Tuesday 11 March 2014


Modest but useful coverage on Wales Today last night where I was able to register our concerns about Child and Adolescent Mental Health Services (CAMHS). Follow the links from the Mental Health Wales article here.

A BBC Wales investigation has found that young people are often left struggling to cope without the appropriate support. One expert said there are only half the required staff in CAMHS: Dr Elspeth Webb, a reader in child health at Cardiff University, said there were many good staff in CAMHS, but services across Wales were operating at between 20% and 40% of the recommended staff levels.

My point was that the government's policy and legislative framework is quite good, quite advanced, and they actually listen to patients and their families about what should be delivered. But on the other hand, delivery falls a long way short. We know from anecdotal feedback that patients' and families' experience of CAMHS is very patchy.

The goal of services for children and young people is to intervene decisively at the right moment. Not too early: it's inappropriate and damaging to identify vaguely at risk youngsters and provide an explicit mental health service to them; it's also expensive and probably ineffective to try to provide more than basic information about mental health to all children - and that should be done mainly through the education system.

On the other hand it is of course important not to intervene too late. all the evidence points to much better outcomes even in the long term for children who are helped promptly when their illness is pretty much in evidence - and that means saving money longer-term too. The Government knows this and indeed the Minister of Health Mark Drakeford has spoken eloquently about the need to strike this precise balance.

So the main focus needs to be not on prevention nor on picking up the pieces when things have gone to far but rather on early intervention. That's exactly what Hafal is doing with our pioneering Early Intervention Service in SE Wales in conjunction with the NHS - it's early days and it will be a while before we can report how that is working - but watch this space!