Youth Mental Health Policy

Reforming services on the regional, national and international scale

With increasing numbers of people needing mental health support, improved services are a priority to ensure patients can be treated quickly. This is particularly important for young people, who are often at risk during the transition from Child and Adolescent Mental Health Services (CAHMS) to adult mental health services. Professor Max Birchwood and Professor Swaran Singh’s research has improved quality of care, response and access to mental health services. In particular, their work has led to the creation of improved mental health services for 0-25 year olds.

The challenge

In the UK approximately one in four people will experience a mental health issue each year. One in ten children and young people have a diagnosable mental health condition. Yet, at present, many young people drop out of treatment between CAMHS and adult services. Poor transition and integration between the services as well as insufficient dedicated support often leaves young people without access to crucial treatment.

Our approach

Through their research, Professors Birchwood and Singh identified several significant areas for improvement and intervention:

• Intervention response times

• Transition planning between CAMHS and adult services

• The role of community health teams

• Access to direct care pathways

Our impact

Professors Singh and Birchwood’s work has improved mental health care services and encouraged reform worldwide. This includes proving that direct access to Early Intervention in Psychosis (EIP) teams could make a significant difference to patients. By avoiding generic community health teams, delays have halved, with waiting times decreasing by 150 days on average. This became a national standard in 2016. Over 76% of teams now deliver care within two weeks of referral – compared to 33% in 2015. This has both improved clinical outcomes for highly vulnerable patients while saving £5536 per patient per year for the NHS. On average, this represents a total saving of £15862 per patient during EIP care.

The introduction of a 0-25 model in Birmingham has linked CAMHS and adult services, which has transformed mental health care for young people across the West Midlands. This model has now been copied in 10 cities across the UK, as well as in Canada, France, Ireland and Australia. Their research and work has informed the national NHS Long Term Plan of 2019.

The project’s findings have spread further thanks to broadcasts on BBC radio and television. These have included how race impacts on mental health diagnosis, and access to services, for young BAME people in the UK. Working with Santé Theatre and Media Productions, the team created a play that explored these issues. This toured 10 locations in the UK, with total audiences of over 1400 people. After-show talks let the audience question health workers, patients and researchers.

In collaboration with The Creative Gypsy, an independent film-maker in New Delhi, Professor Singh produced “Command And I Shall Obey”. This documentary film explored the risk of untreated psychosis, with the lead winning the Dada Saheb Phalke Best Actor Award, the highest in Indian cinema. Professors Singh and Birchwood are now bringing their early intervention research for EIP to Low- and Middle-Income countries (LMIC), leading the World Psychiatric Association’s task force.

In February 2020, Professor Singh led two national summits at No 10 Downing Street on young people and young people with ethnic minority backgrounds and attended by government officials and senior policymakers from Departments of Health and Social Care, Works and Pension, Education, the Race Disparity Unit and ONS to inform the mental health policies of the new administration.

Access 'Forward Thinking Birmingham'

See the NHS Long Term Plan