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Care for children with mental health problems is woeful, say GPs

Vulnerable young people facing wait of up to a year for specialist help, survey of doctors finds

Norman_Lamb_(2013)Liberal Democrat Norman Lamb MP

The Observer, Sunday 15 May 2016 

Family doctors have condemned NHS care for children with mental health problems as woefully inadequate and warned that vulnerable young people are coming to harm during waits of up to a year for specialist help.

GPs say that, although growing numbers of youngsters are struggling with crippling conditions such as anxiety and depression, many in need of urgent support are missing out because rationing of care means that they are not ill enough to qualify.

A survey of 300 GPs in England has raised particular concern about the availability of NHS help for children aged 11-18 who are self-harming. While 61% of GPs are seeing more such cases than five years ago, 83% describe services as either inadequate or totally inadequate.

Even more GPs – 86% – are worried that young people in distress are coming to harm while they wait for treatment, according to the survey conducted by stem4, a charity that helps such teenagers. “Young mental health problems are a timebomb waiting to explode,” one GP said.

Liberal Democrat MP Norman Lamb, who was the mental health minister in the coalition government, said: “These findings paint a bleak picture and accord with what GPs have told me: that when they refer children with such problems for support, too often support isn’t there at all or they meet with high thresholds which mean that children are in effect told ‘get sicker before we will help you’. Rationing of care in such a vital area of care is scandalous.”


View the full survey findings and report:

Family doctors fear a mental health scandal waiting to happen

nihara Dr Nihara Krause, consultant clinical psychologist and founder of stem4

The Observer, Sunday 16th May 2016 

One in 12 UK teenagers self-harms and one in 10 is clinically depressed, yet still the NHS allocates only 11% of its budget to mental health services

Most GPs think mental health services for young people are inadequate, with nine in 10 fearing that children in their care could come to harm while waiting for specialist treatment.

Those are the worrying key findings from a survey for stem4, the charity I set up to support teenagers with mental health problems. Under pressure to achieve efficiencies, and with a reduced specialist workforce, mental health providers are applying increasingly strict criteria for access to their services.

Let’s think about what that might mean. You’re 16 and going through a tough time. At school you’re worried because your performance in pending exams determines your chances of getting to university, or to succeed in a ruthlessly tough job market…


Dr Nihara Krause is a consultant clinical psychologist and founder of stem4 mental health charity.

“A time bomb waiting to explode” – Survey reveals GPs’ concerns about mental health services for young people


Report from mental health charity stem4 finds 78% of GPs are seeing more young patients with mental health problems

GPs fear lack of funding, specialist training and access to services is putting children at risk

Most GPs believe mental health services for young people are inadequate, with almost nine in ten fearing that children or teenagers may come to harm while waiting for specialist treatment, new research shows today.

A survey[i] for stem4, the charity which works to prevent mental ill health in teenagers, found that almost four in five (78%) GPs are seeing more young patients with mental health problems than five years ago.   Most (87%) expect pressure on services to increase.

Nearly all (97%) the doctors surveyed had seen a patient aged 11-18 suffering from depression over the past five years.   The same number (97%) said they had seen a patient experiencing self-harm, and six in ten (61%) were seeing more young patients self-harming than five years ago

However, half (50%) said they had received no specialist training on self-harm and over a third (36%) said they had received training but it was not adequate for them to feel confident supporting young patients.

The survey forms the basis of stem4’s new report ‘A Time Bomb Waiting to Explode’.   302 GPs in England were asked about their patients aged 11-18:

  • Almost eight in ten (78%) said the number of patients experiencing mental health problems had increased, either somewhat (61%) or greatly (17%), over the past five years
  • 63% had seen a young patient with an addiction problem
  • 89% had seen patients with eating disorders
  • 85% say health and social care services for children are either inadequate (59%) or extremely inadequate (26% )
  • 83% say services for young people who self-harm are either inadequate or extremely inadequate
  • Almost nine in ten (86%) had concerns about patients coming to harm while waiting for treatment
  • Most (76%) want to see increased funding for mental health, and over half (54%) want more specialist training for GPs on young people’s mental health problems

Dr Nihara Krause, Consultant Clinical Psychologist and Founder of stem 4, said:

“Young people’s mental health services are at crisis point.  GPs are having to cope with the consequences of our failure to focus on prevention, and a lack of access to specialist services.  We may not be able to change the world we have created for our young people, but we need to take action to ensure that help is available when they need it.  GPs are at the forefront of addressing this crisis and they need far more support.

“The increase in mental ill health among our young people is exacerbated by our trophy culture. They are under enormous pressure to succeed in every way, not only at school where they are constantly tested and graded, but also by endeavouring to gain social cachet by competing to be ‘followed’ and ‘liked’ on social media.”

Dr Faraz Mughal, Royal College of GPs Clinical Fellow for Youth Mental Health, said: “This report provides a worrying insight into the difficulties currently facing young people who need mental health care – and the issues faced by GPs who are trying to care for them.

“GPs are seeing more and more young patients with mental health problems, and they often present in a different way to adults when experiencing mental illness or distress, but services in the community that they could benefit from are underfunded and this invariably puts general practice under pressure and our patients’ safety at risk.

“This report brings home how important it is that family doctors receive appropriate specialist-led training in mental health, that there is more investment in mental health services right across the NHS, and that there is greater integration across health, social care, education and justice services, so that we can deliver the care and support our young patients with mental health problems need and deserve.”

The report paints a picture of patchy and underfunded services hit by shortages of specialists, long waits for treatment, and eligibility criteria so strict that GPs are deterred from making referrals.

Comments from the doctors surveyed included:

  • “Recently several parents have had to pay for private appointments so that their youngsters could receive the care they needed. These were not affluent parents, just desperate and caring.”
  • “Referrals are increasingly bounced back from secondary care with instructions to simply seek counselling”
  • “I feel mental health services for patients this age are woefully inadequate.  The few patients that we actually manage to get seen still have to wait for often over a year in order to be seen”
  • “I feel it is appalling that someone who has asked for help needs to wait up to 6 months for any intervention I can provide in a secondary setting. Only the most severe get any help at all.”
  • “Young mental health problems are a time bomb waiting to explode!”

Three quarters of the GPs surveyed (76%) said funding beyond that which has already been promised is necessary to improve mental health services for young people.  Over half (54%) said specialist training on young people’s mental health was necessary.  Most (56%) wanted to see a complete overhaul of mental health service provision.

The report calls for a greater emphasis on the identification and prevention of young people’s mental health problems at primary care level, and for more specialist training for GPs.   On 22 June, stem4 is holding a conference to provide with GPs with the latest information on dealing with mental health problems affecting children and young people.  Calm Harm, the charity’s smartphone app to help people manage the urge to self-harm, is available for free, and has been downloaded more than 14,700 times.

Notes to editors

View the full survey findings and report:

View a Q and A on self-harm and young people’s mental health services:

View more about the ‘Calm Harm’ App:



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[1] Survey of 302 GPs in England carried out by Research Now between 8 April and 13 April 2016