Revealed: Pupils' 'appalling' Camhs postcode lottery

More than 25 per cent of pupils with mental health problems turned away in crisis that leaves schools struggling to access specialist help

Depressed schoolgirl

More than a quarter of 5- to 18-year-olds referred for specialist mental health treatment are rejected, according to a report published today.

The study, carried out by the Education Policy Institute (EPI), has found that pupils who had experienced abuse, had an eating disorder or who had self-harmed were among those rejected by Camhs (child and adolescent mental health services).


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The report also highlights how teachers' lack of knowledge about some mental health conditions such as conduct disorder could be driving an increase in school exclusions.

EPI reports that it is not clear what support was available for the 132,700 young people turned away from mental health services in 2018-19.

The report also reveals widespread regional disparities in access to treatment. While 26 per cent of referrals were rejected overall, in London, 17 per cent of young people referred for treatment were rejected on average, compared with approximately 28 per cent in the South of England, the Midlands and the East of England, and 22 per cent in the North.

And it finds that children and young people waited an average of two months to start treatment in 2019, double the length of the government's proposed standard of four weeks.

Geoff Barton, Association of School and College Leaders (ASCL) general secretary, said the findings revealed an "appalling postcode lottery" for young people seeking mental health support.

And he said that while the government's plans to create mental health teams to support school counselling services were a positive move, this could never compare with specialist support.

"This report confirms what schools know only too well – that thresholds for children’s mental health services are often too high and waiting lists too long," he said.

"It is an appalling postcode lottery which leaves schools struggling to secure the specialist help needed by young people suffering from serious mental health illnesses.

“The government has outlined plans for a four-week waiting time for access to children’s mental health services, but the findings of this report suggest this is a pipe dream without significant additional investment.

“In the meantime, the government is also creating new mental health teams to support counselling services in schools, which is a welcome move but does not address the deficiency in access to clinical treatment.

“School counselling services, however good, cannot possibly provide the level of support which is required to treat young people with clinical needs.

"It is imperative that the government puts more focus into improving the availability of specialist NHS care as a matter of urgency.”

Referrals were most commonly rejected if providers felt young people's conditions were unsuitable for Camhs or if it was felt their conditions were not serious enough to meet the criteria.

The study noted that young people "with complex needs that do not fit clearly into diagnostic boxes, those with lower-level mental health needs and older adolescents may be unable to access the support they require".

In some areas, children wait an average of six months to access treatment. The report said that despite an additional £1.4 billion of additional spending announced since 2015, the proportion of rejected referrals had not changed over the past four years.

EPI gathered data under the Freedom of Information Act from 62 mental health providers in England out of 64.

The report concluded: "Our newly collected data reinforces the picture of a system that is failing to meet need across the country, despite significant extra spending on Camhs since 2015.

"It remains unclear what support is available for the one in four children with mental health difficulties referred to, but not accepted into, treatment.

"Children with complex or less well-understood needs, including those with conduct difficulties, those in care, and those transitioning to adult mental health services, face a postcode lottery of provision."

EPI executive chairman David Laws said: "Progress in improving access over this period has been hugely disappointing, and it is unacceptable that as many as one in four children referred to mental health services are being turned away."

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