Concern at child mental health rejections
Mental health campaigners have called for an urgent review into why so many young people in Scotland are being turned down for specialist treatment.
More than 7,000 children and adolescents had their mental health referrals rejected last year.
The Scottish Association for Mental Health (SAMH) described the figure as "astonishing".
The Scottish government has already said it will commission a review into rejected referrals.
But SAMH said the issue needed to be addressed as quickly as possible because young people were "waiting now to get help and support".
'Inundated with calls'
The charity's Jo Anderson said 17,500 people had been turned away from receiving Child and Adolescent Mental Health Services (CAMHS) support over the past three years.
She added: "That's an astonishing figure, and we don't know what happens to them after they've been turned away. We don't know whether they received any other support.
"In the last few weeks of the campaign we've been running, we've been inundated with calls from parents who're in that situation and their child has been rejected from receiving a CAMHS service.
"They haven't been signposted anywhere else - that's a very worrying picture."
Referral rejection 'made me feel even more worthless'
Caitlin Wyllie-Quinn, 20, a student from Irvine, had a difficult transition to secondary school.
Bullying left her isolated and very down, crying all the time.
She got some initial help from the local Child and Adolescent Mental Health Service but after leaving therapy she went downhill rapidly.
Her GP made another referral to CAMHS but this time it was rejected. Caitlin was told that because she was not suicidal or self-harming, her case was not serious enough.
"If the person doing the assessment had asked me if I was suicidal or self-harming I would have answered yes to both those questions, but basically I was refused help because they didn't have the capability to assess me properly," she said.
"I was at a real low point and I felt that getting referred to CAMHS was some sort of light at the end of the tunnel and finally maybe getting some help.
"For that to be stripped away from me made me feel even more worthless and just made things so much worse for me."
The NHS in Scotland provides mental health services for children and young people with a wide range of mental health problems including anxiety, behaviour problems, depression and early onset psychosis.
The Scottish government's mental health strategy commits it to carrying out reviews into school counselling and rejected child and adolescent mental health service referrals.
Its mental health minister, Maureen Watt, said the reviews would happen "soon", and would allow improvements to be made to the system.
Ms Anderson said this was encouraging, but added: "We really urge that to be quick and thorough because there are young people waiting now to get help and support.
"It might be that the CAMHS service isn't appropriate for them, but we simply don't know what the problem is."
Meanwhile, statistics published on Tuesday also showed that a waiting time target for people to receive specialist mental health treatment has again been missed.
The Scottish government has had a target in place since 2014 for 90% of patients to be seen within 18 weeks of referral for mental health support.
But the target has never been met nationally - with the latest figures showing that 83.6% of children and adolescents, and 73.7% of adults, were seen within the required timescale between January and March of this year.
At the end of March, there were 6,932 children and young people across Scotland waiting for help from CAMHS, up from 6,359 at the end of December, according to the NHS statistics.
At the same time, there were 20,952 adults waiting for treatment, compared to 20,195 in December.
Average waiting times varied dramatically across the country, with 10 NHS boards meeting the target for CAMHS treatment but only three health boards meeting it for adult psychological care.
The figures also showed that 74 children and young people starting their treatment had been waiting more than a year to be seen.
NHS Grampian met the waiting time target for just 45.2% of young people, while in NHS Lothian the target was met for 47.8% of youngsters
And in the NHS Forth Valley area, only 40% of adults starting psychological treatment between January and March were seen within 18 weeks, with an average wait of 25 weeks.
A spokesman for the Scottish Children's Services Coalition (SCSC) said research has suggested 10% of children aged between five and 16 have a clinically diagnosable mental health problem.
'Range of measures'
Pointing to a "clear postcode lottery" when it comes to treatment, he added: "We are deeply concerned about what is happening to the more than a fifth of children and young people not accepted for treatment.
"There is a need for an urgent inquiry to ascertain why these young people are being rejected for treatment and what is happening to them."
Ms Watt, the mental health minster, said the number of health boards which had met the waiting time target for young people had increased from seven to 10 since the end of 2016.
She added: "However, I'm clear that we must continue to reduce waiting times and I will not be satisfied until our target is met sustainably.
"Our recently published 10-year strategy for mental health sets out a range of measures that focus on prevention and early intervention to meet the mental health needs of children and young people, backed by £150m of funding.
"We will also soon commission reviews into school counselling and rejected child and adolescent mental health service referrals, as a foundation for making further improvements."