Action needed to support children’s mental health before ‘crisis point’

Nurses have highlighted the importance of prevention and early intervention for young people’s mental health, while calling for better investment.

Several nurses took to the stand at the annual Royal College of Nursing Congress, held this week in Liverpool, to express their concerns about a shortage of specialist adolescent mental health units, leading to long waits and deteriorating mental health for children and young people.

They highlighted various systemic failures, including inadequate funding and resources.

Nurses spoke of the importance of early intervention and adequate support to prevent long-term harm.

Members voted to call on the RCN Council to lobby UK governments to improve the provision of services to children and young people presenting in acute mental health crisis.

Senior mental health lecturer at Liverpool John Moores University Dean McShane said investment in adolescent mental health would save the NHS money in the future.

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He said: ‘Many local councils spend up to five to six times more on potholes than we actually get for child and adolescent mental health support.

‘Nearly three-quarters of all mental health problems manifest by the age of 18, so why would we not invest heavily in this area?

‘Every pound we invest in child and adolescent mental health, the NHS saves many times more in adulthood.

‘So, the question isn’t, can we afford to invest in [Child and Adolescent Mental Health Services] CAMHS? The real question is, can we afford not to?’

Yorkshire nurse Rachel Milton added that a lack of early intervention leads young people to reach a ‘crisis point’ with their mental health, placing them at a ‘great immediate risk’.

She said: ‘Young people are more likely to need long-term support into adulthood, potentially as a direct result of lack of preventative and proactive provision of the child – impacting on their adulthood.’

Ms Milton added that some children and young people who require additional needs face ‘further barriers’ due to a ‘lack of specialist support’.

Mental health nurse Lisa Cook said is it ‘heartbreaking’ to see young people experience suicidal thoughts or thoughts of self-harm.

She highlighted the need for services to have reached them ‘before they got to crisis point’.

‘Within my area, the [minute the] school hears the word self-harm, suicide, anything like that, it’s straight to the hospital, straight to somewhere that is not doable… that causes more trauma.’

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The discussion comes after an RCN analysis, published this week, which revealed that around 500,000 under-18s visited A&E in a mental health crisis since 2019, with some facing waits as long as three days before being transferred to a mental health unit.

Freedom of Information requests (FOIs) which were sent to acute trusts in England showed waits of 12 hours or more for children in a mental health crisis more than tripled during the same period.

The analysis was published following the government’s announcement of a new mental health strategy which aims to ‘drive shift from crisis intervention to preventative care’.

Nurses are being asked for their views on the new strategy, with the Department of Health and Social Care (DHSC) announcing a new ‘call for evidence’ from nurses and other healthcare professionals.

Speaking at congress, RCN’s general secretary and chief executive Professor Nicola Ranger said the strategy should address the ‘social determinants of mental health’ in children, such as poverty, poor and insecure housing, social isolation, as well as unstable employment.

She warned the strategy would ‘die on the page if social determinants of mental health are not given parity, not just politically, but in pure investment terms too’.

‘Half a million children and young people attending A&E in a mental health crisis is evidence of a catastrophic system-wide failure,’ she said.

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‘Nursing staff give their all in the most difficult circumstances, but the fact is that busy and stressful A&Es are wholly unsuitable places for anyone in mental distress, let alone vulnerable children.

‘It’s absolutely vital the government rapidly rolls out mental health emergency departments across the country to put a stop to these damaging and potentially traumatising A&E visits.

‘Children and young people deserve appropriate treatment in a safe and dignified environment.’