The Royal College of Paediatrics and Child Health has produced a valuable report on 'Building and sustaining specialist Child and Adolescent Mental Health Services (CAMHS) to improve outcomes for children and young people'. The report outlines essential services to be delivered by CAMHS and associated workforce requirements, with a focus on ensuring sustainable, effective services during the current period of austerity.

We all know that mental health needs are a huge but often publicly under-recognised issue for children and young people. Indeed 50% of mental illness in adult life (excluding dementia) starts before the age of 15, and 75% before 18 years. Moreover there is an important link with social inequalities - children and young people in the poorest households are three times more likely to have a mental health problem than their peers in better off homes.

What is less widely known, perhaps, is that, in England, CAMHS funding comes from NHS and local government. So any nominal ring fencing of NHS money does not apply to the portion of CAMHS funding that comes from local authorities. Whilst funding models differ elsewhere in the UK, for example in Scotland CAMHS services are generally funded entirely through the NHS, budget cuts are a real threat everywhere. CAMHS services cannot be run more efficiently for example by sourcing less expensive equipment or supplies. There are no corners to be cut. When money runs short, services are cut. Clinics are cancelled. Children and young people go without support. In many cases these are the most vulnerable disadvantaged children in our society. We will all pay the price for this neglect in the long term.

Ingrid Wolfe
Chair (public health)