It is not possible to estimate unmet need for Tier 1 or Tier 2 services without reliable estimates of the number of children and young people receiving these services from non-specialists in general settings such as schools and GP practices.
There are an estimated 1,900 children and young people in need of Tier 3 services in Hackney and the City (Table 4 in estimates section). At the end of financial year 2014/15, the number of open City and Hackney cases in Tier 3 services was 57% of this estimate (Figure 2). Note that these data form snapshot from the final quarter of 2014/15 and may not be reflective of the full year’s caseload.
Combining the estimated and known caseloads suggests that around 800 children and young people who are eligible for Tier 3 services may not be receiving the support they need.
Figure 2: Estimated number of Hackney and the City residents (aged 0-17) who require Tier 3 CAMHS compared to known service use (Q4 2014/15)
Local data: City and Hackney CCG, CAMHS Performance Data Q4 2014/15
Estimates: Table 4
No data are available to examine unmet need at Tier 4.
Figure 3 breaks down Tier 3 unmet need by condition. It has been compiled from data submitted to the CAMHS Outcomes Research Consortium (CORC) for 2013. These data are known to be incomplete (see caveats below), but comparing this with estimates of need presented in Table 3 gives some indication that conduct disorder in particular may be significantly under-treated in Hackney and the City.
Please note the following caveats when interpreting these data:
- Service data are only available for those teams who submitted CORC data. This is not the full range of teams serving Hackney and the City, and there may be some overlap between people seen by more than one service.
- There is a large overlap between types of disorder – over 20% of children with a disorder were diagnosed with more than one of the main types.
- It is not always obvious from the stated disorder(s) what tier of service the child or young person requires.
Figure 3: Estimated number of Hackney and the City residents (aged 5-15) with certain mental health disorders compared to service use submitted to CORC of City and Hackney CAMHS Tier 3 services in 2013
Local data: CAMHS Outcomes Research Consortium, 2013
Estimates: See section on estimates