An independent rigorous assessment of children’s mental health services is long overdue, wake up National Audit Office! Therapists are navigating children through a fog. Paula, not her real name, a 6 year old, had a traumatic incident at a fair and suffered separation anxiety disorder. She had 6 treatment sessions with CAMHS, she was discharged on the basis of ‘low chance suffering from post traumatic stress’ and recalling the event with ‘no distress’. But having seen her myself and assessing her using a standardised diagnostic interview she never did suffer from PTSD and the separation anxiety disorder has not been systematically addressed. Nevertheless the therapist calls for the whole family to attend ‘family systemic therapy’, notwithstanding that Dad does not live with them and sees mum as irresponsible for taking her to the fair. Mum sees this as just a further example of his being a ****** and is unphased by this!
The current zeitgeist is to ask for more resources for children’s mental health, putting mental health workers in school etc. The idea is that adult mental health problems could be prevented by such actions but the evidence base on this is at present weak. But even in the unlikely event of extra resources being delivered,(as opposed to promised), if we multiply very poor treatment you still get very poor treatment. It is crucially important to clarify the landmarks that child and adolescent therapists should use to assist children and their caregivers through the fog.
Charities often link up with formal bodies to provide services, but they are often a) desperate for funding and b) don’t have the training (or wish) to measure real world outcomes. Perhaps the best Christmas gift to children would be a truly independent and rigorous assessment of the psychological treatment they receive. This is not at all to marginalise the importance of support groups for children and adolescents with a wide range of problems.
Dr Mike Scott
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Review of IAPT and Young peoples services Feb 2020