Spike in referrals to children’s mental health services played down at committee meeting

By Grainne Cuffe, local democracy reporter

A spike in referrals to children and young people’s mental health services in May is being “monitored closely”, a Lewisham committee was told yesterday (June 17).  

The details emerged when an update report on Child and Adolescent Mental Health Services (CAMHS)’s performance was presented to the children and young people’s select committee.

On average 123 referrals were received by CAMHS in 2020/21, down from 134 in 2019/20, though there were 173 received in March 2021.   

In April referrals dropped down to 130 but went up to 213 in May. 

It showed that 74 per cent of referrals were accepted in 2019/20, which dropped to 69 per cent on average in 20/21, with 74 per cent accepted in March 2021.   

Acceptance rates remained the same as March in April and May this year.  

Committee members raised concerns about the “alarming” increase.  

Cllr Liz Johnston-Franklin said: “We’ve seen this quite big jump in one month […] If we’re going to be seeing this increase going up and up and up, we need to be looking at what our capacity is to be able to deal with that.  

“Because those increases are quite a lot and the needs of the young people will be very diverse.” 

Caroline Hirst, who manages the children’s joint commissioning team on behalf of Lewisham Council and the South East London CCG, presented the report.  

She said it was important to note that there are “peaks and troughs” with the figures, while schools closing and reopening can have an impact.  

“It goes up and down. It went up in March, dropped down in April, and it’s gone up again in May and that’s why I try to take a full year comparison.  

“It’s been a really unusual year with schools closing, where we do get a high number of referrals.  

“The referrals from GPs have remained the same throughout the pandemic but schools have obviously been affected.  

“It’s something that we’re closely monitoring. There is a lot of work behind the scenes to monitor this, but also how we make best use of the resources to respond to that demand,” she said.  

Lewisham Council approved its budget for the year in February, along with £40 million worth of cuts planned over the next three years.     

The plans included a controversial £250,000 cut to the council’s contribution to CAMHS.    

However, the council decided to keep the quarter of a million pounds as a “contingency”, so if there was a surge in demand it could be released to deal with it.  

Committee chair Cllr Luke Sorba asked the director for children and young people, Pinaki Ghoshal, whether he thought the council would be calling on the funds.  

“It’s only a snapshot, but the May CAMHS referral rate is ringing an alarm.  

“The central Government austerity imposed on local government has forced us to make cuts in areas we never wanted to make, but Lewisham’s managed to set aside a contingency. 

“I’m wondering whether that May figure is the beginning of a series of indicators that might endorse the warnings that were made earlier in the year by mental health professionals about the suppressed need being stored up by the pandemic and where and how it will be released,” Cllr Sorba said.  

Mr Ghoshal said it was too early to tell.  

“There was a dip and then an increase so you need to look over a three/four-month period not just over a single month.  

“I’m really pleased the acceptance rate hasn’t changed within CAMHS,” he said, adding the council is doing work focused on prevention.  

“This is part of a much wider view of the work we need to do to support our children and young people’s emotional health and wellbeing,” he said.  

Elsewhere, Ms Hirst said there was “significant” progress being made.  

“The key messages of the report are there has been a substantial increase across the council and the NHS in relation to children and young people’s emotional mental health spend. 

“The paper shows that there’s a £5.2 million investment in 2017/18 and that increased up to £7.2 million for 2020/21. The indicative figures for 2021/22 do show a further increase, but this is still being worked up,” she said.  

In 2019/20, 73 young people had to wait between 39 and 51 weeks for their first contact with CAMHS, compared to 26 young people in 20/21, while 18 had to wait more than a year in 19/20 compared to two in 20/21.   

The average number of weeks wait from referral to first assessment was 28 weeks in 19/20 compared to 16 weeks in 20/21.  

The average number of weeks wait from first contact to treatment was 33 weeks in 19/20 compared to 21 in 20/21.   

The update also revealed that 50 per cent of referrals received in 20/21 were young people from a Black, Asian, or ethnic minority background. 

This was an increase of 10 per cent compared to the year before.   

“Ethnicity data is collected now consistently. We are seeing that BAME access overall has increased from 40 to 50 per cent over the last 12 months so that’s a significant improvement,” Ms Hirst said.