The hospital has a 25 year history as the only specialist NHS centre providing residential, therapeutic interventions for families with severe mental health problems.
This flagship service provides psychotherapy and specialist support for the most vulnerable families struggling with complex psychiatric issues. If these families do not receive such intensive interventions it is likely that their children will be removed.
Children who are placed in the care system often experience instability, placement moves and achieve poorer educational outcomes. A woman who has been in care is 33% more likely to have her children taken into care.
Families are referred to the Cassel Hospital from across England, Wales and Northern Ireland. However, the hospital falls under the auspices of the West London Mental Health Trust, rather than being a centrally funded service. Specialised therapeutic help which may require residential stays of up to nine months is expensive and local authorities no longer have the funds to commission such services.
In November 2006 the Lords of Appeal reinterpreted section 38 (6) of the Children Act 1989, and removed the legal obligation for local councils and primary care trusts to pay for ‘psycho-social’ treatment. This meant that local authorities no longer had to fund intensive support for the most vulnerable families, and so referrals to the Cassel began to decline.
The current huge cuts in local authority budgets mean that even less families will be referred. It is also impossible for local authorities to predict when a family needing such help may appear. A situation compounded by localised commissioning, rather than centralised funding.
The Cassel has applied for funding from the Independent Advisory Group for National Specialised Services (AGNSS), whilst the West London Mental Health Trust has said that ‘It’s not tenable for us to carry the financial burden of an under-subscribed service.’ The short term policy making and financial decisions of local authorities means the longer term cost effectiveness of keeping families together, and preventing a cycle of deprivation, is ignored.
Real parents and children pay the price when their access to services and chance for help is reduced to a series of sums on spreadsheets. The loss of expertise if the Cassel closes down and the staff team is disbanded will be immeasurable.
Indeed, when the Cassel was previously threatened with closure in 2007, it was the Lib Dems who campaigned to keep it open. Susan Kramer and Annette Brooke, both Lib Dem MPs, argued for the hospital to be kept open and to be centrally funded. The cuts that the Lib Dems now support may well be the death knell of a unique and truly excellent service.
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