Some GPs are “thinking three or four times” before making a referral to child and adolescent mental health services (CAMHS) as a result of rejected referrals and long waiting lists, MSPs have heard.
A paper by Audit Scotland in 2018 claimed 7,199 referrals to CAMHS were rejected in 2017-18, a 24% increase from 2013-14.
Dr Catriona Morton, a GP in Edinburgh and the deputy chairwoman of the College of General Practitioners, told Holyrood’s Public Audit Committee on Thursday that the situation now is much the same.
“The feeling still is that the bar for referrals is very, very high,” she said.
“The feedback was that GPs – and I include myself in this – will think three or four times before even considering a referral and we have high levels of referral rejections.
“I think the other thing about referrals is we know how damaging it can sometimes be to the person referred and their family if they get a rejection, because they’ve often tried lots of things before they get to us.
“The feedback I’ve got is that the waiting times are often one to two years and that’s also a deterrent to referral because if you know that people aren’t going to be seen for such a long time and receive treatment for such a long time, it means that it’s difficult to say to a patient in their family ‘this is what’s going to happen’.”
Dr Morton went on to read a text from a fellow GP whose daughter has been waiting for CAMHS services.
“My soon-to-be 13-year-old daughter has been on the CAMHS waiting list for over two years,” the text read.
“In this time her anxiety has progressively worsened and has become critical in the past two months to the extent that she can barely leave the house. She’s been to school less than six days since the start of term.
“School have been contacting CAHMS twice weekly asking for her to be urgently seen, our GP has written again asking for her to be seen urgently, but she has no appointment.
“The impact on children and their families cannot be overstated.”
Dr Morton said: “When we talk about a two-year waiting list, that’s what that means.
“People don’t get on a waiting list easily, as we’ve heard – it’s a high bar to refer, it’s a high bar to then not be rejected and then go on the waiting list.”
MSPs on the committee were also told of a “tsunami” of mental health cases being dealt with across the country.
Martin McKay, a registered mental health nurse in the north east and representative for the Unison trade union, said: “What we have found – and we’ve got data on this nationally – is that we’ve had more and more admissions into case loads and into hospital that have never been known to mental health services, and that will be exactly the same for CAMHS.
“We know what’s coming and we know it hasn’t finished – the wave, the impact of the pandemic in terms of mental health referrals and hospital admissions will continue.
“Most of our services are at full capacity, most of our hospital beds are full and at the top end, at tier four level, when that is full the pressure expands through the rest of the system… I don’t apologise for painting a bleak picture.
“We are not post-anything, this is a tsunami wave that just keeps coming. It isn’t slowing and it’s just constant pressure.”
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