CAMHS under pressure

Written by: HTU | Published:

A recent survey of school leaders shows that many are concerned about their pupils’ mental health and wellbeing, but that delays to CAMHS are preventing them getting quick and effective help. Amy Cook reports.

I heard rather a lot about mental health recently. In June I went along to the Sunday Times Festival of Education where I heard the author Andrew Solomon talk about his interviews with an American woman whose schizophrenia was so devastating that she could hear her neck muscles sizzling and feel them burning. She was completely convinced that she was possessed by a demon.

Schizophrenia afflicts only a tiny minority, and hers was an extreme case. But it took her years to find help and to understand that there was a name for what she was experiencing. And the emotional difficulties she experienced at school went unnoticed.

Here in England, it seems that schools are paying more attention to their pupils’ state of mind.

As a researcher who specialises in pupil wellbeing at The Key, I am seeing more questions from our members on supporting pupils under extreme stress. For example, we have recently been asked how a school can support a transgender pupil and how to help pupils with “severe” mental health problems. 

In fact, 56 per cent of primary school respondents to our June survey of school leaders about mental health were concerned about depression among pupils in their school, while a third were concerned about eating disorders, and more than eight in 10 about anxiety disorders. 

Furthermore, the most popular of our articles in this area during the last term were:

  1. Can schools make referrals to CAMHS?
  2. How can we support a pupil with severe mental health problems?
  3. What procedures should we follow if a pupil self-harms?

Speaking at the Festival of Education, Professor Tanya Byron, a clinical psychologist specialising in working with children, explained that mental health problems appear to be growing most quickly among children of wealthy families who attend independent schools: anxiety levels are increasing because of the extreme pressure on these young people to succeed.

So when I read that two-thirds of councils in England have cut spending on Child and Adolescent Mental Health Services (CAMHS) since 2010, I am afraid. I am afraid because, having written articles for school leaders on how schools can make referrals to CAMHS, I fear I may be sending them up the garden path. 

And while recent government guidance will help teachers to distinguish challenging behaviour from problems with mental health, I don’t feel reassured.

Pupil wellbeing should certainly be a core concern of schools. But work in schools cannot compensate for sound, professional support when problems go beyond the self-esteem issues that can be successfully addressed in the classroom. This professional support seems to be getting harder to come by. 

Our June survey found that almost a quarter of those who had made a referral to CAMHS had to wait three to six months for this to be followed up, and nearly 10 per cent had to wait even longer. So we are pushing schools to support pupils’ mental health, but who is supporting the schools?

I am worried that we are at risk of creating an emergency service approach, where cases are only addressed at crisis point. This won’t save money in the long term, and it could also leave children feeling isolated and anxious for longer. Hardly the best state of mind for learning.

Of course, not every child needs emotional support beyond the pastoral care normally offered by families and schools, but with school leaders so worried, and some schools offering unprecedented levels of psychological support, is it time for a national strategy?

I am thinking of the kind of approach we are seeing for another pressing problem – childhood obesity. We are seeing a more co-ordinated strategy to tackle this, with central funding to support the school food plan and the introduction of universal infant free school meals from this September. We will need research to develop a similar approach to mental health. While we measure the weight and height of children in schools each year, the last set of national statistics on mental health of children and young people was produced back in 2004. The physical signs of good health are easier to measure, but I’d also like to see the mental health of young people being prioritised. 

And with more of a focus on emotional wellbeing in schools, perhaps we’ll see fewer young people struggling alone with the kind of unimaginable suffering I heard about from Andrew Solomon. 

The Key’s Survey

A sample of 7,000 school leaders across all phases was selected, of which 1,031 completed the full survey in June 2014. When asked, how they would rate the mental health of pupils in their school, 

66.9 per cent said “good”, 19.5 per cent “very good”. However, 11.8 per cent said “poor”, while 1.9 per cent said “very poor”.

Around three-quarters of primary leaders in the survey said that they have had to deal with mental health issues among pupils in their school. The conditions that were of concern for these school leaders included anxiety (82 per cent of primary leaders), depression (55.8 per cent), eating disorders (41 per cent), and self-harm (51.2 per cent).

When it came to CAMHS, 65.8 per cent said that they have made a referral at some point in their career, with 19.5 per cent of these respondents waiting less than one month for a response. However, 45.2 per cent waited one to three months, 25.9 per cent waited three to six months, and 9.4 per cent waited more than six months.

The full results of the survey are available at

  • Amy Cook is a senior researcher at The Key.

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