When we don't have psychiatrists, equality law can't save us

One of the biggest sources of confusion in the campaign to make care experience a protected characteristic is the failure to distinguish between discrimination, disadvantage and demarcation.

Discrimination is being treated unfairly because of who you are.

Disadvantage is harm caused by experiences, conditions or systems.

Demarcation is the act of drawing a line around a group so that support, services and resources can be directed to them.

Care experience already sits firmly within demarcation. Children are identified, prioritised and supported through policy, funding and specialist services. That is not discrimination in action, it is the system responding to need.

In my view, the campaign is dangerously repackaging disadvantage as discrimination and suggesting that demarcation itself is harmful.

Mental health is where this confusion becomes potentially dangerous.

One of the biggest challenges care-experienced people face is access to mental-health support. Since 2016, demand in CAMHS has increased more than four times faster than the psychiatry workforce (British Medical Association, 2025), widening the gap between need and capacity.

As of 2024, services in England received 5.2 million referrals to secondary mental-health services, up 38% compared with 2019. Data from the BMA shows that children in the most deprived areas are twice as likely to be in contact with mental-health services as those in the least deprived communities.

A review by the Children’s Commissioner (2024) found that among the 305,000 children and young people entering treatment in 2022 to 23, the average waiting time from referral to treatment was 35 days. But many waited far longer: nearly 40,000 children waited over two years.

What does this tell us?

There are not enough clinicians to meet demand. The more deprived your area, the more likely you are to need support. And depending on your postcode, you may be seen quickly, or you may wait years. This points clearly to problems of capacity, poverty and geography.

The campaign often argues that care-experienced young people do not receive enough mental-health support. On this, I completely agree. But the data shows that this is not because of discrimination, it is the result of an overwhelmed system operating far beyond capacity.

The campaign solution is for care-experienced people to be “considered”, via Equality Impact Assessments when services are designed. Consideration does not recruit psychiatrists.

In policy and system terms, care-experienced people are already considered and structurally prioritised in the health system. They have access to designated Looked After Children’s Nurses. Many local authorities have health partnership groups under Integrated Care Boards (ICB) that oversee the physical and mental health of children in care. These boards monitor assessments, track CAMHS access and escalate waiting-list concerns.

The system knows care-experienced children need mental health support, it’s organised around that reality. But when there are not enough staff, resources or services, prioritisation alone cannot compensate.

There is one greater risk no one is talking about: legal claims for discrimination under the Equality Act.

If this campaign encourages people to interpret system failure for intent, we risk opening the door to claims that are built on despair rather than discrimination.

Let me be clear, when discrimination happens, it should be challenged and redress should follow. But we do not currently have evidence that service failure in mental health is being driven by discrimination rather than capacity.

Taking the NHS to court is lengthy, costly and emotionally heavy, whether you win or lose.

My biggest fear is not that care experienced people challenge the system. It is that they fight and lose to the wrong enemy.