by Leneta Hey
Sarah, a friend who works with me at the café, is all bright colours in the dim light. Her hair is electric blue. Colourful tattoos run the length of her arms.
“What are you writing?” she asks, peering at my screen.
“About CAMHS, and why I think it is failing young people,” I reply.
As soon as I say the word ‘CAMHS’ (Children and Adolescent Mental Health Services), her eyebrows lift and her face stiffens. She grips the back of the chair opposite and slides into it quickly.
“I can tell you about CAMHS,” she says, quietly. “It was the worst experience of my life.”
She looks down at the table. “I was fifteen. I went because I was self-harming. The nurses didn’t actually want to help me. They just sent me home with sheets of paper, telling me what to do if I got the urge again: to slap elastic bands on my wrists. Hold ice cubes, have a brew, take a bath.’”
I wish I could say a sense of disbelief or horror came over me. But I saw exactly what she was describing at school. With its boxy structure and tiny windows, school resembled a prison. Two thousand children were crammed inside, clutching onto stress balls, worksheets and red doodle pens, frustrated that none of it made their problems go away.
Jessica was a small, skinny girl in my year who rarely talked to anyone. Occasionally she would shock everyone by snapping her pen, raging at the boys in class, storming out and running to the ‘green room’, a space set aside for pupils who struggled with temper, anxiety or depression.
Jessica was referred to CAMHS when she was fourteen. She often sat in lessons quietly twisting a small green and blue tangle toy she had been given at one of her appointments.
“I remember sitting in the waiting room at Birch Hill hospital,” she told me. “Most of it was shut down, but a small bit stayed open for CAMHS. It wasn’t very nice to be in, all old and run-down. Anyway, I felt like I was waiting forever to be seen, then only got a 20-minute appointment. I’d walk out with a few work sheets and some stress toys, and that would be it. The nurses didn’t care.”
I visited Birch Hill Hospital before it closed in 2013. The building was over a century old, a red-brick giant with a clocktower and what seemed like a million windows. When the hospital finally shut, parts of the site were sold off for redevelopment. The clocktower and rear wings were turned into apartments.
Though a handful of mental health services remain tucked away there, much of the grounds have been converted into housing. It is telling that a site once dedicated to public care has been handed over to private profit.
What happened at Birch Hill is not unique to Rochdale. Across England, CAMHS teams were squeezed into whatever space could be found — old hospital annexes, GP surgeries, even makeshift offices — as the NHS struggled to cope with overwhelming demand and ever-shrinking resources.
Ever since the financial crash of 2008, when local services like youth clubs and Sure Start took massive cuts, everyone has felt the burden: nurses, parents, carers.
Schools were left carrying the weight of children’s mental health struggles. They lack the training or resources to meet those needs.
My old school counsellor, Miss Smith, walked into the café recently. She has the same face: a dark-haired woman in her forties with tired eyes and a distinct mole on her right cheek. Her features are almost identical to her daughter’s, who was in my year at school. Back then, Miss Smith was often criticised by students as cold, distant, not a ‘real’ counsellor. She had an ‘old school’ approach to helping the kids, which often amounted to platitudes and advice that felt out of touch.
My close friend Olivia had regular sessions with her. Olivia needed to vent her frustrations about living with her stepfather and his aggressive tendencies, which dominated a household otherwise made up of women. The sessions would always end the same way: Olivia rolling her eyes as she walked out of the office.
“She doesn’t know what she’s doing,” Olivia would say, closing the door behind her. “She tried telling me I’m not actually depressed. Can you believe that?’
Now, years later, as she was leaving the café, Miss Smith said, ‘…and tell Olivia I wish her well.’ Under her breath she said, ‘I was just trying my best.’
As she picked up her bag, my heart sank. I hadn’t seen Miss Smith in seven years. I had only ever thought of her as the ineffective school counsellor. But her failings had not really been hers at all. Her job had been made impossible by a system that did not give her the training, resources or support she needed.
In 2015, the Coalition Government under David Cameron finally recognised there was a serious CAMHS crisis. In March that year they released the ‘Future in Mind’ report, led by Care Minister Norman Lamb, pledging £1.25 billion over the next five years exclusively for CAMHS.
‘I want to change the way we think about mental health care so that any child, whether they have a mental illness or simply need support through a difficult time, can get the right help at the right time,’ Lamb said at the launch. ‘These plans set out how we can ensure no child is left struggling alone.’
The promise of expanded capacity, slashed waiting times (one week for urgent cases and four weeks for routine referrals) as well as thousands of newly recruited staff, raised everyone’s hopes.
Ambassadors from mental health charities like Mind, Place2Be and YoungMinds, who were tired of standing in school halls talking about wellbeing while the system itself failed to provide it, saw it as a breakthrough moment.
It was the biggest investment in children’s mental health in decades. But the delivery fell short.
My research shows that in the first year only £143 million of the promised £250 million was released.
Of that, around £75 million was handed to Clinical Commissioning Groups (CCGs) — the local NHS bodies responsible for deciding how health budgets were spent.
The problem was, CCGs had other pressing priorities: struggling hospitals, overstretched adult services, community care. And because the CAMHS funding wasn’t ring-fenced, large chunks of it were diverted elsewhere, never reaching the front line teams and the sufferers it was intended for.
Children kept waiting. Clinics like Birch Hill stayed understaffed. Teachers and school counsellors like Miss Smith kept trying to pick up the slack.
Since then, various governments have tried to plug the gap. The 2017 Green Paper promised new Mental Health Support Teams in schools.
The 2019 NHS Long Term Plan pledged extra funding for children and young people’s services.
In 2023 came the commitment to extend Mental Health Support Teams to 60% of schools by 2025.Notably, the last three Conservative governments have gone back again and again to the same solution: putting the emphasis on schools.
Instead of putting serious, sustained funding into CAMHS, new money has been pushed towards school-based schemes. And while those schemes aren’t worthless, they’ve never been a substitute for a properly resourced CAMHS.
That, I would argue, is one of the biggest reasons we’re in the crisis we face now.
The most recent NHS statistics for CAMHS waiting times shows that in 2022/23 over 78,000 young people in England waited more than a year for mental health support, and more than 34,000 waited over two years.
On average, the wait after referral was more than a full year — 392 days. In that same year, 171,000 referrals were closed before the child even got any treatment.
Thanks to the many people I spoke with who shared their stories of CAMHS, these devastating figures did not surprise me when I looked them up: they make horrible, logical sense.
The wider national story became clear thanks to a conversation in the pub one night with my friend John, who has been in and out of therapy all his life.
‘A lot of young people are waiting crazy amounts of time. So they have no choice but to go private,’ he says, matter-of-factly, as he stubs his cigarette on the ledge.
Once again, children from poorer families take the hardest hit. John has been lucky — he has the family support and the money to get the help he needs. But kids like the ones I went to school with, who struggle every day with their mental health, rely entirely on the NHS. It’s not like they can buy their way out.
*Names have been changed
