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Use of health services

Good outcomes for young people rely on youth friendly health services – from community based health promotion through to NHS inpatient care.

Around two thirds of year 10 pupils had visited the doctors in the last six months

Child and adolescent mental health services (CAMHS)

Child and adolescent mental health services (CAMHS) are delivered through a network of providers offering universal, targeted and specialist services. These are organised in four ‘tiers’. Tier 1 consists of universal services provided through early year services and primary care. Tiers 2 and 3 provide targeted services through youth offending teams, school and youth counselling, and specialist community based psychiatric and psychological services. Tier 4 consists of inpatient and very specialised outpatient services.

Only 19 in 1000 children and young people under 18 were on the community mental health services caseload in England in 2019Up to date data about use of CAMHS have been delayed by the pandemic. For example, the latest NHS England’s CAMHS benchmarking report available is the 2019 report (NHS Benchmarking Network, 2020). This estimated that only 19 in 1000 children and young people under 18 were on the community mental health services caseload. This figure relates to referrals to Tiers 2 and 3, not including inpatient services. It suggests that only a very small proportion of those with difficulties are referred and accepted for treatment.

After referral there is a further treatment gap, as some are not accepted for treatment, and others experience a long wait. In 2019 the average waiting time to the start of treatment was 14 weeks (NHS Benchmarking Network, 2020). In Scotland in the same year approximately 70% of CAMHS patients were seen within 18 weeks (Public Health Scotland, 2019).

In addition to community CAMHS, there is a very small number of specialised inpatient beds for young people under 18 (Tier 4); approximately 1,600 across the whole of England.

The pandemic has clearly put an increased strain on CAMHS services. Data are still emerging, but the initial picture in the UK is that, after an initial drop in demand for services during the first lockdown in early 2020, this is now being followed by a rise (Huange and Ougria, 2021).

Eating disorders have been of particular concern during the pandemic. Recent data suggest that the proportion of children and young people who are receiving timely access to treatment (Chart 7.7) was improving but took a dip as the pandemic unfolded.

Timely access to eating disorder services has fallen since the pandemic

Information on CAMHS from these sources does not record provision from the voluntary and independent sectors, who often provide services to fill the treatment gap, and to help those who do not meet the threshold for CAMHS. We also note there is a shortage of data on young adults who have transitioned from CAMHS into adult services, or who are referred to services for the first time between 18 and 25 years.

All data correct as of 1st November 2021