Intended for healthcare professionals


Child mental health: government has “long way to go” to improve access, NAO finds

BMJ 2018; 363 doi: (Published 10 October 2018) Cite this as: BMJ 2018;363:k4269
  1. Gareth Iacobucci
  1. The BMJ

Mental health services for young people in England may struggle to meet demand despite ministerial pledges to boost funding, the government’s spending watchdog has warned.1

The National Audit Office (NAO) noted the government’s “laudable ambitions” to improve access by investing an additional £1.4bn (€1.6bn; $1.84bn) from 2015-16 to 2020-21. But it said that this was starting from “a very low base” and warned of “significant unmet need.”

The report identified slow progress on tackling staff shortages and “significant data weaknesses” as major obstacles to delivery.

Auditors noted that the NHS cannot reliably track progress against its current key target to treat an additional 70 000 young people by 2020-21 to increase the rate of access to NHS funded treatment from around 25% to 35%.

Regarding the workforce, the NAO reported ongoing difficulties in recruitment and found evidence that pledges to increase staff numbers were behind schedule. Auditors also found “limited visibility” of what public sector bodies outside the NHS, such as schools and colleges, spend on mental health and what services they provide.

Allied to this, the NAO said that the upcoming survey of children’s mental health requirements, scheduled for late 2018, was likely to reveal that the number of young people with a mental health condition who need help is substantially higher than the 10% estimated when the survey was last conducted in 2004. This will make it “even harder for ministers to achieve the government’s ambition,” the auditors said.

Amyas Morse, head of the NAO, said, “Parity of esteem between physical and mental health services for children and young people is a laudable aim. However, to deliver meaningful change, this must be matched by the necessary planning, resourcing, and coordination.

“Despite a welcome start this aim remains far off. Current targets to improve care are modest and even if met would still mean two thirds of those who need help are not seen. Rising estimates of demand may indicate that the government is even further away than it thought.”

Responding to the report, Saffron Cordery, deputy chief executive of NHS Providers, said, “The NAO’s findings show that the original plans have not been supported with enough planning, oversight, and frontline funding to ensure that children and young people can access the mental health services they need.

“The recommendations reinforce the need for cross government commitment to children’s mental health services as a key priority of the NHS long term plan.”


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