More than one in five child mental health referrals in Scotland are rejected

Figures from an FOI request show wide variation between health boards

15th August 2023 about a 3 minute read
"I was shocked to discover that as many as four in 10 young people are being rejected from mental health support services. Long waits and letters of rejection just aren’t good enough." Alex Cole-Hamilton, leader, Scottish Liberal Democrats

More than 20% of referrals to children and adolescent mental health services (CAMHS) in Scotland were rejected in 2022, new figures show.

The data, obtained from health boards via Freedom of Information (FOI) requests by the Scottish Liberal Democrats, shows that out of 37,728 referrals to CAMHS last year, 8,576 were turned down.

The proportion of cases rejected varied between boards, however. In NHS Borders and Forth Valley, more than 40% of cases were rejected. In NHS Glasgow and Greater Clyde, the country’s largest health board, the rejection rate was 28%.

Referrals for CAMHS can come from GPs, schools or hospital A&E departments.

Alex Cole-Hamilton, the leader of the Scottish Liberal Democrats, said that first minister Humza Yousaf should take action to improve CAMHS performance: “I was shocked to discover that as many as four in 10 young people are being rejected from mental health support services. Long waits and letters of rejection just aren’t good enough.

“Two years ago, Scottish Liberal Democrats secured an additional £120m for mental health services but that is just the start of our ambition. No young person who seeks mental health support should come up against these road blocks.

“My party will continue to fight to double the number of specialist psychiatrists for young people in training and ensure that there is no wrong door for accessing service so that families are never sent back to the start of the process.”

More than a quarter of young people wait more than 18 weeks

Figures published in June showed that the Scottish government had failed to meet its target of ensuring 90% of young people start treatment within 18 weeks of being referred to CAMHS. More than a quarter of young people, the figures showed, have to wait longer than 18 weeks to be treated. The figures also showed that 7701 children and young people were still stuck on waiting lists to start treatment at the end of the quarter ending March 2023, an increase of 138 on the previous quarter ending December 2022.

Commenting in June, Dr Kandarp Joshi, vice-chair of the CAMHS faculty at the Royal College of Psychiatrists, said: “Once again we have a situation where many young people and their families are having to wait weeks to receive care which increases their chances of developing more complex and severe mental ill health.

“It’s a mental health emergency and we predict demand is set to soar due to the cost-of-living crisis. We’re also dealing with the double whammy of having a postcode lottery of CAMHS services across Scotland.

“As psychiatrists on the frontline, we’re doing all we can to support our young patients, but capacity simply isn’t keeping up with demand. It takes years to train new staff and services don’t have the resources they need to tackle the mental health crisis that is happening right now.”

Maree Todd, the mental wellbeing minister, said that the Scottish government was committed to supporting people to access the care system, saying that in 2022/23 the Scottish government allocated an extra £46 million to improve mental health and psychological services.

She said: “We know that CAMHS will only be the right service for a small proportion of children and young people. To provide an alternative to the service, over the last two years we have invested £30 million in community-based mental health supports for children, young people and their families. Local authorities report that 45,000 people accessed those services between July and December last year. We are also providing £16 million a year to local authorities to ensure that every secondary school has access to a school counsellor.”


FCC Insight

CAMHS services are stretched throughout the UK, as referrals soar. Although the Scottish government has allocated extra funding to mental health services to children and young people, and recruited more staff, the figures suggest it is not enough to cope with demand. What isn’t clear from this story is why referrals are being turned down ­– whether it is because the children don’t meet the threshold for treatment, or whether the services are too overwhelmed to cope. There is a need, however, to tackle this problem at root and to help children and young people with their mental health struggles before they require referral.