Single point of access lines

It's thought that 75 per cent of children with mental health disorders in the UK do not receive treatment (2015 government figures from the Future in Mind report). Many can be left experiencing mental health crises with no direct access to a specialised team or psychologist. Parents and statutory services may feel overwhelmed, unaware of who to contact for urgent healthcare support. In some cases, children can be under the care of multiple mental health agencies, complicating the management of support from a parental perspective. The CAMHS Single Point of Access (SPA) can enable parents and carers to make enquiries on behalf of patients, subject to confidentiality issues. 

The long-term aim is to reduce A&E admissions due to mental health crisis. NHS figures from 2014 suggested 1 in 10 young people in London have a clinically significant mental health problem, and 1 in 15 Londoners aged 8-25 will deliberately self-harm. Deliberate self-harm accounted for one of the five most common presentations within the emergency department. Crisis lines work towards successfully reducing the likelihood of attempted suicides, in addition to reducing feelings of hopelessness, which is associated with self-harm. This is achieved via effective de-escalation techniques from the CAMHS SPA team, plus signposting to allow children to receive community-based care.

CAMHS SPA also act as a point of information to police services, where they can access advice regarding suitability of enforcing Section 136 – detentions under the Mental Health Act. In the London region alone, the year 2019/2020 saw almost 5000 of these detentions. The person is often taken to police cells, and for someone experiencing a mental health crisis this is clearly likely to enhance mental health distress. It's vital that we look to improve the accuracy of sectioning by allowing police urgent access to the support of a CAMHS Practitioner when required. 

The Central and North West London Single Point of Access service provides one number and one email address for referrals to secondary mental health services and support in a mental health crisis in the Boroughs of Brent, Harrow, Hillingdon, Kensington and Chelsea, and Westminster, and also Milton Keynes (out of hours). This service has recently been extended to provide a tailored phone line for children and adolescents in central and north west London and is accessible 24/7, 365 days a year. 

The pandemic has impacted the delivery and also children's access to mental health services. Now more than ever we need a collaborative approach towards children at risk of experiencing a mental health crisis. Urgent SPA lines should be used to improve not only patient access to treatment, but also to appropriate services which can reduce the chances they go on to experience mental health crises, potentially ending up in hospital or a police station. Professionals who regularly manage patients with high risk should also take advantage of these provisions in order to access immediate supervision and guidance which will, in turn, alleviate their own anxieties at a time when many in the mental health profession are feeling overwhelmed.

We now need to expand the provision of the national funded urgent crisis lines – for example, better serving Wales, where there is a higher rate of suicide than in London according to Office of National Statistics figures – in order to increase the quality of support provided to those in mental health crises. 

Georgia Harvey

CAMHS Practitioner 

Central and North West London Single Point of Access service