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School-based Counselling Services

Volume 703: debated on Tuesday 9 November 2021

Debate resumed.

I also have to inform the House that I have to reduce the time limit to six minutes. I call Paul Blomfield.

I am pleased to have the opportunity, after the last contribution, to return the discussion to the topic under debate, and to thank my right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) and the right hon. Member for Harlow (Robert Halfon) for securing the debate on which there has been, until the last contribution, a great deal of consensus across the House.

Every year, as part of my annual community consultation at the start of the year, I meet school students in each of the secondary schools in my constituency. Maybe this is my naivety, but the first I time did that I was genuinely shocked. When I asked them, “What is the most important thing we could be doing to change your lives?” they told me in each of the schools that it was to provide access to mental health support. Over the past 10 years, I have heard the same message year after year.

As with so many issues, the pandemic has brought this crisis into sharper relief. In Sheffield, I have heard from worried parents, teachers and health professionals who tell me about the scale of the problem with child and adolescent mental health and the lack of available services. Last Friday, I discussed the position with those at Sheffield Children’s Hospital. They are worried. For the most serious cases, they are deeply concerned about the lack of psychiatric beds for young people. They have worked hard to narrow the gap between referral to CAMHS and first appointment, but it is still about five months—five months—for that critical initial intervention. That situation is reflected across the country.

The former Children’s Commissioner highlighted in 2021 the fact that over 500,000 children and young people were referred to CAMHS in the previous two years. Of those, approximately 3,500 either had their referral closed or were still on the waiting list at the end of the reporting period. The number of A&E attendances by young people aged 18 or under with a recorded diagnosis of a psychiatric condition has tripled since 2010. The hon. Member for Chatham and Aylesford (Tracey Crouch) made a striking contribution about the number of suicides. Our schools are caught in the middle of this crisis, desperate to support their students but without the resources to do so. Prior to the pandemic, one third of schools did not provide any in-school mental health support. Those that do provide support have to dip into their teaching budgets, distracting from other priorities to do so. That is why parents, along with professionals, believe that access to counselling is so important.

Of course, it is not just about counselling. We need to be ahead of the problem and view mental wellbeing in the same way as we view physical wellbeing. Our Healthy Minds and Mental Health Support Team in Sheffield works with local schools to develop a culture of emotional wellbeing among young people, which includes feeling safe and valued, with social connectedness and structure in their lives. Young people want to be heard and to have staff who understand that other things might be going on in their lives and who know how to listen. That cannot be a bolt-on; it has to be embedded in a school’s culture. For example, if a young person is feeling anxious about exams, there are therapeutic interventions to help them to manage that stress. But time and funding to do that is vital to its success.

When young people are struggling, early intervention is key, helping them to deal with the problems that they face when they face them and, as my right hon. Friend the Member for North Durham (Mr Jones) pointed out, taking the pressure off services further down the line that would be drawn in if the problem got worse. That is why the Local Government Association recently urged the Government to fully fund counselling services in all state-funded secondary schools, providing immediate support. It called for £100 million a year to

“ensure access to a…counsellor for at least two days a week for more than 90 per cent of schools.”

The Government’s response is to ask more of already overstretched school staff. The plans for mental health support teams are welcome, but they do not go far enough. Encouraging mental health leads in schools to undertake training to help to fill the gap by equipping teachers to recognise problems and point students towards help just will not do. As the assistant principal of one of my local secondary schools said to me yesterday:

“Frankly I do not need to be trained in how to signpost young people to mental health care providers, I need the money to be invested in providing the actual mental health care.”

Clearly, support does not stop with counselling. How will CAMHS waiting times be addressed? How many more mental health professionals are being trained? As Members on both sides of the House have consistently said, preventive and early intervention is vital. Half of all mental health problems manifest by the age of 14. It is striking that NHS England recognises that the current investment in children and young people’s mental health meets only 33% of need. That is truly shocking. What if that were to apply to other illnesses? Is there any other kind of epidemic that we would allow to run rampant among our children? Is there any other type of illness that we would let lie untreated without concern for the impact on future generations?

As chair of the all-party group on students, I co-led an inquiry into the provision of mental health support for 16 to 21-year-olds moving into FE and HE. That demonstrated the numbers who were transitioning into HE and FE without previously having had support. When the Minister rises to say what the Government have done, I hope that he will recognise what more needs to be done, as has been reflected in contributions from Members on both sides of the House.

I congratulate the right hon. Member for Newcastle upon Tyne East (Mr Brown) and my right hon. Friend the Member for Harlow (Robert Halfon) on securing this really important debate, and I thank the Backbench Business Committee for allowing it.

Since I was elected, I have been working with young people from Peterborough schools on mental health services for children and young people. I am so lucky to have in my city a group of talented, passionate young people who are ready and willing to offer their time to work with their MP on this important issue. I genuinely consider it a privilege to be working with many of them. The speech that I am making today has in part been drafted by those young people; they have provided me with quotes, statistics and testimony. So I would like to thank Darya Robson, Charlotte Hemens, Amelia Lawson, Austeya Dalansamskita and Amira Dinari for all that they have done. They have done superb work and they make me proud of Peterborough.

It is well documented that there has been an increasing demand for mental health services for children and young people, much of it because of the measures taken to prevent the spread of covid. A recent survey by the National Society for the Prevention of Cruelty to Children reported that ChildLine helped as many as 67 children with suicidal thoughts a day. In my region, the Cambridgeshire and Peterborough NHS Foundation Trust had 1,625 urgent referrals in the month of May 2021 alone, of which 795 were for potentially life-threatening conditions. We are facing a mental health crisis in our young people and the more that we can support them by providing access to early intervention in the form of in-school counselling, the better things will be.

The group of young people I have been working with has also been working with Cambridgeshire and Peterborough clinical commissioning group to secure a system with a single point of referral and a new website. The group approached me last week to request that I participate in this debate and campaign for school-based counselling, which I am more than happy to do.

In 2020, amid the first wave of the covid pandemic, one in six children aged five to 19 was identified as having a probable mental health disorder—up from one in nine before the pandemic. School should be the one safe place where every child can feel valued, cared for and accepted. It is the perfect place for students who are suffering with their mental health to access an on-site qualified counsellor.

I feel that the current systems and mechanisms for mental health provision are not serving young people as they should. In 2019, more than half of GP referrals to child and adolescent mental health services in the UK were rejected on the grounds that the symptoms were not severe enough. Although other services such as NHS mental health support teams are being developed, they are patchy in coverage and tend to focus on parental interventions. They are no substitute for on-site access to a qualified counsellor.

All the evidence, including research undertaken in my county, supports early intervention to prevent an issue from becoming a full-blown crisis. School-based counselling can provide an alternative option for young people who have nowhere else to turn. The young people I have been working with are from a range of schools and colleges; some are fortunate enough to have a school-based counsellor, but others are not.

Students who benefit from easily accessible on-site counselling testify that they feel more comfortable talking with a professional with whom they have a long-term relationship because of their presence in the school community. They also emphasise the overwhelming advantage from not missing education time by leaving school for external mental health appointments; a pre-covid study found that absence due to poor mental health accounted for more than 13% of school days lost. Students who have this option are also free from the burden of waiting times, referral lists and possible rejection for not meeting criteria, and are less likely to need access to emergency services.

Providing school-based counselling means that no student slips through the net. Students from schools and colleges that are not able to offer the service tell a different story. One group I met spoke of having access only to a trainee counsellor, who was limited in the support that they could provide, meaning that students waited a long time to access a non-qualified counsellor, only to be signposted to outside organisations. One student told me:

“Having a qualified counsellor would increase the attendance and engagement of students. More importantly it would mean that students can get the support they need without having to reach a crisis point before any action is taken. It would mean that students felt safer and more willing to seek the help they need without feeling like a burden.”

The pandemic has put an enormous strain on our young people. I believe that we owe it to them to ensure that they have the support that they need at the place where they need it: their school or college. I therefore urge Ministers to listen carefully to the voices of young people from a variety of schools in my constituency, including Peterborough School, the King’s School, Thomas Deacon Academy and St John Fisher School—lots of schools in my constituency have taken the time to contact me about the subject. Will Ministers please outline what they will do to get more counsellors based in schools?

I congratulate my right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) and the right hon. Member for Harlow (Robert Halfon) on securing the debate.

Young people have faced a great deal of uncertainty and disruption to their daily lives, education and support networks, with many facing financial insecurity, trauma and bereavement. A recent survey by YoungMinds found that two thirds of young people aged 13 to 25 believed that the pandemic would have a negative long-term impact on their mental health. In 2017, one in nine children and young people was estimated to have a diagnosable mental health condition; in September, NHS Digital suggested that one in six young people now has a probable mental health disorder.

Access to free, timely counselling interventions for young people can play a critical role in responding to pre-existing mental health needs and to those brought about by the pandemic or other traumatic experiences. However, Government complacency has left CAMHS overwhelmed and many schools without the necessary resources. Before the pandemic, a third of schools did not provide any in-school mental health support; recent research by the Institute for Public Policy Research suggests that as few as 48% of schools were providing on-site access to a counsellor.

I visited Downside Primary School in my constituency of Luton South as part of UK Parliament Week last week. The headteacher told me about the excellent work that the school is doing to support children’s mental health needs. However, Downside has had to resort to using its own grant funding to hire appropriate mental wellbeing support, be it a counsellor or a psychologist, to work with pupils directly in the school.

That is because of three overarching barriers restricting children and young people’s access to mental health support. First, CAMHS simply lacks the capacity to meet demand at the level at which it is needed—often long before a child is in crisis—and in a timely manner. Secondly, there is too much bureaucracy and form-filling, restricting school staff’s ability to secure mental health support for children quickly—perhaps in relation to a longer-term condition, but particularly at that early stage before the child reaches crisis. Thirdly, CAMHS is not always reaching, or meeting the needs of, an ethnically diverse and multi-faith community, owing to social stigma about going “outside” home or school for support, particularly mental health support. Expanding that support in schools to reduce stigma is a priority for parents, who would be much more comfortable about enabling their children to access it in a school setting, and more financially able to do so. I would welcome the Minister’s comments on this complex and sensitive issue.

Parentkind’s Annual Parent Survey 2021 found that 41% of parents wanted any additional school funding to be spent on child mental health services, which meant that it was their second biggest priority, while 88% wanted mental health development to be an important focus within the curriculum. However, the Government are only aiming to get mental health support teams to a quarter of young people by 2023. Will the Minister explain why there is such a lack of urgency on the Government’s part?

We need the Government to listen to the proposals put forward by the Labour party, which would expand the mental health workforce, deliver access to trained mental health counsellors in every school—which, as we have heard, works well—and deliver support to young people through open-access mental health hubs in every community. Under our proposals, every secondary school would have access to a full-time staff member, and primary schools would have access to specialist staff time shared between different local primary schools. Open-access mental health hubs would also help us to reach marginalised children who would otherwise not have access to mental health treatment.

I hope to hear from the Minister whether he agrees that a trained mental health counsellor should be available in every school.

I thank the right hon. Member for Newcastle upon Tyne East (Mr Brown) and my right hon. Friend the Member for Harlow (Robert Halfon) for securing the debate. It is particularly close to my heart, because in my constituency we have three of the UK’s leading specialist schools for children with learning difficulties. I have had the privilege of visiting them and speaking to staff and children, who I understand come from miles around for the specialist care that Merefield, Peterhouse and Presfield Schools provide. I realise how lucky we are to have those wonderful schools in Southport on our doorstep, and I also realise that, sadly, this is not a success shared universally across the UK. Indeed, the schools themselves have told me that they are at capacity, and that although they would like to take on more children, they are often unable to do so.

In the case of many children, it is not full-time specialist care that they need, but simply a friendly, qualified counsellor to whom they can speak in confidence, perhaps on a regular basis, about their problems. Small interventions now can pay dividends in the long run, helping children to achieve their potential.

I back the Government’s record on support for children’s mental health, particularly during covid, and am proud to have voted for many of those measures. In March last year, as covid took hold, I was pleased to support the offer of £79 million to boost mental health provision for children and young people. By April 2023, that should enable nearly 3 million children to have access to some 400 mental health support teams in schools and colleges. These are noble goals and I fully support them, but there is still much more to do.

Just two months later, we announced the provision of £17 million to improve mental health and wellbeing support in schools and colleges, with up to 7,800 institutions in England being offered up to £9.5 million to train senior mental health leads. These measures are clearly popular. The British Association for Counselling and Psychotherapy reports that 72% of adults believe that schools should offer counselling services, including some 79% of parents with children under the age of 18. Among 16 to 24-year-olds, the figure jumps to a staggering 83%. The support is clearly there, but, while the Government are doing an unprecedented amount to support mental health in schools, specific measures such as increased provision of well-trained schools-based counsellors would be of great benefit.

I do not think that fixing this is just a job for the Government. It is right that the decisions are delegated to schools, and that while the Government are clear that all schools should make counselling services available to their pupils, it is ultimately individual schools and colleges that know best what support to offer their students. That is why they should have the freedom to enact the Government’s recommendations as they wish. However, I would encourage them to work closely with their local NHS, clinical commissioning groups, councils and, most importantly, parents and carers of children, to achieve the ends that we all want to achieve.

In speaking to my constituents and helping them with their casework, I understand the difficulty that many have had in getting an educational health and care plan—an EHCP—once they are referred to SEND. This plan is crucial to the wellbeing of some children, as without it they will struggle to get the necessary arrangements implemented in school that they need for their mental wellbeing. My constituents suffer from a lack of information throughout the process of getting an EHCP, as well as ongoing delays, and they sometimes do not get the support they need. Children can find this frustrating, and I fear a situation where we see children with mental health issues being excluded because they cannot get the treatment they so clearly need.

We need to see mental health support being provided as early as possible in a child’s school career, so that it is there when they need it, not years after their mental illness first occurs. We need to look at what more we can do to support those with moderate mental health problems who do not need specialist schools, but rather qualified counsellors. We need to hit this Government’s ambitious target and then set even more ambitious ones until 100% of children have access to mental health support in schools.

I welcome this debate. I worked in childcare many years ago, when it was difficult to get people to comprehend the scale of mental illness among children and young people. We have moved on from there, and I am really grateful to my right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) and the right hon. Member for Harlow (Mr Halfon) for securing this debate. I chaired the all-party parliamentary group for parental participation in education last week, and we heard that the charity Parentkind had produced a survey revealing parents’ concerns. It found that 41% of parents now see the need for additional resources to be spent on mental health services for children, and that this was their second highest priority after the need for additional learning resources.

We also received a briefing from the division of educational and child psychology of the British Psychological Society. I declare an interest, in that my wife is an educational psychologist, but as she reminds me, she is also a constituent so she has the right to lobby me, even if it is at the breakfast table. That report confirmed what my right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) said about incidence. The NHS’s own survey showed that in 2020, one in six children—that is 16%—aged between five and 16 were identified as having a probable mental disorder, increasing from one in nine in 2017. What I found startling was that the same study showed that only six in 10 children aged between five and 16 with a probable mental disorder had regular support from their school or college.

I fully welcome the additional funds that the Government have given, but most stakeholders believe that it is inadequate to meet the scale of the problem. My right hon. Friend pointed out that even by 2023, only 3 million of the 9.5 million children will receive the support that they need. What we have been arguing for is a comprehensive, fully functioning and fully funded pathway to support children with mental health problems, and that starts in school. That pathway usually starts as a result of a parent or teacher’s action, but some children now are self-reporting their mental health issues.

A crucial point was made by my hon. Friend the Member for York Central (Rachael Maskell) about a workforce strategy to provide support for teachers and special educational needs co-ordinators, but in this debate we are emphasising the fact that there have to be comprehensive counselling services embedded within those schools as well. Let me now give a plug for educational psychologists. They have the expertise to provide early help and targeted mental health interventions. They work with the counselling services, where they exist, and also with families. They are often the access points to child and adult mental health services and other health provision that is available, often through local health services and now through local authorities as well.

While we welcome the additional resources, I think we are arguing for the Government to stand back and look for that comprehensive approach, based on a work- force strategy and on the investment overall.

I refer back to educational psychologists. There are 3,000 of them in this country at the moment. That means one educational psychologist for every 3,500 five to 19-year-olds—or, because they now deal with those aged nought to 25, one for every 5,000. One early investment could be the expansion of educational psychology training places on the three-year doctoral programme, which could be readily invested in and could turn around relatively quickly to meet the increase in demand if we are to construct the comprehensive pathway service for which we have all been campaigning for so long. I will leave it at that point, because I know that other hon. Members want to speak.

Throughout this debate, we have heard time and again how important early intervention is. It is essential to a person’s proper recovery from a mental illness, and that is specifically true for children and young people suffering from an eating disorder. I speak today as the chair of the all-party parliamentary group on eating disorders to highlight once more the huge problem that eating disorders pose and the big difference that early intervention can make.

Eating disorders have no single cause, but they have the highest mortality rate of all mental health disorders. I say that again: they have the highest mortality rate of all mental health disorders. Recovery lasts, on average, three times as long as the disorder itself. One third of people suffering from an eating disorder get better, one third stay the same—a life sentence in itself—and one third get worse; quite a lot of them, tragically, either die of malnutrition or take their own lives.

All too often, eating disorders can go undiagnosed and untreated. Although they do not discriminate, school-aged children are a particularly vulnerable group; most eating disorders develop during adolescence. According to data from NHS England, the number of children and young people waiting for eating disorder treatment has increased significantly in 2021 compared with previous years. In June, that figure was four times higher than at the same point in 2020. Eating disorders thrive in the shadows, where there is no social contact, and the pandemic has been particularly bad for sufferers from eating disorders.

There is much that we must do to improve outcomes for all with eating disorders. The APPG is looking into research funding, reducing waiting times and improving access to treatment, but the best possible thing we can do is to help children and young people to avoid reaching crisis point in the first place. The first point of contact for many children and young people in the UK is their school. Speaking to a counsellor can help them to cope with the different circumstances they face in their lives, within a familiar setting—yes, sometimes some of the problems our young people face are not so severe, but often they are. School is a daily contact that they have and a setting where they can access counselling.

I am not denying that other centres would be useful too, but surely we need to do more in schools. School staff are ideally placed to spot the early signs of an eating disorder, as well as the potential factors that can lead to the development of one. I have been a secondary school teacher too, and the problem is finding the time in the school day to really go into where a young person has an issue. It is that extra time and extra counselling resource that schools need.

I highlight the excellent work of the eating disorder charity Beat, which supports the APPG and runs training courses aimed at school professionals. Access to support should never be a postcode lottery, but England lags behind the rest of our family of nations, where school counselling services have statutory funding. Research shows that as few as 48% of schools provide on-site access to a counsellor, with a growing divide between affluent and more deprived communities. School counsellors can provide that crucial missing middle between the lower-level intervention traditionally provided in schools and specialist children’s and young people’s mental health services.

Many leading mental health charities have got behind the campaign for a counsellor in every school in England, and I urge the Minister to support that call. Access to counselling should not just be for the schools and families that have the budget to fund this essential provision. I know that every school in Bath is committed not only to our children’s education, but to their wellbeing. They must be given the additional funding that they need to offer sustainable counselling provision as part of the wider mental health support package available to students. I repeat what many Members from across the House have said: this is the biggest issue that school leaders come to us with—they say that when I go into schools to talk to them. They want more mental health support for their young people.

There is no easy solution on the issue of mental health, but we cannot afford to cut corners, especially on the mental wellbeing of children and young people. We need a multifaceted approach that recognises the value of our schools, community services and society as a whole. Let me say again to the Minister: please pay attention to eating disorders, as they have reached epidemic levels and we need to do something about them.

I thank the right hon. Member for Harlow (Robert Halfon) and my right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) for leading this important debate on school-based counselling. It is a testament to how much we value this topic that on the day the House rises everyone has stayed back to contribute to this debate.

Lots of issues have been raised. The importance of looking at mental health holistically was talked about passionately by my hon. Friend the Member for York Central (Rachael Maskell). The right hon. Member for Harlow passionately discussed the impact of social media on mental health. We heard repeatedly about the stigma around tackling mental health, including from my right hon. Friend.

Every Member who spoke talked about the impact of covid on young people. My hon. Friend the Member for Luton South (Rachel Hopkins) cited the survey by the charity YoungMinds showing that throughout this pandemic, in the past 18 months, the mental health problems for two thirds of young people have been exacerbated enormously. My right hon. Friend the Member for Newcastle upon Tyne East also talked about covid-19 and how it has restricted access to mental health services for far too many people. He also made important points about the impact on deaf children, and similar points were made to me when I met a group of headteachers from special needs schools, all of whom talked about the impact covid has had on people with physical disabilities and the mental health impact that moves on from there.

This is a perfect storm, which is likely to have devastating consequences for young people. We are already starting to see this impact as constituency MPs, with an astonishing 96% increase in under-18s being referred to mental health services between spring 2019 and spring 2021, according to the Royal College of Psychiatrists. Yet just two in five children with a diagnosed condition can actually access specialist support. My hon. Friend the Member for Sheffield Central (Paul Blomfield) talked powerfully about how shocked he was when he heard local children talk about the lack of access to specialist support. I felt similarly when I spoke to a group of young people in my constituency. When we are sitting here in the Chamber, we do not often think about how people struggle to access support. We think it is there and they can access it, but I felt the same as he did when I spoke to people. I was shocked when I read that an estimated one in six children and young people now have a mental health condition—that has increased from one in nine just four years ago. It is also shocking to see that the number of accident and emergency attendances for young people with a psychiatric condition has tripled since then. My hon. Friend the Member for York Central used a statistic that I had also looked up, which was that in 2017 almost a quarter of 17-year-olds had self-harmed. The situation was bad before and it is getting worse, just at the same time as access to mental health services, both in and out of school, has been restricted.

Many of the answers to how we tackle this crisis can relate to school. As well as wider positive impacts that schooling can have, my right hon. Friend the Member for Newcastle upon Tyne East talked about ample evidence that school-based counselling can improve wellbeing and attainment. My hon. Friend the Member for Luton South talked about the IPPR report, which I also read and which showed that far fewer state schools are providing on-site counselling than were doing so a decade ago, when nine in 10 schools offered it—the figure is now about half that, according to a recent survey of teachers. When children returned to school after lockdown, just one in five teachers thought that their school’s mental health services were sufficient to support their pupils. We know how much pressure teachers are under, so I hope that the Minister will pay attention to teachers returning to find that not enough mental health support was in place.

My hon. Friends the Members for Washington and Sunderland West (Mrs Hodgson) and for York Central both talked about the importance of trained professionals, and the former talked about the missing middle. I know from my experience as a school governor, and we will all know from our experiences in our constituencies, that many teachers and school staff are currently taking on additional responsibilities for supporting pupils’ mental health, on top of their day jobs. They are mostly not trained to do it and neither do they have the resource to do it.

The Labour party believes that there is an alternative. My right hon. Friend the Member for North Durham (Mr Jones) talked about the economics of mental health and how it pays off to invest in it, which is what Labour believes. We want to give all schools the additional resources they need to hire specialist counselling and mental health support. That was one of the key commitments of the £15 billion children’s recovery plan to deal with the fallout of the pandemic that Labour announced earlier this year. The Welsh Labour Government have made huge progress on this issue by legislating to put counselling support for 10 to 18-year-olds on a statutory footing.

Under Labour’s costed proposals, every secondary school would have a full-time staff member whose job is to support pupils’ mental health, and primary schools would have access to such specialist support, shared among schools in the local area. As my hon. Friend the Member for Sheffield Central said, that would mean that problems would be caught and resolved before they could escalate, and teachers and other school staff would be able to focus on their jobs. We know what demanding jobs they have already.

As my hon. Friend the Member for Washington and Sunderland West said, schools have to be part of the solution, but fixing the crisis in children and young people’s mental health cannot just be left to schools, as my right hon. Friend the Member for Hayes and Harlington (John McDonnell) said. Even with the support and resources that we would provide if we were in government, we would have to look at the support provided by CAMHS and other NHS services as well, and I am afraid that the situation in that respect is even worse. My right hon. Friend the Member for North Durham talked about early intervention; the truth is that waiting lists for mental health support are currently unacceptably long, thereby allowing problems to escalate well before young people can be seen by a specialist. My hon. Friend the Member for Sheffield Central also made that point.

I say again that there is an alternative. Labour has pledged to implement a new national NHS target that guarantees mental health support within a month, backed up by our plan to recruit 12,000 mental health professionals and to introduce a lock to ensure that mental health spending always rises when NHS funding is increased.

Lots of people talked about the local organisations that are so important in our areas. My right hon. Friend the Member for North Durham talked about Rollercoaster and my hon. Friend the Member for York Central talked about the Island. In both Camden and Brent in my constituency, several organisations provide support for young people. We in the Labour party want to make sure that every community has an open-access mental health hub for children and young people. Having visible, easy-to-find, drop-in mental health support centres is so important and complements the counselling support offered in schools, because the hubs ensure that those who are marginalised or feel unable to come forward at school can get the support they need.

There is a crisis of children and young people’s mental health in this country that we cannot ignore. The crisis is deepening as a result of the pandemic, as we heard over and over again, and the mental health support that is available in and out of school is not sufficient to tackle it. Those facts have come through loudly and clearly in this important debate. The situation in far too many schools does not match the ambition that parents, teachers and we in the Labour have for our children, mainly because of the huge pressures on school budgets following real-terms cuts of 9% in the past decade. We really need a proper plan from the Government to address that.

My right hon. Friend the Member for Hayes and Harlington advocated well for his constituent and his wife, but he also spoke passionately about a comprehensive strategy, which is what I urge the Minister to produce. It is time for change. We want the Minister to look at what Labour proposes on in-school counselling and a one-month support guarantee. We want mental health workforce expansion, community hubs and much else. The wellbeing, learning and prospects of an entire generation could be transformed by the bold step change in mental health support that we are calling for. I hope the Minister will listen to all the voices in the House that have made their points so passionately today.

I congratulate the right hon. Member for Newcastle upon Tyne East (Mr Brown) and my right hon. Friend the Member for Harlow (Robert Halfon) on securing this important debate. I am conscious that time has been short, but I would like to thank all those who have spoken for their constructive contributions to this debate. Colleagues will know me well enough to know that I have never refused a meeting with a colleague and, although I will not be able to cover all of the points raised today, I would be very happy to meet any Member from across the House to further discuss the points that they have raised. I have already accepted a request from my hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates).

We know that mental health can have a profound impact on the whole of a child’s life. That is why the Government are committed to treating mental health with the same urgency as physical health and to deliver parity of esteem, and we are supporting mental health and wellbeing at all stages of people’s lives. We recognise that schools are in a unique position as they are able to help to prevent mental health problems by promoting resilience as part of an integrated, whole school approach that is tailored to the needs of their pupils.

Improving mental health starts with promoting good mental wellbeing and ensuring that children and young people get the help and support that they need. Schools with the right support from specialist services can play a vital role in that, which is why improving mental health support for schools has been a long-standing priority for this Government, with a shared approach led by the Department of Health and Social Care and supported by the Department for Education.

Supporting mental health and wellbeing is especially important at this time. As many Members from across the Chamber have referenced today, the covid-19 pandemic has had a particular impact on the wellbeing and mental health of children and young people. The Government’s national survey on the mental health of children and young people in England, which was published in September, found that rates of probable mental health disorder in six to 16-year-olds have risen from one in nine in 2017 to one in six in 2021. Those findings, which are helping us to ensure that the action we are taking is informed by the most up-to-date evidence, reinforce what we have been hearing from schools and colleges about how many children face issues and the need to continue to act.

Because of that, the Government have made children’s wellbeing and mental health a central part of our response to the coronavirus pandemic. Throughout the pandemic, we have prioritised keeping schools open above all else, as long as it was safe to do so, because it is so vital for children and young people’s wellbeing, as well as their education.

The Government have also invested £7 million this year in our Wellbeing for Education Recovery programme. That programme enabled local authorities to provide further support to schools and colleges to develop their curriculum and pastoral care provision in the context of the pandemic. The programme built on our £8 million Wellbeing for Education Return programme in 2020, which provided free expert training, support and resources for education staff dealing with children and young people experiencing additional pressures, including trauma, anxiety, or grief. Around 12,000 schools and colleges across the country have benefited from that support, which was delivered through local authorities.

In addition, we are investing up to £5 billion to support recovery for children and young people who need it most. That includes an additional £1 billion of new recovery premium funding for disadvantaged pupils. Our guidance is clear that schools can use that funding, as well as other funding such as pupil premium, to support their pupils’ mental health and wellbeing, including for counselling and other therapeutic services, alongside supporting their academic attainment.

As we move forward, the Government remain committed to improving the support available to schools by helping them to put in place whole school approaches to mental health and wellbeing which are tailored to the particular needs of their pupils. We know that school-based counselling by well-qualified practitioners can be an effective part of a whole school approach and that many schools already provide access to some counselling support. Our national survey of school provision, published in 2017, found that 61% of schools offered counselling services, with 84% of secondary schools providing their pupils with access to counselling support.

To further support schools that have decided that counselling support is the appropriate path for their pupils, we have produced guidance on how to deliver high-quality, school-based counselling. In the light of the impacts of the pandemic, we have committed to updating that guidance to make sure that it reflects the current context.

The guidance sets out our strong expectation that, over time, all schools will offer counselling services, alongside other interventions, because evidence suggests that counselling can have a positive effect, in particular on children’s psychological distress, self-esteem and general wellbeing. However, we have not mandated that all schools should provide access to counselling services as we believe that it is vital that they have the freedom to decide what support to offer their pupils based on their particular needs and drawing on an evidence base of effective practice.

We are taking action to help schools to build their capability to promote children and young people’s mental health and wellbeing, as well as ensuring that those who need help with their mental health receive appropriate support. The Government are providing £9.5 million to offer senior mental health lead training to about a third of all state schools and colleges in England in 2021-22. Part of the commitment that we made in our 2017 Green Paper, “Transforming children and young people’s mental health provision”, was to offer this training to all state schools and colleges by 2025. The senior mental health lead is a strategic leadership role, with responsibility for overseeing the school’s whole school approach to mental health and wellbeing.

As part of this training, leads will learn about how to develop a culture and ethos that promotes positive mental health and wellbeing, as well as how to make the best use of local resources, including counselling services, to support children and young people who are experiencing issues. I am pleased to report that nearly a quarter of schools and colleges in England—about 6,000—have already applied for one of these £1,200 grants. Many senior mental health leads have already started their training, which will enable them to start to apply their learning this academic year. That will help them to build on the incredible work that they and their colleagues have done throughout the pandemic to promote and support the wellbeing of their pupils.

Another important part of the whole school approach is ensuring that all pupils understand how to promote their own mental health and wellbeing, and that they have the knowledge and confidence to seek additional support when it is needed. That is why, in September 2020, we made health education compulsory—

On a point of order, Madam Deputy Speaker. Call me old-fashioned, but I thought that in a wind-up the Minister was supposed to respond to the debate. He has now been on his feet for seven or eight minutes, and all we have heard is a pre-prepared, read-out speech.

The right hon. Gentleman knows that that is not a point of order for the Chair. If he does not like what the Minister is saying, he is at liberty to intervene on him and suggest that he says something else. The Minister also has plenty more time to make plenty more points.

Thank you, Madam Deputy Speaker. In response to the right hon. Gentleman, I am responding to what the Government are doing on the issues that have been raised.

As I mentioned, another important part of the whole school approach is ensuring that all pupils understand how to promote their own mental health and wellbeing. We must ensure that they have the knowledge and confidence to seek additional support when it is needed. That is why we made health education compulsory for pupils receiving primary and secondary education, alongside relationships education in all primary schools, and relationships and sex education in all secondary schools. Through these new subjects, all children will be taught about mental health, including how to recognise and manage any wellbeing issues. We have published a support package for schools to ensure that teachers have the confidence to deliver the subjects, specifically including the content on mental health and wellbeing.

Let me turn to the mental health support teams, which have been referenced by numerous Members across the Chamber. Although schools have an important role to play, teachers are not mental health professionals and they should not be expected to act as such. Where more serious problems occur, schools should expect the pupil and their family to be able to access support from specialist children and young people’s mental health services, voluntary organisations and local GP practices.

I have been encouraged by Madam Deputy Speaker to intervene. The point that Opposition Members are trying to make is that schools need to have in-house support, rather than just signposting to outside support. We would like to hear what the Minister has to say about that.

The mental health support teams are exactly that. Let me also respond in passing to the hon. Lady’s point about eating disorders. I am very much alive to that issue, and would be happy to meet her to discuss it at length. It certainly concerns me, as I know it concerns our colleagues at the Department of Health and Social Care.

We mentioned support in schools. The new mental health support teams are really important in this regard. The teams comprise newly-trained education mental health practitioners—an entirely new role—as well as more senior clinicians and therapists. They work alongside provisions such as counselling services to help to ensure that children and young people get the support that they need. They support staff in schools and colleges to develop their whole school approach to mental health and wellbeing, provide early intervention for those experiencing mild to moderate issues, and liaise with external specialist services where additional support is needed, which it sometimes is.

The Minister talks about mental health support teams being able to provide practical support to children with problems. What assessment has the Department made of the coverage that will be provided by these teams in terms of the massive problem that Members on both sides of the House have described?

I thank the hon. Gentleman for that question, and I will come on to that exact point. We have over 180 mental health support teams already operational and supporting children and young people in around 3,000 schools and colleges at present. That covers about 15% of pupils in England, as has been pointed out. These teams have played a vital role throughout the pandemic, adapting their services to make sure that children and young people have continued to receive the support that they needed remotely. We have 104 additional teams in development, with more to be commissioned this year. That will help the Government to deliver the commitment made in the NHS long-term plan for these teams to reach a quarter of all schools a year earlier than planned, in 2022.

Earlier this year, as part of the Government’s commitment to build back better, the hon. Gentleman will have noticed that the £500 million mental health recovery action plan was launched. That included an additional £79 million that will help to accelerate the coverage of these teams, with over 100 additional teams set to be established during 2021-22. It will bring the total number of those teams to around 400, and that will cover approximately 3 million children and young people—about 35% of all pupils in England—by 2023. Of course, our aspiration and ambition are to go further.

The Minister talks about the number of teams. Could he give an estimate of the number of full-time equivalent professional mental health workers who are part of those teams supporting pupils in our schools?

I do not have those figures to hand, but I am very happy to write to the hon. Gentleman with that information.

In the longer term, ensuring that children and young people have access to the mental health support that they need remains a priority for the Government. The NHS long-term plan sets out our commitment to ensure that funding for children and young people’s mental health services will grow faster than both overall NHS funding and total mental health spending. By 2023-24, at least an additional 345,000 children and young people aged nought to 25 will be able to access support via NHS-funded mental health services, including mental health support teams.

In conclusion—I am conscious that the right hon. Member for Newcastle upon Tyne East needs some time to wind up—I am grateful for the support that the right hon. Member and my right hon. Friend the Member for Harlow have given to this agenda. Good mental health and wellbeing for our children and young people remains a priority for the Government, particularly in the light of the impact of the covid-19 pandemic. We want to make sure that all our children are able to fulfil their potential, and we continue to tackle the injustice of mental health problems so that future generations can develop into confident adults, equipped to go as far as their talents will take them.

I was really proud of the parliamentary Labour party this afternoon. I thought the speeches from Labour Members were very clear in their purpose and full of compassion for people who have every right to look to us to help them on this important topic. I would say the same of Members from all the Opposition parties. I thank my hon. Friend the Member for Hampstead and Kilburn (Tulip Siddiq) for her Front-Bench contribution, which I thought was excellent.

I thank the Minister for catching the tone and spirit of the debate. Clearly, we will want to pursue the conversation, and I welcome his willingness to engage, perhaps after he has had his meeting with his hon. Friend the Member for Penistone and Stocksbridge (Miriam Cates), which I frankly do not envy him. I thought that Conservative colleagues’ contributions were absolutely excellent—[Interruption.] All right; on the whole. I particularly thank my hon. Friend the Member for Stoke-on-Trent Central (Jo Gideon), and I say to her that, yes, her constituents have our congratulations and praise for the award that they have won in starting off down a track that the Opposition so strongly support.

There is a lot of common ground and a lot of common purpose, and even the Minister was not so far away from where we want to get to. This is the start of a journey, rather than the end.

Question put and agreed to.


That this House has considered the provision of school-based counselling services.