CYPMHC Response to Next Steps on the Five Year Forward View

7 April 2017

There is a lot to welcome in the Next-Steps on the Five Year Forward View. Long gone are the command and control days where delivering on health transformation was thought best done by way of a Whitehall prescription, without properly involving those concerned. Today we’re moving in the right direction, towards more person-centred and cross-sector approaches to improving the nation’s health.

It is clear that many positive things have happened in Children and Young People’s mental health over the past few years, but it is equally clear that a lot remains to be done. In these most recent delivery plans, there are many recommendations which could be transformational if delivered on. However it’s often not clear whether the plans cover Children and Young People, and whether services tailored to young people will be brought along on this journey of transformation.

For example it is promising to see that mental health providers will have to work with local council to reduce delayed discharge – but this needs to be applied to young people’s services too.

A lot hinges on the forthcoming green paper; whether or not the whole system is built around children and young people’s mental health will be the pivotal difference between a generation of young people supported by society to thrive, and one that is not.

If the green paper looks at the whole system, beyond the NHS and social care, and considers how each is a vital part of an ecosystem that can make or break the mental health of the next generation, there is a real opportunity for transformative and lasting change.

The paper needs to have a vision of a more joined up approach to health, and to bring clarity to that vision with specific proposals, for example on the role of educational settings in the system.

The Next Steps on the Five Year Forward View, also talk about developments around specialist perinatal mental health services, but again failing to recognise the bigger picture, there is no mention of lower level support which can prevent people reaching mental health crisis point such as health visitors. There has been a big decrease in health visitor numbers because of cuts to public health budgets. Health visitors are essential; with the right training they can spot the early signs of mental health problems in parents, especially mothers and also identify potential mental health issues regarding the baby.

It’s also crucial that we continue to see strong leadership around guiding commissioners to invest more in Child and Adolescent Mental Health Services (CAMHS). We know some areas are investing very little of the money allocated for CAMHS because of competing priorities.

Cash injections have helped, but one of the biggest barriers to bringing about change is that this funding is not making it to frontline services as it is being used to plug holes in the wider health budget.

This is why we’re encouraged to hear that more is being done to make funding more transparent, and to encourage CCGs to invest in Children and Young People’s mental health.

Finally, it is encouraging to hear that more young people are accessing mental health services and plans are in place that enable easier access to inpatient beds. But even with extra money, services will only be seeing about a third of the young people we estimate to be living with mental health problems. By taking a step back we can design a system that reaches the other two thirds. We have an opportunity to build a system that invests more in preventative approaches and more in schools, thus improving the mental health of all young people.