Posted: 27 September 2017

Why we’re worried about young people missing mental health appointments

When a teenager doesn’t go to their mental health appointment, it should be a serious cause for concern. Something could be seriously wrong.

So it’s worrying that our new research has found that many mental health services aren’t checking why a young person didn’t attend an appointment and whether they are OK.

Missing out on vital support

Our latest report, Stick with us, found there were more than 150,000 specialist appointments missed in 2016 within Child and Adolescent Mental Health Services (CAMHS). It shows that the system isn’t working for many of the vulnerable children and young people who need mental health care.

Some young people repeatedly miss appointments – a serious warning sign

'They need a more settled, relaxed approach to mental health. It’s hard for me to trust people right, I need to know them a bit so I can trust them.’ – Ricky, a young person supported by one of our services

Young people miss mental health appointments for a variety of reasons, often because of the mental health problem itself. It’s understandable why a teenager struggling with a condition like anxiety or depression may find it impossible to make it to an appointment. Other factors include long waiting times to get treatment, difficulty with getting to appointments, trust in adults and the stigma around mental health.

The risks of missed appointments

Some young people repeatedly miss appointments – a serious warning sign. Our research shows that a very worrying proportion of young people repeatedly miss their appointment, with 20% missing three or more appointments.

But rather than finding out what’s going on and if the young person is OK, some services are discharging them without assessing the risks posed to the child. 

'I started missing appointments because I was worried what they thought of me.’ – Mike, 17

The young person loses treatment altogether, at risk of deteriorating mental health and needing more intensive support later down the line. Worryingly, our analysis shows that older teenagers are twice as likely than younger children to be discharged because they have repeatedly missed appointments.

'I was discharged at least twice. The first time was because I promised I’d never do anything stupid ever again. I started missing appointments because I was worried what they thought of me.’ – Mike, 17, a young person supported by one of our services

Significant costs to young people’s health and the NHS

If a young person misses an appointment, the consequences can be severe and even fatal. We know that in some of the most serious incidents where children died or were seriously harmed because professionals failed to keep them safe, missed CAMHS appointments were a significant factor.

We estimate that missed CAMHS appointments are costing the NHS over £45 million a year. We know services are already under immense pressure and it’s clear young people are struggling to engage with the system. It’s costing the NHS and young people’s health, and things must change in order to tackle missed appointments.

How can missed appointments be reduced?

We are calling for three key things to change:

  • The Government must make it mandatory for mental health services to follow up with children and young people when they miss an appointment.
  • Shorter waiting times so children don’t give up and drop out of the system.
  • Providers of services should incorporate children and young people’s views in the way services are designed and delivered.

Read the report

By Kadra Abdinasir - Policy team

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