A six-year-old autistic boy has been refused NHS child and adolescent mental health services by Alder Hey Children’s NHS Foundation Trust solely because he attends an independent school, his mother has disclosed.
The woman, who has asked not to be named, contacted the trust after growing alarmed that her son might be experiencing auditory hallucinations. She had already sought private help from a child psychologist at £40 per session, but felt it was wrong to pay when other families receive free support through the NHS. When she approached NHS mental health services, however, Alder Hey declined to assist. In a letter, the trust explained: “As [her son] attends an independent primary school, our Mental Health Support Teams do not cover this school.”
The trust’s Mental Health Support Teams (MHSTs) are NHS teams embedded in schools to provide early intervention for children and young people with mild to moderate mental health concerns, including low mood, worry, anxiety, avoidance and sleep difficulties. The Alder Hey MHST currently works with more than 160 schools across Liverpool and Sefton. But independent schools are excluded from that coverage. The trust directed the mother to website resources, suggested using “social stories” to help her son understand social situations, recommended contacting a charity, and then closed the file on her son.
The boy, who has special educational needs, had recently started hitting other children. When his mother asked why, he replied: “Because my brain told me to do it.” She described him as exceptionally gifted at mathematics, with a mind that “never seems to switch off”, causing difficulty sitting still and controlling his behaviour. He also developed a severe phobia of bald men — a specific fear known as peladophobia — so intense that the family had to leave soft-play centres and crowded public spaces. His mother grew worried he might be suffering from intrusive thoughts or hearing voices. Auditory hallucinations, which involve hearing sounds or voices not present in reality, can occur in up to 17% of children and are often transient, but can also be symptoms of psychotic or mood disorders. Intrusive thoughts — unwanted, distressing ideas that can cause anxiety and compulsive behaviour — are associated with conditions such as obsessive-compulsive disorder.
“I pay for my son’s education privately while also paying my taxes, yet I was denied support on that basis alone,” the mother said. “It feels unfair that access to help should be restricted because of the type of school a child attends.”
Maria Eagle, the Labour MP for Liverpool Garston whose constituency includes the family, said she was “very concerned” and promised to seek answers from Alder Hey. Shadow Culture Secretary Nigel Huddleston, a Conservative MP, condemned the decision. “No child should be denied the help they need because of the school they attend or their family background,” he said. “Yet clearly, vulnerable children are falling through the cracks.” Toni Bailey, chairman of the Send Foundation, which campaigns for children with special educational needs and disabilities, added: “Healthcare is based on clinical need and place of residence and not on the type of school.”
NHS trust defends eligibility criteria
Alder Hey Children’s NHS Foundation Trust has defended its position by arguing that access to its Child and Adolescent Mental Health Services (CAMHS) is based on clinical need. The trust said all referrals are assessed by clinicians to ensure children and young people receive the most appropriate support, whether through Alder Hey specialist mental health services or other local providers. Children who require specialist CAMHS support and meet relevant eligibility criteria will receive care based on their individual needs, the trust stated.
However, the trust’s reasoning for refusing support to children at independent schools hinges on the role of its Mental Health Support Teams. These teams are designed to work in partnership with state-funded schools. The trust noted that independent schools “typically arrange their own Social, Emotional and Mental Health (SEMH) support”, and added that they can access senior mental health leads training grants in the same way as local authority schools can. This means that while the NHS provides early-intervention support in maintained schools, the responsibility for equivalent mental health provision in the independent sector is left to the schools themselves.
Independent schools in the UK can offer tailored programmes for children with special educational needs, including specialist staff, individualised learning plans and smaller class sizes. Some independent schools specialise in supporting children with autism spectrum condition and SEMH needs. However, they are not always legally required to follow the SEN Code of Practice in the same way as maintained schools, and local authorities are generally only required to fund provision in maintained settings, not independent mainstream schools. As a result, the quality and availability of mental health support can vary significantly.
For families unable to access NHS services, the cost of private therapy is substantial. Private child psychology sessions typically range from £80 to £150 for a 50-minute session, with initial consultations costing between £100 and £250. Clinical and counselling psychologists may charge £100 to £180 or more per session, while counsellors average £40 to £70. The mother in this case had been paying £40 per session for private help — at the lower end of the scale — yet still felt the inequality of paying taxes while being denied free NHS care.
Alder Hey, meanwhile, is developing digital platforms such as ‘AlderHey@nywhere’ to provide hybrid access to care, aiming for preventative care and early intervention to manage health needs from home, reflecting a move towards a “hospital without walls” model. But for the mother of this six-year-old boy, the immediate help she sought for her son’s auditory hallucinations, intrusive thoughts and severe phobia was withdrawn on the grounds of the type of school he attends.