Doubts raised over £31m cAMHs inpatient funding as key areas of need fail in cash bid

Concerns are being raised about the government’s £31m capital expenditure programme to increase bed capacity and improve child and adolescent inpatient facilities after new research showed that some areas where service need is greatest are not to receive any money.

The Department of Health (DH) funding is part of a government commitment to ensure that by November 2008 no under-16s will be treated on adult mental health wards. Ministers have also pledged to reduce significantly the number of 16-18 year olds on adult wards. Most of the money will be spent on creating new beds (59 across eight projects).

Just under a third of the projects are in the North West and one is in the West Midlands, but no funds have been allocated to Yorkshire/Humberside, although all three areas are identified in Royal College of Psychiatrists (RCPsych) research as lacking facilities.

Jean Hawkins, children and families services manager at Yorkshire and Humber strategic health authority (SHA), said the SHA had not been told why its bid had failed. But she believes the application for £11m was too high. Also, some projects did not meet the age criteria – for example, a £1.5m 20-bed unit for 16-25 year olds.

The RCPsych is concerned about  the uneven distribution of funds. ‘It’s important the money goes to services which need it,’ said RCPsych research worker Simon Tulloch, one of the authors of a study of child and adolscent inpatient facilities: ‘Our updated study shows distribution of inpatient beds for children and young people is still uneven across the
country.’

He added: ‘The lack of a time frame about this typically vague and difficult-to-pin-down government announcement is a problem. The £31m could be over the next 10 years – that’s a cut in funding.

‘Also, it focuses on preventing under-16s going onto adult wards, but we need to target inappropriate admissions of 16, 17 and 18-year-olds, too. Also the closure of children’s units is a great concern in this issue.’

Tulloch said the funding is welcome if it is to be spent specifically on inpatient facilities, but said that if it is spread across CAMHS the value is less significant.

Money has been allocated to a wide variety of projects. South Essex Partnership Foundation Trust, for example, will spend its cash on creating a 12-bed inpatient unit. At Norfolk’s King’s Lynn Trust, on the other hand, the Queen Elizabeth Hospital will use the money to build an interview room in which professionals can talk to under-18s in a ‘safe and supportive environment’.

Professor Sue Bailey, a child and adolescent psychiatrist working in the North West, welcomed the funding, but said that beds were only part of the picture. ‘We hope the government will strengthen and develop transitional services for those
adolescents who continue to require services in adulthood,’ said Bailey, who is RCPsych registrar.

‘We need to build on the early-intervention services in psychosis but also all other forms of mental disorders, including services for children with learning disabilities.’