Meet Sorcha, a teenager laid low by mental illness. When she started self-harming and showing other symptoms of acute anxiety as a 13-year-old the first GP she saw agreed she need urgent help. After three months she was offered “family therapy” but any benefit was temporary. She had to wait three years for the cognitive behavioural therapy she needed. Looking back, her mother believes the endless waiting and the frustration of being considered not quite ill enough for intensive treatment only made her daughter’s symptoms worse.
Sorcha’s story should be exceptional. In fact such cases are all too common in teenage mental healthcare, one of the most neglected corners of the health service despite evidence of a mental illness epidemic among young people. Inheriting a system that was manifestly failing, the coalition promised to give mental health services more money and “parity of esteem” with physical services. Five years on, spending has fallen year on year and A&E admissions of under 18-year-olds with psychiatric conditions have doubled.
Westminster will not be allowed to sweep this scandal under the carpet. A report commissioned by the Department of Health will next week accuse successive governments of treating children’s mental health services as a soft target for cuts. Today The Times publishes a guide for worried parents and a mental health manifesto. The main parties should digest all three documents as they draft and re-draft their own manifestos, because the goal is clear: the next government must end the shame of untreated teenage mental illness.
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The first requirement is for better information so that the scale of the epidemic is understood. The last full study of the state of teenage mental health was published in 2004. It found that one in ten children had a diagnosable mental problem. Labour, fearful of being blamed, cancelled plans for a follow-up. The coalition has dithered instead of acting, but the broad trend since 2004 is clear and troubling. Figures from the Health and Social Care Information Centre show a 62 per cent increase in self-harming since 2004 and a 98 per cent increase in cases of anorexia and other eating disorders among young women aged 15 to 19.
Part of the increase is a result of better reporting as the stigma attached to mental illness slowly fades. Yet much of it must be attributed to the fast-changing culture in which teenagers grow up, vulnerable to cyberbullying and living in the distorting mirror of social media. The tragedy is that treatment is most effective, and cost-effective, when early and appropriate, but it is usually denied and often wrong. One unacceptable effect of a system that delivers healthcare in separate “silos” is that clinics responsible for early inter-ventions frequently do nothing. They know that if they wait long enough children will be admitted to hospital and the cost will be incurred elsewhere.
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Nearly three quarters of teenagers with mental illness receive no care at all. Those treated as urgent psychiatric cases face a shortage of specialist hospital beds so critical that 236 children last year were forced to spend nights in police cells. Too often a troubled child’s first encounter with the system leads to a flawed diagnosis, a counter-productive referral and years of avoidable heartache.
The crisis is deepened by the frequent assumption by GPs as well as parents that teenage misbehaviour is a passing phase. It usually is, but with clinical mental conditions “wait and see” is not an option. The symptoms and treatments are well-established and well-known to professionals. There are simply too few of them, and the cost is high: 75 per cent of adult victims of mental illness first showed symptoms as children. We are pro- mised better data and more resources by 2017. That will be too late for too many. The time for action on teenage mental illness is now.