What forces a caring health service to refuse care?

27 Feb 2020 | What forces Caring Health Services in UK to refuse care to Patient.

In the last decade, we have seen an increasing awareness of mental health problems in the general population. People are more prepared to seek much-needed help. The internet and social media have helped with this awareness, though ironically are also often blamed for causing well-being problems. With this emerging awareness, the demand for children’s mental health services has increased exponentially.
CAMHS services are a finite resource, designed to meet the needs of a specific number of young people at a time. As demand has increased, CAMHS has attempted to deploy all those resources in the most efficient manner, to provide care to patients who require the Tier 3 service for which it was designed. Tier 4 (inpatient) services are reserved for severely ill patients, whereas Tier 1 and Tier 2 were specified to be more preventative and less specialised services, provided by primary health care services (including schools, colleges, GP surgeries).
For effective care to be provided, all tiers must provide meaningful mental health care to young people accordingly. Due to austerity measures during the last decade, funding cuts have impacted Tier 1 and 2 services (for example counselling, educational psychologists) so the principles of preventative early help have been compromised. This has resulted in a wider caseload of mental health problems being funnelled towards Tier 3 CAMHS. This is akin to expecting a specialist neuro surgery unit to see patients who have issues ranging from headaches to much more serious neurological cases. Such units will usually only accept the cases which need their level of skill, leading to large numbers of patients in need falling out of the system.
It is too easy and facile to blame CAMHS; it deserves our understanding support. Other services need enabling - particularly schools and GPs - to provide or signpost much needed preventative mental health interventions. This would allow CAMHS to become more effective and responsive, performing the role it is designed for.

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