Young people in the midst of a mental health crisis need to have attempted suicide several times before they get a bed in an inpatient unit in England, a report has revealed.
Admission criteria for beds in child and adolescent mental health units are now so tight that even very vulnerable under-18s who pose a clear risk to themselves cannot get one.
The practice – caused by the NHS’s lack of mental health beds – leaves young people at risk of further harm, their parents confused, exhausted and worried, and the police and ambulance services potentially having to step in.
The high thresholds for admission to a child and adolescent mental health services (Camhs) unit are detailed in a report on NHS mental health care for under-18s in England based on interviews with patients, their parents and specialist staff who look after them.
The report says a young person has to “have attempted suicide multiple times to be offered inpatient support”. It was commissioned by Look Ahead Care, a charity that provides mental health services in 40 areas of England, and is being launched on Wednesday in the House of Lords.
“For many mental health professionals, this threshold level was deeply frustrating,” the report says. “For parents and service users, it provoked strong emotional responses: they reported feeling angry and abandoned.”
The parent of one child quoted in the report said: “It was very clear from what the doctor had written that he has suicidal intentions and was planning for it. It kind of felt that at that time Camhs were only interested if he attempted it, which obviously we didn’t want him to do.”
One Camhs nurse quoted said: “The parents were like: ‘What do you mean? What do you mean I’m taking her home?’ It was quite difficult for them, which I get because the parents were coming to us crying for help.”
The report, funded by the Wates Family Enterprise Trust, also highlights how:
Under-18s are seeking help at A&E for serious mental health problems because mental health crisis services are inadequate, even though emergency departments are not set up to deal with that.
Private operators now provide most of the mental health inpatient care for children and young people who are deemed unwell enough to need a bed, but these cost up to £4,200 a week – far more than on the NHS.
Some under-18s who have taken an overdose or self-harmed end up being looked after in children’s wards of acute hospitals while they wait to undergo a mental health assessment, and then wait “for days or weeks” for a bed in a Camhs unit.
Olly Parker, the head of external affairs at the charity Young Minds, said: “It is shameful that children and young people are reaching crisis point before they get any support for their mental health. We know from our own research that thousands have waited so long for mental health support or treatment that they have attempted to take their own life.
“Those who end up in A&E are often there because they don’t know where else to turn. But A&E can be a crowded and stressful environment, and is usually not the best place to get appropriate help.”
A survey of 13,887 young people last year found that more than one in four had tried to take their own life because they had had to wait to receive mental health help.
Daisy Cooper, the Liberal Democrats’ health spokesperson, said: “The findings of this research are devastating and should serve as a wake-up call for the government on young people’s mental health.
“The harrowing interviews in this report lay bare just how desperate young people and their families are for treatment, and that there is nowhere to turn unless they have reached crisis point, sometimes many times.”
An NHS spokesperson said: “It is untrue that private providers offer most hospitalised mental health care for young people and actually the latest data shows that over 701,000 children and young people were supported by NHS mental health services in the year up to October 2022.
“The NHS has expanded mental health teams in schools to cover 2.4 million pupils along with rolling out 24/7 crisis lines supporting those in a crisis without them needing to attend hospital, so anybody who thinks they might need care should come forward as soon as possible.”
In the UK and Ireland, Samaritans can be contacted on 116 123, or email jo@samaritans.org or jo@samaritans.ie. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international helplines can be found at befrienders.org.
