Editorial
| Published date | 01 June 2004 |
| Date | 01 June 2004 |
| DOI | https://doi.org/10.1108/13619322200400012 |
| Pages | 2-2 |
| Author | Elizabeth Parker |
| Subject Matter | Health & social care |
Editorial
when staff shortages were pushing up waiting times again,
made further adaptations to provide a quality service
within existing limited resources. In the second example
Tony Gillam describes the award wining Goldenhill
project to support the parenting needs of mental health
service users who have children. Both these initiatives
show the importance of a ‘can do’ attitude: when clients
are listened to and there is a willingness to frame
acceptable services to meet their needs much can be
achieved at a grassroots level which, after all, is where
effective intervention takes place.
But mental health services do not seem to reach some
vulnerable young people. Juliet Lyon presents a shocking
account of young people in prison, 90 per cent of whom
have a diagnosable mental disorder and 10 per cent a
severe psychotic disorder. A small but growing number
kill themselves in custody each year. She sets out a plan
for action, much of it in the public health sector and in
accordance with the government’s view of CAMHS being
an element of a wider children’s service. But why are
there psychotic children in prison when there is provision
for them to be transferred to hospital under the Mental
Health Act 1983? More recently there has been the
landmark judgement that the Children Act 1989 applies
to children held in prison. Under this Act local authorities
have a duty to protect the welfare of children which is
held to be paramount.
It is disgraceful that a country that has ratified the
United Nations Convention on the Rights of the Child
and has appropriate domestic legislation in place should
detain psychotic young people in prison. Children are our
legacy for the future. Effectively meeting their mental
health needs helps to ensure that the next generation is
better equipped to minister to the needs, both physical
and mental, of children for whom they themselves
become responsible. By meeting our responsibilities we
set up a benign, humane and progressive cycle and help
to bring a bright future into the present.
Elizabeth Parker
2The Mental Health Review Volume 9 Issue 2 June 2004 ©Pavilion Publishing (Brighton) 2004
he future seems bright for mental
health services for children and young people. The
government has endorsed a strategic model for the
development of CAMHS to form the basis of a
comprehensive service, including mental health
promotion and early intervention, to be in place by 2006.
To help bring all this about a national CAMHS support
service has been created and an additional £250 million
allocated.
And yet, the future for CAMHS has been bright for at
least the last decade; it is the present that causes concerns.
During the nineties, following various authoritative
reports, attempts were made to bring the isolated and
somewhat introverted CAMHS into closer partnership
with mainstream mental health services and with other
services for children. There was a raft of government
guidance setting out the strategic direction, new funding
was allocated and progress, albeit slow, began to develop.
But in 2001, as Stella Charman shows in the Framework
Feature, the establishment of primary care trusts led to
the jettisoning of health authorities and, disastrously for
CAMHS, the loss of their specialist commissioning and
public health skills that had begun to steer development.
Children’s mental health services currently lack a
congruous provider structure and are awaiting the
outcome of pilot studies to demonstrate whether the
proposed children’s trusts (of which CAMHS would be a
key component) are viable. Other problems are the
chronic shortage of suitably qualified staff, inadequate
administrative backup, and that priority tends to be given
to adult mental health services at the expense of
CAMHS. Despite all this, the government’s explicit
commitment to CAMHS, the increased investment and
the requirement for annual improvements does seem to
be having results and services are changing so as to better
meet the needs of their users.
This issue of the Mental Health Review features two
such examples. The Case Study contains a report on a
CAMH service that effectively reorganised itself twice.
Initially to significantly reduce waiting times and then,
T
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