Dr David Turner is a GP in Hertfordshire.
“An especially serious problem has arisen with the provision of mental health services to children and adolescents in the last 18 months. This is the first time in my 25-year career as a doctor that I feel the need to speak publicly. Many other GPs and I feel that the problem has become critical and it is only a matter of time before a child dies.
“The provision of mental health care by the Child and Adolescent Mental Health Service (CAMHS) was never great before Covid. Since the pandemic it has become hideous. There are two main reasons for this: underinvestment in mental health services for decades, and an increase in demand.
“There has always been a long wait for CAMHS services, but over the last year or so a more worrying trend has occurred: the specific problem is that ‘recovering’ CAMHS patients are being referred to them for primary care management. Patients with serious mental health disorders, such as anorexia nervosa, are referred to CAMHS but say that because they are too busy, they would like the GP to continue monitoring the patient. This is unacceptable and dangerous.
“In my practice, we are now monitoring a number of seriously mentally ill adolescents, including some with anorexia nervosa, who CAMHS says are simply unable to see due to workload pressures. They are at increased risk of self-harm and suicide, and the very nature of starvation leads to a multitude of physical health problems, the most serious of which can lead to death.
“This condition needs careful monitoring with weekly blood pressure and weight checks and blood tests to monitor the function of vital organs such as the liver and kidneys. In addition, patients will need regular cardiac recordings (ECGs) to monitor for signs of heart failure or abnormal heart rhythms. Anorexy It is not a trivial disease.
“CAMHS now routinely expects GPs to check in on adolescents with anorexia nervosa on a weekly basis and do all of these checks. We do not have specific training in this specialized area of child psychiatry. We have also seen a huge increase in our workload since Covid restrictions were relaxed and we are struggling to do this complex work on top of our regular tasks.
“However, most GPs feel that if we don’t do everything we can to help these children, they will not receive any treatment for many months while they wait to see a doctor at CAMHS. We also have adolescent patients who have been out of school for many months while awaiting treatment for severe anxiety and depression. This has repercussions on their families. In some cases, it has meant one parent quitting work to stay home and care for them.
“There is no doubt that many hundreds of adolescents across the country are suffering due to a deficiency in mental health services tailored to their needs, and sadly, some will die. This situation could be quickly reversed with a quick investment of cash and resources. As we have seen during the Covid pandemic, when there is political will and money, we are able to provide world-class healthcare in this country. Now we have to do this for our young people.”
As he told Andrew Gregory
