In June and July 2021, the Care Quality Commission carried out reviews in seven areas of England to explore how services were working together to support children and young people's mental health during the pandemic.
The review teams followed the journey of a number of individuals as they moved through the health and social care system - as well as hearing from young people, their families, and people who work in services.
In all areas we visited, we saw agility and dedication from people working in services to provide the best care possible despite difficult circumstances. In one area, more than 60 system partners came together, including people working in the voluntary sector, to coordinate care for children and young people as well as identify gaps in provision. In many areas there were also improvements in sharing information between services and also with young people and their families - however this was not the case everywhere and siloed or disjointed working was a concern.
For many young people, improved use of technology was embraced by providers to ensure continued, and in some cases improved, access to day services and crisis support. Digital solutions also came with concerns about digital exclusion and we heard of different tactics to tackle this - including data packages and digital devices being provided to people who needed them, as well as services offering face-to-face appointments for vulnerable young people where appropriate.
We heard concerns, including from children and young people themselves, that they had to become very unwell before they could access care, and that they waited long times to receive help. In particular, in most areas that we reviewed we heard that more young people are seeking help for eating disorders and as a result were waiting longer to access care than would have been the case before the pandemic.
The impact on staff was also clear with people working in services telling us they were worried about stress and burnout. In response to this, there were many examples of services prioritising wellbeing such as providing wobble rooms' (a space that staff use if they need to take a break), wellbeing clinics and counselling sessions.
The pandemic has also highlighted and deepened health inequalities faced by some children and young people, in particular those people living in deprived areas. While some areas were taking steps to tackle this, more needs to be done. Significantly, concerns in this review also echo many of those found by CQC in 2018's Are we listening? A review of children and young people's mental health services.
Dr Rosie Benneyworth, Chief Inspector of Primary Medical Services and Integrated Care at CQC yesterday said:
As systems begin to move towards recovery, we need to hold onto and share the hard-won developments that have driven better care for children and young people, and their families.
Examples like improved data sharing, joint commissioning of roles between CAMHS and social care and improved mental health training for non-mental health staff have huge potential to help tackle issues we have sadly seen in this area for too long.
Demand has soared over the last 18 months and children and young people should not have to reach a crisis point before they get proper mental health support. We have to take this opportunity to learn from this incredibly challenging time and do better for them.