GPs “bypassing CAMHS”

GPs and other statutory professionals are increasingly referring vulnerable young people with complex mental health issues straight to voluntary sector youth counselling services, where they know they will be helped.

That is the conclusion of an analysis of data on over 1,000 young people who were helped by youth counselling services through a Youth Access project (‘Young People in Mind’) which targeted 16-19 year olds in England.

The data shows that:

1. Young people helped by VCS youth counselling services are often highly vulnerable

77% of young people helped through the project were assessed as vulnerable, with many experiencing multiple risk factors. Nearly one in five young people were assessed as vulnerable due to sexual abuse, sexual exploitation or other safeguarding issues, whilst other common vulnerability factors included: parental mental ill-health; living in financial difficulty; being a victim of domestic violence; unemployment; and experience of the care system. The services were also highly effective in offering access to young people from BAME communities and those who identify themselves as LGBTQ.

2. The issues dealt with by VCS youth counselling services are increasingly complex

Many of the young people presented with multiple and complex problems, ranging from mental health difficulties to homelessness. Nearly a quarter of young people presented with suicidal thoughts or had made a suicide attempt.

The five most common presenting issues were:
- Depression (reported by 43% of young people)
- General anxiety/stress (32%)
- General confidence/self-esteem (27%)
- Self harm (25%)
- Suicidal thoughts (20%)

3. VCS youth counselling services are supporting many young people who cannot or do not want to be helped by statutory services

42% of the young people helped were referred to the youth counselling services by statutory services, with nearly half of these referrals coming from GPs. Although CAMHS and adult mental health services accounted for one in four referrals, the majority of young people had no past or ongoing contact with statutory mental health services. Of the minority who had had contact, many had disengaged from CAMHS, or their support had ended due to their age.

Barbara Rayment, Director of Youth Access, says:

“The data highlights the accessibility of voluntary sector youth counselling services for young people from a wide variety of backgrounds and with a wide variety of needs. Many of the young people helped through the Young People in Mind project simply wouldn’t have been picked up by statutory services despite their vulnerability and complex needs.

“It also appears that GPs are bypassing CAMHS and sending young people straight to youth counselling services, where they know they will be helped effectively. These voluntary sector providers are helping relieve the pressure on GP surgeries. However, the funding does not currently follow young patients into these services.

“Youth Access will continue working with the NHS to ensure the potential of voluntary sector providers to drive transformation of youth mental health services is realised.”


Notes for Editors

1.   Youth Access is the national membership association for a network of around 170 Youth Information, Advice and Counselling Services (YIACS)

2. Young People in Mind project and reports

Young People in Mind was a one-year project managed by Youth Access and funded by the Department for Education from 1st April 2015 – 31st March 2016. The project set out to provide direct services to young people and also enable the local YIACS to have increased capacity to engage with local partners. It specifically aimed to increase access to counselling and other psychological therapies to young people aged 16-19 at high risk of mental health difficulties, especially at points of transition, and to improve integration between voluntary sector Youth Information, Advice and Counselling Services (YIACS) and statutory mental health and other services.

The project was delivered through a consortium of nine YIACS, operating in 12 areas across England. The nine agencies were: 42nd Street, Manchester; Alone in London, Islington; Croydon Drop In, Croydon; MAP, Norwich; No Limits, Southampton; Off Centre, Hackney; Off the Record, Bristol; Off the Record, Croydon; Young Persons Advisory Service (YPAS), Liverpool.

Alongside their strategic engagement work with local partners, the YIACS offered therapeutic interventions to young people, including counselling, psychotherapy, art therapy and drama therapy.

Youth Access is today publishing two reports:

- Young People in Mind: The Young People – reporting data collected on 1,094 young people helped through the project

- Young People in Mind: Transforming Service Delivery

The reports highlight how investment in voluntary sector YIACS can bring an improved and integrated response to the delivery of local mental health and wellbeing support to young people, including those moving through late adolescence and into young adulthood.

3. Case Study

The following case study relates the story of Zara (not her real name), a young person helped through the Young People in Mind project:

Zara is a 19 year old of mixed White/Black Caribbean parentage. She is bisexual, and has no particular faith or religion. She is studying business, and is a qualified fitness instructor.
Zara’s mother died when she was 8. She was put into care, but remained in close contact with her father. She is HIV positive. As a child, Zara has had counselling and help from CAMHS and was referred to the YIACS by her social worker. She was experiencing suicidal ideation, low mood, and was binge drinking. Zara attributed the cause of her issues to the turmoil of her on/off relationship with her boyfriend.

Zara wanted help with anger-management and depression. Her sense of self and self-esteem were low; she felt rage about the loss of her mum and her experiences of sexual and physical abuse. Zara also felt her alcohol abuse was a coping technique to help blank out her feelings.

In the first session, Zara was at pains to explain to the counsellor her feelings about her HIV status. She was able to connect her shame in part to her father’s insistence on keeping it a secret, and also to her boyfriend’s disapproval. Her feelings had also been compounded by her traumatic experiences at the hands of the police; she was charged with exposing someone to the risk of HIV infection when she bit them.

Through the counselling, Zara began to realise how and why she acted when under pressure and how her anger towards her boyfriend was a reaction to his domineering behaviour. Zara started to realise how much she had changed to please her boyfriend, including her appearance. She was hurt by his demands and also realised she no longer wanted to deny her sexuality. Zara also felt her hopes for the future were being thwarted and frustrated by her boyfriend’s lack of ambitions for himself or them as a couple.

Whilst her motivations wavered as she struggled with her college course, Zara managed to set up Zumba classes in her local church hall and towards the end of the sessions, applied for and got a job teaching in a gym. She began to develop a sense of belonging and purpose; she made friends and was able to accept that she was valued by her clients. These achievements and regular exercise calmed her; she became less aggressive, and more up-beat. As her self-worth developed, the relationship with her boyfriend ended.

At the end of the counselling, whilst there are still unresolved areas in her life, Zara no longer has suicidal thoughts, or uses alcohol to cope. She is more self-aware and is committed to working through her issues and seeking further help.

4. Further information

For a copy of the reports, case studies and access to interviewees, please contact:

James Kenrick, Youth Access
020 8772 9900 ext. 25 / 07535 344881;