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Insight: Young shoulders

Insight: Young shoulders



Mental health services for young people have been identified as a particular commissioning priority.

If there was one thing that everyone agreed on at a recent meeting about commissioning mental health services for children and young people, it was that the current system needs to change – and for the better.

Over seventy mental health leads from clinical commissioning groups (CCGs) and local authorities around the country gathered at the event Transforming Child and Adolescent Mental Health Care Through Commissioning, which was hosted by the NHS Clinical Commissioners Mental Health Commissioners Network (MHCN) in March 2014.

Experts including Camila Batmanghelidjh CBE, the founder of Kidsco, Dr Jackie Cornish OBE, national clinical director for children, young people and transition to adulthood for NHS England, Professor Peter Fonagy, national advisor on improved access to psychological therapies for children and young people for NHS England, and Jack Falkingham, a youth champion from the Right Here project, each provided eloquent insights into why and how commissioning young people’s mental health services could and should be transformed.

Others had their own views, based on their experience of commissioning these services. Throughout the day delegates were encouraged to share their experiences and their concerns. 

Key themes to emerge were the need for parity of esteem (and funding) for young people’s mental health services, the negative impact of age-based cut-off points for services, and the impact of deeply ingrained silo working in the different agencies responsible for young people’s health and wellbeing. A lack of good quality, up to date data was highlighted, as was the increasing pressure on services, particularly at Tier 4 level, and the resulting impact through other tiers of the system. 

Commissioners called for young people’s mental health to be recognised as the national issue it is, with budgets and resources allocated appropriately; for services to be designed on the basis of need and appropriateness, not age, with the introduction of graduated transition and patient choice; urgent attention to be paid to the need for good quality, up to date data; for divisions between different agencies to be broken down, with the focus being on the needs of patients and their outcomes; and for young people to be actively involved in the design of their services. The group also recommended that a mental health impact assessment should be included in all government policy.

MHCN members’ recommendations for change have been submitted as evidence to the current Health Select Committee enquiry on children’s and adolescent mental health and shared with other key stakeholders. And clearly the issues have resonated with others working in the field, with a number of organisations having contacted MHCN since the event to discuss ways of working together to promote change in this critical area.

Dr Phil Moore, Chair of the Mental Health Commissioners Network, NHSCC Leadership Group member and Deputy Chair (clinical), NHS Kingston CCG, said, “The commissioning of mental health services for children and young people was identified very early on in the network’s life as a key area of concern for our members, and the strength of feeling and determination at the event was quite palpable.

“It is vitally important that mental health is given parity of esteem with physical health, and that within that the mental health of children, teenagers and young adults is recognised as the priority it is. Mental health issues in young people impact on their education, their employment prospects, their family relationships and their physical health. Early intervention and prevention, good quality treatment and effective transition between young peoples’ and adult services could all play an essential role in improving the mental health of a generation, and have enormous societal benefits as a result.

“Commissioners have the opportunity to play a big part in improving those services by looking carefully at how they commission in their local areas, drawing on the evidence of what is effective and identifying key partnerships to work together in designing services.

“And as a network we will be looking to carry forward the key messages from our members about the changes they want to see at national level.”

The Mental Health Commissioners Network is hosted by NHS Clinical Commissioners, the membership body for CCGs in England. For more information please go to 

Jane Ide is the interim network manager at NHS Clinical Commissioners.


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