children’s mental health | ncasc 2014 children and young people’s mental health and well-being a...
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Children’s Mental Health | NCASC 2014
Children and Young People’s Mental Health and Well-being
A Local Perspective
Alison O’Sullivan
Director of Children’s Services, Kirklees
Vice President, ADCS
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Facts and Figures…
With thanks to NHS England for following slides
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Impact of mental disorder: Most lifetime mental disorder arises early adulthood
Age of onset of lifetime mental illness – predates subsequent illness by several decades
Source: Kim-Cohen et al, 2003; Kessler et al, 2005; Kessler et al, 2007
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Mental health problems are the greatest health problem faced by children and young people
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% With anxiety or diagnosable depression not in contact with mental
health services
Source: Ford et al. (2005) Child & Adol Ment Health, 10:2-9
Dean et al., (2004) DoH; McCrone et al., (2008) King’s Fund
80%
70%
60%
50%
40%
30%
20%
Adults withdepression
5-15 year olds
Percentage
unknown
to any
service
35%
76%
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Number of under 20 young people per 11Pspecialist in child mental health
Source PEDRINI ET AL., (2012) ; LEVAY ET AL., (2004); WHO MENTAL HEALTH ATLAS (2005)
NU
MB
ER
OF
UN
DE
R 2
0 Y
EA
R O
LDS
SWITZERLAND0
FINLAND
30,000
5,300
FRANCE UK
6,0007,500
30,000
20,000
10,000
5,000
15,000
25,000
No of under 20 year olds per CAMHS medical specialist
With permission P Fonagy
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Biggest Barriers
• Commissioning fragmentation – ‘shared’ responsibility• Professional preciousness – commissioners and
providers
• Low status – low priority – stigma
• Disinvestment – overall funding level
• Inconsistent use of best practice
• Child perspective and voice not heard
Children’s Mental Health | NCASC 2014
Only 6% of current spending on mental health goes to services aimed at children and young people Kennedy, 2010
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Potential Case Studies
Children’s Mental Health | NCASC 2014
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Solutions – what?
• National leadership across the system
• Policy and some National design
• Standards and clear measurement of outcomes
• Coherent collaborative commissioning
• Voice of the child
Children’s Mental Health | NCASC 2014
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Solutions – how?
• Make visible and own poor starting point
• Really cut through silos
• Face the ‘demons’
• Recognise it’s a journey
• Create and apply leadership
Evidence-based practice has substantial clinical & cost benefitsLittle & Edovald, 2012; Suhrcke, Puillas & Selai, 2008
Children’s Mental Health | NCASC 2014