Children's Mental Health Funding: Where Is It Going?
In 2015, the Government committed to an extra £1.4 billion to CAMHS over five years. We have carried out a series of Freedom of Information requests to find out where it's going.
Every day, we hear from young people and families who simply can’t get the help they need from Child and Adolescent Mental Health Services (CAMHS). We hear about long waiting times, inconsistent services, and such high thresholds for treatment that even young people who are self-harming or feeling suicidal aren’t always referred for support.
This is despite the fact that, after years of underfunding, the government committed an extra £1.4 billion to CAMHS over five years in 2015. Parents who call our helpline often ask us – where did the extra money go?
We have carried out a series of Freedom of Information requests – to NHS England, to Clinical Commissioning Groups (CCGs), and to Local Authorities – in an attempt to understand what impact the extra £1.4 billion is having, and whether it’s sufficient to tackle the crisis.Our research shows that, in total, less than 1% of the total NHS budget is spent on CAMHS, and only 8.7% of the total mental health budget goes on under-18s.
And, while there is no doubt that the investment has led to substantial extra spending on children’s mental health in almost every CCG across the country, these budget increases are not consistent.
Our analysis suggests that, in 2017/18, 43% of CCGs had increased their CAMHS budgets by less than the extra money they had been allocated for children’s mental health. In those areas, it seems that some of the extra money was in fact spent on other priorities.
In many other areas, CCGs have increased their budgets by more than the additional investment, which suggests an inconsistent approach across the country.
We also found that – while the majority of CCGs have increased their CAMHS budgets – over half of local authorities have actually cut their CAMHS budgets in real terms since 2013/14. This may be because some of the services they were funding are now being funded by CCGs. In other words, some of the new money for CCGs may, in practice, be used to backfill local authority cuts.
All of these figures are to be treated with some caution. As the National Audit Office highlighted in its recent report, there are “significant data weaknesses” around CAMHS activity and spending.
While around 90% of CCGs and 77% of Local Authorities were able to provide us with some relevant data about their CAMHS budgets, many were not able to give us all the information that we requested. And the figures they did provide didn’t always appear to correlate with figures that had been reported to the NHS Mental Health Dashboard.
The overwhelming conclusion from our research is that while the extra investment has made a significant difference – and now represents around a quarter of CAMHS funding overall – it simply isn’t enough to tackle the crisis.
With the extra £1.4 billion, the NHS is aiming to support around a third of children and young people with mental health problems by 2020 - and even that low figure is likely to be unachievable, because of growing demand.
A new improved funding settlement
That is why, if we are to tackle this crisis, the new NHS Long Term Plan must lead to a new, improved funding settlement for CAMHS. But we also need greater transparency and accountability to ensure that all money for children’s mental health is spent where it’s intended.
In addition, we need to address the black hole in practical mental health support in the community. Years of cuts to wider local authority youth services have left gaps in practical support in the community. That means fewer youth workers, fewer youth centres, and fewer spaces where young people with emerging mental health problems can go to talk through their problems.
Only by creating a new era for children’s mental health, and ensuring that we focus on prevention and early intervention, can we hope to end the crisis.