National Assembly for Wales
Children, Young People and Education Committee

CAM 45

Inquiry into Child and Adolescent Mental Health Services (CAMHS)
Evidence from : British Association for Counselling and Psychotherapy (BACP)

The British Association for Counselling and Psychotherapy (BACP) would like to submit the following response to the Children, Young People and Education Committee’s inquiry into Child and Adolescent Mental Health Services (CAMHS)

1. The  British Association for Counselling and Psychotherapy

The British Association for Counselling and Psychotherapy (BACP) is the leading body for counselling and psychotherapy in the UK with 40,000 members, with approaching 1,600 in Wales, who work across the public, private and voluntary sectors.  Of our 40,000 members, almost half say that they have an interest in working with children and young people.

BACP also has a specialist Counselling Children and Young People Division.  It is the biggest, and the fastest growing Division, with currently over 4000 members across the UK. 

BACP has a strong public commitment to high practice standards and public protection.  All BACP members are bound by the Ethical Framework for Good Practice for Counselling and Psychotherapy and within this, the Professional Conduct Procedure. These set out the basis of good practice for BACP therapists and their clients.

BACP has worked with the Welsh Government (WG) to develop a toolkit to support the development of school counselling services in Wales, as part of this project BACP also worked with a Welsh secondary school to develop the Masks and Mirrors short film and a follow up production Reflections. The film tells the (fictional) stories of four young people and their experience of school counselling.

BACP was commissioned by the WG to undertake an evaluation into the WG’s schools based counselling strategy looking into the impact on young people’s mental health, satisfaction rates (clients and schools), perceptions, where added value could be employed, relationships between counselling services and wider support groups and cost effectiveness.  This evaluation was published in November 2011.

The Welsh Government was awarded the BACP Innovation in Counselling and Psychotherapy award 2009 for their National School-based Counselling Strategy.

2. Committee Questions

a. The availability of early intervention services for children and adolescents with mental health problems.

Counselling can be an effective early intervention strategy for young people who have a range of problems. Evidence shows that school-based counselling is associated with improvements around family issues, bereavement, eating disorders, bullying and relationships as well as other emotional, behavioural and social difficulties, including anger management.

Furthermore, early and easy access to counselling in schools can prevent mental health problems developing or becoming more serious, and can help to build up trust and confidence to enable young people to access more specialist services if required.  Counselling builds resilience in young people, equipping them with skills to cope with problems as they occur.

When there is adequate provision and therefore waiting lists are small, school-based counselling is an excellent early intervention service for children and adolescents with mental health problems.   BACP believes that the Welsh Government’s decision to place a statutory duty on local authorities to provide school-based counselling through the School Standards and Organisation (Wales) Act was a very positive step for children and young people suffering a variety of mental health problems.  

However, despite the School Standards and Organisation (Wales) Act requiring an extension of school-based counselling for year 6 pupils in transition to secondary school and for children and young people not in schools there has been no increase in funding to local authorities to help them deliver these additional requirements.  Due to the proven  effectiveness and success of school-based counselling, demand is growing and BACP has evidence that waiting lists for school-based counselling are increasing and we urge the Welsh Government to review funding for school-based counselling services and ensure that the provision is at least as good as it was prior to becoming a statutory requirement.  

b. Access to community specialist CAMHS at tier 2 and above for children and adolescents with mental health problems, including access to psychological therapies.

BACP knows from its members that access to mental health services for children and young people is patchy and not consistent, with some services having long waiting lists.

c. The extent to which CAMHS are embedded within broader health and social care services.

Counsellors have reported to BACP that the relationship between school-based counselling services and CAMHS is mixed and dependent on individual relationships at ground level rather than through a strategic approach at local level or through a national directive.

A recent scoping report commissioned by BACP - The relationship between specialist child and adolescent mental health services (CAMHS) and school and community based counselling for children and young people led by Sheila Spong of the University of South Wales has looked at the current situation.  Whilst the report’s findings are based mostly on evidence from England, an interview was held with a service manager with experience of working with a specialist CAMHS team in Wales and we believe from our experience and from our members, that these same issues are equally apparent in Wales.  

The report shows systems for developing sound working relationships between specialist CAMHS and school and community based counselling are highly variable in both structure and effect.

Quoting the executive summary from the report:

‘The responses in this study indicate that the relationship between specialist CAMHS and school and community based counselling services varies on a number of dimensions including the extent of mutual knowledge, understanding and respect, levels of interaction, the extent of co-working with individual clients, and shared vision of service development. Where the relationship between counselling services and specialist CAMHS is well developed, it can be regarded as symbiotic, as the two types of agency work closely together with mutual respect, creating a shared approach to meeting the needs of young people with mental health problems.

‘At the other extreme, in some areas there is considerable distance between counselling provision and specialist CAMHS reported.’

d. Whether there is significant regional variation in access to CAMHS across Wales.

BACP believes there is significant regional variation in terms of the relationship between school based counselling and CAMHS and therefore on access to these services.  Some CAMHS have good relationships with school based counselling services and are willing to liaise and take referrals, while others are not.

e. Any other key issues identified by stakeholders

School based counselling, as delivered in Wales – see further information - is a professional activity delivered by qualified practitioners in schools.  Counsellors offer troubled and/or distressed children and young people an opportunity to talk about their difficulties, within a relationship of agreed confidentiality. 

Counselling is one of a range of services that help to support the health, emotional and social needs of pupils. Evidence shows that a counselling service which provides support within a whole school strategy can be highly effective in promoting young people’s welfare, supporting their learning and alleviating and preventing the escalation of mental health problems. Counsellors work with children and young people to help them cope with social, emotional and psychological problems. Counselling is provided by professional practitioners and aims to give young people opportunities to:

§ Discuss difficulties in a confidential and non-judgemental atmosphere

§ Explore the nature of their difficulties

§ Increase their self-awareness

§ Develop a better understanding of their difficulties

§ Develop the personal resources needed to manage their problems

§ Develop strategies to cope with change.

Parents, teachers and young people reported case study evidence of the impact of the counselling service in the following areas:

§ Increased student well-being, happiness and confidence

§ Reduction in problematic behaviours such as aggression

§ Reduction in high risk behaviour such as self-harm

§ Increased ability to concentrate in class or improvements in school work

§ Reduced classroom disruption

§ Improved attendance and engagement with the school

§ Reduced risk of suspension and exclusion

§ Improved relationships at home

§ Improved relationships with friends

§ Better coping

§ Reduction in fear or acute anxiety symptoms

§ An observable impact on achievement was identified from the qualitative data.

Due to the popularity, effectiveness and success of school based counselling in Wales, it is vital that the Government continue to maintain resources to deliver it efficiently, especially as the programme expands to assist children and young people not in school.

School based counselling services in Wales are helping many children and young people who would have previously been diverted to CAMHS, indeed evidence indicates that school based counselling reduces referrals to more costly CAMHS interventions.   It is important that the contribution that counselling is making to help children and young people with mental health problems is recognised through continued funding and further investment in these now statutory services.

3. Further information

Scoping Report:  The relationship between specialist child and adolescent mental health services (CAMHS) and school- and community based counselling for children and young people.  Spong, Waters, Dowd and Jackson, June 2013: http://counsellingminded.com/wp-content/uploads/2013/12/spong_MindEd_report.pdf

Evaluation of the Welsh school based counselling strategy – Executive Summary: http://wales.gov.uk/docs/caecd/research/111118EvalWelshSchoolCounsellingStrategyExecSummaryen.pdf

Evaluation of the Welsh school based counselling strategy – Final Report:  http://wales.gov.uk/docs/caecd/research/111118EvalWelshSchoolCounsellingStrategyFinalReporten.pdf

Should the Committee be seeking further written or oral evidence, BACP would be delighted to provide additional information about school based counselling and CAMHS.

Contact details:

Martin Bell

Parliamentary and Public Affairs Advisor

British Association for Counselling and Psychotherapy

BACP House, 15 St.John's Business Park

Lutterworth

Leicestershire

LE17 4HB