CAMHS in crisis?

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Black cracks and blue by Geir Tønnessen. Sourced from Flickr and reproduced under a Creative Commons Attribution 2.0 Generic (CC BY 2.0) licence

The UK rarely fails to find a scapegoat, and within the media a spectacle is developing where children’s mental health services across the country are being shepherded towards the city gates, as reports make reference to services being fragmented and in need of complete overhaul (CYPN 2014, The Independent 2014). Large waiting lists and a shortage of beds are used to shine a blamelight, and there is nervous anticipation regarding Norma Lambs’ report scheduled for spring 2015. (The Guardian 2014, 2015)

Sarah Brennan says that cuts to preventative services underpin these apparent difficulties in CAMHS, and she is right, but the large weight of responsibility that is placed on CAMHS by the media suggests some level of societal misunderstanding surrounding how to maintain good mental health, and how to treat it when it becomes problematic. (Community Care 2014)

Sloping responsibility to CAMHS suggests that mental health difficulties can only be tackled by experts who have professional knowledge and also alludes that it is beyond the skillset that currently exists within other agencies.

However, societally based interventions other than CAMHS play an important part in the mental health picture. For example, within psychotherapy relationship with the therapist is crucial (Persons 1989), and this effect of relationship on mental health is mirrored in society (Soulsby & Bennett 2015).

On another level, an individual’s perceived belonging to a community (Amiot and Aubin 2013), as well as an individual’s sense of community (Hendryx & Ahern 1997) also feature prominently in good mental health.

It is also of no surprise that levels of disadvantage and environmental stressors have a big impact on mental health, with neighbourhood disadvantage being associated with symptoms of depression and anxiety (Aneshensel & Frerichs 1982, McMahon, Coker & Parnes 2013).

Parkinson argues that the very nature of emotions themselves are social, and suggests that attending to the interpersonal, institutional, and cultural factors surrounding emotion is what will lead us to understand its causes, consequences and functions in everyday life (Parkinson 1996).

The mental health profession has not helped itself at times with communicating this message, either due to neglect of the social (Orford 2008) or due to internal debates regarding the nature of MH itself (The Guardian 2013).

We live in a market drive state (Davies 2013), and by not advocating for the social aspects to treating mental health, we are in danger of falling into the rhythm of the machine in our society that trades on speedy economic viability and a production lined mentality. This is aligned to what Bloxham (1993) identified as a managerialistic approach.

Too much responsibility is placed on CAMHS to tackle child and adolescent mental health, where in reality the responsibility lies with all streams of society and to say that CAMHS is in crisis is misleading.

Yes professionals are needed who have the knowledge and experience to inform appropriate MH interventions. However, the argument that an increase in mental health problems is indicative of a problem within CAMHS, is a narrative that those in power would gladly advocate.

References

Amiot, C.E., & Aubin, R.M. (2012). Why and how are you attached to your Social Group? Investigating different forms of social identification. British Journal of Social Psychology, No. 52: 563-586.

Aneshensel, S.C & Frerichs R.R. (1982). Stress, support and depression: A longitudinal causal model. Journal of Community Psychology. Vol 10: 363-376.

Bloxham, S. (1993). Managerialism in Youth and Community Work. Youth & Policy. Vol 41: 1-12.

Community Care. 2014. Cuts to early intervention underpin these children’s mental health care failings . [ONLINE] Available at: http://www.communitycare.co.uk/2014/02/20/cuts-early-intervention-underpin-childrens-mental-health-care-failings/. [Accessed 10 February 15].

CYPN. 2014. Council leaders call for overhaul of children’s mental health services. [ONLINE] Available at: http://www.cypnow.co.uk/cyp/news/1145988/council-leaders-overhaul-childrens-mental-health-services. [Accessed 10 February 15].

Davies, B. (2013). Youth Work in a changing policy landscape: The view from England. Youth & Policy. Vol 110: 6-32.

Hendryx, M.S., & Ahern, M.M. (1997). Mental health functioning and community problems. Journal of Community Psychology. Vol 25, No. 2: 147-157.

Orford, J. (2008). Community Psychology. Challenges, Controversies and Emerging Consensus. Chicester: Wiley.

Parkinson, B. (1996). Emotions are social. British Journal of Psychology. Vol 87: 663-683.

Persons, J. (1989). Cognitive Therapy: a case formulation approach. London: W.W Norton & Co.

Soulsby, L., and Bennett, K. (2015). How relationships help us to age well. The Psychologist, Vol 28, No. 2: 110-113.

The guardian. 2013. Psychiatrists under fire in mental health battle. [ONLINE] Available at: http://www.theguardian.com/society/2013/may/12/psychiatrists-under-fire-mental-health. [Accessed 10 February 15].

The Guardian. 2014. Children are suffering as mental health services fail to cope, say parents and teachers. [ONLINE] Available at: http://www.theguardian.com/education/2014/jul/29/chilld-and-adolescent-mental-health-service-failing-children. [Accessed 10 February 15].

The Guardian. 2015. Beds crisis hits NHS care for mentally ill children. [ONLINE] Available at: http://www.theguardian.com/society/2015/jan/31/nhs-crisis-mentally-ill-children-adult-wards?CMP=share_btn_tw. [Accessed 10 February 15].

The Independent. 2014. Exclusive: Children’s mental healthcare in crisis, Care Minister Norman Lamb admits. [ONLINE] Available at: http://www.independent.co.uk/life-style/health-and-families/health-news/exclusive-childrens-mental-healthcare-in-crisis-care-minister-norman-lamb-admits-9679098.html. [Accessed 10 February 15].

 

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One thought on “CAMHS in crisis?

  1. Good article. The current focus on CBT as the treatment of choice for Camhs strengthens the argument that political motives underpin the emphasis on mental health difficulties being a problem of individual faulty thinking and handily diverts attention away from the cultural context. Neo liberal capitalism is founded on the concept of individualism (rather than the individual as a social being) and discourages any attempt to question the status quo.

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