One in three child and adolescent consultant psychiatrist posts in England are vacant, according to a “shocking” analysis laying bare the workforce crisis that experts say is fuelling “unacceptable” long waits for NHS care. Dr Elaine Lockhart, a consultant paediatric liaison psychiatrist who works in NHS child and adolescent mental health services (CAMHS), describes the frustrating but rewarding daily battle to meet the soaring demand and to help those most in need.
At a time when children’s mental health is supposed to be a public policy priority, waiting times for children’s and adolescent mental health services are unacceptably long. Some children wait more than two years to be treated. And that delay can have stark consequences for their mental health and their life chances.
Some of our most vulnerable children are ending up in crisis, needing urgent referrals and emergency care when they should have been treated effectively months before and allowed to enjoy what they will miss out on: their childhood.
As a psychiatrist for children and young people, it is deeply frustrating to see children so unwell that they require an emergency response, when we know that early intervention and treatment can transform their lives and prevent their illness getting worse.
Late and delayed treatment has many unwanted and distressing effects on their lives. Take a child with untreated anxiety – something that can be distressing and painful for anyone. The very activities and pleasures of childhood that should protect them, enrich their lives and offer resilience start to disappear.
Friendships become harder to maintain, absence from school can lead to isolation and they can fall behind in their learning, causing even more anxiety and affecting their development. Missing out on day-to-day life reinforces their difficulties and can make them feel even more unwell.
You have to wonder why, when the urge to protect our youngest in society is so instinctive and overwhelming, the resources to reduce the waiting lists and recruit more psychiatrists haven’t already been provided?
I’m often asked what it’s like to be a psychiatrist. Like most of my colleagues in the profession, I can honestly say it is a wonderful job and a privilege to work with children and young people.
My job is to understand the whole child, the wider context of the family and the environment in which they live. It is incredibly interesting, engaging and highly collaborative work.
Our best work involves a multi-disciplinary team of highly motivated, skilled colleagues, which I’ve been lucky to have had throughout my consultant career. I learn something new every day from the children and families I work with. To see young people recover and thrive because of my input is deeply motivating and fulfilling.
Imagine what we could achieve with the right resources and funds to build a mental health service fit for the children and young people of today. Prevention and early intervention would be a daily reality rather than a hoped-for future, and crisis referrals for children would be rare, rather than the frequent occurrence they are today.
• Dr Elaine Lockhart is a consultant paediatric liaison psychiatrist
