NHS treatment for children with mental health problems is shockingly poor, the Children's Commissioner for England has said.
In a new report to MPs, Anne Longfield said she was "very concerned that children's inability to access mental health support" was leading to a whole range of extra problems, "from school exclusions to care placements breaking down to children ending up in the youth justice system".
She said the current system of care was a "postcode lottery of fragmented support depending almost entirely on where a child grows up and which school they attend".
The report found a massive discrepancy between children's and adults' mental health, with local areas spending just 6% of their mental health budget on children, despite children making up around 20% of the population.
Meanwhile, almost 60% of local areas are failing to meet NHS standards on improving services, while more than 55% are failing to meet NHS standards on providing crisis care, it said.
The study estimated that between one in four and one in five children with a mental health condition in England received help last year.
The vast majority of NHS spending on children's mental health services is on those with the most severe need, with 38% of funding going on inpatient care.
Some 46% of spending is for community mental health services while 16% goes on those children who are not accessing formal care.
This latter group accounts for the one in 10 children who are thought to have a significant mental health condition and those with lesser needs "who would be less likely to develop a more serious mental health condition if they were provided with timely support", the report said.
The study argues that earlier interventions are far cheaper than leaving it until children need inpatient care.
For example, it costs £5.08 per pupil to deliver an emotional resilience programme in schools, but £61,000 to admit a child to NHS services as an inpatient.
In her foreword, Ms Longfield (pictured) said: "I was interested to compare the systems for adult mental health with that for children. The results are shocking.
"There are enormous disparities. NHS England lays out clear expectations to local areas about what should be provided for adults, backed up by targets and benchmarks on success rates and waiting times.
"In contrast, there is no monitoring of how many children are seeking mental health treatment, no information on how many are accepted into treatment, how long they will wait or what outcomes they achieve."
The report also said NHS England does not know how many children were referred to them last year for sectioning but could not be found a safe and secure bed.
Ms Longfield said: "The Government needs to be bold, brave and uncompromising in its strategy for improving treatment for children with mental health illnesses.
"If changes aren't made urgently, not only will there will be severe consequences for the hundreds of thousands of children who are failing to receive the support they need now, but we risk leaving an adult mental health care ticking time bomb with a generation of children entering adulthood with untreated mental health problems."
An NHS England spokeswoman said: "Sadly this report contains numerous basic factual errors and omissions which could easily have been avoided if the authors had first bothered to check their information.
"It confuses NHS and local authority spending; it strangely ignores the 42% increase over the past year in young people able to get NHS care for eating disorders, thanks to 70 new and enhanced local services; and it fails to mention that an extra 21,000 young people received NHS mental health services over the last year.
"Two years into a five-year programme to substantially expand adult and young people's mental health services, an extra 120,000 people are now getting the specialist mental health support they need, and local NHS commissioning groups spent £575 million more on mental health than the year before. So without a doubt the corner has been turned, but there's more to do."
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