Well the year is nearly at an end, and hasn't it been an interesting one. In 2015 we got a new government in Westminster, two major earthquakes in Nepal, fears of a Grexit from the EU, Ireland legalized gay marriage, A global climate change pact was agreed in the Climate Change summit in Paris, and most recently UK’S Tim Peake went up to the Space station. As a mental health campaigner in Wales I am delighted to say that 2015 has been full of progress.
At the beginning of the year, following the Children, Young People and Education Committee’s report on CAMHS published in November 2014, Professor Mark Drakeford, Wales’ Health and Social Care Minister, acknowledged the shocking and unjustifiable findings in the report in February 2015. The main statistic which came from the report was that between 2010 and 2014 referrals to CAMHS (The Children and Adolescent Mental Health Services) had increased by 100%. WalesOnline noted Mark Drakeford’s response to this finding;
“far too many referrals to CAMHS today turn out not to be in need of that specialist service.”
“With this goes a great deal of frustration for those children, young people and their families who learned that they have been sent down a route which will not best meet their needs.” –Dr Mark Drakeford, WalesOnline 26th Feb 2015.
On the same day as this article was published Dr Mark Drakeford also launched Together For Children and Young People (T4CYP), a multi-agency service improvement programme, led by NHS Wales. The programme has and will be looking at ways to improve CAMHS for children and Young people, and ways to improve the general mental health of the young population in Wales. The programme is specifically trying to remodel and refocus CAMHS in line with the principles of prudent health care. The health and social minister endorsed the four main principles of ‘Prudent healthcare’ in January 2015, and made them priorities for healthcare in 2015. The four main Prudent Health Care priorities are;
- Achieve health and wellbeing with the public, patients and professionals as equal partners through co-production;
- Care for those with the greatest health need first, making the most effective use of all skills and resources;
- Do only what is needed, no more, no less; and do no harm
- Reduce inappropriate variation using evidence based practices consistently and transparently.
T4CYP have outlined their four main priorities;
Early Years and Resilience of Young People:
· -Whole school approaches to promoting mental health and wellbeing
· - Attachment issues for mothers with perinatal problems
· - Training professionals across statutory and third sectors in child development and mental
· - Early years’ support
Early Intervention and Enhanced Support:
-Identification of young people at risk of development of severe mental illness such as
psychosis, severe eating disorders or severe self-harm
· - Cross sector services with emphasis on early support
· - Support for the most vulnerable children and young people (CYP) including Looked After
· Children (LAC)
Neuro Developmental Issues and Co-morbid MH/ LD:
· -Better understanding of ADHD/ASD across all agencies
· -Bespoke care pathways for individuals with ADHD/ ASD
· -Timely access to those needing specialist assessment and treatment services
· -Drawing together the skills of mental health, paediatrics, therapists and LD
Specialist CAHMS Pathway:
· -Crisis care and out of hours provision
· -Cross sector working to deliver best possible care to improve outcomes
· -Early intervention for young people with psychosis
· -Evidence based psychologically-minded therapies
Everyone in the Mental health field is waiting with fingers crossed to see what comes from T4CYP. In my opinion this is the first time there has been a real potential for some much needed change, especially for Children and Young People. This could be a turning point, however promises have been made in the past and we have been let down. It is too early to see how this opportunity progresses, but I certainly feel an atmosphere of hope amongst my peers and colleagues.
Another statistic revealed by the Children, Young People and Education Committee’s report was that £82.75 was spent per head on general mental illness compared to only £13.94 per head on child and adolescent mental health. This statistic showed just how underfunded the Children and Adolescent Mental Health Service (CAMHS) actually was. Myself and many of my colleagues argued that if the money was spent earlier on in a person life then many complications that people face with their mental health could be fixed or even prevented, resulting in less people requiring mental health services later in life, and reducing chronic suffering of many people. In response to this Welsh Government announced in May 2015 it would be investing an extra 7.6milllion pounds into CAMHS each year, an 18% rise from the previous year. Of which;
- £2m is to develop neuro-developmental services, including ADHD and autistic spectrum disorders. A significant number of referrals to specialist CAMHS services relate to children with autism or ADHD even though they do not meet the criteria for treatment by CAMHS. This can delay access to the support they do need and access to specialist CAMHS for those who need this service;
- £2.7m is to improve out-of-hours and crisis CAMHS response;
- £1.1m is to expand access to psychological therapies for young people;
- £800,000 is to improve local primary mental health support services;
- £250,000 is to expand provision for children and young people in the criminal justice system;
- £800,000 is to address the needs of young people who have an early onset of a severe illness, such as a psychosis. This will mean the service can support young people aged 14 to 25.
The extra funding is welcomed by most in the Mental health field, and I certainly am very grateful that it was recognised that CAMHS needed more funding. Many also argue that it may not be enough, however, Dr Mark Drakeford has already said that there simply isn't any more money to invest in Children and Young people’s Mental health in Wales, and there won’t be for the next 4-5 years (you can thank the new government in Westminster for that one)*insert annoyed emoji*). I am sympathetic of Dr Mark Drakeford’s position in this circumstance, and in the future my main point will be for systematic change within CAMHS. There is no point calling for more funding when there is no more money.
Mental illness charity, Hafal conducted a survey to find out the experiences of Children and Young people and their carer’s of CAMHS. The campaign, called MakingSense, is endorsed by the High Needs Collaborative formed by the Mental health foundation, Diverse Cymru, Bipolar UK, Hafal and the Wales Observatory on Human Rights of Children and Young people. I worked alongside my colleagues on MakingSense and can say that the results were very interesting. Unfortunately, I am unable to give any more details as the report hasn’t been published yet. We are hoping to publish the report in Jan 2016, and possibly present to T4CYP the report, findings and recommendations in January 2016 also.
Professor Sally Holland, the new Children’s Commissioner for Wales, has also launched a survey to identify the needs of children and young people in Wales. Professor Holland has said that the mental health of children and young people in Wales is a concern brought to her attention often, she predicts that it will also be a key point coming through from her survey.
Amongst many other concerns brought to light this year in connection with the Mental Health and Mental Health services in Wales, including concerns of inadequate services and treatment for those young people suffering from Eating disorders, and concerns about the number of beds in Wales for children and young people requiring hospitalisation, an ongoing problem of waiting times continues to be at the forefront of people’s attention. Most people with even just a slight interest in this area will know that the waiting times for assessment and treatment by CAMHS are huge. In T4CYP’s August 2015 newsletter the following was said about waiting times;
"By the end of this financial year Welsh Government expects to see tangible improvements in access and a reduction in waiting times for both those children with neuro-developmental and specialist CAMHS needs by the end of December 2015, with;
-All urgent specialist CAMHS assessments undertaken within 48 hours, by the end of October 2015.
-All routine specialist CAMHS assessments seen within 28 days, by the 1st April 2016. "
It will be interesting to see if these goals were/going to be achieved. It could be an indication as to whether T4CYP will deliver over the next year.
Personally this year has been possibly the most life changing year of my life. When I fell ill at 14 years old, and throughout the time in which I was most ill I would never have believed that I would be able to achieve what I have over the past year. Achievements like getting to my 18th birthday, numerous interviews with BBC, ITV, S4C, BBCRadio Wales, and various newspapers. Completing a training course called YoungEnablers with Disability Wales, and speaking at several conferences and events, such as the Mental Health Today Wales Exhibition in Cardiff’s Motorpoint arena. Completing my Peer advocacy training with Pembrokeshire People First, and becoming a member of Hywel Da University Health board’s Young people forum. Becoming a Research Champion for the National Centre for mental Health and becoming a Trustee for Hafal, a Wales wide Mental illness charity. And so much other Campaign work. I managed to get through my A-Levels, and came out with an A in Biology, and I passed my driving test. Up at the top of my achievements list for this year is winning the BAFTACymru Award for the TV Programme I did with S4C in 2014. I have met with so many interesting people, and made some good memories.
Despite all of my professional achievements, the most important things that I have achieved this year is the steps I have taken with my mental health. I said to myself at the beginning of 2015 that I would focus on getting better. Now as 2015 comes to an end, I must reflect on what progress I have made. At the beginning of the year I was plagued by visual and auditory hallucinations, an eating disorder, depression, anxiety, Self-harm and suicidal thoughts. Anyone who has experienced mental illness will understand that I wasn't really living, I was surviving. But now, through hard work and perseverance I have gotten to the point in which I no longer allow my eating disorder to control me and I am physically healthy, I still experience hallucinations but I no longer believe in them, I do not allow myself to engage with them, and I can ignore them. My hallucinations had the power to reduce me to tears in fear of them, they haunted me and tortured me, but no longer do they cause me any distress at all. I have accepted that I will continue to see things and hear things, but they are not real and only part of my imagination. I have managed to learn how to control my depression and anxiety, reducing to suicidal thoughts and putting an end to Self-harm. For the first time in many years I find myself being able to do something which most people take for granted, and that’s the ability to genuinely smile and feel happy.
2015 was an incredible year for me, and I feel a huge turning point in my life. It was also an interesting year for Mental health with so much progress being made. It’s now time to look towards the future and what’s to come in 2016. Currently there is a lot of attention on Mental health and I truly feel if we are intelligent and persistent a lot of change could potentially happen, possibly even a culture shift amongst society. I was asked in an interview a couple of weeks ago whether or not I would like to see Mental Illness take the same journey as Cancer has over the past couple of years. Several years ago Cancer was only whispered in society and a huge stigma clung to it, but now people run marathons and huge national events take place to support those facing cancer. The people behind the culture change of Cancer saw an opportunity and ran with it. I truly believe Mental illness could go through a similar journey in the next few years if we all work together and do what we can to tackle the issues surrounding mental illness. I for one will be doing all I can to make sure young people with mental illness get the right help from appropriate services, and that all young people in Wales get the opportunity to have good Mental Health. For now, Happy New Year! I hope 2016 is rewarding and exciting for all of you.