Dr David Turner is a GP in Hertfordshire
“A particularly serious problem has arisen with the provision of mental healthcare for children and adolescents over the last 18 months. This is the first time in my 25-year career as a doctor I have felt the need to speak out publicly. I and many other GPs feel the issue has become critical and it is only a matter of time before a child dies.
“Provision of mental healthcare by child and adolescent mental health service (CAMHS) was never great pre-Covid. Since the pandemic it has become appalling. There are two main reasons for this: underinvestment in mental health services for decades and a spike in demand.
“There was always a long wait for CAMHS services, but over the last year or so a more worrying trend has occurred: the specific problem is CAMHS ‘bouncing back’ patients referred to them for primary care to manage. Patients with serious mental health disorders such as anorexia nervosa are being referred to CAMHS, but they say because they are too busy they would like the GP to continue to monitor the patient. This is both unacceptable and dangerous.
“In my practice we are now monitoring several seriously mentally ill teenagers, including some with anorexia nervosa, who CAMHS say they are simply unable to see due to workload pressures. They are at increased risk of self-harm and suicide, and the very nature of self-starvation leads to a multitude of physical health problems, the most serious of which can lead to death.
“This condition needs careful monitoring with weekly blood-pressure and weight checks and blood tests to monitor the function of vital organs, such as the liver and kidneys. In addition, patients will need regular heart recordings (ECG) to monitor for signs of heart failure or abnormal heart rhythms. Anorexia is not a trivial illness.
“CAMHS are now routinely expecting GPs to monitor teenagers with anorexia nervosa weekly and undertake all these checks. We have no specific training in this specialised area of child psychiatry. We are also suffering from an enormous increase in our workload since the easing of Covid restrictions and are struggling to do this complex work in addition to our usual duties.
“However, most GPs feel that if we do not do our best to help these children, they will get no treatment at all for many months while they wait to see a practitioner in CAMHS. We also have adolescent patients who have not attended school for many months while awaiting treatment for severe anxiety and depression. This has knock-on effects on their families. In some cases, it has meant a parent giving up work to stay at home to look after them.
“There is no doubt many hundreds of teenagers around the country are suffering due to a deficiency in mental health services tailored to their needs and, sadly, some will die. This situation could be turned around quickly with a rapid investment of cash and resources. As we have seen during the Covid pandemic, when there is a political will and money we are capable of providing top-class healthcare in this country. We now need to do this for our young people.”
As told to Andrew Gregory
