Last week was my final one in the NHS after 10 years in a child and adolescent mental health service (Camhs). I’m the 28th clinical member of staff to move on in the last two years. When I came back to the NHS 10 years ago, there was a layer of more experienced staff above me and a few grandees above them. Now, people with four or five years’ post-qualification experience are the wise old hands.
I completely agree with your editorial (6 November) highlighting the important role that educational mental health practitioners play, and we have been lucky to also have children’s wellbeing practitioners adding enormously to the service. But young people with complex needs are now facing an 18-month wait for a first appointment, often spending months being batted between Camhs and social care as both services creak under the strain, only to find that neither service can adequately meet their needs.
Long waiting times, a staff exodus and an inability to meet rising demand have opened the door to “exciting new opportunities to work with partner organisations” – privatisation. Some of our initial waiting lists and cognitive behavioural therapy waiting lists have been farmed out to a private company whose clinicians have no local knowledge and cannot meet young people face to face. It feels very different from the same clinician working in NHS and private roles in the same city.
The Camhs service I have left is still staffed by dedicated, caring and talented people who are desperate to do the right thing for families. When I left, the most common thing I heard was: “Well, you have to look after yourself.” My concern is that it is becoming difficult for many to do both – work in the NHS and look after yourself – and the people who will suffer will be those seeking help.
Dr David Fong
Clinical psychologist
• The rise in prescriptions for antidepressants to young people under 18 is a symptom of 12 years of neglect in Camhs (GPs giving antidepressants to children against guidelines, 4 November). The underresourcing of Camhs has been regularly cited by clinicians and parents frantic to get help for their children. GPs have no choice but to prescribe medication because waiting times for talking therapy are too long. Research shows a correlation between poverty and mental illness among young people, leading to higher rates of self-harm and suicide. A generation of young people are under greater stress than at any time, and the prospects for their future mental health will be jeopardised further with more budget cuts on the way.
Steven Walker
Former head of Camhs, Anglia Ruskin University
