The distressing story of children being admitted to general wards because mental health beds aren’t available (Sharp rise in acute medical beds occupied by children with nowhere else to go, 13 September) is a story that’s been told time and again, including in my own life as someone who has lived with an eating disorder since my teens.

As a child, I was admitted to a paediatric ward with anorexia, but never saw a member of staff who specialised in mental health. As a young adult, I was on many general wards as a result of overdoses or eating disorder symptoms, but was always discharged without ever seeing a psychiatrist. It shouldn’t be a surprise that as an adult, I live with entrenched mental health problems that could have been prevented with the right care when I was younger. This is a hugely false economy played out in the lives of so many people.

The people with the power to overhaul our mental health services are not listening hard enough to these stories, otherwise they would act faster. They would massively expand mental health care, as soon as possible. Instead, demand outstrips supply, current investment lags behind rising referrals and services face cuts in real terms. For all the talk of mental health being as important as physical health, and legislation for “parity of esteem”, things are still grossly unequal.

The roots of this must be in stigma. In policy terms, mental health just isn’t as important. With a new pathogen, we can provide tens of thousands of hospital beds almost overnight. Yet a chronic shortage of mental health beds seems to be a problem we can’t solve. The point of investment is to save. So many lived experiences like mine show that investing in mental health can save lives as well as improve quality of life for so many.
James Downs
Cambridge

Sadly, it is of little surprise that there are so few facilities for the support and treatment of the most vulnerable children. Until about 20 years ago, there were a number of specialist therapeutic care homes that had collectively built up many decades of knowledge and skill in this field. These centres provided secure care in more senses than one, leading in many cases to the recovery and rehabilitation of these deeply distressed young people. Successful outcomes led in turn to reduced demands on adult services, and thus incidentally saved the NHS considerable ongoing expenditure of just the sort that is now being reported.

Such facilities have been systematically undermined and underfunded by successive local and national governments, and many of the most effective and successful centres have closed. It is extremely difficult and demanding work – as the researcher Prof James Anglin once noted, “Child and youth care is not rocket science; it’s far more complex than that” – but with these closures, the accumulated expertise of a whole generation of therapeutic care staff was lost.

In the intervening years, there have been dozens of reviews and reports in this field, but almost no concerted action to remedy the situation and make a proper new beginning for these young people in need. How terribly we as a society are failing them. Do we just not care enough about children to do anything about it?
Adrian Ward
Former senior clinical lecturer in social work, Tavistock clinic

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