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The Rural Divide: inequalities facing children and young people

Our recent report spotlights CAMHS challenges for children and young people in rural Scotland.

Young People during Your Resilience workshop - CAMHS challenges for children and young people in rural Scotland: A closer look at NHS Highland, NHS Borders and NHS Dumfries & Galloway.

A new report by Change Mental Health has shed light on the stark inequalities facing children and young people in rural Scotland when accessing mental healthcare services across the three most rural NHS health boards in Scotland.

The latest report, ‘The Rural Divide: The Realities of Mental Healthcare for Children and Young People in Rural Scotland‘, analyses Public Health Scotland data for the wait distribution of those who started treatment for Children and Adolescent Mental Health Services (CAMHS) in NHS Scotland from the recent quarter ending December 2023.

The latest nationwide figures show progress towards achieving this goal, with 83.8% of patients being seen within 18 weeks, up from 75.6% in the previous quarter. Yet across the three most rural health boards in Scotland – NHS Highland, NHS Borders, and NHS Dumfries & Galloway – the data shows significant challenges with their youth mental health services.

The Scottish Government’s CAMHS standard states that children and young people should be seen for treatment within 18 weeks of being referred. The report emphasises that they will not meet their target of 90% of children and young people starting treatment within this period without action in rural areas to address inequalities.

Read the full report below, which includes more background, suggestions and recommendations:

In NHS Highland, more than 13% of children and young people waited more than 53 weeks for treatment. This is in stark comparison to the Scotland-wide figures which show that only 1.4% of total patients waited more than 53 weeks. Children and young people in NHS Highland were, therefore, nearly 10 times more likely to wait more than a year for treatment than in NHS Scotland as a whole. Almost a third of all of the children and young people in Scotland who are on the waiting list for more than a year are within NHS Highland.

In NHS Dumfries and Galloway, 44% of children and young people were not seen by CAMHS within 18 weeks of referral, compared to 16.8% nationally. In a service that was seeing 94% of patients within 18 weeks as of June 2023, it now sees only 56% of patients within that standard period – a worrying trend.

NHS Borders is the only health board in Scotland where a majority of children and young people are not seen within the 18-week window. 60% of children and young people in this rural health board were seen between 19 to 35 weeks, compared to just 12.6% across Scotland as a whole, a 47.6% difference.

“This report shows us that once again children and young people in some of our most rural areas aren’t getting the support they need and when they need it. There must be targeted action from the Scottish Government in tackling these significant rural inequalities.

“We want a future where children and young people aren’t put on waiting lists for support but instead get the early intervention, community-based support we know stops poor mental health escalating to a point where it requires medical intervention.

“We need to change the way we think about how we support children and young people with their mental health and we need to make sure that no matter where they live in the country they get the timely high quality support that they deserve.”

 – Nick Ward, CEO at Change Mental Health

We know that early intervention is key to building mental resilience in children and young people and will reduce the current waiting time pressures in CAMHS.

Our Young People’s Programmes are delivered in schools and colleges, training teachers and equipping young people with the tools and knowledge to maintain their mental health.

As part of our young people’s programmes, Bloom and Your Resilience, we have supported 8,352  young people in Scotland so far.

Commenting, our Young People Programmes Engagement Officer Ciara Mallon said:

“There is a growing need for preventative mental health support for young people, with 75% of mental illnesses starting before a young persons 18th birthday. It is essential that services are accessible to all young people in Scotland. Empowering young people with appropriate tools, skills and knowledge not only addresses immediate needs but also paves the way for their wellbeing into the future.”

Furthermore, this year, our Young People’s programme has identified young people living in rurally isolated communities as a key priority group at risk of poorer mental health. They are taking forward work to understand the lived experience of young people in rural areas, to build an strong evidence base to ensure our programmes are fit for purpose for these young people.

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