Surrey teens took own lives after waiting six months for NHS help

Two teenagers who took their own lives in Surrey had waited more than six months to get their mental health assessed by the NHS.

Nine boys and three girls, one as young as 14, are believed to have committed suicide in the county in the last six years up to April.

Two of their families had sought private support after waiting so long to see Child and Adolescent Mental Health Services (CAMHS).

The NHS constitution says no one should wait more than 18 weeks from referral to be treated.

Fiona Edwards, chief executive of Surrey and Borders Partnership NHS Foundation Trust, said at a Surrey County Council (SCC) health and well-being board meeting last Thursday: "I do think the work led by Dave Hill late children’s services director at SCC that we’ve been doing together over the last couple of years to try to really shift our collective focus, to move to an early intervention model, is crucial."

A thematic review commissioned by Surrey Safeguarding Children Partnership noted one of the 12 teenagers did not enter any care pathway after being seen at the emergency department for self-harming, while one was told they did not meet the threshold following a CAMHS referral.

It reads: "As such these opportunities for intervention were missed with little apparent oversight, communication or follow-up of loss of contact."

The review looked for patterns among the 12 probable suicides to try to avoid future tragedies.

Among its nine recommendations is timely support for young people in crisis, with risk assessments updated in a timely manner.

It also concluded more needed to be done to raise awareness that autism spectrum disorder (ASD) is a known risk factor for suicide.

More than half (seven) of the young people had been diagnosed with ASD or attention deficit disorder (ADD). Parents told the Child Death Review (CDR) team they were not made aware of the increased risk of suicide if a child had ASD.

One third of the teens who died had started or increased medication within the last month.

Parents felt there should have been clearer warnings that suicide risks are increased when people start to improve and respond to treatment.

Amanda Boodhoo, Surrey-wide associate director of safeguarding, who chaired the case review group, said: "This has been a really valuable opportunity to gather some rich data that’s very pertinent to the deaths of our children in Surrey. We have benefited from the really rich engagement of our families at this very tragic time. Some really very significant themes came out of it."

They also found that two thirds had experienced four or more adverse childhood experiences. These could be for example neglect, abuse or a parent in prison.

Councillor Mary Lewis, SCC cabinet member for children, young people and families, said: "100% of these children were living, growing up and learning in Surrey at the time of their death.

"For all the analysis that’s been done and the impressive quality of it, it won’t really mean anything until we take action and we start doing some things differently."

Before coronavirus, NHS England was testing a 28-day waiting time for CAMHS. The Government’s green paper Transforming children and young people’s mental health hoped to roll this out across the country by 2023.

Before this the average waiting time for a child’s first assessment from referral was 71 days for Surrey Downs CCG (now merged into Surrey Heartlands), 68 days for North East Hampshire and Farnham CCG, and 66 days for Surrey Heath CCG.

This compares with 53 days on average in England.

Only between 7-11% of Surrey children were assessed within four weeks of referral (compared to 15% in England), with 31-42% of children classed as still waiting with no contact.

This is according to the latest published data (April 2018-March 2019) from Mental Health Data Set and NHS Digital.

A spokesperson for NHS Surrey Heartlands CCG said: "We are working hard to improve routine waiting times for CAMHS services and as of June 2020, the average wait has reduced to 40 days.

"We have also increased capacity with our voluntary and community sector partners who can help address concerns earlier and reduce the need for more specialist interventions.

"All CAMHS services have continued to operate throughout COVID and as schools return we are focused on helping staff and parents to know how to access local emotional wellbeing support for children and young people."

Alison Griffiths, who sits on the suicide prevention board, told the health and wellbeing board they had recently secured three mental health support teams from NHS SE England.

She was also enthusiastic about the Samaritans run Step by Step, which provides practical support to help schools prepare for and recover from a suspected or attempted suicide.

Support can be found at www.cyphaven.net and www.kooth.com

Or you can call Samaritans for free on 116 123, email them at jo@samaritans.org, or visit samaritans.org to find your nearest branch.