MORE children and young people are being referred to mental health services in Scotland than ever before, but auditors warn the system is "fragmented" and there is no data to show whether or not patients are recovering.

A major report today on the Child and Adolescent Mental Health Service (CAMHS) warns that the current system is still geared towards specialist care and responding to crisis, rather than early intervention and prevention.

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Audit Scotland found that more than a quarter (26%) of patients waited more than 18 weeks to start treatment last year, up from 15% in 2013/14, and said confusion over the referrals process means young people "get bounced between services and professionals, adding to their anxiety".

In 2017/18, 33,270 children and teenagers were referred to CAMHS - the highest number to date and a 22% increase in four years. Of these, 7,199 were knocked back - 24% more than in 2013/14.

Referrals can be rejected for a number of reasons including patients failing to meet the treatment criteria.

However, the public spending watchdog notes that the threshold for access to specialist CAMHS is "high" and varies between health boards.

It adds: "National data on reasons for referral and rejection is not collected, making it difficult to understand the nature of demand for specialist CAMHS.

"Collecting this data would help to assess the level of referrals that are not suitable for CAMHS and indicate the number of children and young people who would benefit from lower level support and services."

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Services such as school counselling are "not consistently available" across Scotland, and poor financial and performance data means it is difficult to identify how much is being spent on services or the difference they are making, said the report.

One NHS manager quoted anonymously said compliance with waiting times had become an over-riding focus, adding: "It’s been useful in focusing attention on how to do things differently, but once you’ve met the target I would question whether it is actually a good measure of success or progress."

Caroline Gardner, the Auditor General, said a "step change" was required in the way youth mental health services are delivered.

She said: "The mental health system is complex and fragmented, making it difficult for children, young people and their families to get the support they need."

A spokesman for the Scottish Children's Services Coalition said: “The latest waiting time figures around the country are the worst on record and clearly demonstrate that we are failing many of our children and young people with mental health problems.

“The supposed Scottish Government focus on prevention and early intervention needs to be immediately shifted from theory into practice."

Dr Elaine Lockhart, chair of the Royal College of Psychiatrists Scotland's CAMHS Faculty, said: “It is vital that the most vulnerable children and young people with severe and complex mental health disorders and their families have speedy access to well-resourced specialist services for assessment, diagnosis and treatment.  

“We must ensure there are strategies in place to ensure the CAMHS workforce is sustainable.”

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The Scottish Government announced last week that it would invest an extra £100 million this year on youth mental health services, including fast-tracking young people with serious conditions to specialist treatment, putting counsellors into every secondary school and funding 80 new counsellors for universities and colleges.

Mental Health Minister Clare Haughey said: “Dedicated mental health professionals provide high quality care to our young people across Scotland every day.

"But despite this, too many children and adolescents are being let down by the current system. I have been clear that this is unacceptable and that we must look at making the changes necessary to ensure young people get the care they need and deserve.

“I welcome Audit Scotland’s report. It provides a very helpful independent and external view of the issues facing our mental health services, and reinforces many of our own conclusions and the action we are taking, supported with record levels of investment.

"Mental health is a priority for this government and I am determined that we will address the issues affecting the care of young people.”