CAMHS transformation - or ‘more of the same’?

19 Jan 2016

As CCGs reveal their Transformation Plans, a new report finds local authority cuts, a lack of joined-up commissioning and protectionism threatening early intervention and prevention services.

There is an urgent need to reform Child and Adolescent Mental Health Services (CAMHS) – described even by ministers as ‘stuck in the dark ages’1  – so that young people can get the help they need, when they need it. NHS England have told Clinical Commissioning Groups (CCGs) that “more of the same is not an option”.2

Last March, a Government taskforce proposed greater investment in voluntary sector Youth Information, Advice and Counselling Services (YIACS) as a way of addressing the current inaccessibility of mental health services for young people.3  YIACS were hailed as a model for meeting the needs of young people who fall through the gaps in statutory services at key points of transition.

As CCGs reveal their CAMHS Transformation Plans, Youth Access – the advice and counselling charity – today publishes a report which raises questions about the extent to which investment is really likely to become more focussed on preventative voluntary sector services. Findings include:

  • Despite a steady increase in NHS funding for YIACS’ youth counselling services over recent years, the collapse of local authority funding is undermining the capacity of YIACS to provide a range of complementary services, such as advice on money and housing, which are known to tackle the underlying ‘social determinants’ of mental health
  • Local funding available to YIACS is increasingly focussed on crisis interventions
  • Turbulence within local public services is hindering effective joined-up commissioning across service boundaries, limiting the potential to take a more strategic approach to early intervention and prevention
  • Vested interests within local authorities and the NHS may lead to protectionism, with investment centred on existing statutory services at the exclusion of effective voluntary sector services that take a more preventative approach

We will not improve access or reduce the need for expensive crisis interventions unless we can really start to expand our investment in genuinely young people-focussed services that are accessible, flexible and preventative. Voluntary sector YIACS have been identified as part of the solution and are highly cost-effective.

However, while CAMHS Transformation Planning promises much, there remains a risk that wider cuts, a lack of joined-up commissioning and protectionism will result in ‘more of the same’ – and even higher levels of unmet need.

Barbara Rayment, Youth Access Director

Youth Access’ report, More of the same?, examines how YIACS are faring in the CAMHS transformation agenda, focussing on a number of themes, such as integration and co-production, that will determine the success of CCGs’ Transformation Plans from the voluntary sector’s perspective.

 

Notes for Editors

1. Youth Access is the national membership association for a network of around 170 Youth Information, Advice and Counselling Services (YIACS) www.youthaccess.org.uk
 
2. YIACS support young people on issues as diverse as mental health, sexual health, relationships, homelessness and benefits. YIACS grew out of a need to bridge both the gaps and failings of statutory and adult-oriented services in meeting the needs of young people. Through interventions such as counselling and other psychological therapies, advice work, health clinics, community education and personal support, YIACS offer a unique combination of early intervention, prevention and crisis intervention for young people. 85-90% of YIACS are managed by voluntary sector organisations.
 
3. Policy context

The Government report of the work of the Children and Young People’s Mental Health and Wellbeing (CYPMHW) Taskforce, Future in Mind, was published in March 2015, setting out “what we need to do to overcome the status quo”.4  One of the report’s proposals was to increase investment in the existing network of Youth Information, Advice and Counselling Services (YIACS) as a way of increasing the accessibility of services to young people:

"Provide a key role for the voluntary and community sector to encourage an increase in the number of one-stop-shop services based in the community. They should be a key part of any universal local offer, building on the existing network of YIACS (Youth Information, Advice, and Counselling Services). Building up such a network would be an excellent use of any identified early additional investment."5

In his March 2015 Budget, The Chancellor, George Osborne, announced £1.25 billion of additional funding for children and young people’s mental health over five years. Shortly following the 2015 General Election, the incoming Minister with responsibility for young people’s mental health, Alistair Burt MP, stated that children and young people’s mental health was his top priority and that he was committed to taking forward the vision set out in Future in Mind.6

Every CCG is required by NHS England to produce a Local Transformation Plan for Children and Young People’s Mental Health and Wellbeing. One of the key messages included in NHS England’s guidance to CCGs on Transformation Plans was that “more of the same is simply not an option”.7  Every CCG was originally required to publish its Transformation Plan by the end of November 2015, but this deadline slipped to 31st December. As at 18th January 2016, we were still unable to locate many areas’ Plans, but understand from NHS England that they should have all been published.
 
For further information, a copy of the report, case studies and access to interviewees, please contact:

James Kenrick, Advice Services Development Manager, Youth Access

020 8772 9900 ext. 25 / 07535 344881; james@youthaccess.org.uk

 

1 http://www.theguardian.com/society/2014/aug/20/child-mental-health-dark…

2 Local Transformation Plans for Children and Young People’s Mental Health and Wellbeing: Guidance and support for local areas, NHS England, August 2015; p. 9.

3 Future in Mind, the Government report of the work of the Children and Young People’s Mental Health and Wellbeing Taskforce, said: “One-stop-shops based in the community….should be a key part of any universal offer, building on the existing network of YIACS”.

4 Future in mind, Foreword from Norman Lamb, p. 3.

5 Future in mind, p. 43.

6 https://www.gov.uk/government/speeches/the-royal-college-of-psychiatris…

7 Local Transformation Plans Guidance, p. 9.