Psychiatric backlog is a `ticking time bomb' for families
A growing shortage of psychiatrists is jeopardising the education of Scotland's most vulnerable children as families reach breaking point, an alliance of experts warned this week.
The Scottish Children's Services Coalition (SCSC) said urgent action was needed to tackle rising vacancies in key child and adolescent psychiatric posts, which left pupils waiting months for diagnoses needed to obtain school referrals and other help.
The recruitment crisis also put the prospects of other children in affected families at risk, because couples' relationships often broke down under the strain, the SCSC warned.
One specialist provider of care and education for children with additional support needs (ASN) claimed that in some cases councils had threatened to take brothers and sisters of undiagnosed children into care because their home life was suffering.
The warnings were prompted by official figures obtained by the SCSC, which reveal that less than half of all top-level training places for psychiatrists specialising in childhood and adolescence have been taken for the coming academic year.
Just five out of 13 key posts starting next term across Scotland are currently filled. The statistics highlight the deepening recruitment crisis in recent years - only just over half of vacancies (19 out of 37) for psychiatric doctors caring for children and young people have been successfully filled since 2011.
Stuart Jacob, director of Falkland House School in Fife, which takes referrals from across the UK for primary- and secondary-aged ASN students, is a member of the SCSC alliance of professionals providing specialist care and education.
"Having a diagnosis makes it much easier for parents to find help and get a referral, or to be able to say to a local authority or a school `This is what my child needs'," he said. "Without a diagnosis, children's behaviour gets worse and it is even more stressful for parents. I would say that by the time they manage to get a placement at Falkland, around 10 per cent of parents are on the edge of divorce.It does have a knock-on effect on siblings as mothers and fathers struggle to cope.
"We have heard that local authorities have threatened to take parents' other children into care. They say, `You can't cope with him [the child with ASN] and it is harming your other children'. That isn't common but we have heard it more than once and that is not the solution."
The SCSC warned that the situation was likely to get worse, with separate Scottish government data indicating an 89 per cent rise in the number of ASN pupils in schools between 2010 and 2013.
A SCSC spokesman said: "It is those children and young people requiring these services who are missing out - the most vulnerable in our society.
"Waiting times will undoubtedly increase and we are heading for a ticking time bomb when it comes to the delivery of psychiatry and psychologist services. High-level strategic management is required in order to get a grip on the situation and we will be writing to the Scottish government, urging it to act quickly to address this shortfall in numbers."
A recent report found that numbers of educational psychologists in Scotland were also "dangerously low". Data from mental health services has fuelled concerns, with one in 10 children and young people waiting more than 26 weeks to see a specialist after being referred.
The government said it was committed to ensuring that children and young people with ASN got the "necessary assistance to realise their potential". A spokesman added that ministers were working to address recruitment issues, which were not unique to Scotland.
The Royal College of Psychiatrists in Scotland said recent changes to training, which would introduce more junior doctors to psychiatry earlier in their training, were aimed at improving recruitment. Chairman Dr Alastair Cook said: "There's a perception among medical students that people don't get better in psychiatry, that it's less scientific and has less status than other specialties, all of which are false."
A spokesman from local authorities body Cosla said: "Councils employ educational psychologists to assess pupils and recommend a support package if needed in order that pupils have as much chance as possible of remaining in mainstream schools." He added: "Scotland's councils take their duty of care to all those under their supervision very seriously indeed."