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Call for a review of children and young people rejected by mental health services as new research highlights serious issues with the referral process

Release Date: 20/03/2017

Barnardo’s Scotland today, Monday 21 March, called for the Scottish Government to undertake a full review of the referral and assessment process for children and young people to Child and Adolescent Mental Health Services (CAMHS).

The children’s charity is supporting a call made by Scottish Labour in their briefing on Mental Health in 2016, ‘Ending the Scandal’.

NHS figures show that of all referrals to Child and Adolescent Mental Health Services around 1 in 5 were rejected in 2015.  Over the last three years the number of referrals rejected total around 17,000 children and young people.

Barnardo’s Scotland has become increasingly concerned after carrying out a review of its services supporting around 3,000 children and young people. The review found that 50% of the children and young people the organisation supports have a diagnosis of mental ill health or are presenting with a mental health issue. At the time of review three quarters of those presenting with mental health issues were receiving no service from CAMHS. Children and young people described losing trust in CAMHS because of the fear that they would not be seen.

Martin Crewe, Director of Barnardo’s Scotland, said:

Although waiting times for CAMHS continue to be an issue, it is increasingly worrying that there are significant numbers of children and young people who are not being seen at all. These children and young people either go without support or receive limited or inappropriate help. In our experience this can be the result of something as simple as insufficient information being included on a referral form.

Martin Crewe continued:

A review should consider how the current system works including looking at the criteria for referral nationally, the process for making a decision and crucially what happens to those children and young people who are rejected. The children and young people we work with who are referred and not seen by CAMHS receive some support, but there are many who fall through the net.  It is vital that the Scottish Government’s forthcoming mental health strategy addresses this issue.

Barnardo’s Scotland also highlights new research from The University of Stirling which shows that the odds of being rejected by CAMHS were significantly higher if a child or young person was referred by a teacher or had emotional or behavioural difficulties. A key recommendation from the research is that more work is urgently needed to investigate the experiences of children and young people who are waiting for or are rejected by CAMHS.

Joanna Smith, Lecturer, at The University of Stirling, who undertook the research said:

In Scotland we do not routinely collect national data about the source of referral, the reason for referral or any socio-demographic features of children and young people. It is then extremely difficult to gain an understanding of the influencing factors on children and young people’s referral pathways and wait time to CAMHS. It is also not clear what happens after children and young people are rejected by CAMHS as to whether and where they obtain support elsewhere.

Professor Brigid Daniel, Director of Child Well Being and Protection at The University of Stirling, said:

Given the nature of the difficulties faced by children and young people who someone saw fit to refer to specialist mental health services, a review of the system and timely access to appropriate services is urgently needed.

Monica Lennon MSP, Scottish Labour's Inequalities Spokesperson, said:  

It’s shocking enough that one in five children in Scotland are having to wait far too long for mental health treatment, but this new research indicates that many children and young people are not able to access specialist treatment at all. Scottish Labour’s call for a review of rejected referrals to CAMHS seeks to ensure no child or young person is missing out on treatment they should be receiving.

Many children across Scotland in need of mental health care are clearly not able to access the help they need, and I urge the SNP Government to listen to Barnardo’s Scotland’s call for a complete review of the referral process.

This new research is welcome and timely. Scottish Labour’s plans for access to a school-based counsellor in every secondary school and a review of rejected referrals are crucial. Early intervention and investment in support that extends beyond CAMHS is crucial to ensuring our children and young people receive the right support at the right time for their mental health.

Barnardo’s Scotland is calling for the review as part of the forthcoming mental health strategy.


Notes to Editors:

Scottish Labour briefing on Mental Health 2016: Ending the Scandal: Improving mental health treatment for young people in Scotland

What are CAMHs? Child and Adolescent Mental Health (CAMH) services provide a range of treatments for a variety of mental health conditions including Attention Deficit Hyperactivity Disorder (ADHD), anxiety, behaviour problems, depression and early onset psychosis.

Child and Adolescent Mental Health Services Waiting Times in NHS Scotland (Feb 2016)

Patterns of referral and waiting times for specialist Child and Adolescent Mental Health Services – Authors: Smith, Joanna; Kyle, Richard; Daniel, Brigid; Hubbard, Gill. (Feb 2017)

Barnardo’s Scotland surveyed 2,736 children and young people supported by our services. Of these children and young people, 24.42% were identified as having a formal mental health diagnosis. A further 25.18% were identified as presenting with mental health issues but with no formal diagnosis.  The data is currently in preparation for publication.

Barnardo’s Scotland work with more than 26,500 children and young people in over 130 specialised community-based services across Scotland and has over 95 shops.  We believe in children and we believe every young person has a right to thrive. Our vision is to realise Thomas Barnardo’s dream of a world where no child is turned away from the help that they need. Our work includes: fostering and adoption services and support; helping children break free from sexual exploitation; supporting young people leaving care; helping young people in to employment and helping children living in poverty.   

Visit to find out how you can get involved and show you believe in children.  Twitter: @BarnardosScot Facebook: Barnardo’s Scotland

Media enquiries:

Katrina Slater / Sabrina Hayes media office – Barnardo’s Scotland; telephone: 0131 446 7022 / 7101 or 0208 498 7555 (24 hours), email: /

With regards to the University of Stirling research please contact:

Professor Brigid Daniel – The University of Stirling; telephone: 01786 467726, email:

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