January 2018

RCGP Wales welcomes the opportunity to respond to the National Assembly for Wales’ Children, Young People and Education Committee’s inquiry on the emotional and mental health of children and young people in Wales.

The Royal College of GPs Wales represents a network of around 2,000 GPs, aiming to improve care for patients. We work to encourage and maintain the highest standards of general medical practice and act as the voice of GPs on resources, education, training, research and clinical standards.

When GPs identify people with problems there are inconsistent services available for them across Wales. We continue to be concerned that access to Children and Adolescent Mental Health Services (CAMHS) are poor in parts of Wales, despite reviews. We acknowledge that the service is restricted to those in need to specialist services but the criteria for assessment can be limited. The reconfiguration of services in some areas has not improved services. Some children may have to travel long distances for consultations or inpatient services. This can put additional strains on families. This is made worse when other children in the family have to be cared for by others while parents are supporting the child having assessments or treatment. This can result in emotional ill health for the other family members.

The Mental Health Measure and the development of Primary Care Mental Health Support Services may have been introduced and reviewed, but access to these services for children and young people is limited due to lack of experience and professional capacity within teams. GP counselling services are not available to children and adolescents. Improving links with schools and school nursing services to develop these services would be better and prevent children missing classes.

Despite the development of a new pathway, transition can cause problems as there still remain some services which have no clear adult equivalent and older teenagers may neither engage with paediatric services or adult services. Transition to general practice of young people with specialist needs should never be the norm on the basis that there is no adult service that is not ring fenced by exclusion arrangements.