MASSIVE regional variations in support for mentally ill children have emerged in a major new report by the Audit Commission, which is demanding an immediate shake-up in services.

Forty-six per cent of all child psychotherapists in England and Wales are in London, and only 1 per cent in Wales - home to 3 million people.

Twenty per cent of children are believed to suffer mental health problems at some stage, yet the service they receive varies enormouslydepending on where they live, says the report.

The Audit Commission, the local government watchdog, blames a failure to set aside cash for child and adolescent mental health servicefor the variations in funding and waiting times.

While in some areas non-urgent cases are dealt with immediately, in 5 per cent of cases patients must wait more than a year.

The report found the differences have little to do with the socio-economic profile of each health authority area and are more likely to be the result of the absence of a national policy.

The report, Children in Mind, was published this week and looks at the performance of child mental health services across England and Wales.

The commission wants health authorities to monitor demand and set clear standards for the services that families should expect. Authorities and trusts should have a separate child mental health budget, monitor the suitability of their staff, and set maximum waiting times.

The report was welcomed by Peter Wilson, director of the charity Young Minds and an adviser to the commission.

He said: “We are, at last, talking about children’s thoughts and feelings as they grow up. The report is very welcome because it takes a hard look at the facts. Facts which are not very comfortable to digest.

“With the authority that the Audit Commission has, it will keep up the pressure in an area which has been overlooked for many years.”

The past decade has seen a decline in the number of community-based mental health clinics for children, as financial pressure has increased on health and education services.

The number of schools specialising in therapeutic approaches for troubled youngsters has also fallen, with Peper Harrow near Guildford in Surrey perhaps the best-known casualty.

The Government last week announced a pound;20 million package to pay for counsellors for teenagers and family therapists. It is the first tranche of pound;90m, spread over three years, that has been allocated for child mental health.

“The new money from the Government is historic,” said Peter Wilson. “There hasn’t been this much money announced for this specific purpose for many years.

“But, as the report says, one in five children has mental health problems. That’s about two million children. They all need some sort of help and I don’t think anyone can really grasp the scale of the problem.”

THE WELSH HEADS’ VIEWS

“We don’t use psychotherapists in Powys,” says assistant head Val Robinson. “But perhaps that’s because we haven’t got any. We would use educational and clinical psychologists.”

Gwernyfed High School in Brecon is, as she puts it, out in the middle of nowhere. But rural schools still have their share of children needing extra support or therapy, whether the result of family breakdown or tangling with the police.

“We have very very long waiting lists. Sometimes it takes months and months and months. Although it’s faster if the problem is severe.”

Only 1 per cent of the nation’s psychotherapists work in the principality. Colin Eves, head of Brecon high, said: “Typically children have to wait about six months. It does make you wonder if too many of the professionals are in London.”

“Children in Mind”, pound;20, phone 0800 502030 or write to Bookpoint Ltd, 39 Minton Park, Abingdon, Oxfordshire OX14 4TD.