Child mental health: Lancashire should set target for improvement, medic says

Lancashire is redesigning its child and adolescent mental health services
Lancashire is redesigning its child and adolescent mental health services
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Lancashire’s public health boss has called for the introduction of a target to reduce the number of young people experiencing mental health problems in the county.

Dr Sakthi Karunanithi told a meeting of Lancashire’s health and wellbeing board that the region should be aiming to bring the proportion of youngsters affected by mental illness below the national rate.

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Figures published late last year revealed that one in eight five to 19 year olds across England had at least one “mental health disorder” in 2017.

“We continue to see concern locally about suicide and self-harm,” Dr Karunanithi said.

“If we are wanting that one in eight to fall to one in 16 or even lower, we should first have that as an ambition – or do we want one in eight young people in Lancashire to have a mental health condition?”

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The meeting heard that Lancashire is on track to meet a government target for 35 per cent of young people with a mental health problem to have access to a specialist NHS service by 2021. The county is currently achieving 32 percent and so will be subject to a so-called “stretch target” to exceed the government’s expectations, because of its progress to date.

But Dr Karunanithi warned Lancashire is “in danger of meeting the target, but missing the point”.

The county is currently redesigning its mental health services for young people and aims to incorporate support up to the age of 19 – currently, 17 and 18 year olds are usually referred to adult services, a policy which is out of step with the rest of England.

Early intervention programmes have also been overhauled and 97 percent of young people in Lancashire who receive help when the first signs of a problem develop go on to show an improvement. Waiting times for those services have also shortened over the past year – by December 2018, the waiting list was down to eight and no child was waiting longer than a fortnight for an appointment.

More than 1,700 young people are expected to be referred to early help services this year, many of which are provided by the voluntary sector.

The meeting also heard that advice for parents was crucial to improving young people’s mental health – even if much of the work is taking place during the school day.

“If a child is being given additional support in school, the onus is on teachers to then engage with the parents and help them understand the reasons behind it,” Marie Demaine, a senior public health practitioner at Lancashire County Council, said.

“It’s like with obesity – there’s no point having healthy meals in school and then going home and having fish and chips.”

There are now also 16 primary mental health workers operating across Lancashire delivering help to young people with ‘low-level’ mental health problems.

Lancashire’s Clinical Commissioning Groups (CCGs) are currently assessing the cash and the staff that will be needed to deliver mental health services for young people in the coming years – and continue the initiatives which have already begun.

Dr Karunanithi called for the calculation of an overall spending total across the NHS, local authorities and other organisations involved in providing services.

But Dave Carr, head of policy and commissioning at Lancashire County Council, said it would be difficult to derive an accurate figure.

“We have been very transparent about county council funding and how we have invested it. The challenge for the whole system is that we’re working together, but we haven’t got a long-term resource plan together,” Mr Carr said.

The NHS in Lancashire is spending £16.5m on child and adolescent mental health in Lancashire this year.