Analysis shows that one in three child psychiatrist vacancies in England are vacant

One in three child and adolescent psychiatrist posts in England are vacant, according to a ‘shocking’ analysis that exposes the staffing crisis that experts say is fueling ‘unacceptably’ long waiting times for NHS care.

The number of children and young people needing mental health care has risen dramatically in recent years, but many face long delays before accessing treatment. Some deteriorate into dangerously serious mental health conditions while they wait.

At the same time, persistent underfunding of the health care system over the past decade has devastated the health care system’s ability to recruit and retain enough psychiatrists to meet the dramatic increase in demand for care.

A workforce survey published by the Royal College of Psychiatrists shows that child and adolescent mental health now has the highest vacancy rate for consultants of any psychiatric specialty.

Of the 842 child and adolescent psychiatrist posts in England, one in five (19.2% or 162 posts) were vacant, according to the census. Combined with posts covered by locums, the overall vacancy rate was more than one in three (36.8% or 310 posts), the report said.

In an interview with the Guardian, Dr. Lade Smith, the president of the Royal College of Psychiatrists, called for immediate government action to resolve the staffing crisis.

“Chronic underfunding for more than 15 years, in addition to pressure on mental health services, has had a detrimental effect on the ability to recruit and retain sufficient numbers of psychiatrists,” she said.

“As the workforce ages and pressures on staff increase, consultants are leaving without enough new recruits to replace them. The result is high staff shortages, with children in the most vulnerable positions experiencing delays in accessing treatments that we know are effective treatments that will keep them healthy and well.”

Smith said the solution was simple. “The Government must fully implement the updated NHS long-term workforce plan. It should also fund the expansion of the mental health workforce and additional services that can help meet this demand, while investing in children’s mental health as a priority.”

The increase in waiting times for children and young people to access mental health care was “unacceptable”, she added. Too many children experience a decline in their mental health while on waiting lists, she said.

The Guardian revealed earlier this year that the number of children referred to emergency mental health services in England had risen by more than 50% in three years, reflecting the impact of long waiting lists for mainstream NHS treatment.

There were 32,521 emergency and emergency referrals to child and adolescent mental health crisis teams in 2022-2023. In 2019-2020, the year before the Covid pandemic, this number was 21,242.

The rise means more than 600 mentally ill children a week are deteriorating to the point of reaching crisis point, a review of NHS figures by the Guardian shows.

“We know that many children and young people can recover if they are treated early,” says Smith. “The evidence shows that children who receive early support are less likely to develop long-term conditions that can affect their education, social development, employment prospects, overall productivity and, of course, their health later in life.

“The government must prioritize tackling the child mental health crisis. Anything else will be short-sighted and even more expensive, as it creates further pressure and demand for services as their mental health problems continue into adulthood.”

Smith said many medical students want to choose child and adolescent psychiatry.

“Our members tell us that working with children and seeing them flourish after treatment motivates them and gives them a high level of job satisfaction. But there are simply not enough training positions and this ultimately results in not enough psychiatrists to meet the overwhelming need.

“This is solvable. All it takes is for the government to prioritize our children.”

Commenting on the staffing count, Olly Parker, head of external affairs at children’s mental health charity YoungMinds, said: “It is shocking that so many posts remain vacant.”

The labor shortage is “a major obstacle” to increasing the number of young people receiving aid, he said. “It takes years to become a psychiatrist – the government needs both long-term and short-term solutions to fill the gaps.

“Insufficient staff has very real consequences for young people, who often already face enormous waiting lists. More than a million young people under the age of 18 are referred to services every year, and systems change is needed to both support the greater numbers of people who need support and to prevent young people from falling into crisis.

“The government must urgently roll out open access early support hubs to ease pressure on the NHS and provide more detail on how they will fill staff shortages that are putting extra pressure on an already overburdened mental health system.”

The Department of Health and Social Care has been approached for comment.