- Report commissioned by Look Ahead Care and Support finds increasing demand for children and young people’s crisis mental health services amidst challenges with existing services
- Yet researchers heard from professionals, service users and their families and carers found that you “had to have attempted suicide multiple times to be offered inpatient support.”
- Interviewees say A&E departments have become an ‘accidental hub’ for children and young people experiencing crisis but are ill equipped to offer the treatment required.
- Private sector providers now deliver the majority of support for hospitalised young people with mental health difficulties at “exceptionally high” cost.
- Report recommends alternative community crisis services, including supported housing away from hospital settings to reduce pressure on A&E and reduce costs by more than 50%
Based on in-depth interviews with service users, parents and carers, and NHS and social care staff from across England, the findings draw on experience of treating depression, anxiety, self-harm, suicidal thoughts and suicide attempts, eating disorders, addiction and psychosis.
The number of children and young people contacting mental health services rose by nearly a third from 2020 to 2021. Data also shows families are increasingly relying on ambulance and police services to deliver mental health support, particularly for those young people aged 16-17.
Launched this morning in the House of Lords, the report – funded by Wates Family Enterprise Trust and produced by experts Care Research – argues Accident and Emergency departments have become an ‘accidental hub’ for children and young people experiencing crisis but are ill-equipped to offer the treatment required.
Accounts from patients and experts indicate that young people suffering the effects of mental health crisis are then frequently placed in unsuitable general paediatric wards alongside younger children, for ongoing medical monitoring.
Where children and young people are referred away from general wards, the report highlights that 55% are looked after in the private sector, where costs for crisis CYPMH services, “are exceptionally high, and do not always support young people in the most effective way”.
Chief Executive
“The deep challenges in mental health care crisis provision for young people is setting up a ticking timebomb for mental health services in the future – as young people become vulnerable adults.
The NHS is doing all it can in impossible circumstances, but the result is a service that both costs more than it should and helps too few of those in crisis.
This research shows how much more needs to be done to redirect funds towards early intervention and prevention, in particular through intensive supported housing as an alternative to hospital. These are the community services that can help people before they reach crisis point.”
Away from hospital and into the community makes a series of recommendations to policymakers and identifies alternative commissioning routes for a new residential, community-based crisis service which sits outside hospital and could cost 52% less than existing services. Such services would be an alternative for those in mental health crisis, or for those who did not meet the current – very high – threshold for admission.
The report examines examples including The Hope Service, run by Surrey and Borders Partnership NHS Foundation Trust.
The service provides intensive community support to young people aged 11-18, preventing, or shortening, their admission to inpatient units. The Extended Hope Service also provides out of hours support for young people in crisis, offering mental health assessments and a unit to provide residential care for young people in crisis for up to 7 days.
MP
“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."
The Hope Service is CQC and Ofsted registered, and is staffed by social workers, nurses, teachers, psychologists, art and drama therapists, psychiatrists, family therapists and activity workers. The team works with young people, their families and carers to co-produce a plan of care aimed at preventing the escalation of mental ill health or intensive social care support.
According to the report, an expansion of these housing and care facilities for young people in mental health crisis would make the best use of the government’s commitment to increase overall NHS mental healthcare funding by £2.3bn a year.
Financial modelling undertaken as part of the research demonstrates that specialised health and housing services for young people in mental health crisis could cost some 52% less than an equivalent stay in hospital, at £2,000 per week instead of £4,200.
On the report launch Liberal Democrat Health Spokesperson, Daisy Cooper MP 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.
“Expanding community support should be a no-brainer: it’s better for young people in mental health crisis and would save money in the public purses. Adopting this approach would be nothing short of a revolution in mental health care, saving thousands of people from ongoing ill-health in adulthood.”
Tim Wates, Lead Trustee for Housing at the Wates Family Enterprise Trust, said:
“We urgently need to start conversations across the NHS, housing, social care and local authorities about the most appropriate form of accommodation and care for young people as they experience mental health crisis. As a Trust we are very pleased to have funded this critical report that emphasises the importance of community-based care solutions which keep young people away from hospital where possible.”
Lead Trustee
We urgently need to start conversations across the NHS, housing, social care and local authorities about the most appropriate form of accommodation and care for young people as they experience mental health crisis
Notes to Editors
The report also makes a series of other recommendations including:
- The wider health and social care system should support the NHS in its aim to deliver 0-25-year-old services, easing the transition from Children and Young People’s (CYP) to Adult services.
- The NHS and wider partners should enhance their capacity to keep young people away from A&E when they are experiencing crisis.
- A&E departments should have dedicated space and dedicated teams for young people experiencing a mental health crisis. These could be attached to the psychiatric liaison teams for adults in many acute hospitals.
- Integrated Care Systems should use their commissioning power to expand community provision to take young people away from over stretched A&E departments.
- Priority should be given to provision of a dedicated national crisis support line for young people.
- Medical staff should be better trained to support both CYP with mental health issues and their families.
About Look Ahead
Look Ahead is a leading provider of specialist housing, support and care services for people with complex and multiple needs, bridging the gap between social care, health and housing. Look Ahead has 50 years of experience in delivering mental health, learning disabilities, homelessness and young people’s services.
Look Ahead works with around 6500 people each year across 30 local authorities, a large majority of the people they work with experience mental health issues. They also deliver 40 specialist mental health services across 18 local authorities. The services are delivered in close collaboration with the NHS, CCGs and local authorities in a number of areas including crisis and recovery houses and forensic step down services, rehabilitation services, supported housing and community based floating support.
About the report/event
In 2022 Care Research was commissioned by Look Ahead to carry out an independent analysis of current provisions for mental crisis care in young people, and to develop new models of specialist community-based services that provide a real alternative to the current provision. The event is the launch of the report.
Care Research
Care Research is an independent research organisation that supports innovative, independent research designed to improve the care people receive. Care Research has completed work across a wide range of sectors including social care, education, healthcare, and the charity sector. The team is made up of academics from universities around the country who come together to develop bespoke, tailored research.
The Wates Family Enterprise Trust
The Wates Family Enterprise Trust is an independent charity set up by the Wates family, the owners of the Wates Group. Launched in 2008, the Trust is integral to the Wates family’s approach of being responsible business owners and its vision of being a force for good. The Trust’s mission is focused on building communities and improving lives beyond tomorrow.
About the Report
The full report is available upon request. Please contact Polly Marsh
polly@higginsonstrategy.com / 07966268902
