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Evidence of Large-Scale Neglect for Child Mental Health - Dr Mark Burgin

02/04/20. Dr. Mark Burgin BM BCh (oxon) MRCGP considers the legal implications of a recent study by Stem4 reported in GP online based on a poll of 1000 GPs.

Courts have been reluctant to find health authorities liable for the consequences of rationing but there has been increasing public concern about Child Mental Health.

Stem4 is a charity that promotes positive mental health in teenagers through use of mental health apps and education activities.

30% of 14-year-old girls have mental health problems and GPs refer only the most seriously ill but secondary care rejects over half of these referrals.

Without treatment these young people will find it difficult to study or work and their parenting will suffer leading to child protection issues for their children.

Increasing Cost of treatment

The majority of the costs for child and adolescent mental health services (CAMHS) is to manage the few patients who require intensive care.

These seriously ill young people have typically suffered from abuse throughout their lives and describe their previous care as ‘a joke’.

Their records show that their mental health conditions were recognised early by those in primary care but there was a lack of resources for low cost treatments.

Each time they were assessed the likely cost of the treatment they needed had increased but the problem was not dealt with.

Prevention of mental illness in young people

Young women with untreated mental health problems make up the majority of those whose children are on child protection register.

My experience is (unsurprisingly) that young mothers find child rearing stressful and that with appropriate mental health support their parenting improves.

This type of work is time intensive and requires a good working relationship between GPs and health visitors but is essential to keep the next generation well.

With the crisis in General Practice GPs do not have time for the training provided by stem4 or to take on this type of work in their practices.

Evidence of Neglect

“Nine out of 10 GPs say mental health services for children and young people are inadequate”

There is no body of opinion (reasonable or otherwise) that believes that providing mental health treatment to children and young people should be delayed or refused.

There is no public interest in allowing young people’s mental health to deteriorate so that they become a burden rather than benefit to society.

There is extensive evidence that early treatment is more effective, cheaper and has benefits for the family and society as a whole.

Final Points

Sir James Munby, retired President of the Family Division has campaigned for greater openness in cases involving young people which has led to greater scrutiny.

It is time for the legal process to challenge institutionalised negligence in the treatment of mental health services from the anxious child to the ill treatment of in patients.

The evidence for neglect can be found in the GP’s records of child (and parents) and health visitor, school nurse and social worker records.

The right expert would have experience of primary care prevention of mental health problems and an understanding how to analyse dysfunctional systems.

Doctor Mark Burgin, BM BCh (oxon) MRCGP is on the General Practitioner Specialist Register.

Dr. Burgin can be contacted This email address is being protected from spambots. You need JavaScript enabled to view it. and 0845 331 3304 website

Bostock 3 January 2020 More than half of GP referrals to CAMHS services rejected, poll reveals

Stem4 2020 The Failure of Children and Young People’s Mental Health Services 2019: Another year in decline

Opening up the family courts: Transparency in the family court and the court of protection speech by Sir James Munby, president of the family division and president of the court of protection at the annual conference of the society of editors ‘freedom to inform’ London 11 November 2013

Image: CC0 Public Domain from

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