Dame Christine Lenehan, Director of the Council for Disabled Children, was commissioned by the Department of Health to look into how to improve the quality of care service to children and young people who have mental health, learning difficulties or autism and challenging behaviour issues. The review was instigated by several individual cases, and has now been published, called ‘These are our Children’.
Mental health services, in general, have come under close scrutiny over the past year. The Government has been criticised for underfunding these services, compared to the funding of services for physical health. I wrote recently about an ITN survey of Trusts, which highlighted that a majority of the responding Trusts had reduced the number of beds for mental health care, despite promises by Government of increased funding, and no compensating increase in community support services for this group of people.
The outcome of this reduction was that many people had to travel far beyond their area to receive appropriate support, in some cases they had to move over 100 miles.
A national problem
Similar issues arose in Scotland. MSPs in Scotland have warned of a decline in the availability of mental health support in many parts of the country. The Health Committee convener, Neil Finlay wrote a letter of concern to the Government about lengthy waiting times beyond agreed limits, particularly for young people. The Committee stated that they had seen no improvement in early intervention and prevention work over the past 13 years. They could also see no justification for the continuation of different waiting times for people requiring physical and mental health support.
It is sad to see that review after review is highlighting shortfalls in services, and doubly so for the group looked at in ‘These are our Children’. Dame Lenehan found that many of these children aged 12 to 15 were taken out of their communities to institutional settings far from home, and seemed to be quietly forgotten about by local services. Some of their problems had been diagnosed at the age of two, yet the problems had multiplied rather than being addressed in many cases. The ultimate solution was often long-term institutional care.
A history of not enough action
Clearly, these issues apply across the ages for people with mental health support needs. One has to only think of Winterbourne View, and its aftermath of apparent inaction, to see the harm that long-term, often unnecessary institutional care can do. Dame Lenehan also reminds us that the problem stretches back in time. She stated that:
“It should be noted that this is not a recent issue. Almost 20 years ago a committee of the Mental Health Foundation published Don’t Forget Us, Children with Learning Disabilities and Severe Challenging Behaviour (Mental Health Foundation, 1997).”
Her review emphasises that these children are part of our community, they are our neighbour’s or relative’s children, and that they deserve better.
Solutions?
The review makes 11 recommendations. They focus on early diagnosis, preventive and early intervention, professional collaboration and local support for families. It is encouraging that the solutions she favours seem to need little new funding, but for what we all do to be done better. Of course, change always costs money, but it is hoped that this thorough review will act as a stimulus to our consciences, whether as funders, commissioners, all members of our local communities, or direct support providers. Only if it does so can we expect things to change for these most vulnerable people, to look forward to a better future.
