Black Country Children's Mental Health Report

The Black Country Healthwatch organisations (Sandwell, Dudley, Walsall and Wolverhampton) carried out a joint project to explore young people's experiences of mental health services, particularly the transition from Child and Adolescent Mental Health Services (CAMHS) to Adult Mental Health Services (AMHS). The project was undertaken in response to concerns that the COVID-19 pandemic had worsened mental health difficulties among young people and highlighted ongoing challenges in accessing support. The research included 59 survey responses, six focus groups and 17 interviews with young people and their parents or carers. 

The findings showed that most participants were aware of CAMHS, but many did not know how to access the service or had experienced difficulties obtaining support. Although awareness of CAMHS was high, waiting times varied considerably, with many respondents waiting six months or longer for an appointment and around one-fifth waiting more than a year. A large majority felt that young people should be able to self-refer to CAMHS rather than having to go through a healthcare professional. 

Participants overwhelmingly preferred face-to-face mental health support and appointments, although some also valued video calls and digital options. Many respondents stated that they wanted faster access to services and easier routes to obtaining help. 

Transition from children's to adult mental health services emerged as a key concern. While some young people reported positive and well-planned transitions, others described poor communication between CAMHS and adult services, delays in transfers, having to repeat their stories to new professionals, and difficulties meeting the eligibility criteria for adult services. Some participants felt unsupported when they no longer qualified for children's services but were not accepted by adult services, leaving them without appropriate care. 

The report found that many respondents were unsure where to seek help during a mental health crisis. Nearly two-thirds either did not know or were uncertain where to go in a crisis, and only a small proportion had accessed crisis teams. Experiences of crisis services varied, with some reporting good support but others describing poor follow-up and inadequate responses to serious mental health concerns.

Many respondents also highlighted difficulties relating to autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). Concerns included long waits for assessments, limited support following diagnosis, and a lack of specialised services in some areas. Some families reported receiving little or no support after diagnosis and described having to fight continually for services. 

Participants repeatedly emphasised the importance of better communication, continuity of care and more joined-up services. Young people and parents wanted clear information about available support, easier access to services, and a single point of contact or information hub. Most respondents supported having one website or contact number where information about mental health services could be accessed.

Focus groups and interviews highlighted significant variation in experiences. Some young people felt well supported and involved in decisions about their care, while others described being discharged too early, struggling to access services, or feeling that professionals did not take their concerns seriously. Several participants reported that they had to reach crisis point before receiving help. Others felt that services lacked understanding of conditions diagnosed in childhood once individuals moved into adult services.

Case studies included accounts from parents caring for children with autism, OCD, depression and other complex needs. Families described the emotional and practical challenges of obtaining support and often felt that services failed to provide long-term, coordinated care. Young people also reported feeling unheard, dismissed, or inadequately supported by mental health services. Many credited voluntary and community organisations with providing the most effective support when statutory services were unavailable or difficult to access. 

The report concluded that there is a need for more consistent, joined-up and person-centred mental health support across the Black Country. Healthwatch recommended improving awareness and access to CAMHS, strengthening communication between child and adult services, ensuring better follow-up after discharge, providing greater continuity of staff, considering a dedicated care coordinator role, improving support for young people placed outside the area, increasing training within adult services, and involving young people and families more closely in designing future services. The report also called for stronger collaboration between healthcare providers, schools, charities and community organisations to create more integrated support systems