The Uncomfortable Truths of Camila Batmanghelidjh

Batmanghelidjh was not perfect, but she was right. Destroying somebody who tried to hold a mirror up to us collectively was easier than acknowledging her message.

Camila Batmanghelidjh, the flamboyant and outspoken champion of vulnerable children, was a force of nature. Her tireless advocacy for those failed by the system, her unorthodox methods, and her unwavering belief in the potential of every child, left an indelible mark on the landscape of child welfare in the UK. Though Kids Company, her ground-breaking charity, ultimately met a controversial end, Batmanghelidjh’s legacy continues to challenge us to confront uncomfortable truths about how we, as a society, support and protect our most vulnerable young people.  

Batmanghelidjh's journey began long before the dramatic rise and fall of Kids Company. In 1991, she co-founded The Place To Be, a Family Service Unit project, which pioneered in-school counselling services. These days, you probably know it sas Place2Be. This early work laid the foundation for her understanding of the profound impact of trauma and neglect on children's development. As she eloquently articulated in her book, Shattered Lives, "traumatised children don't need punishment; they need healing." This belief fuelled her drive to create a space where children could access therapeutic support within the familiar environment of their school.

Place2Be flourished, becoming a respected and established organisation. However, Batmanghelidjh recognised that for some children, the conventional support offered by Place2Be was simply not enough. Driven by a deep empathy for those facing the most extreme challenges, she founded Kids Company in 1996 and left Place2Be. While Place2Be was pioneering in its approach, bringing therapy into schools as an intervention for troubled children, there was a realisation from Batmanghelidjh that the most trouble children might never make it to or past the school gates. They come from families and communities so challenging that there was no support to even get them into school in the first place. There needed to be help in the community.  

Kids Company was more than just a charity for this reason. It was a sanctuary. It offered a lifeline to children who had experienced unimaginable trauma, providing not only practical support like food and shelter but also a deep sense of belonging and unconditional love. Batmanghelidjh understood that these children needed more than just traditional interventions; they needed a space where their pain could be acknowledged and their humanity affirmed. In her own words from A Home for the Heart: "These children arrive with a history of having their needs unmet, their feelings invalidated, and their trust betrayed. They need a place where they can experience the opposite."  

Kids Company's approach was radical. It embraced creativity, play, and emotional expression, recognising the limitations of traditional therapeutic models for children who had experienced complex trauma. Batmanghelidjh and her team were fiercely dedicated to meeting the individual needs of each child, often going above and beyond what was expected of a typical charity.

Yet, despite its successes, Kids Company was plagued by controversy. Accusations of financial mismanagement and unsustainable practices ultimately led to its collapse in 2015. The media scrutiny and public criticism that followed were relentless, often focusing on Batmanghelidjh's personality and leadership style rather than the systemic issues she sought to address.  Sadly, even after her untimely death, these issues remain unresolved. A litany of controversial actions by the Charity Commission, the Metropolitan Police, then the Office of the Official Receiver that led to Kids Company’s untimely collapse continue to be litigated in the courts. Whatever the failing of Kids Company, it’s clear that what is in the public domain wasn’t the full story.

However, amidst the controversy and the accusations, Batmanghelidjh's core message remained clear: we are failing our children. She argued that the focus on individual pathology and personal responsibility obscures the deeper societal failures that contribute to child neglect and abuse. In Kids, she wrote: "We are quick to blame the child, the family, the community, but we rarely question the systems that perpetuate inequality and disadvantage."

Batmanghelidjh's legacy is a complex one. She was a visionary leader who challenged the status quo and gave a voice to the voiceless. She was also a controversial figure whose methods were often questioned and criticised. But one thing is undeniable: she forced us to confront uncomfortable truths about our society's failure to protect and nurture its most vulnerable members.

It is time to move beyond the blame and recriminations that surrounded Kids Company and engage with the deeper issues Batmanghelidjh raised. It is time to consider that she and others were attacked so vociferously because they invited so much scrutiny of statutory services We need to invest in early intervention services, address the root causes of poverty and inequality, and create a more compassionate and understanding approach to child welfare. Only then can we begin to truly honour the legacy of Camila Batmanghelidjh and ensure no child is left behind.

Why We Still Fail Our Children

Mental Health Support Continues To Be Rare And Slow

Eight years on from the demise of Kids Company, the issues Batmanghelidjh highlighted remain deeply entrenched. Child poverty rates are alarmingly high, mental health services are overwhelmed, and the number of children in care continues to rise. The pandemic has only exacerbated these existing inequalities, leaving many young people feeling isolated, anxious, and hopeless.  The responses to these issues remain deeply inadequate as the challenges grow. As published in The Children’s Mental Health Services 2022-23:

• 270,300 children and adolescents are currently awaiting mental health support following referrals to Children and Young People’s Mental Health Services (CYPMHS) during this period

• In the same period, 949,200 children and adolescents were referred to CYPMHS—8% of England's 11.9 million children

• ~32% (305,000) of the referred children and young individuals received mental health support, with an average waiting period of 35 days

• 28% (270,300) are still awaiting assistance from mental health services

• 39% (372,800) had their referrals closed prior to accessing support

In this context, especially in the context of rejections, NHS England has, to its credit, embarked upon a programme of rolling out Mental Health Support Teams (MHSTs). These will train a new wave of professionals that will be based inside schools and can help implement a whole-school approach to mental health as well as carry out lower-level mental health interventions.

At this current time, there are around 498 MHSTs that are operational. This only amounts to around 35% of school or college-aged young people. This means around two-thirds of young people do not have an appropriately-qualified mental health provision in their school. This is before we get to the uneven roll-out of this programme. While approximately 53% of young people in secondary schools have access to an MHST, that number is 0% in Cornwall and Isles of Scilly—MHSTs are only being available in Primary Schools in this region.

ADHD and Autism Support Is Much The Same

Just as access to mental health support remains a significant challenge for children and young people in England, so too does the timely diagnosis of neurodevelopmental conditions like Attention Deficit/Hyperactivity Disorder (ADHD) and Autism Spectrum Disorder (ASD). Lengthy waiting lists, inconsistent pathways, and regional disparities create significant barriers for families seeking assessments and support.

The scale of the problem is alarming:

• Lengthy Waiting Times: Children and young people face excessively long waits for ADHD and ASD assessments. The norm is now for the 18-week Right To Treatment target to be far exceeded. While comprehensive national data on ADHD waiting times specifically for children and young people is not routinely collected, a 2023 survey by the ADHD Foundation found that amongst their respondents, 18% of children had been waiting between 1 and 6 months for an NHS ADHD assessment, 22% had been waiting between 6 months and 1 year, 30% had been waiting between 1 and 2 years, and 14% had been waiting between 2 and 3 years. For autism, NHS England figures show that in December 2023, there were 172,022 patients with an open referral for suspected autism – the highest number ever reported. This represents a more than five-fold increase since 2019.  

• Regional Variations: Waiting times vary significantly across the country. Analysis by the Nuffield Trust found that in October to December 2023, the median waiting time for a first appointment for autism assessment was 35 weeks—almost twice the Right To Treatment target. However, this masked significant regional variation, with waiting times ranging from 15 weeks in the North East and Yorkshire to 58 weeks in the South West. Some areas, such as Sussex and Surrey, have reported waiting times of up to five years for children's ADHD assessments. A Freedom of Information request by the BBC in 2022 found that some children in Northern Ireland were waiting up to seven years for an autism assessment.

• Inconsistent Pathways: The above is compounded by the fact that pathway to diagnosis varies significantly across the country. Some areas have dedicated child development centres or neurodevelopmental services with clear referral processes, while others rely on a patchwork of provision involving GPs, paediatricians, and CAMHS. This lack of standardisation can create confusion and delays for families. For example, some services may leave you to wait up to 130 weeks for an initial appointment. At this point, you may be sent away with questionnaires or put on a further assessment waiting list.

• Post-Diagnostic Support Often Does Not Exist: Even after receiving a diagnosis, families often struggle to access appropriate support and interventions. Waiting lists for therapies such as Speech And Language Therapy and Occupational Therapy can be long, there may be limited provision for educational support within schools and often, unless it is ADHD medication, paediatric and psychiatric services often won’t often other types of interventions for managing ADHD or ASD. The National Autistic Society reports that many autistic children and their families struggle to access the support they need after diagnosis, with significant variation in the availability and quality of services across the country.

These challenges have significant consequences for children and young people:

• Missed Opportunities for Early Intervention: Early diagnosis and intervention are crucial for children with ADHD/ASD, helping them to manage their traits and reach their full potential. Long waiting times mean that children may miss out on vital early support, with potential long-term consequences for their education, wellbeing, and social development. A wait of three years or longer may be the difference between moving between one or even two levels of schooling.

• Increased Stress and Anxiety: The process of seeking a diagnosis can be stressful and frustrating for families, particularly when faced with long waits and complex pathways. This can exacerbate existing anxieties and have a negative impact on family relationships.

• Education Difficulties: Children with undiagnosed ADHD or ASD may struggle in school, facing difficulties with attention, learning, and social interaction. This can lead to poor academic attainment, exclusion from school, and a negative impact on self-esteem.

• Increased risk of Mental Health Problems: Children with ADHD and ASD are at increased risk of experiencing mental health difficulties such as anxiety and depression. Delayed diagnosis and lack of access to appropriate support can exacerbate these difficulties.

Addressing these challenges requires a multi-faceted approach:

• Increased Investment in Diagnostic Services: Increased funding is needed to expand capacity and reduce waiting times for assessments. This should include investment in training and recruitment of specialist staff, such as paediatricians, psychiatrists, nurses, therapists and other professionals with expertise in ADHD and ASD.

• Standardised Pathways: Clear and consistent pathways to diagnosis should be established across the country, ensuring families can access the information and support they need. This should include clear referral criteria, timelines for assessment, and information on post-diagnostic support specifically for children and young people.

• Increased Post-Diagnostic Support: Investment in post-diagnostic support, including therapies, coaching and educational provision, is crucial to ensure that children and young people receive the ongoing help they need to thrive. This should include increased capacity within specialist services, such as Speech And Language Therapy and Occupational Therapy, and improved support for children with ADHD and ASD within schools.

• Improved Data Collection: Routine collection of national data on waiting times for children and young people's ADHD and ASD assessments is essential to monitor progress and identify areas for improvement. This data should be broken down by region and local authority to identify areas with the longest waiting times and greatest need for investment.

By prioritising timely diagnosis and access to support for children with ADHD and ASD, we can help them to overcome the challenges they face and reach their full potential. All of this links explicitly to the core problem:

Postcode Lottery Persists; Services Remain Hard To Access

Despite a national commitment to child welfare, the reality in England is that access to crucial support services for children, young people, and families is shockingly inconsistent. A child's chances of receiving the help they need can hinge dramatically on their postcode, creating a deeply unfair system that entrenches disadvantage and undermines their potential.

This "postcode lottery" of support is driven by a complex web of factors, including:

• Funding Disparities: Local Authorities operate with vastly different budgets, leading to stark variations in the quantity and quality of services they can offer. This means a child in one area might have access to a comprehensive range of early intervention programs, mental health support (as discussed above), and family support services, while a child just a few miles away may face long waiting lists and limited options. For example, research by the Children's Society found that spending on early intervention services for children and young people varied by as much as £276 per child between different local authorities in 2020/21.

• Varying Thresholds for Intervention: Local Authorities also differ significantly in their thresholds for intervention. This means families in some areas may receive support proactively, preventing problems from escalating, while families in other areas may only receive help when a crisis point has been reached. This reactive approach can have devastating consequences for children and families, and increase the burden on already stretched services. The County Councils Network found that referrals to children's social care services increased by 10% in 2022/23, with many councils reporting significant increases in demand for support.

• Lack of Coordination Between Services: Even when services are available, families often struggle to navigate a fragmented and complex system. Poor communication and a lack of joined-up thinking between different agencies can lead to children falling through the gaps. A 2021 report by the National Audit Office found that "services for children and young people are often not joined up, with poor communication and information sharing between agencies." This is made worse in authorities where several Single Points of Access operate, with confusion for professionals and little information being shared between agencies at the point of the referral, adding burden for referrers and leading to avoidable instances of care not being provided.

• Workforce Shortages: A chronic shortage of social workers, mental health professionals, and other key support staff further compounds the problem. Overstretched and under-resourced services struggle to meet the growing demand, leaving many children and families without the support they desperately need. The British Association of Social Workers has warned of a "national crisis" in social work, with high vacancy rates and increasing caseloads putting immense pressure on the workforce.

The consequences of this inconsistent provision are stark and far-reaching, contributing to significant health inequalities:

• Poor Mental Health: According to the Mental Health Foundation, one in six children in England had a probable mental disorder in 2020. The Royal College of Psychiatrists found that in 2022, almost 40% of children referred to CAMHS waited longer than the 18-week target for their first appointment, with some waiting for over a year. This lack of access can have devastating consequences, with suicide rates amongst young people tragically increasing. Consider this in the context of the above and the picture is more damning than it first seems.

• Physical Health Inequalities: Children from disadvantaged backgrounds experience worse physical health outcomes, including higher rates of obesity, asthma, and dental problems. These inequalities are further exacerbated by inconsistent access to healthcare services. Research by the King's Fund has shown that children living in the most deprived areas are less likely to have access to a GP and more likely to experience delays in receiving hospital treatment.

• School Exclusion: Children facing challenges at home or with their mental health are more likely to struggle at school and face exclusion. Government figures show that permanent exclusions have been rising in recent years, with children from disadvantaged backgrounds disproportionately affected. Analysis by the Education Policy Institute found that pupils eligible for free school meals are around four times more likely to be permanently excluded than their peers.

• Going Into Care: When families are unable to access the support they need, children may end up being taken into care. The number of children in care in England has reached record highs, placing a significant strain on the system. The latest figures show that there were 82,170 children in care in England as of March 2023.

• Becoming Known to the Criminal Justice System: Vulnerable young people who don't receive adequate support are at increased risk of becoming involved in crime. The Youth Justice Board reports that children in care are disproportionately represented in the youth justice system. In 2021/22, looked-after children were over five times more likely to be in custody than children not in care.

The current situation is simply unacceptable. Every child, regardless of their background or where they live, deserves access to timely and effective support. This requires:

• Increased and Equitable Funding: The government must ensure all Local Authorities have sufficient funding to provide a comprehensive range of services for children and families, with funding targeted to areas of greatest need.

• Clear National Standards: National standards for service provision and thresholds for intervention should be established to ensure consistency and equity across the country.

• Investment in Workforce: We need to attract and retain more skilled professionals to work in children's services, through improved pay, working conditions, and professional development opportunities.

This is possibly the biggest recommendation that is needed for all of this to work.

A Single Point of Access for Support

At the moment, the amount of fragmentation and lack of communication with colleagues is created systematically and it happens at a systemic level. This is by no means a systemic list, but think about all of the agencies that might be involved with families:

• Primary Care Team

• Health Visiting / School Nursing

• Education/MHSTs

• Paediatrics

• Mental Health Services

• Therapies (Speech and Language, Occupational, Physio)

• Police

• Local Authority

• The Voluntary Sector

At present, coming to be known to all of the above agencies would require at minimum nine different referrals in most areas. With all referrals being considered separately, there is no joint-up decision-making about which services are in the best interest of the young people or the family. There is no coordination between agencies when making appointments or offering any type of intervention to these families. The only time when anything approaching this many professionals will get together to discuss a young person would be when things have either started to go wrong, or when they are currently going wrong—that is, if you are lucky enough to live in an area with a Multi-Agency Safeguarding Hub is the mode of operation. This leads to a whole host of problems:

1. Referrals Being Rejected With Signposting Elsewhere: Parents or young people may wait weeks to find out when they can access support, only to be told they won’t be. They might be referred to a local charity, or to another service that is commissioned differently or separately. More holistic commissioning might solve some of these problems, but not most of them, where Multi-Agency Assessments being the norm would bridge the gap.

2. Where Better Coordination Is Aimed For, It’s Hard: A system that is not designed for cooperation will make it harder purely by its own design. The relationships will not exist, regular meetings will not be in diaries, and coordination might ultimately come down to parents who are already struggling with other things on their plate.

3. Bad Advice May Be Given: A triaging clinician may reject a referral as it does not meet the referral criteria for their service. They may signpost elsewhere based on their own impression of what thresholds might be met. With changing criteria, this might mean that a new referral made elsewhere is also rejected. This can frustrate professionals and families alike as referrals bounce around for families who are clearly in need, with waiting times not starting.

4. The Third-Sector Is Either Overburdened or Left Out: A lot of discharge notices, whether successfully following an episode of care or not, will signpost towards Voluntary, Community, Faith and Social Enterprise (VCFSE). While VCFSE definitely has a role in helping children and families improve their overall wellbeing, they need to be at the table at the point of families need intervention to begin with.

I won’t pretend any answers to this are simple, but I think an answer to this might look like:

1. A Single Referral Form for any Young Person/Family Seeking Support: One form, completed once, read by dozens of agencies. This will save time throughout stretched services hundreds of hours and take the guesswork out of making referrals.

2. Public Authorities Combining Resources and Commissioning Jointly: There are certain services where there is very clear overlapping clinical issues, and more scope for joint commissioning and joint working. The best examples of this would be the fact that ASD and ADHD assessments are split from Dyslexia assessments, and come out of different budgets. Educational Psychology assessment/intervention? Different budget. EHCP planning? It’s a new budget, and it’s a new service. None of this makes sense to parents and carers. The solution likely lies in much more joint commissioning. Despite the advent of Integrated Care Boards, and their predecessor systems, it does not seem that this is advancing at pace.

I feel so strongly about this that I have actually applied to The Churchill Fellowship, where I hope to be awarded funding to research this problem in depth and learn from what other countries are doing, what works well, and whether we can incorporate this in the UK. With their support, if I were a successful Fellow, I would also try and promote these findings to Local Authorities and work to end the postcode lottery of provision.

Can you help me?

Check back with me if I get that Fellowship. Otherwise, always happy to chat.

Please get in touch:

Final thoughts

The state of children’s services in this country is poor and has been declining. None of the answers are easy but, alongside renewed and continued funding, the answer is unlikely to not involve significant transformation of services.

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