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Mental Health Services

Volume 757: debated on Wednesday 26 November 2014


Asked by

To ask Her Majesty’s Government what plans they have to improve mental health services for infants, children and young people in local authority care, and for care leavers.

My Lords, in August 2014 the Government established the children and young people’s mental health and well-being task force, which is looking at how to improve access to services that are more responsive to children and young people’s needs. It has a particular focus on the needs of the most vulnerable children, including care leavers and those in local authority care.

I thank the noble Earl for his Answer and for the work of the task force, which is most welcome. Is he considering encouraging the systemic approach to supporting foster carers and staff in children’s homes, whereby clinicians support groups of staff in children’s homes and foster carers? This can be a very effective way of making use of scarce CAMHS resource. Will he also look at undertaking another, very thorough, survey of the mental health of looked-after children? The last very thorough examination of their mental health was carried out in 2002, and it would seem that it is time to look again at their mental health issues.

My Lords, on the noble Earl’s second point, yes, a survey is most certainly being actively considered. On his first point, he is absolutely right. One of the task force’s focuses will be to consider and make recommendations on how we can provide more joined-up, more accessible services built around the needs of children and young people, looking at sometimes innovative solutions about how to get there and how to improve access to health and support across different sectors, including in schools, through voluntary organisations and online. I am very encouraged by the task force’s terms of reference.

Given that some 60% of children and young people in care are currently reported to have emotional and mental health problems, can the Minister say what plans the Government have to set access standards for these children as part of their wider drive to increase access to mental health services, to ensure that these very vulnerable people get the support that they need?

My noble friend is absolutely right: there is a high prevalence of mental health issues in those leaving care. The Government are dedicated to supporting NHS England’s work to develop a service specification for the transition from CAMHS that is aimed at CCG-commissioned services. CCGs and local authorities will be able to use the specification to build on the best measurable services to take into account the developmental needs of the young person. A separate specification for transition from CAMHS to adult services is also in development.

My Lords, does the Minister agree with me and the recent Health Select Committee report into child and adolescent mental health services that it is wholly unacceptable that so many children and young people suffering a mental health crisis face detention under Section 136 of the Mental Health Act in police cells rather than an appropriate place of safety? What action are the Government taking to eradicate this practice immediately?

My Lords, it is unacceptable for a child in a mental health crisis to be taken to a police cell. The mental health crisis care concordat, launched in February this year, reinforces the duty on the NHS to make sure that people aged under 18 are treated in an environment that is suitable for their age, according to their needs. It also makes it clear for the first time that adult places of safety should be used for children if necessary so long as their use is safe and appropriate. We have seen a reduction in the use of police cells across the country but there is still further work to do.

My Lords, I understand that child and adolescent mental health services are under pressure anyway, and therefore that puts greater pressure on those who are hardest to reach. Perhaps I may therefore ask the noble Earl two specific questions. First, what is being done to ensure that private children’s homes have as good access to CAMHS services as local authority homes? Secondly, when a looked-after child is placed out of an authority or experiences a change in placement, what measures are in place to ensure that he or she receives priority in the new waiting list?

My Lords, both of those issues will be looked at by the task force. There have been concerns on both fronts that the noble Lord raises about access to services, and we are clear that the task force must come up with recommendations in those areas.

My Lords, does the Minister agree that when the state assumes the parenting of a child or young person it takes on an enormous responsibility and a moral commitment to be a good parent to that child? Will the noble Earl assure the House that every effort is made for these children to be given access to all the services, including often some of the basic, ordinary health services that we assume there will be access to?

My Lords, I fully agree with the noble Lord. He may like to know that my department is currently working with the Department for Education to revise the statutory guidance on promoting the health and well-being of looked-after children. We plan to consult on this later this month and to publish the final guidance early next year. It will make it clear that the CCGs and local authorities are responsible for providing services for looked-after children to give equal importance—parity of esteem—to their mental and physical health and to follow the concordat that I referred to.

My Lords, my noble friend will be aware that early diagnosis in terms of getting support for children is very important, but very often these children are excluded from school—they end up in pupil referral units and are just generally not in school when they really need help. Is he satisfied that local authorities are doing what they can to make sure that these children who are excluded are getting mental health support?

My noble friend raises a very important point. My department has invested £3 million in MindEd, which provides clear guidance on children and young people’s mental health for any adult working with children, young people and their families so that, for example, school teachers and those working with children in schools can recognise when a child needs help and can make sure that they get that help early.

My Lords, can the Minister confirm whether there is a sufficiency of trained mental health nurses and specialists to carry out all the tasks that this welcome task force will undoubtedly identify?

There are concerns about the sufficiency of mental health nurses and professionals, particularly in certain areas of the country. Workforce issues therefore will be under the spotlight for the task force.