicide, they are seen by CAMHS on the same day or within two weeks.
For severe cases where life is at risk, NHS Lanarkshire CAMHS also has an allocation of beds at adolescent inpatient unit, Skye House, at Stobhill Hospital.