title: A lot of mental illness starts in adolescence. Therefore should we shift some of the spending from adult to adolescent mental health services?
abstract: In May 2015 the UK elected a new government. In election campaigns, health is one of the most important areas of debate and over the preceding 12 months, the state of child and adolescent mental health services (CAMHS) had held a particularly high profile in the media and in political debate. Many had suggested that the rate of mental illness starting in adolescence is increasing and that service provision is not of sufficient quality or scale to meet this need. A brief review of the sources for these statistics reveals that whilst this may be true, there is a dearth of accurate and up to date data on the scale of the need for CAMHS or the extent to which it is being met. Nonetheless, members of all parties claimed to support improvements in mental health service provision for children and adolescents through increases in funding. A key question for policy makers has therefore become, from where any additional funding might be derived. One suggestion has been that funding be transferred from spending on adult mental health services. The exact practical nature of such a policy is yet to be explored in detail by government or stakeholders. The primary purpose of the present discussion is therefore to consider the possible ethical implications of such a policy in principle. The discussion forms part of a wider and evolving political and professional discourse on society's and government's attitude towards mental illness, towards the balance of individual and societal needs and towards the balance between preventative and supportive interventions to improve health.
authors.affiliation: Clinical School, University of Cambridge, Cambridge, UK, dpn27@cam.ac.uk.
authors.forename: David
authors.initials: D
authors.lastname: Neal
mesh_terms: D000293:Adolescent; D016497:Adolescent Health Services / Q000191:economics*; D000328:Adult; D002648:Child; D003361:Cost Allocation; D003430:Cross-Sectional Studies; D004739:England; D006292:Health Priorities / Q000191:economics; D006301:Health Services Needs and Demand / Q000191:economics; D006801:Humans; D001523:Mental Disorders / Q000191:economics* / Q000453:epidemiology / Q000628:therapy*; D008605:Mental Health Services / Q000191:economics*; D011057:Politics; D013222:State Medicine / Q000191:economics*