Cancellations of NHS child mental health sessions jump 25%

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By Denis Campbell Health policy editor

Staff shortages and growing demand reported to be behind annual rise in England

Growing numbers of troubled children are having appointments with NHS mental health services cancelled, the organisation’s data show.

Figures obtained by the mental health charity Mind reveal that CAMHS (child and adolescent mental health services) in England cancelled 175,094 appointments with vulnerable patients between August 2018 and July 2019.

That was 25% more than the 140,327 which were cancelled during the same period in 2017-18.

Experts think staff shortages and the growing demand from young people for help with anxiety, depression and other conditions, lie behind the trend.

Although under-18s with mental health problems can pull out of planned sessions, the proportion of appointments cancelled by a CAMHS provider rose as a percentage of all appointments year-on-year, from 3.3% in 2017-18 to 3.7% last year – one in 27 of all consultations.

Mind called the upward trend deeply concerning, especially as some appointments were with young people who were self harming or having suicidal thoughts.

“We know services are struggling to cope with the increasing numbers of people needing help. But no young person should face being stood up by the NHS,” said Vicki Nash, the charity’s health of policy and campaigns. She added that a cancellation could set back both the young person’s relationship with CAMHS staff at and potentially their mental health.

Nash said: “Having a mental health appointment cancelled can break a young person’s trust in the health service. People are often at their most vulnerable at the point they receive professional support for issues as complex as eating disorders, self-harm and psychosis, let alone children who may be interacting with services for the first time in their lives.

“No young person should have to worry about whether their next appointment will happen. Once someone enters the mental health system they deserve timely and consistent support that gives them the best possible chance of recovery.

“It is deeply concerning that the number of cancelled appointments continues to rise, even in proportion to the increase in appointments. As demand grows under-supported staff are leaving in droves, and this can impact the gaps between appointments and chances of cancellation.”

The figures underline the difficulties facing NHS England in honouring its ambitious pledges to transform access to specialist care for children and young people facing mental health challenges, and especially in reducing what are often long waits for care. Experts say the continuing fall in the number of mental health nurses and vacancies for specialist child psychiatrists in many CAMHS teams threaten delivery of the plans.

The number of under-18s in England referred to CAMHS has risen fast. It increased from 343,386 in 2017-18 to 405,479 last year – an 18% jump from the year before. Exam pressure, online bullying, pressure to look good, difficulties within families and dysfunctional backgrounds, as well as a greater openness among young people in acknowledging their condition and seeking help, have all been cited as explanations for the soaring demand.

GPs revealed last week that many of the young people struggling mentally who were referred to CAMHS were rejected for being not ill enough. Sometimes the youngs people faced delays lasting months before they first saw a mental health professional.

Under-18s and their families cancelled about four times as many appointments as CAMHSproviders, the figures obtained by Mind also showed. During 2018 a total of 798,010 appointments were cancelled because the young person called off the meeting or did not attend. Overall, CAMHS services provided 3,734,000 appointments in 2018-19 where the patient did attend.

Emma Thomas, the chief executive of the charity YoungMinds, urged ministers and NHS chiefs to ensure more help for young people as soon as they develop problems, and to go beyond just concentrating on improving access to CAMHS once patients become more ill.

Thomas said: “The next government must ensure service improvements through investment in the NHS, but also make sure that young people can get help when they first need it, whether that’s through youth clubs, drop-in centres, local charities, schools, or online. We urgently need a new strategy that makes prevention and early intervention a priority.”

The Guardian approached Matt Hancock, the health and social care secretary, for a comment but have yet to receive a reply.