§ Jacqui Smith
A survey of the mental health of children and adolescents in Great Britain was carried out in 1999 by the Office for National Statistics on behalf of the Department of Health, the Scottish Health Executive and the National Assembly for Wales.
Nearly 10 per cent, of white children and 12 per cent, of black children were assessed as having a mental health problem whereas the prevalence rates among Asian children were 8 per cent, of the Pakistani and Bangladeshi children and 4 per cent, of the Indian children.
Despite the large number of interviews achieved in this survey, ethnic differences are difficult to interpret because of the small numbers in the sample who regarded themselves as belonging to particular ethnic groups. Nevertheless, Indian children, particularly girls, seem to have far lower rates of mental disorder than both white or black children.
Mental health services for children will be part of the Children's National Service Framework. Part of the remit of the framework will be to tackle problems surrounding access and inequality, which can particularly affect people from ethnic minorities.
§ Jacqui Smith
The responsibility for the provision of child and adolescent mental health services (CAMHS) in England lies with health authorities and local authorities. They are required to have joint development strategies which will ensure that a comprehensive range of services are available for children and young people.
We have an ongoing commitment to the improvement of CAMHS and it will be an important part of the Children's National Service Framework. We shall be working closely with the Department for Education and Skills when developing the CAMHS module of the 959W National Service Framework. This is a major development and will safeguard the quality of child mental health services.
The Department for Education and Skills is developing a number of initiatives designed to help schools and teachers work with children with a range of emotional and behavioural needs. In June 2001 they issued their guidance "Promoting Children's Mental Health within Early Years and School Settings". This covers not only mental health problems faced by children but the approaches schools can take to promote children's mental health.
The framework for comprehensive service provision contained in "Promoting Children's Mental Health within Early Years and School Settings" sets out four service levels. Tier 1: a primary level provided by non-specialists, tier 2: a level provided by uni-professional groups, tier 3: a specialist service for more severe, complex and persistent disorders, and tier 4: tertiary services such as day units and in-patient units for older children and adolescents who are severely mentally ill or at suicide risk.
In Teesside, services for children with mental health problems requiring input at tiers 1 and 2 are provided through educational psychology service links with schools and school nurses. This ensures that the identified teachers link with locality CAMHS groups to ensure continuity.
At tier 3 psychiatrists, Grade A and B clinical psychologists and community psychiatric nurses from Tees and North East Yorkshire national health service trust's Roseberry Centre at Middlesbrough provide out-patient outreach services along with primary care link workers.
At tier 4, for children up to the age of 12 requiring in-patient care, the health authority utilises the Fleming Nuffield Unit at Newcastle. Children in the age group over 12 to 18 years have in-patient provision through the Roseberry Centre. If it is identified by clinicians that an adolescent requires a more secure environment because of behavioural presentation or offending behaviour, the adolescent forensic service at Newcastle is utilised.