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Mental Health: Children and Adolescents

Volume 776: debated on Wednesday 16 November 2016


Asked by

To ask Her Majesty’s Government what is their response to the Report of the Values-Based Child and Adolescent Mental Health System Commission What Really Matters in Children and Young People’s Mental Health, published on 7 November.

My Lords, we welcome the noble Baroness’s report and its endorsement of the direction set out in Future in Mind, our own report which puts children, young people and their families at the centre of this Government’s ambitious transformation programme to improve children and young people’s mental health and well-being. This means listening to their views and enabling them to access the high-quality care they need. This report builds on and strengthens that approach.

My Lords, I thank the Minister for his response. Does he agree with one of the key recommendations of the commission’s report that schools, if properly funded and supported, have the potential to make a really big difference to improving children’s mental health, not least because children spend one-third of their time in school? Linked to this, does he also agree that the proposed Prime Minister’s challenge on children’s mental health should incorporate this strong focus on schools?

My Lords, when I read the noble Baroness’s paper over the last couple of days, I thought the part about schools was the most persuasive. School is clearly critical. The pilot project being done by the Department of Health and the Department for Education, trialling the single point of contact in schools, is very important, as is the PSHE guidance on teaching about mental health at the four key stages of education.

My Lords, the noble Lord’s sincerity in this area is not in any doubt. However, he knows that, despite the instructions that Ministers have given to the NHS through the NHS mandate, the health service is actually disinvesting in many mental health services. On Monday, the noble Lord will have seen the King’s Fund report on sustainability and transformation plans, on which he has rested much of his hope about the future of the NHS. Mental health services appear to be very marginal to the focus of those STPs. What action do the Government intend to take on this?

The noble Lord raises an important point. Interestingly, the spend on mental health in 2015-16 is up by 8.4% on the previous year compared to 3.7% for health spending overall. So there is clear evidence that the money that we have been talking about is getting through. The local transformation plans to which the noble Lord refers are being incorporated in all the strategic transformation plans. So there is evidence that it is getting through. It is taking longer than the noble Lord and I and others would wish, but when Theresa May became Prime Minister one of the things that she said on the steps of Downing Street was that she put mental health near the top of all her priorities. There is serious hope now that the money promised by the Government is getting through to the front line.

My Lords, the commission highlighted the importance of valuing the workforce, but a 2014 survey of teachers and lecturers indicated that about 55% of them reckoned that their work was seriously damaging their own mental health. Have Her Majesty’s Government any plans to address that particular issue so that the mental health of teachers can be improved and so they are better equipped to help and improve the mental health of their pupils?

My Lords, I cannot answer that question effectively and would like some time to think about it. Clearly, the mental health of teachers, nurses and doctors is critical. Certainly in the medical profession we are doing quite a lot to help doctors who are going through periods of mental health problems. If it is all right with the right reverend Prelate, I shall reflect on his question and write to him at my leisure.

My Lords, does the Minister recognise the harm to children’s mental health when they and their families live in temporary accommodation? Is he concerned that there will be 120,000 children living in temporary accommodation this Christmas and that the use of bed and breakfast has increased by 15% over the last year? Will he discuss this matter with colleagues developing the housing White Paper and impress on them the importance to children’s mental health of finding stable accommodation for families on low incomes?

My Lords, there is no doubt that whether it is housing for young people or loneliness for old people, many factors affect people’s mental well-being. The noble Lord may be interested to know, as I know that his particular interest is in looked-after children, that we have set up an expert working group to look particularly at that case. Interestingly, 85% of the local transformation plans that have been developed single out looked-after children as a group that requires special attention.

My Lords, I welcome the mental health dashboards, which allow people to hold their local clinical commissioning group to account for how much it spends on mental health, including on children, and on the quality of the services that it provides. However, can the Minister say how those dashboards are being publicised, and whether there is any way in which local people can benchmark the performance of their local CCG compared to others across the country?

My Lords, transparency is critical to this and every CCG will have its improvement assessment framework. Unless I am badly mistaken, they will all be in the public domain and it will be possible to look at the relative performance of each CCG. NHS England will also produce its own matrix and integrated dashboard, which will have all the key information about funding, the numbers of people accessing mental health provision and the improvements that those people achieve once they are in the system.

My Lords, from the mental dataset it is very clear that black and Asian minority ethnic adults are overrepresented in the mental health field, but the data on CAMHS are very inconsistent. They show that young black and Asian people are underrepresented, despite the fact that they are overrepresented in the criminal justice system, excluded from school more and overrepresented in the care system. Is it a recipe for disaster if young black people with challenging behaviours are being pressed through the criminal justice system as opposed to receiving good, early mental health care? Is that the reason why 40% of young people in secure institutions are from a BME background?

If it is indeed the case that young black and Asian people are not attending school and are going into the criminal justice system because they cannot get access to mental health services on the same basis as other children, it will be a national scandal, to be honest. I will certainly take away those figures. I have not seen David Lammy’s report, which I gather came out this morning. The noble Lord said that 40%, I think, of all young people in secure detention are black or Asian—I think in London it is 80%, which is a staggering statistic.