Tag Archives: child

Treating a dying child made me reflect on my role as a paramedic

We arrived at the scene in an ambulance to see the usual collection of bystanders clustered around a body. It was a child. She was still alive. A pale grey face, mumbling and moaning, eyes half shut and flickering. There was blood pooling from a wound to the back of her head and one of her legs was facing the wrong way.

The five-year-old girl had been struck by a car. The driver hadn’t been speeding or driving recklessly. The road was quiet. She had been out on her scooter. Suddenly, with a child’s spontaneity, she rode her scooter off the pavement and onto the road. The driver didn’t have time to brake.

We started high-flow oxygen and inserted a plastic airway into her mouth to stop her tongue blocking her airway, taking extreme care not to move her head in case she had a spinal injury. A dressing was placed under her head and her leg was realigned to a neutral position to prevent further tissue damage. Although she was breathing and her lungs sounded normal, we placed a bag valve mask over her mouth.

I shone a light into the child’s eyes. The right pupil was fixed and dilated. I advised the rest of the team of my finding and a colleague started to cry as she knew it meant bad news.

When the helicopter arrived, the doctor administered anaesthetic drugs and passed a tube down the child’s throat to manually control her breathing.

At some point the parents arrived. I can’t remember when, but it was before the helicopter had landed. I remember the mother running up to our huddle of green paramedic shirts and seeing her daughter lying there, her hands clamping over her mouth in horror. I cannot begin to imagine what she was going through. Seeing your small child, grey, moaning, bleeding and unable to respond to you is something no parent should experience. We encouraged her to kneel next to her daughter’s head, hold her hand and keep talking to her. Even now, years later, I’m crying while typing this.

As the crescendo of the ascending helicopter became a distant clatter I reflected on the picturesque setting. This was a tranquil village – in complete contrast to the trauma that had unfolded at its centre.

In the post adrenaline-fuelled, great-team-work atmosphere we bantered with each other. There was dark, dark humour as we checked over our shoulders to make sure the bystanders were out of range. Lots of swearing and jokes that only paramedics remain hardened to. Each of us adding another layer of veneer to shield our bravado.

After a quick debrief back at base we were back on the road, dealing with all the usual mundane shit.

I thought I would be ok.

When I got home my seven-year-old wanted to dance with me in the kitchen while my wife was preparing dinner. I remembered how three short years ago he had been riding his green scooter around our neighbourhood, carefree and happy, jumping off curbs crying: “Watch me do this, watch me do this.”

During dinner I held his hands and remembered how I had held smaller hands a few hours earlier, my blue examination gloves sticky with blood.

I remember an anecdote about a city where the ambulance service went on strike. The police were called upon to fill the gap in emergency medical response. When someone dialled the emergency number they would turn up, throw the patient in the back of a police car, no matter how serious the condition, and rush them to hospital. It was reported that patient survival rates significantly increased during this period, which caused the public to question the utility of the ambulance service.

I was left with similar questions. Two ambulances and a helicopter didn’t make any real difference to the outcome for this little girl. We made a difference to the parents and the bystanders. For as long as we were still treating their child, they held on to the fragile hope that everything would be ok in the end.

I guess sometimes that’s the only difference you can make.

Some details have been changed.

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Calls for ban on Coca-Cola’s Christmas truck tour over child health fears

The NHS’s public health boss is urging local councils and shopping centres to ban visits from Coca-Cola’s promotional Christmas trucks because of sugar’s key role in rotting children’s teeth and making them fat.

Duncan Selbie, the chief executive of Public Health England, has criticised the soft drink giant’s annual PR stunt, in which 14-tonne lorries decorated with fairy lights and fake snow visit towns, cities and landmarks around the UK to advertise its products.

Selbie’s comments come as PHE research found that most of the places the trucks plan to visit before Christmas have above-average rates of children with tooth decay or obesity.

“Big-name brands touring the country at Christmas to advertise their most sugary products to children and boost sales does nothing to help families make healthy choices and wider efforts to combat childhood obesity and rotten teeth,” Selbie said.

“Local authorities celebrating sugary drinks in this way need to reflect on whether it’s in the best interests of the health of local children and families.”

Coca-Cola is sending two articulated lorries to 42 locations in England and Scotland in the run-up to Christmas, including Wembley in north London, the O2 complex in the capital’s Docklands and the Lakeside shopping centre in Thurrock, Essex.

The firm’s promotional material says the trucks will be “delivering Christmas cheer up and down the country. At every stop you’ll have the chance to project your festive selfies across the side of the truck as it lights up.

“You’ll also be able to experience a snowy winter wonderland setting while enjoying a choice of Coca-Cola Classic, Diet Coke or Coca Cola Zero Sugar.”

Staff will offer consumers, many of them children, free 150ml samples of the three drinks at a truck lit by 372 bulbs and 8,772 fairy lights.

But PHE believes that Coke’s marketing risks worsening already high rates of tooth decay and obesity. On Thursday, one of the trucks is due to visit Bolton, where 40.5% of five-year-olds have tooth decay – the highest number of all the areas on the list.

Overall, 61% of the stops are in places where both five- and 12-year-olds have higher rates of rotten teeth than the English average, NHS dental statistics reveal.

The same proportion of places have an unusually high number of 10- and 11-year-olds who are overweight or obese, while 56% have above-average numbers of children aged three and four in reception class who are dangerously overweight.

Councils and health officials in areas already visitedby the trucks have protested against the marketing stunt, and some have called for an outright ban on the trucks.

The tour began on 11 November in Glasgow, where Linda de Caestecker, the director of public health at NHS Greater Glasgow and Clyde, was among 44 people urging Coke to give away only water and sugar-free versions of its products. In a letter, they called on the company to be more responsible in how it markets its products and highlighted the large numbers of young children in the city who were overweight, obese or have tooth decay.

“The bright lights of the Coca-Cola truck and giving out free fizzy drinks will of course appeal to children. But when we’re in the midst of an obesity epidemic – and have increasing numbers of children with tooth decay – it’s not really doing children any favours,” said Prof Mary Fewtrell, nutrition lead at the Royal College of Paediatrics and Child Health.

“We’re seeing increasing numbers of local protests against the truck, both from the public and council leaders, public health professionals and dentists. The motivation behind these is not to take the joy out of Christmas; but to recognise that linking fizzy drinks with the fun of the festive season is a marketing tactic and not good for child health,” she added.

Coca-Cola defended its use of the promotional Christmas trucks, which it says have made 397 stops and covered 730,000 miles in the UK.

“The Coca-Cola Christmas truck tour is a one-off, annual event where we offer people a choice of 150ml samples of Coca-Cola Classic, Coca-Cola Zero Sugar or Diet Coke, so two of the three options are no sugar drinks. This is also reflected in the take-up of samples on the truck tour, with on average over 70% of what we sample being a zero-sugar option,” a spokesperson for the company said.

“We also have a policy of not providing drinks to children under the age of 12, unless their parent or guardian is present and says they can have one. The truck tour route changes every year as we try to cover a fair geographical spread of the UK.”

Calls for ban on Coca-Cola’s Christmas truck tour over child health fears

The NHS’s public health boss is urging local councils and shopping centres to ban visits from Coca-Cola’s promotional Christmas trucks because of sugar’s key role in rotting children’s teeth and making them fat.

Duncan Selbie, the chief executive of Public Health England, has criticised the soft drink giant’s annual PR stunt, in which 14-tonne lorries decorated with fairy lights and fake snow visit towns, cities and landmarks around the UK to advertise its products.

Selbie’s comments come as PHE research found that most of the places the trucks plan to visit before Christmas have above-average rates of children with tooth decay or obesity.

“Big-name brands touring the country at Christmas to advertise their most sugary products to children and boost sales does nothing to help families make healthy choices and wider efforts to combat childhood obesity and rotten teeth,” Selbie said.

“Local authorities celebrating sugary drinks in this way need to reflect on whether it’s in the best interests of the health of local children and families.”

Coca-Cola is sending two articulated lorries to 42 locations in England and Scotland in the run-up to Christmas, including Wembley in north London, the O2 complex in the capital’s Docklands and the Lakeside shopping centre in Thurrock, Essex.

The firm’s promotional material says the trucks will be “delivering Christmas cheer up and down the country. At every stop you’ll have the chance to project your festive selfies across the side of the truck as it lights up.

“You’ll also be able to experience a snowy winter wonderland setting while enjoying a choice of Coca-Cola Classic, Diet Coke or Coca Cola Zero Sugar.”

Staff will offer consumers, many of them children, free 150ml samples of the three drinks at a truck lit by 372 bulbs and 8,772 fairy lights.

But PHE believes that Coke’s marketing risks worsening already high rates of tooth decay and obesity. On Thursday, one of the trucks is due to visit Bolton, where 40.5% of five-year-olds have tooth decay – the highest number of all the areas on the list.

Overall, 61% of the stops are in places where both five- and 12-year-olds have higher rates of rotten teeth than the English average, NHS dental statistics reveal.

The same proportion of places have an unusually high number of 10- and 11-year-olds who are overweight or obese, while 56% have above-average numbers of children aged three and four in reception class who are dangerously overweight.

Councils and health officials in areas already visitedby the trucks have protested against the marketing stunt, and some have called for an outright ban on the trucks.

The tour began on 11 November in Glasgow, where Linda de Caestecker, the director of public health at NHS Greater Glasgow and Clyde, was among 44 people urging Coke to give away only water and sugar-free versions of its products. In a letter, they called on the company to be more responsible in how it markets its products and highlighted the large numbers of young children in the city who were overweight, obese or have tooth decay.

“The bright lights of the Coca-Cola truck and giving out free fizzy drinks will of course appeal to children. But when we’re in the midst of an obesity epidemic – and have increasing numbers of children with tooth decay – it’s not really doing children any favours,” said Prof Mary Fewtrell, nutrition lead at the Royal College of Paediatrics and Child Health.

“We’re seeing increasing numbers of local protests against the truck, both from the public and council leaders, public health professionals and dentists. The motivation behind these is not to take the joy out of Christmas; but to recognise that linking fizzy drinks with the fun of the festive season is a marketing tactic and not good for child health,” she added.

Coca-Cola defended its use of the promotional Christmas trucks, which it says have made 397 stops and covered 730,000 miles in the UK.

“The Coca-Cola Christmas truck tour is a one-off, annual event where we offer people a choice of 150ml samples of Coca-Cola Classic, Coca-Cola Zero Sugar or Diet Coke, so two of the three options are no sugar drinks. This is also reflected in the take-up of samples on the truck tour, with on average over 70% of what we sample being a zero-sugar option,” a spokesperson for the company said.

“We also have a policy of not providing drinks to children under the age of 12, unless their parent or guardian is present and says they can have one. The truck tour route changes every year as we try to cover a fair geographical spread of the UK.”

Losing a child to suicide is devastating. Schools can help prevent these tragedies

The tragedy of losing a child is unimaginable. Losing a child to suicide is worse. Those who have endured such horrors will know the grief is utterly excruciating. It’s no wonder that parents who have lost children in such a way become serious risks of suicide themselves.

My son Patrick was 25 when he took his own life, although I believe his suicidal thoughts began in childhood. It’s distressing to think that an average of four schoolchildren take their own lives every week in Great Britain and Northern Ireland. The majority are teenagers, but some are still in primary school – and because the official statistics don’t recognise suicides by children under 10, that number is likely to be even higher.


The 200 children lost to suicide each year could be dozens more. E​ven if it’s dozens less it’s still a national scandal

Coroners seem particularly reluctant to find suicide verdicts in the case of children, perhaps in their desire to spare families further pain. Such is the stigma that still exists around suicide. The requirement to meet the criminal standard of proof, “beyond reasonable doubt”, also makes it difficult for them to reach this conclusion. The charity Papyrus, which works to prevent young suicide and of which I am now a trustee, continues to press the Department of Justice for change. Only when a suicide verdict can be recorded on the “balance of probabilities” will the true scale be revealed.

As things currently stand, the 200 schoolchildren lost to suicide each year in the UK could be dozens more. Even if it was dozens less, it would still be a national scandal. Those of us in the club that no one wants to join are aware that life will never be the same again. Yet the grief is not confined to parents – the suicide of a child has a devastating effect on siblings, family, friends and entire school communities.

Schools are in a unique position to help prevent these tragedies. Children spend much of their waking hours at school, so teachers are in the right place to recognise that a child might be at risk. But without effective training or guidance, the opportunity for such interventions are lost. So while a recent YouGov survey commissioned by Papyrus found that more than 10% of teaching professionals said a student shares suicidal thoughts with them at least once a term, only half felt confident they could provide adequate support.

As part of its current campaign – Save the Class of 2018 – which aims to increase teacher awareness of suicide prevention, Papyrus has created a free guide (pdf) to give schools and colleges the information they need to support students who might be at risk of suicide.

It includes guidance on prevention, such as how to improve connectedness, developing a suicide prevention policy, and helpful and unhelpful language to use. There’s intervention advice, which covers what to do when you have a concern, what to look out for, and how to ask about suicide. It covers what to do after a pupil has taken their own life, how to inform and support other students, and how to communicate with the media.

The guide is very deliberately aimed at the whole school community, because it could be a teacher, secretary, dinner lady or support assistant who first identifies a vulnerable student. The challenge now is making all of our 20,000-plus UK schools aware of it.

Of course, this is not just a school issue, but a societal one. Suicide prevention is everyone’s business, but human nature tends to persuade us, until fate intervenes, that tragedies like suicide affect other people and not us.

Had I, as a headteacher, been told just how critical it was to have a suicide prevention plan in place, I’m pretty confident that I would have acted on it. Every school community we get on side could help to save even more young lives.

In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

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Losing a child to suicide is devastating. Schools can help prevent these tragedies

The tragedy of losing a child is unimaginable. Losing a child to suicide is worse. Those who have endured such horrors will know the grief is utterly excruciating. It’s no wonder that parents who have lost children in such a way become serious risks of suicide themselves.

My son Patrick was 25 when he took his own life, although I believe his suicidal thoughts began in childhood. It’s distressing to think that an average of four schoolchildren take their own lives every week in Great Britain and Northern Ireland. The majority are teenagers, but some are still in primary school – and because the official statistics don’t recognise suicides by children under 10, that number is likely to be even higher.


The 200 children lost to suicide each year could be dozens more. E​ven if it’s dozens less it’s still a national scandal

Coroners seem particularly reluctant to find suicide verdicts in the case of children, perhaps in their desire to spare families further pain. Such is the stigma that still exists around suicide. The requirement to meet the criminal standard of proof, “beyond reasonable doubt”, also makes it difficult for them to reach this conclusion. The charity Papyrus, which works to prevent young suicide and of which I am now a trustee, continues to press the Department of Justice for change. Only when a suicide verdict can be recorded on the “balance of probabilities” will the true scale be revealed.

As things currently stand, the 200 schoolchildren lost to suicide each year in the UK could be dozens more. Even if it was dozens less, it would still be a national scandal. Those of us in the club that no one wants to join are aware that life will never be the same again. Yet the grief is not confined to parents – the suicide of a child has a devastating effect on siblings, family, friends and entire school communities.

Schools are in a unique position to help prevent these tragedies. Children spend much of their waking hours at school, so teachers are in the right place to recognise that a child might be at risk. But without effective training or guidance, the opportunity for such interventions are lost. So while a recent YouGov survey commissioned by Papyrus found that more than 10% of teaching professionals said a student shares suicidal thoughts with them at least once a term, only half felt confident they could provide adequate support.

As part of its current campaign – Save the Class of 2018 – which aims to increase teacher awareness of suicide prevention, Papyrus has created a free guide (pdf) to give schools and colleges the information they need to support students who might be at risk of suicide.

It includes guidance on prevention, such as how to improve connectedness, developing a suicide prevention policy, and helpful and unhelpful language to use. There’s intervention advice, which covers what to do when you have a concern, what to look out for, and how to ask about suicide. It covers what to do after a pupil has taken their own life, how to inform and support other students, and how to communicate with the media.

The guide is very deliberately aimed at the whole school community, because it could be a teacher, secretary, dinner lady or support assistant who first identifies a vulnerable student. The challenge now is making all of our 20,000-plus UK schools aware of it.

Of course, this is not just a school issue, but a societal one. Suicide prevention is everyone’s business, but human nature tends to persuade us, until fate intervenes, that tragedies like suicide affect other people and not us.

Had I, as a headteacher, been told just how critical it was to have a suicide prevention plan in place, I’m pretty confident that I would have acted on it. Every school community we get on side could help to save even more young lives.

In the UK the Samaritans can be contacted on 116 123. In the US, the National Suicide Prevention Lifeline is 1-800-273-8255. In Australia, the crisis support service Lifeline is 13 11 14. Other international suicide helplines can be found at www.befrienders.org.

Follow us on Twitter via @GuardianTeach, like us on Facebook, and join the Guardian Teacher Network the latest articles direct to your inbox

Looking for a teaching job? Or perhaps you need to recruit school staff? Take a look at Guardian Jobs, the education specialist.

It’s not enough to train GPs in child protection. What happens next? | Zara Aziz

Following a colleague’s retirement I have now become the safeguarding lead for children at my GP practice. This means that I review cases, update our practice policies on safeguarding children and act as a liaison between staff, families, school nurses, paediatricians and social services. Like many other GPs, I come across cases of emotional or physical neglect through poverty, or parents having mental health or substance abuse problems.

Sometimes it is the police, A&E or health visitors who alert me to concerns they have about a child’s welfare. But worryingly, for every child on the child protection register there are another eight who are not known to agencies, according to the NSPCC. And this can only get worse as cuts to local authority children’s services continue.


The reality is that the child protection system is simply unable to keep up with demand

Since 2013, the Care Quality Commission asks that all GPs do at least two hours’ safeguarding training a year. Mine has focused on real cases of neglect and abuse. We discuss these cases, with failings highlighted often at multiple points where a child may have come into contact with health professionals. It has helped us to make informed and early referrals to child protection.

The decision to make a safeguarding referral is not one taken lightly. But once done, often help is either very hard to access or just not available. It’s usually not the social worker’s fault: the reality is that the child protection system is simply unable to keep up with demand.

For example, when I refer Daisy (not her real name), who is three years old, to the child protection team for neglect, her mother is struggling with alcohol use and Daisy is malnourished and physically and emotionally left to fend for herself. Her nursery attendance is poor. After some delay, the social worker decides that Daisy should not have a child protection plan but is a child in need instead (an allocation that comes with little resources or practical support for Daisy or her mother). The system’s focus is on severe cases (such as those of physical or sexual abuse) rather than prevention through early help for less severe cases.

Children’s social services have lost £2bn in savage funding cuts, despite the growth in safeguarding referrals, up 15% between 2013 and 2016 for adults and children. Vacancy rates for social workers are high and long-term sickness common, meaning caseloads often have to be reallocated. Children’s social services cuts have also slashed the early help and intervention that young people and families used to receive, such as through Sure Start or similar schemes).

Social workers do a very difficult job in a system under huge strain. Yet, from a doctor’s perspective, it often feels as if the threshold for accepting safeguarding referrals is governed more by the level of demand or staffing on the day than the severity of the case. This is particularly true for issues of neglect or where there are parental mental health or substance misuse problems, when I have been asked to access help for the parent, rather than focus on the child as well.

My experience is echoed across the country. Many GPs says they find it hard to access timely support from social services and lengthy delays, unclear pathways or ineffective responses to safeguarding concerns are common complaints. Where is the effective response for them when thresholds for taking action remain ambiguous or sky high, or funding cuts mean that early help is lacking?

As GPs become more proficient in spotting the signs of neglect and abuse, we are likely to make more safeguarding referrals. But without more funding for children’s services, we will be only adding to the pressure on social workers.

It seems ill-conceived that the government has pushed for widespread safeguarding training, but not planned at all for its aftermath. ​

Zara Aziz is a GP partner in north-east Bristol

Falling number of NHS child psychiatrists provokes ‘deep concern’

The number of NHS psychiatrists helping troubled children and young people in England is falling despite the growing demand for care, new official figures have shown.

The total number of psychiatrists working in children and adolescent mental health services (CAMHS) fell from 1,015 full-time equivalent posts in May 2013 to 948 in May this year. The figure includes all doctors working in CAMHS psychiatry, both consultants and trainees.

The Royal College of Psychiatrists, which uncovered the drop in NHS Digital’s most recent detailed breakdown of the NHS’s 1.4 million workforce, said it was “deeply concerning”. CAMHS teams are already struggling to keep up with the fast-rising number of referrals they are receiving for young people who have anxiety, depression, eating disorders or other conditions. Growing numbers of under-18s in England are self-harming, with the recent rise especially pronounced among girls.

“At a time when demand on mental health services is at its most acute, we are continuously finding that the supply is just not there. As more and more children and young people come forward with mental health problems, fewer and fewer specialists are available,” said Dr Jon Goldin, the vice-chair of the college’s faculty of child and adolescent psychiatry. “The government must show they are aware of the deficit of doctors working in mental health, and commit to a plan to address this deeply concerning imbalance,” said Goldin.

Many CAMHS teams are seeing experienced psychiatrists retire and are also having difficulty finding recruits to fill vacant posts, leading to a shortfall that is affecting the delivery of patient care.

The charity Young Minds warned that the dwindling CAMHS medical workforce could lead to children and young people waiting even longer to receive urgent treatment.

“CAMHS services are overstretched and leave many young people waiting for assessments or turn them away because the thresholds to access care are too high. So these figures showing a reduction in child psychiatrists are concerning,” said Dr Marc Bush, its chief policy adviser.

There is huge unmet need for support and treatment among distressed children. One in four children and young people referred to specialist mental health services are refused help and do not receive any NHS care, despite their mental distress, according to a report earlier this month by the Education Policy Institute thinktank. That equates to about 50,000 under-18s a year not getting vital help.

The state of children’s mental health has acquired a high profile politically in recent years. Theresa May has made it one of her main domestic policy priorities and has suggested that every secondary school could assign a teacher to help pupils with mental health needs and refer them on to NHS services. Jeremy Hunt, the health secretary, claimed last year that CAMHS was the most inadequate area of care across the whole range of services the NHS provides.

The proportion of under-18s refused help because they do not meet increasingly high thresholds for care imposed by local CAMHS teams has not fallen, despite the high-level political focus. Pushed by the Liberal Democrats, the coalition pledged to put an extra £250m a year into CAMHS between 2015 and 2020 to improve services.

Bush challenged ministers to deliver on pledges they have made. “Earlier this year the government committed to bringing in 2,000 more posts in CAHMS, as well as new jobs in crisis settings. Bringing in more staff and valuing and incentivising those who are overstretched or have left the profession is vital in improving mental health services for children and young people, and a welcome step,” he added.

The Education Policy Institute did find some evidence of recent improvements. The average waiting time for a troubled young person to be assessed fell from 39 days in 2015-16 to 33 days in 2016-17. Similarly, the delay in starting treatment fell from 67 to 56 days in the same period.

Falling number of NHS child psychiatrists provokes ‘deep concern’

The number of NHS psychiatrists helping troubled children and young people in England is falling despite the growing demand for care, new official figures have shown.

The total number of psychiatrists working in children and adolescent mental health services (CAMHS) fell from 1,015 full-time equivalent posts in May 2013 to 948 in May this year. The figure includes all doctors working in CAMHS psychiatry, both consultants and trainees.

The Royal College of Psychiatrists, which uncovered the drop in NHS Digital’s most recent detailed breakdown of the NHS’s 1.4 million workforce, said it was “deeply concerning”. CAMHS teams are already struggling to keep up with the fast-rising number of referrals they are receiving for young people who have anxiety, depression, eating disorders or other conditions. Growing numbers of under-18s in England are self-harming, with the recent rise especially pronounced among girls.

“At a time when demand on mental health services is at its most acute, we are continuously finding that the supply is just not there. As more and more children and young people come forward with mental health problems, fewer and fewer specialists are available,” said Dr Jon Goldin, the vice-chair of the college’s faculty of child and adolescent psychiatry. “The government must show they are aware of the deficit of doctors working in mental health, and commit to a plan to address this deeply concerning imbalance,” said Goldin.

Many CAMHS teams are seeing experienced psychiatrists retire and are also having difficulty finding recruits to fill vacant posts, leading to a shortfall that is affecting the delivery of patient care.

The charity Young Minds warned that the dwindling CAMHS medical workforce could lead to children and young people waiting even longer to receive urgent treatment.

“CAMHS services are overstretched and leave many young people waiting for assessments or turn them away because the thresholds to access care are too high. So these figures showing a reduction in child psychiatrists are concerning,” said Dr Marc Bush, its chief policy adviser.

There is huge unmet need for support and treatment among distressed children. One in four children and young people referred to specialist mental health services are refused help and do not receive any NHS care, despite their mental distress, according to a report earlier this month by the Education Policy Institute thinktank. That equates to about 50,000 under-18s a year not getting vital help.

The state of children’s mental health has acquired a high profile politically in recent years. Theresa May has made it one of her main domestic policy priorities and has suggested that every secondary school could assign a teacher to help pupils with mental health needs and refer them on to NHS services. Jeremy Hunt, the health secretary, claimed last year that CAMHS was the most inadequate area of care across the whole range of services the NHS provides.

The proportion of under-18s refused help because they do not meet increasingly high thresholds for care imposed by local CAMHS teams has not fallen, despite the high-level political focus. Pushed by the Liberal Democrats, the coalition pledged to put an extra £250m a year into CAMHS between 2015 and 2020 to improve services.

Bush challenged ministers to deliver on pledges they have made. “Earlier this year the government committed to bringing in 2,000 more posts in CAHMS, as well as new jobs in crisis settings. Bringing in more staff and valuing and incentivising those who are overstretched or have left the profession is vital in improving mental health services for children and young people, and a welcome step,” he added.

The Education Policy Institute did find some evidence of recent improvements. The average waiting time for a troubled young person to be assessed fell from 39 days in 2015-16 to 33 days in 2016-17. Similarly, the delay in starting treatment fell from 67 to 56 days in the same period.

Falling number of NHS child psychiatrists provokes ‘deep concern’

The number of NHS psychiatrists helping troubled children and young people in England is falling despite the growing demand for care, new official figures have shown.

The total number of psychiatrists working in children and adolescent mental health services (CAMHS) fell from 1,015 full-time equivalent posts in May 2013 to 948 in May this year. The figure includes all doctors working in CAMHS psychiatry, both consultants and trainees.

The Royal College of Psychiatrists, which uncovered the drop in NHS Digital’s most recent detailed breakdown of the NHS’s 1.4 million workforce, said it was “deeply concerning”. CAMHS teams are already struggling to keep up with the fast-rising number of referrals they are receiving for young people who have anxiety, depression, eating disorders or other conditions. Growing numbers of under-18s in England are self-harming, with the recent rise especially pronounced among girls.

“At a time when demand on mental health services is at its most acute, we are continuously finding that the supply is just not there. As more and more children and young people come forward with mental health problems, fewer and fewer specialists are available,” said Dr Jon Goldin, the vice-chair of the college’s faculty of child and adolescent psychiatry. “The government must show they are aware of the deficit of doctors working in mental health, and commit to a plan to address this deeply concerning imbalance,” said Goldin.

Many CAMHS teams are seeing experienced psychiatrists retire and are also having difficulty finding recruits to fill vacant posts, leading to a shortfall that is affecting the delivery of patient care.

The charity Young Minds warned that the dwindling CAMHS medical workforce could lead to children and young people waiting even longer to receive urgent treatment.

“CAMHS services are overstretched and leave many young people waiting for assessments or turn them away because the thresholds to access care are too high. So these figures showing a reduction in child psychiatrists are concerning,” said Dr Marc Bush, its chief policy adviser.

There is huge unmet need for support and treatment among distressed children. One in four children and young people referred to specialist mental health services are refused help and do not receive any NHS care, despite their mental distress, according to a report earlier this month by the Education Policy Institute thinktank. That equates to about 50,000 under-18s a year not getting vital help.

The state of children’s mental health has acquired a high profile politically in recent years. Theresa May has made it one of her main domestic policy priorities and has suggested that every secondary school could assign a teacher to help pupils with mental health needs and refer them on to NHS services. Jeremy Hunt, the health secretary, claimed last year that CAMHS was the most inadequate area of care across the whole range of services the NHS provides.

The proportion of under-18s refused help because they do not meet increasingly high thresholds for care imposed by local CAMHS teams has not fallen, despite the high-level political focus. Pushed by the Liberal Democrats, the coalition pledged to put an extra £250m a year into CAMHS between 2015 and 2020 to improve services.

Bush challenged ministers to deliver on pledges they have made. “Earlier this year the government committed to bringing in 2,000 more posts in CAHMS, as well as new jobs in crisis settings. Bringing in more staff and valuing and incentivising those who are overstretched or have left the profession is vital in improving mental health services for children and young people, and a welcome step,” he added.

The Education Policy Institute did find some evidence of recent improvements. The average waiting time for a troubled young person to be assessed fell from 39 days in 2015-16 to 33 days in 2016-17. Similarly, the delay in starting treatment fell from 67 to 56 days in the same period.

Falling number of NHS child psychiatrists provokes ‘deep concern’

The number of NHS psychiatrists helping troubled children and young people in England is falling, despite the growing demand for care, new official figures have shown.

The total number of psychiatrists working in children and adolescent mental health services (Camhs) fell from 1,015 full-time equivalent posts in May 2013 to 948 in May this year. The figure includes all doctors working in Camhs psychiatry, both consultants and trainees.

The Royal College of Psychiatrists, which uncovered the drop in NHS Digital’s most recent detailed breakdown of the NHS’s 1.4 million workforce, said it was “deeply concerning”. Camhs teams are already struggling to keep up with the fast-rising number of referrals they are receiving for young people who have anxiety, depression, eating disorders or other conditions. Growing numbers of under-18s in England are self-harming, with the recent rise especially pronounced among girls.

“At a time when demand on mental health services is at its most acute, we are continuously finding that the supply is just not there. As more and more children and young people come forward with mental health problems, fewer and fewer specialists are available,” said Dr Jon Goldin, the vice-chair of the college’s faculty of child and adolescent psychiatry. “The government must show they are aware of the deficit of doctors working in mental health, and commit to a plan to address this deeply concerning imbalance,” said Goldin.

Many Camhs teams are seeing experienced psychiatrists retire and are also having difficulty finding new recruits to fill vacant posts, leading to a shortfall that is affecting the delivery of patient care.

The charity Young Minds warned that the dwindling Camhs medical workforce could lead to children and young people waiting even longer to receive urgent treatment.

“Camhs services are overstretched and leave many young people waiting for assessments or turn them away because the thresholds to access care are too high. So these figures showing a reduction in child psychiatrists are concerning,” said Dr Marc Bush, its chief policy adviser.

There is huge unmet need for support and treatment among distressed children. One in four children and young people referred to specialist mental health services are refused help and do not receive any NHS care, despite their mental distress, according to a report earlier this month by the Education Policy Institute (EPI) thinktank. That equates to about 50,000 under-18s a year not getting vital help.

The state of children’s mental health has acquired a high profile politically in recent years. Theresa May has made it one of her main domestic policy priorities and has suggested that every secondary school could assign a teacher to help pupils with mental health needs and refer them on to NHS services. Jeremy Hunt, the health secretary, last year claimed that Camhs was the most inadequate area of care across the whole range of services the NHS provides.

The proportion of under-18s refused help because they do not meet increasingly high thresholds for care imposed by local Camhs teams, has not fallen, despite the high-level political focus. Pushed by the Liberal Democrats, the coalition pledged to put an extra £250m a year into Camhs between 2015 and 2020 to improve services.

Bush challenged ministers to deliver on pledges they have made. “Earlier this year the government committed to bringing in 2,000 more posts in Camhs, as well as new jobs in crisis settings. Bringing in more staff and valuing and incentivising those who are overstretched or have left the profession is vital in improving mental health services for children and young people, and a welcome step,” he added.

The EPI did find recently some evidence of recent improvements. The average waiting time for a troubled young person to be assessed fell from 39 days in 2015-16 to 33 days in 2016-17. Similarly, the delay in starting treatment fell from 67 to 56 days in the same period.