THOUSANDS of troubled young Scots are going without help because they are “not mentally ill enough” for NHS services.

Every year, around 20 per cent of those referred to Scotland’s overstretched Child and Adolescent Mental Health Service (Camhs) are rejected.

Last year, 7,255 children and young people were turned away. But while they may not have a diagnosable condition or meet the threshold for medication or counselling, many still need help according to Scotland’s leading mental health charity.

“For people with significant mental health problems Camhs can be a very good service. But the clinical, medical model is the only response, and only if you are mentally ill enough to access services,” said Billy Watson, chief executive of Scottish Association for Mental Health (SAMH).

The charity is calling for alternatives for those who do not meet the threshold for mainstream Camhs services, claiming that early intervention could help some children with lesser symptoms avoid a worsening of their condition.

Proposals include better training for teachers and all school staff who interact with children in how to respond to mental health concerns. SAMH also wants to see GPs given more information about what other options might exist in the community, such as peer support groups.

But SAMH is also appealing to children who have experience of Camhs, and their families, to share their views, as part of a Scottish Government research on rejected referrals.

The research will aim to shed light on data from a statistical audit of the system with the help of NHS researchers.

Since May, researchers have spoken to thousands of people and are looking to gather more evidence of people’s actual experiences of asking for mental health help.

Mr Watson said the Government should be congratulated for a focus on Camhs. “It has been apparent that supply and demand around the service is posing problems on a scale we have not seen before,” he said.

“Rising referrals are a positive by product of a greater willingness to talk about mental health problems and seek help earlier. However the responses are inadequate. We need a more differentiated and sophisticated response.”

The Scottish Government has put more money and staff into Camhs, but without results, he added, and it is vital to find out why one in five young people whose GPs think they need help is not being accepted for treatment. “If they don’t meet the threshold what happens next? 

“We know 70 per cent of Camhs referrals come from GPs. Why are so many being rejected? I can’t imagine that happening for physical complaints,” Watson said.

Levels of rejections are highest in the Borders, and in Glasgow, which is one of the best health boards for meeting an 18-week target on waiting time for treatment – but which also has the highest level of cases rejected by Camhs in the country, Mr Watson said.

Nicky Bridges, whose 15 year old daughter Charlie attempted to end her life after a mental health problem escalated when she went to high school in the Highlands, said their experience of support from NHS Camhs services had been largely positive as matters worsened after Charlie turned 13.
"She had been suffering from low mood and wrote me a letter saying she wanted to die. We got an urgent referral to Camhs and it took four weeks before she was seen. In the grand scale of things that is quite quick but it didn't feel that way at the time," Nicky, a children's nurse, says.
Matters improved for a while by a year later in the summer of 2015 Charlie's behaviour and mood deteriorated during a family holiday and her mum referred her back to Camhs. But before she could be seen, two weeks later she took an overdose of paracetamol. Later she tried again. Both attempts on her life were unsuccessful and she is now doing well in treatment. "You wouldn't believe she was the same person."
But Nicky backs providing schools with more training and resources. One guidance teacher told her Charlie was just hormonal, she said, while latterly the school said it couldn't help because she was "in the Camhs system".
"Because I know the system I was able to say that wasn't right and call for a meeting of the team around the child. But most parents don't know where to go for help," she says. 

Health Secretary Shona Robison welcomed SAMH seeking the views of young people using Camhs.

“This is important so we can understand how we can make improvements and route young people to the most appropriate help and support,” she said.