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Children and Young People: Mental Health

Volume 790: debated on Wednesday 28 March 2018


Asked by

To ask Her Majesty’s Government what progress they have made in implementing the proposals for support for mental health provision for children and young people in schools, set out in the December 2017 Green Paper, Transforming children and young people’s mental health provision.

My Lords, following publication of the Green Paper in December, we are working across health and education to explore options for implementing the proposals, which will be informed by responses from the consultation. This includes consideration of training programmes for the designated leads and mental health support teams, delivery of the four-week waiting time pilot and criteria and processes for selecting the trailblazers. We will publish a response to the consultation in due course.

My Lords, I thank the Minister for his reply. As we all know, mental illness is an increasing concern. It is good that the Green Paper to which he referred has been produced. Appendix B refers specifically to schools and says that,

“68% have a designated member of staff”,

for mental health. However, does the Minister not agree that it is equally important that teachers are fully trained and involved in the process of dealing with mental health, since, unwittingly, they can exacerbate young people’s lack of confidence? For example, I heard recently of a young person who needs encouragement being told by a teacher, “Your mother did this work for you”. Teachers need training to deal with this issue.

The noble Lord hits on an important point. Not only is mental illness unfortunately rising in prevalence, but it is everybody’s responsibility to try to help young people who suffer from it. That is what lies behind the proposals in the Green Paper, which contains a number of elements. He is quite right: there is additional training that will be applicable for all teachers, in mental health first aid, for example. It will also make sure that pupils understand it, changing the PHSE curriculum for more focus on mental health and well-being. That is why the designated leads are so important, because they bring that together at school level. So I agree with the noble Lord that schools have a critical role to play in dealing with this problem of mental health.

My Lords, the Minister will be aware that young people with severe mental health problems can wait up to four and half months for treatment when a young person with severe physical health problems can expect to be seen within the day. Of course we all want equal treatment of these two groups. I very much welcome the Government’s plan to spend £1.25 billion extra in this area. However, does the Minister have an estimated average waiting time for young people with severe mental health problems once the £1.25 billion is in place?

I do not have a specific time, but I point to two things. First, there are now waiting time standards for early intervention in psychosis and eating disorders. Those waiting time standards will become more exacting over time, but they are being met at the moment. The Green Paper also proposes a pilot of four-week waiting times for access to specialist services in the NHS. We have a long way to go—average waits are 12 weeks—so we are inevitably starting incrementally, but the ambition is that over time, we will roll that out as a nationwide ambition. However, I am afraid that I cannot give the noble Baroness a deadline.

My Lords, a lot of mental health issues among young people, including bullying and suicides, are caused by the use of social media. Is this an area that the Government should be addressing urgently?

It absolutely is, and the Green Paper covers some of these issues, both in terms of providing resilience for young people themselves and getting social media to act more responsibly.

My Lords, in my area, the diocese of Ely, which covers Cambridgeshire, some young people wait for up to 12 months for effective treatment, and the referral rejection rates are at the highest they have ever been—over 50% in Cambridgeshire. In many cases, voluntary sector organisations are working with us to mitigate the amount of time that children and young people have to wait. Does the Minister agree that 2025 is too long to wait until the changes proposed in the Green Paper are fully rolled out?

I recognise the right reverend Prelate’s point about the rising demand for services. We are trying to increase the proportion of children and young people who are helped from a quarter to a third, but obviously that leaves two-thirds who will not be helped. So there is a long way to go. We are unfortunately starting from a low base; we have to bring together many new staff and teams. I agree with the right reverend Prelate that speed is of the essence, but we must also be realistic about what we can achieve.

My Lords, are the Government carrying out research on the causes of the increase in mental health issues in both young children and teenagers?

The answer is yes, they are: the Green Paper has commissioned further research, and the amount of funding the National Institute for Health Research puts into this area has increased by 50% over the last seven years. However, we still do not understand the causes behind all mental illness, so this is an essential part of the strategy.

My Lords, given that the number of child and adolescent psychiatrists has declined by over 6% since 2013, and the number of mental health nurses by more than that, will the Government agree to consider the recommendation from the Royal College of Psychiatrists to add child and adolescent psychiatrists to the national shortage occupation list?

There has undoubtedly been an impact on mental health nursing. In fact, the widest definition of the mental health and learning disability workforce according to the latest workforce stats is up by around 3,000 full-time equivalent posts. But we agree that more needs to be done. That is why there is an ambition to bring in 4,400 more mental health staff to support children and young people over the next few years. It is also reassuring to know that there are 8,000 mental health nurses in training at the moment.

My Lords, the Minister will be aware that the incidence of mental health issues in children of primary school age is growing. Whatever the causes, they are almost always amplified and exacerbated by the onset of puberty and the transition to secondary schooling. What emphasis is being put on identifying and helping to meet the unmet need in primary schools, and who is undertaking that work?

That is an excellent question. A terrifying statistic is that 8,000 of those under 10 years old are suffering from severe depression. The designated leaders will be in every school; that is the ambition. We are also rolling out mental health support teams to support all schools, both primary and secondary, so I can reassure the noble Baroness that primary schools are within the scope of the plans.

My Lords, following on from the right reverend Prelate’s question, I would like to make a plea. Will the Minister agree that the proposed mental health support team should work with the voluntary sector—particularly the children’s voluntary sector—especially in the area of palliative care, and in children’s hospices, where children are bereaved by the death of their siblings and the incidence of mental health problems is also extremely high?

The noble Lord makes an excellent point, and I will make sure it is fed back into our deliberations.