A quarter of children referred to mental health services in Scotland have been thinking about or attempted suicide – and face a postcode lottery as to whether they will be assessed or treated, a new Stirling University study suggests.
Suicide among children and young people is a leading cause of death globally and, in the UK, the number of suicides among under 25s has been continually rising since 2017. Scotland has the highest rate of suicides among children in the UK – however, the number referred to mental health services for suicidality, and the care they receive, is largely unknown.
Funded through a PhD from the Economic and Social Research Council, part of UK Research and Innovation, researchers at the University of Stirling have addressed this dearth of evidence by reviewing referrals to Child and Adolescent Mental Health Services (CAMHS) in two of Scotland’s NHS board areas. They found 25 per cent of all referrals – those made to both boards across a six-month period – were for children who had been thinking about or had attempted suicide – and a third of those were under the age of 12.
The study also highlighted a significant disparity in the response of health boards to children referred for suicidality. In the first health board, more than two thirds (69 per cent) were not offered a face-to-face assessment and just eight per cent of those assessed were offered treatment immediately. By contrast, the second health board – which had a specific suicide and self-harm team – offered face-to-face assessments to most (82 per cent), with 66 per cent of those offered treatment.
Dr Lynne Gilmour led the study alongside colleagues from the Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP-RU) at the university.
She said: “In the UK, children who have attempted suicide or have suicidal ideation are referred to CAMHS for assessment and treatment – however, little is known about the numbers referred for suicidality or the care they receive.
“This is of particular concern given CAMHS are under phenomenal pressure, staff are doing their utmost to provide timely and appropriate support, however, as our study shows, systems in place are not sufficient for the overall numbers being referred, some services are overwhelmed – and this has been further exacerbated by the pandemic.
“Our research sought to understand how the children referred for suicidality are processed, assessed and treated.
“Overall, we found that one in four referrals to CAMHS involved children who had either attempted suicide or had suicidal ideation – and 33 per cent of those were under 12.
“We also identified a variation within and between health boards in terms of assessment, referral outcomes, and care pathways for these children – with most, in one area, not receiving a face-to-face assessment, let alone treatment or support. This highlights the often-missed yet vital opportunity for early intervention with very young suicidal children.
“Having a dedicated team to respond to referrals for suicidality appears to support access to assessment and treatment,” the authors said.
Underlying issues identified by referrers were similar across both sites, including: domestic abuse, child abuse (physical, emotional, sexual, neglect), bullying, Autism Spectrum Disorders, and other mental health issues.
