Audit of CAMHS rejected referrals

Health Secretary designate Jeane Freeman has described the current system of rejecting referrals for child and adolescent mental health services as “completely unacceptable”.

A Scottish Government commissioned report on ‘rejected referrals’ has found that young people are not being given adequate explanations for the refusal, or directed to alternative support services.

The audit was carried out by the Scottish Association for Mental Health (SAMH) and NHS Information Services Division on behalf of the government.

To drive change, a new CAMHS Taskforce is being created, backed with £5 million of investment, to reshape and improve child and adolescent mental health services (CAMHS). Internationally respected mental health expert Dr Dame Denise Coia will head the taskforce, with an expectation for initial recommendations for action being provided over the summer.

Ms Freeman said:

“Demand on mental health services is growing but far too many young people are being turned away from help or waiting too long to be seen. This report finds that, while CAMHS may not be the right path for some of those referred, young people are being rejected from treatment without proper explanation or being directed to more appropriate care. That is completely unacceptable.

“I am accepting the recommendations in this report and I am determined that our mental health service will be refounded on the need to empathise, engage and explain how to get help to often very vulnerable young people.

“That’s why I am today instigating a new taskforce for CAMHS to examine the whole approach to mental health services. Our first step is to put in place an initial £5 million to help reshape and CAMHS, not least to ensure that all children and young people get appropriately triaged, given proper explanations if their referral is refused, and directed to alternative support services.

“Over the summer we will also be establishing new arrangements for senior leadership of mental health and CAMHS within the Scottish Government’s health directorates. This will enhance our administration’s capacity and help ensure that the recommendations in this report are delivered.” 

Dr Dame Denise said:

“I am delighted and honoured to take forward such important work. Children and young people are talking about their mental health and wellbeing, and we need to hear them. We need to improve services in a cohesive way to respond with practical and emotional support as well as clinical treatment.

“I’m particularly pleased that this is an initiative to be delivered in partnership between the Scottish Government and local authorities, because I think this is key to our chances of success. I’m looking forward to working with colleagues in health, education, children’s services and the third sector, to improve children’s mental health services delivery.”

Councillor Peter Johnston COSLA's Health and Social Care Spokesperson said:  

“The achievement of good outcomes for children and young people’s mental health demands a contribution from the whole system, including the health service, local government, the third sector and beyond.  As this report demonstrates, there remain significant improvements to be made. These improvements for children, young people and their families can only be made through a collaborative approach between partner agencies which the integration of health and social care and community planning partnership working facilitates.

“The Scottish Government’s transformation fund is therefore a welcome contribution and we look forward to working together with partners to drive improvement in CAMHS and deliver on our collective responsibility to provide high quality mental health support to children and young people.”

SAMH Chief Executive, Billy Watson said:

“We welcome the Scottish Government’s commitment to improve the experiences of children and young people who are seeking help for their mental health.  We know that during the period we have conducted this audit, thousands more young people have seen their referral to CAMHS services rejected.

“Achieving positive outcomes for children and young people has been at the heart of this study and speaking to more than 360 children, young people and their families about their experiences has been a real privilege.  Thank you to every single person who has been in touch and engaged with SAMH to take part in this important research.

“Our hope was that this audit would provide substantive evidence as we seek to achieve positive change. We are delighted that the recommendations have been accepted and welcome the announcement of a new CAMHS Taskforce that includes £5m of investment.  We look forward to engaging with Dr Dame Denise Coia at this crucial opportunity to make the mental health and wellbeing of young people an on-going national priority.”

Background

In addition to the audit of rejected referrals the Taskforce will have access to research conducted by the Youth Commission on Mental Health Services and the biggest conversation on mental health with See Me, the national programme to tackle mental health stigma and discrimination.

Dr Dame Denise Coia, was made a Dame in the Queen’s Birthday Honours for services to mental health and healthcare quality improvement. She is a clinical psychiatrist and leader in the field of mental health whose work has been recognised internationally. She was instrumental in the design and delivery of transformational mental health services in Glasgow through developing specialist community provision, work that has been influential nationally. Having served its predecessor bodies, in 2010 she became inaugural Chair of the Healthcare Improvement Scotland. She is a former Chair of the Royal College of Psychiatrists in Scotland and a former Vice-President of the Royal College of Psychiatrists as well as the current convenor of Children In Scotland.