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Three year CAMHS waiting list leaves families to suffer until reaching 'point of crisis'

By Iona M.J. MacDonald

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CHILDREN in the Highlands are facing a three–year waiting list to receive support for mental health issues, with many forced to wait until they reach a 'point of crisis'.

An inspection report was carried out by The Care Inspectorate from April to September 2022.
An inspection report was carried out by The Care Inspectorate from April to September 2022.

A recent inspection report has shown that Children and Adolescent Mental Health Service (CAMHS) has a three–year waiting list for those in need of support for mental health disorders in Highland.

The inspection was carried out by The Care Inspectorate, in partnership with Education Scotland, Healthcare Improvement Scotland and His Majesty’s Inspectorate of Constabulary in Scotland. The inspection report evaluated services for children and young people at risk of harm in Highland, and took place from April to September, 2022.

The report investigated and interviewed staff employed who work with children, young people, at risk of harm. Representatives from social work, education, health, police and third sector were included in the report.

The report said:"Child and adolescent mental health services (CAMHS), had a three–year waiting list and, although it prioritised referrals as they came in, staff were aware that there were significant numbers of children and young people who were not receiving a service over that period."

The report also highlighted that children and young people did not always get the support they needed, particularly early intervention and mental health support.

Services to address early intervention and prevention was limited, resulting in children who needed help, often did not receive support until a 'point of crisis was reached', according to the report.

As well as the three–year waiting list for CAMHS, some families have also been forced to wait four years for the Neurodevelopmental Assesment Service (NDAS), who give diagnostic assessments for neurodevelopmental disorders such as Attention Deficit Hyperactivity Disorder (ADHD), and Autism Spectrum Disorder (ASD). NDAS is a joint service between Highland Council and NHS Highland.

According to research by the Scottish Government in 2018, in Highland, approximately 2400 people are autistic, not all of which are diagnosed.

The report stated:"Approximately 250 children and young people were waiting two or three years, and sometimes up to four years, for an assessment". Options to improve the waiting list times, are said to be under consideration by NHS Highland and Highland council.

The report also stated that:"Just under half of staff felt that children and young people in Highland were being protected from abuse, neglect, harm or exploitation. And less than half of staff felt that children and young people who had experienced abuse and neglect were supported to recover from their trauma." Only a third of staff felt children’s wellbeing and life chances had improved.

The report also found that the quality of assessments, planning, and reviewing for children at risk of harm, was "the older the child the poorer the assessments, plans and reviews were". This has had a significant impact on young people transitioning to adult services.

And when decisions were being made about the children and young people's future, it was reported that the views of parents and carers were more likely to be taken into account, than the views of the children and young people.

As well as this, many children did not recieve any support from their key staff member:"While the majority of children and young people told us that their key staff member spent time with them and gave them the help they needed all or most of the time, just under a third said this did not happen at all"

However, key strengths were also highlighted in the report:"Staff responded promptly and effectively when concerns were raised about children and young people in the majority of cases. This response continued during the period of the pandemic and associated restrictions.

"Information sharing and collaborative decision making were effective at keeping children and young people safe when concerns were first raised."

Most staff were proud of the contribution they made to improve the wellbeing of children and young people at risk, but were less confident that wider improvements had been made.

We asked NHS Highland for a response to the waiting times for CAMHS and NDAS in Highland, and they responded with:"The chief executives of Highland Council and NHS Highland, the commander for Police Scotland, Highlands and Islands, and the chair of the Child Protection Committee, welcome the Care Inspectorate’s findings.

"Collectively, they wish to highlight the key strengths in relation to the partnerships prompt and effective responses when children were at risk of harm. The Care Inspectorate also found that the partnerships response remained a strength throughout the pandemic.

"The Care Inspectorate noted that the partnerships were robustly sharing information and working together in making decisions that ultimately ensured that children at risk of harm were safe. The inspectors also identified a number of key areas for improvement, which are fully accepted to ensure continuous improvement of services across Highland.

"The improvement journey commenced prior to inspection. The findings of the inspection will enable the partnership to continue its journey relentlessly focusing on the best possible outcomes for children and families across the Highlands."

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