I beg to move,
That this House
recognises the importance of Children’s Mental Health Week;
is concerned about the impact of the coronavirus pandemic on the mental health of young people and that there has been a 77% rise in the number of children needing treatment for severe mental health issues since 2019; calls on the Government to guarantee mental health treatment within a month for all who need it and to provide specialist mental health support in every school, including a full-time mental health professional in every secondary school and a part-time professional in every primary school;
and further calls for the Government to establish open access mental health hubs for children and young people in every community to ensure the best start to life for future generations.
This is Children’s Mental Health Week. I congratulate the children’s mental health charity Place2Be, which launched the first ever Children’s Mental Health Week in 2015. I also congratulate all the mental health charities and schools that are taking part in events this week.
The whole House will want to recognise the hard work and dedication of mental health professionals, campaigners, advocates, teachers, parents and guardians, especially over the past two years. So many mental health professionals have themselves suffered mental ill health, exhaustion and burnout. As we reach out to all the children and young people affected by poor mental health, we want them to know that we in this House are with them.
The pandemic has placed a huge weight on the shoulders of our children and young people. With schools closed, financial uncertainty at home, the exams fiasco and anxiety about the future, the pandemic has hit the poorest and most vulnerable children hardest. This highlights the inequalities in our society.
Children with chaotic home lives, children in overcrowded and noisy housing and children from black and ethnic minority communities suffer disproportionately from worse outcomes and worse mental health provision than white communities. Black children are much more likely to experience a mental health problem but far less likely to receive any support.
I thank the hon. Gentleman for his intervention. Perhaps he would like to understand that some white groups from poor socioeconomic backgrounds have such outcomes but, by far and away, it is disproportionately weighted against black and minority ethnic groups as a whole in this country.
There was a crisis in child and adolescent mental health provision in this country even before the pandemic made it worse. The latest report by the Children’s Commissioner shows that demand for child and adolescent mental health services—CAMHS—increased in 2020-21, with one in six children likely to be suffering from a mental health condition, up from one in nine in 2017.
Does my hon. Friend agree that children and young people who have suffered cancer and had long spells of cancer treatment need mental health support, too? That should be part of the package. It should not be an add-on or something they have to search for; it should be part and parcel of their treatment.
My right hon. Friend is absolutely right. Some children endure unspeakable circumstances that unduly affect their mental health in a way that we can never comprehend. It affects not just them but their family—their siblings and parents. I thank him for his intervention.
My hon. Friend is always a powerful advocate when it comes to the importance of positive mental health for young people. I have visited Wales and seen at first hand the fantastic examples of what can be achieved when Labour is in power.
One in six children are suffering with probable mental health issues, but only about a third are able to access treatment. Now things are getting worse: the Conservative cost of living crisis is causing more misery, uncertainty and upheaval in the lives of millions of children and young people. For weeks the House has been witness to the impact of that Conservative cost of living crisis on people and their families across the country.
Children are going to bed cold and hungry, and their life chances are impacted because they are unable to concentrate at school. Many are watching their parents worry and cry about being unable to pay the bills. Dragging an electric heater around the house before jumping under the covers just to keep warm because there is no heating—that, for too many of us, feels far too familiar. It is how my brother and I grew up, and it will stay with me forever. I had hoped that that perpetual fear of insecurity that never leaves one was a thing of the past, but sadly not: it is alive and well in Tory Britain in 2022. This is a “cost of Johnson crisis”.
The hon. Lady is making a powerful speech that stems from her personal experience. One of the groups who seem to be falling off the cliff edge are 16 to 18-year-olds, because by the time they are referred to CAMHS, the waiting lists take them out of the range that CAMHS can deal with. Does the hon. Lady agree that that is awful, and is leaving far too many young people with nowhere to turn?
The hon. Member is absolutely right. So many 16 to 18-year-olds find themselves on a waiting list for an extended period only to drop off it just as they turn 18, or else have one or two sessions, then turn 18 and find that there are no longer any services for them. That goes on to have a detrimental impact. This is not just a tragedy for today but a tragedy for tomorrow as well, because poor mental health in children is carried into adulthood. What happens today will impact demands for mental health services tomorrow. The old saying goes “Prevention is better than cure.” That is why we have a range of public health measures in place for children—check-ups for eyesight, hearing, and growth.
A GP with a surgery in my constituency contacted me recently about a serious incident of attempted suicide. The child involved is now on the waiting list, but must wait a whole year to be seen. Does my hon. Friend think that that is acceptable, or do the Government need to take action as a priority for children’s mental health and wellbeing?
My hon. Friend is entirely right, and that is why we are here today. Our children deserve better; they cannot go on like this. That is why we are talking about measures that can help to ameliorate these difficulties so that no child has to wait that long, and their families do not have to wait that long for answers. This is not okay.
Does my hon. Friend agree that among young people, black and minority ethnic young people often experience particular mental health pressures? There must be more analysis of the support that they and their families need.
As always, my right hon. Friend is a powerful advocate for all groups, but particularly when it comes to black and minority ethnic groups. We do not have the data—we do not collect the data—even to understand the scale of the issue. I think that that is convenient for the Government, because it means they do not have to accept that there is a problem which needs to be dealt with.
That is one of the issues for the future. We have to understand the true scale of the issue when it comes to some minority groups, and tailor support that helps them specifically. When people from minority groups are seeking help, often it is so difficult for them to make a connection with people who understand some of the particular social pressures they live with at home and some of the societal issues they have to deal with that also contribute to mental ill health—for example, systemic racism. My right hon. Friend is absolutely right to bring that up.
We have a range of public health measures in place for children—check-ups for eyesight, hearing and growth—and vaccinations to protect against measles, mumps and rubella, yet we ignore the wisdom of the ages when it comes to children’s mental health. As a doctor, I know that adverse childhood experiences are a key contributing factor to poor mental health in adulthood. In A&E, I see increasingly younger children coming in having self-harmed or living with eating disorders. It is simply heartbreaking, and for parents it is absolutely agonising. Parents bring their children to A&E wondering why they are fainting repeatedly and are constantly exhausted.
Does my hon. Friend agree with me as a parent—we are both parents and many of us here are parents of school-age children—that the coronavirus crisis hit everyone with kids? I have 13 private schools within my constituency boundary, and I even have parents of children there emailing in that their kids, who were happy and outgoing children, are zonked in front of Teams meetings all day and have turned into blithering wrecks of what they used to be. Coronavirus exacerbated what was a problem with CAMHS all the way along and that has hit all children in this country, and the only people who will not recognise it are Conservative Members, who are in denial because they have their own internal problems to be dealing with.
I thank my hon. Friend for her very powerful point. When it comes to mental ill health, no group is unaffected. It is really important that we acknowledge that, while some groups are disproportionately affected, mental ill health can affect anyone. Children can live in a £3 million house, and still feel they want to take their own life or want to self-harm. The pressure that puts on parents is extremely painful, and it causes many parents to give up their job to sit at home and care for their child, because they are so crippled and so worried about what may happen if they leave the house and go to work. That is why it is so important that we acknowledge the real difficulty we have with waiting times for CAMHS.
Given that the hon. Lady and her party, unlike me, were enthusiastic supporters of lockdown measures and closing schools, and were not prepared to stand up to the teaching unions, does she accept any responsibility at all for this mental health crisis among young people, because those lockdowns have had such a negative impact on our young people’s mental health?
Do the right hon. Lady’s Government take any responsibility for the tens of thousands of children who are now bereaved as a result of losing their parents because of this Government’s shocking handling of the pandemic? We shall take no lectures from the right hon. Member and her party when it comes to protecting children’s mental health. I shall move on.
When children come to A&E—[Interruption.] Please feel free to intervene: I will take interventions.
The fact is that we are all in this debate this afternoon because we all care about the mental health of children right across the country. For me, this is an opportunity for us to use this precious time in the Chamber to try to find some common ground between us, so that we can move forward in a positive way and people watching can understand that there are things we can do to make their lives better. In that spirit, can I suggest to the hon. Lady that she look at my report on school exclusions, particularly at how we can ensure that teachers are better prepared at school, including with the mental health leads that the Government are bringing in, so that they understand issues such as trauma and insecure attachment and can enable children to get the support they need at the time they need it? That is the premise on which we should all move forward.
The hon. Member highlights the point that mental health should not be a political football, which is why we hope that he will support the Opposition’s recommendations. I should be delighted if he sent me his report; I will read it with interest.
It is crucial that when a child comes to A&E or a hospital, doctors and nurses take the time to build trust with them as a patient so that they feel safe talking about their condition, but with waiting lists growing and the staffing crisis deepening, it is becoming all too difficult to find the time to build the trust and respect that every patient needs and deserves. That is the human cost of more than a decade of decline caused by under-resourcing and under-investment in our NHS and by the lack of a proper NHS workforce plan for the future.
The impact on entire families is crushing. Time out of school affects a child’s ability to learn and their later life choices and chances. Parents have to take time off work and sometimes leave their jobs as a result, and siblings are deeply affected. It should be a badge of shame for the Government that three quarters of children were not seen within four weeks of being referred to children’s mental health services.
No doubt my hon. Friend is aware of the relationship between children’s mental health and air quality. Poor air quality can give rise to anxiety, depression, lesser focus and dementia, as well as mental health problems in unborn foetuses. Does she agree that more needs to be done, particularly in the most diverse and deprived areas where air pollution is worse? It is directly hitting children’s mental health.
My hon. Friend is right to remind us that adverse childhood experiences and inequalities, including health inequalities, lead to worse mental health outcomes in later life and stop children from achieving their full potential.
Imagine being a mum or dad whose child is self-harming or presenting with symptoms of depression, anxiety or phobia, and being without specialist support for extended periods. We all agree that the pressure that that puts on families and parents is just so crippling. The number of children who needed specialist treatment for severe mental health crises between April 2021 and October 2021 was 77% higher than in the same period in 2019.
This is the UK in 2022. The bar to being seen by a specialist is high, the delays are long and three quarters of children were not seen within four weeks of referral. That time is one of anguish for them and their family. Does the Minister believe that making 369,000 children wait for vital mental health support is acceptable?
According to the latest report by the Children’s Commissioner, waiting times depend on where people live—so much for levelling up—and when they are eventually seen, services may be hundreds of miles away. It is making the situation so much worse. Ask any parent or any young person; they will tell us that the uncertainty and paucity of mental health services damages mental health, exacerbates mental health conditions, allows symptoms to persist and makes conditions harder to treat down the line. Ultimately, it also costs more.
The mental health disorders with the highest mortality rate are eating disorders. What the hon. Member says is particularly true for eating disorders: the longer somebody waits for treatment, the longer the disorder persists, which makes it worse. We really need to look at prevention and early intervention in all our services. Does the hon. Member agree that instead of saving money at the wrong end, it makes absolute sense to put money into early intervention and, better still, prevention?
I entirely agree. It has been a pleasure to work alongside the hon. Member in looking at eating disorder issues over the past couple of years; she is a powerful advocate. She reiterates my point that prevention is better than cure. We know that in the pandemic, eating disorders have increased. Young people who feel the loss of their sense of control through fear can, in trying to understand what is going on in their lives, develop habits that are unfortunately very difficult to break. We know that the earlier someone can intervene when there are such issues, the better the outcomes will be.
Sometimes the damage, especially the damage done by waiting, is permanent. Imagine if we treated childhood cancer like we do children’s mental illness: waiting for symptoms to get worse before seeing a specialist, waiting for months or even years for treatment and leaving patients and parents to rely on charity. There would be an outcry, yet that is what the Government are doing with children’s mental health. When the Minister responds, I invite them to tell the House what new measures the Government are taking, what new money is being allocated to CAMHS, and where it is going. How many mental health staff will be recruited? How will they deal specifically with the impact of the pandemic on mental health? How will they tackle the deep-rooted mental health inequalities on the lines of place, race, class and income?
My hon. Friend is making an excellent speech and showing her deep understanding of this important issue. She is absolutely right to mention the enormous pressure on families and on staff. Does she agree that there should be an important focus on the retention of skilled staff by the NHS and the Government?
I absolutely agree with my hon. Friend. There has to be retention, and I will come on to focus on our plan to grow the workforce. I will make progress, because I appreciate that I have been talking for a long time, and I want as many Members as possible to be able to speak.
I would like the Minister to tell us how they will tackle mental health inequalities on the lines of place, race, class and income—not slogans, not rehashed announcements, but a real plan with real funding. I have no doubt, sadly, that they will rehash old announcements. This is all while the Department of Health and Social Care wrote off £8.7 billion on wasted PPE equipment.
I am afraid I have to make some progress. Labour has a plan for children’s mental health, and the next Labour Government will implement it.
The next Labour Government will guarantee mental health treatment within a month for all who need it, setting a new NHS target to ensure that patients start receiving appropriate treatment—not simply an initial assessment of needs—within a month of referral. The next Labour Government will recruit 8,500 new staff so that 1 million additional people can access treatment every year by the end of Labour’s first term in office. The next Labour Government will put an open-access mental health hub for children and every young person in the community, providing early intervention drop-in services. The next Labour Government will provide specialist mental health support in every school to support pupils and resolve problems before they escalate.
Labour’s plan will see a full-time mental health professional in every secondary school and a part-time professional in every primary school. The next Labour Government will make every week Children’s Mental Health Week, until every child has security, wellbeing and the support they need. Childhood should be a time of wonder and joy; a time to store up precious memories of friendship, holidays and play; and a time to experience the things that form us as adults, yet thousands of children are suffering from stress, anxiety or depression. We are failing them—failing on prevention, failing on access to treatment, failing on funding and failing on supporting their families—and the system is stretched to breaking point. The staff are exhausted. The children are suffering. It is all happening on the Government’s watch, and they are doing nothing about it. That is why I urge all Members across the House to support the motion.
Order. It will be obvious that a great many people wish to speak this afternoon and limited time is available, so there will be an immediate time limit on Back-Bench speeches of five minutes. I give that warning now so that people can tear up several of their bits of paper and adjust accordingly. I call the Minister.
I hear your words loud and clear, Madam Deputy Speaker.
I am grateful to Opposition Members for providing the opportunity to debate the very important issue of children and young people’s mental health on the Floor of the House in Children’s Mental Health Week. As my hon. Friend Edward Timpson stated, this is such an important issue and I hope that we can use this debate to find common ground. I pay tribute to his work on this extremely important issue.
This year’s theme is “Growing Together” and I know that the past two years have been tough for many young people and their families. While some young people may have seen their mental wellbeing improve during lockdown, for many others, the disruption to their home lives and education has caused difficulties. We must support them to grow emotionally and find ways to help one another to grow.
We recognise that both the health and care and education sectors continue to face challenges caused by covid-related issues. I thank all staff across all sectors for their ongoing dedication to supporting children and young people in this vital period and for the support for their families, too.
Children and young people’s mental health and wellbeing are a priority, as is face-to-face education, so that children and young people feel supported in their education and on track with their learning and wider development. Around 12,000 schools and colleges across the country benefited from £17 million to improve mental health and wellbeing support in schools and colleges. I want to be clear that children and young people are not alone on this journey and that the onus is not on them to catch up; it is something that the whole school and whole education system is looking to achieve together, and it is our priority to support them to do so.
The Government are delivering record levels of investment in mental health services, but that was not always the case. Through the 2016 “The Five Year Forward View for Mental Health”, we now have a solid foundation on which we can build the necessary levels of care and support, but we know that we need to be more ambitious. That is why we published the Green Paper on transforming children and young people’s mental health provision in 2017 and the NHS long-term plan in 2019. Together, they set out a clear vision for ensuring that children and young people who need mental health support can get it when they need it.
The NHS long-term plan is backed by an additional £2.3 billion a year for mental health services by 2023-24. That will mean that an additional 345,000 children and young people will be able to access support.
I will make progress because we are short of time and I want to give plenty of time for Back Benchers to contribute.
More than 420,000 children and young people were treated through NHS-commissioned mental health community services in 2020-21, which was almost 100,000 more than three years ago. The NHS children and young people’s mental health workforce has seen growth of 40% from 11,000 whole-time equivalents in 2019 to 15,486 whole-time equivalents in 2021.
Early intervention and mental wellbeing support in schools and colleges can prevent poor mental wellbeing from developing into mental illness. We remain committed to the proposals set out in the Green Paper to roll out mental health support teams based in schools and colleges and staffed by mental health professionals. There are now more than 280 teams set up or in training, with 183 of those teams operational and ready to support young people in around 3,000 schools and colleges. I am really pleased that we have been able to accelerate that programme to meet our original target a year early and then reach around 35% of pupils through 399 mental health support teams by 2023.
A number of parents in my constituency have contacted me with worries about their children and how best they can support them. We know that parental support in the family can lead to great improvements in children’s mental health. What information is the Minister making available to parents on how best they can support their children when they are having difficulties with their health?
My hon. Friend makes a really good point, and I know that she has lots of experience on this issue from a clinician’s point of view. She is right to say that families play a very important role. In her absence, may I offer my hon. Friend a meeting with the Minister for Care and Mental Health, because she will be able to go into much more detail than I can at the Dispatch Box?
I do not think that any of us can imagine what seeing such a trauma can cause to young people, and indeed to people of any age. I know that great community work is being carried out by the voluntary sector. For example, a voluntary group goes into the hospitals near my constituency and works with young people who have been victims of knife crime or of something related to that. I am sure that sort of work has been extended across the country and to many other places. There are many different ways that support can be brought forward, and that is just one example.
No, I will not give way. I must make some headway.
In May 2021 we announced £9.5 million of funding to offer senior mental health lead training to around a third of all state schools and colleges in England in 2021-22, and as part of our commitment to offer this training to all state schools and colleges by 2025. Today we have announced an additional £3 million to respond to the high demand from schools and colleges for this training. This 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 students.
I know that waiting lists are a real source of frustration for young people wanting to access NHS support, and of course for their parents and carers. It is an issue that the shadow Minister also raised. That is why we have set up the first waiting time standard for children and young people’s eating disorder services.
As part of its clinically led review of NHS access standards, the NHS has consulted on the potential to introduce a new waiting time standard, so that children, young people, and their families and carers presenting to community-based mental health services should start to receive care within four weeks from referral. This consultation closed in September 2021, and NHS England and NHS Improvement will publish their response in due course.
I must make some progress.
Throughout the pandemic, NHS mental health services remained open, offering digital and remote access to maintain support and to accept new referrals. It is important that we bank the success of these digital innovations, as service providers are actively considering what has worked well in encouraging children and young people to engage with, and adhere to, their treatment plans.
Government must also play their part. That is why we have provided £79 million of additional funding this year to make a real difference to young people’s lives by ensuring that 22,500 more children and young people can access community mental health services, giving 2,000 more children and young people access to eating disorder services and, as I mentioned earlier, accelerating the delivery of mental health support teams in schools and colleges.
Opposition Members raised the important issue of services for those teenagers transitioning into adulthood, and we have provided £30 million to ensure that young adults, aged 18 to 25, including university students, are provided with tailored mental health support, helping to bridge the gap between children’s and adult services.
Although lockdown measures have been very tough for many, thanks to the success of our world-leading vaccination programme, we can now look to the future. We plan to launch a public discussion paper this spring to inform the development of a new, longer-term mental health strategy, which will include children and young people’s mental health. This will pave the way for a wide-ranging and ambitious conversation about potential solutions to improve mental health and wellbeing both within and beyond Government and the NHS.
We also plan to publish an update to the NHS long-term plan later this year, taking into account the impact of the pandemic. Today we have published the Government’s third annual “State of the nation: children and young people’s wellbeing” report. This year’s report focuses on trends in mental health and wellbeing recovery over the 2020-21 academic year, as well as children and young people’s views about wider society and the future.
We owe it to our future generations to seize the opportunity now for both the health and care and the education sectors to deliver on our commitments to improve the mental health and wellbeing of children and young people in this country. The Government cannot do this alone. There is a crucial role to be played by local authorities, the NHS, the private sector, schools and colleges, and the voluntary and community sector. Most importantly, we must continue to look to children and young people themselves and their parents, families and carers to understand what really matters to them.
Children’s Mental Health Week 2022 comes at a time when the mental health of children and young people is discussed as never before. When I worked in mental health as a psychologist, the stigma was often so great across the generations that no one wanted to discuss mental health. That can never be allowed to happen again. No one should ever silence anyone on mental health, because speaking about it is key to wellbeing.
I welcome the debate today as mental health spokesperson for the Scottish National party but also as chair of the all-party parliamentary group on psychology. In the latter role, I have heard from young people from right across the United Kingdom. They tell me that the focus on mental health is required, as is ringfenced funding. For too long, children’s mental health has been a Cinderella service. It should not be because, the truth be known, children’s mental health is key to our society’s wellbeing for years to come.
It is clear that the pandemic has had a massive impact on the level of anxiety, depression, thoughts of self-harm and social isolation that many children experienced. They have had to process a life-changing event: the pandemic. Now they live with the impact of covid-19 on their childhood, and they will do that for the rest of their lives. We must recognise the trauma and loss for many, and that their childhood has been markedly different from that of other generations. Due to the restrictions, many children missed educational, social and developmental milestones. Many very young children missed vital infant socialisation experiences. As a result, social anxiety, depression and developmental delay is now a feature of many young people’s lives.
For children already struggling with mental health issues, treatment may have been interrupted, exacerbating their distress. For those needing help with an arising mental health issue for the first time, help was not as accessible as it should have been. For those children who have learning difficulties or disabilities, restrictions also meant that they often lost their additional crucial support. Those needs must be met. Children are the most vulnerable in our society and their needs must be prioritised and addressed at this crucial time. That is why it is vital that we recover from the pandemic with a children and young people-led recovery plan.
Children and young people must be involved in how their care is designed, choosing in what modality it is presented and having the option of varying levels of intensity to address mild to severe presentations. Mental health must be viewed as a continuum, with the treatment that best fits.
It is important to say that children’s learning is very different now from when I and many other MPs were at school. It is vital to ask children what works in terms of online technology and innovation. It saddens me that we must also be on top of the algorithms that are online. It is extremely concerning that when someone types in “self-harm” or “eating disorder”, many sites perpetuate harmful content rather than directing young children towards help and assistance. Our online harms Bill must address that. Just last week I discussed those concerns with developers of a new, positive online mental health platform for young children, called Hidden Strength, but I was shocked to hear that harmful content is being enabled and advanced by platforms.
It is exciting that in Scotland a new mental health innovation hub is being developed this year, with children’s mental health the key focus. The NHS Near Me platform is also being used by clinicians to connect with patients remotely, reaching 22,000 contacts a week. Building such services with children and young people themselves, with a “what works” agenda, is key. I was extremely honoured to meet local Members of the Scottish Youth Parliament recently to discuss their leadership on mental health. I was so impressed by what Mitchell Frame, Bethany Ivison, Jack Donaghy and Lennon Boyle had to say, and by their awareness of mental health as a priority for their generation.
Importantly, throughout the pandemic the Scottish Government have developed their mental health recovery plan in conjunction with our local authorities, bringing support directly into our communities. Funding has enabled local authorities at grassroots level to provide a tailored local response for five to 24-year-olds. More than 200 new community mental health and wellbeing services for children and young people have been established and a youth advisory group set up to ensure that young people involved are at the core of self-harm prevention policies.
During the pandemic, the Minister with responsibility for mental health also wrote to all health boards to emphasise that mental health remains a clinical priority. Services must continue. The recovery plan has committed to providing 320 additional staff in Scotland in child and adolescent mental health services. CAMHS should be a step-up service where required, dependent on increased clinical need. It can never be a one-stop shop. A stepped-up model is needed. Online treatments must be available to all, with in-school counselling available across our schools and mental health support normalised across our local authorities and communities for families, as has been described. CAMHS need to be for clinically intensive presentations or they will remain overwhelmed.
It would also be helpful for best practice across the UK—perhaps the Minister will consider this—if diagnostic hubs were developed locally for young people who require assessment for specific issues such as autistic spectrum disorder, attention deficit hyperactivity disorder or learning disability, with input from multidisciplinary teams led by educational psychologists. Children should never have to be on lengthy waiting lists for CAMHS for assessment, because their diagnosis is key to getting other supports involved in their lives.
To conclude, I want briefly to mention the Diana Award and the all-party parliamentary group on mentoring, which I have been chairing. I commend all the MPs in this House from across parties who have contributed to our programme over the past two years. Over 200 MPs during this time have mentored a young person in their community. These are the life-changing opportunities appreciated by young people and their families, so Members should please get in touch with me if they want to prioritise mentoring a young person in conjunction with the Diana Award this year. This successful cross-party programme is promoting opportunity. It increases self-worth and wellbeing, and I thank everyone who has contributed. Together, we can make a difference across the House in policy and in our actions on children’s mental health. I thank all the teachers, volunteers and professionals working in the field. Mental health is key. Let us make a difference together in all our communities.
It is a pleasure to follow Dr Cameron and her very constructive comments.
I welcome the opportunity to speak in this debate on children’s mental health. It is a subject that has thankfully received much more attention in recent years and is discussed far more openly by children themselves, and by their parents and teachers, and healthcare professionals. Children’s Mental Health Week is an excellent way to shine a spotlight on the importance of young people’s mental wellbeing. This year it is particularly appropriate to do so given the tremendous challenges that children have faced during the pandemic.
In Aylesbury, the formidable charity Youth Concern has highlighted mental health problems among young people in Buckinghamshire. The charity supports a wide range of young people, from those who require low-level support to those who have had major relationship breakdowns at home. It provides counselling services, which can be of significant benefit to those who do not reach the threshold for a referral to child and adolescent mental health services, or CAMHS. I commend everyone at Youth Concern for the difference they make to young people’s lives in my constituency.
I would also like to take this opportunity to thank teachers and parents across the constituency of Aylesbury for all they did to look after children at a time of such intense disruption in the pandemic, especially when pupils could not go to school for face-to-face lessons and instead had to learn at home. That is why I am so pleased that the Government focused on getting all children back into the classroom, ensuring that they could get the world-class education they deserve. It was this party and this Government who delivered on our promise to prioritise education, and the first step of the road map for leaving lockdown saw the return of all pupils to schools and colleges in March. That was a very welcome step, because Buckinghamshire Council’s education team, despite doing an incredible job over the past two years, has witnessed considerable increases in mental health issues among pupils, which has in turn put further pressure on local CAMHS.
I absolutely acknowledge that waiting times for help from CAMHS are too long, but that cannot be resolved overnight. There have been shortages of qualified clinicians for a very long time. I would respectfully suggest to Labour Members that it is simplistic to suggest that guarantees of an appointment within one month could be delivered.
One of the reasons I was keen to speak in today’s debate was my previous involvement in the youth justice system. I take this opportunity to declare my interest as a former board member of the Youth Justice Board, former non-executive director of HMPPS, former youth magistrate and member of the Sentencing Council. As the Justice Committee said in our recently published report on children and young people in custody, it is generally recognised that around a third of children in custody report a known mental health disorder. That is an absolutely shocking proportion, and it is very important to recognise the immense efforts of those who work in the youth secure estate to care for those young people, because that is not what our youth custody estate is designed for.
I am pleased to say that over the past few years much has been done to improve provision for children with mental health needs in custody. NHS England and NHS Improvement have led on the development of a framework for integrated care called SECURE STAIRS. That is being delivered in partnership with the Department for Education, the Youth Custody Service and the Ministry of Justice. It is a psychologically informed, trauma-based framework for integrated care that creates a single plan around the child. It is exactly what we need and it is exactly what is being done. It is based on the idea that every interaction matters and input from every member of staff is fundamental. As it was put to us by the NHS, from the top of the Youth Custody Service to the cleaners and the cooks, every interaction matters, and its focus on the child’s story, not on their diagnosis, their offence or any other label.
This is a clear demonstration of the Government recognising the requirement for specific support for a cohort of children with mental health needs, and then bringing together all the relevant organisations to deliver that help. Labour Members have been quick to criticise the Government, but the NHS long-term plan is clear that over the coming decade the goal is to ensure that 100% of children and young people who need specialist care can access it. Mental health support for children and young people will be embedded in schools and colleges. So far from the picture painted of strife and woe, this Conservative Government have grasped the nettle, are delivering on their promises and are taking action to ensure that all children and young people have a strong start in life.
It would be remiss not to mention the impact of covid-19 on mental health over the last two years, but—as the excellent mental health charity Young Minds said in November last year— the crisis in young people’s mental health predates the pandemic. Indeed, in 2017, suicide was the most common cause of death for both boys and girls aged between five and 19. Research from University College London found that in 2018-19 almost a quarter of 17-year-olds had self-harmed in the previous year. Young Minds also highlights the clear inequalities when it comes to children and young people’s mental health, with high rates of mental health problems among young women, LGBTQ+ young people, young people with autism and young carers, alongside clear links between mental health and experiencing racism and discrimination, and mental health and financial insecurity. We clearly have a problem.
While I welcome the acknowledgement this week from the Children’s Commissioner for England that progress has been made to reduce the gap between the number of children with an emerging mental health need and the support available, this is no revolution. She also discussed waiting times and the fact that we now have one in six children with a probable mental health disorder. People are still waiting weeks and weeks for treatment to begin. Under this Government, we have seen a 77% rise in the number of children needing specialist treatment for a severe mental health crisis, and almost 117,000 children were turned away from mental health services last year despite being referred by a professional.
Despite warnings from teachers of an increase in emotional and mental health issues in pupils since the pandemic, the Government continue to give the impression that children and young people are an afterthought in their plans. I wholeheartedly welcome the opportunity to have this important debate today, and I sincerely hope that Ministers will use it to address the unacceptable crisis facing far too many young people and families across our country. We need a revolution in mental health, prevention, early intervention and treatment, and it needs to start today.
Sadly, the impacts of this pandemic have been wide reaching and they will be long lasting. While we are no longer under lockdown, and our physical health may be recovering, the impact of those restrictions on our mental health is still being felt, especially by the youngest in our communities. Of course, there is no doubt that children are robust. However, they have faced real challenges during the pandemic, and it is right that we use this debate to recognise that. While adults were more able to rationalise the changes that we faced in our everyday lives, children were suddenly having to cope with drastic changes such as not being able to go to school, where they both learn and socialise all at once. The structure of the school day, along with the discipline, the routine and the predictability, are so important to children’s development, especially those children from more disadvantaged backgrounds who do not necessarily have those things at home, and the impact of losing them is profound.
NHS surveys show that there has been a sharp increase in the number of children experiencing mental health problems, with one in six children now having a probable mental health disorder. That is up from one in nine. We know that this can be improved on, and we know we can change children’s lives for the better, but only with the right support. I am pleased to say that that support is already coming from the actions of this Government. We are expanding access to community-based mental health services, we are boosting mental health funding by over £2 billion, and we are targeting our support to where it is needed most, through the new £500 million mental health recovery action plan.
Most importantly, it is this Government who are supporting our children’s mental health by keeping them in school. It is worrying to think about where we would be now if we had listened to the Opposition on this and how much worse off our children would be. While they were calling for schools to close, it was this Government who were prioritising children’s and young people’s mental health by opening schools as soon as it was safe to do so. Schools are more than just places to learn. The structure and support that school brings to children is second to none. As a father of three, I know how hard home schooling was, and I am sure I am not alone in feeling grateful that I was excused from doing that, doing this job—[Interruption.] Even doing this job.
Beyond the school walls, there is an excellent, and quite simple, way to support children’s mental health. It is something that I am passionate about, and it is something that we already have in Milton Keynes, through our access to green spaces. The benefits of exercise and our beautiful green spaces are well known. In fact, research from a Danish study has shown that growing up near green spaces reduces the risk of developing mental health problems later in life. If this Government are serious about supporting children’s mental health, which I believe we are, it is important that access to green spaces should be maintained and improved.
Milton Keynes is the perfect example of a town with access to green spaces at its core. We have 15 lakes, over 11 miles of canals and 5,000 acres of parks, woodlands and rivers. That means that no one is ever more than half a mile away from a park. This alone has been a real lifeline for many of my constituents during the pandemic, and hopefully as we move forward, it will be something that remains important throughout their lives.
Milton Keynes is a perfect example of what our cities and towns could be like if they were designed with practicality and our mental health in mind, and I would encourage others to follow our example. Our children and young people are far more resilient than we give them credit for, but if we truly want them not just to survive but to thrive, beyond our current investments, we must also invest in our green spaces.
I am afraid I have to now reduce the time limit to four minutes.
I promised the young people I met that day that I would make their mental health and that of other young people I represent one of my priorities as their MP. That day, we were not to know that the following month we would go into the first covid lockdown. As we have all gone through lockdowns and restrictions, the importance of mental health for the young people I represent has become even more acute. One of the things the young people at the summit told me was that they wanted a mental health worker at their school whom they could talk to about their mental health, so I arranged a meeting with the Health Minister at the time. The Minister offered no extra support, but referred me to the local NHS. After a series of meetings with the NHS, I was glad when it was confirmed last summer that the NHS would, from September that year, put in place a dedicated mental health worker one day a week in every high school in Ealing North.
That represents important progress with limited resources, and I thank the local NHS for listening to the many of us who made the case for such a service, but when I have spoken to high schools about having a mental health worker one day a week, it has been clear that, although welcome, it comes nowhere near to meeting the level of need. The truth is that, without a Government who take this seriously and offer the support that is needed, we will never see the transformation that young people deserve. That is why we have committed that the next Labour Government will provide a full-time mental health professional in every secondary school. That is what young people told me in February 2020 that they want and need, and that is what we would make a reality as part of a package that would also include a part-time professional in every primary school, open-access mental health clubs for children and young people in every community, and a guarantee of mental health treatment within a month for all who need it. Our plans for mental health services would be funded by closing tax loopholes for private equity fund managers and removing the VAT exemption from private schools.
I know we need this transformational change because I was told so by young people themselves. As a new MP, I learned so much from that summit in February 2020. Since then, I have made it a priority to keep listening to young people in my constituency, making sure to visit schools whenever covid restrictions have allowed. I was glad to visit Northolt High School and Alec Reed Academy recently. As ever, I am very grateful to students and teachers for sharing with me their time and their views on mental health. As I was in the mental health summit before the pandemic, I have been informed and inspired by listening to young people talk about their mental health and what support they need. A number of the young people I have met have explained their own techniques for looking after their mental health. From their talking about the subject, I and their fellow pupils have learned something, showing the simple but crucial effectiveness of people talking about mental health, understanding how they can help to look after themselves, and having support there when they need it.
Now is the time for us as MPs not just to listen to young people, but to act. Young people need us to do the right thing and put in place the high-quality mental health services they deserve.
I am pleased to contribute to this important debate on young people’s mental health. The pandemic has had a significant impact on many young people, and I know that our schools and colleges have done huge amounts to support their students through this period. I have been discussing mental health with many of them recently, and only last week I discussed it with the Minister for Care and Mental Health.
This work must start from an early age, and I particularly welcome the work being done in Stoke-on-Trent and nationally through the early years healthy development review. As a city, we must do more to build on the support for the most vulnerable families to ensure that every young person has the best start in life and can achieve their full potential. I very much hope that the city council is successful in securing funding for family hubs in Stoke-on-Trent, as that investment is vital. Importantly, the council recognises that those services must reach out to the families and children who need the support most—not those who are already engaged but those in greatest need of support and who are often the hardest to reach. These are the lessons we must learn if we are to see genuine improvements in levelling up the life chances and achievements of our young people.
It is particularly vital that we continue to improve support for mental health in schools and colleges, including the development of mental health support teams in all education settings. The 2017 Green Paper suggested that that was to be fully rolled out over six years, which seems a long time. We have ambitions to reach the target sooner, and I recognise the challenges with significantly ramping up recruitment and increasing the very specialist skills in this field. However, it is important that young people who need this support get it now.
Not enough young people are getting treatment as quickly as needed, which I know the Government are determined to address. It is only by acting earlier and being more preventive that we will stop more serious mental health issues developing in the longer term. I was pleased to hear from the Minister last week that we are already ahead of schedule in the roll-out to education settings, and I hope that trend continues to accelerate. In Stoke-on-Trent, 22% of schools now have in-school mental health support teams, with the ambition to increase this significantly over the next two years.
I commend our local schools and mental health staff at North Staffordshire Combined Healthcare NHS Trust for their dedicated work in supporting our young people. The increasing challenges they face are significant, with demand for mental health support for our young people surging by some 40% across north Staffordshire during the pandemic. It is particularly concerning that the demand for autism assessments has been double the capacity over the last year. I am pleased that the Government are taking serious action, with the £500 million mental health recovery action plan put in place to help those most impacted by the pandemic. This builds on the additional £2.3 billion committed to mental health through the NHS long-term plan.
Our local mental health services are doing more to help address these issues, including by increasing training and mentoring in schools to help staff better support young people, and by growing capacity further to better meet the increased demand and pressures on these services. This follows the record £15 million investment we secured to improve mental health facilities in Stoke-on-Trent, including a £1.3 million investment in new CAMHS intensive-support services.
As we move towards more integrated healthcare models with the development of integrated care systems, we must continue to address these issues and better integrate mental health services with other public sector and third sector services.
I am pleased to be able to speak in this hugely important debate.
The facts and figures speak for themselves: a 77% rise in the number of children needing specialist treatment in 2021; three quarters of children not being seen within four weeks of being referred to children’s mental health services, and there were half a million referrals in 2021 according to the Children’s Commissioner; and over a third of children with professional referrals being turned away from mental health services. There are also differences according to where people live and in which clinical commissioning group they are. This is not good enough for our children. We need to do more.
I echo my hon. Friend Kim Leadbeater, who said that, although we are looking at the impact of the pandemic, this problem predates the pandemic. Many of us have taken part in previous debates to ask for action and Government progress. Although the pandemic has certainly made things worse for children, this situation predates the pandemic, as the Minister knows. We need to make sure that there is early intervention for young people with mental health problems, with professional help, and we need to take local action as well.
I chair the all-party parliamentary group on suicide and self-harm prevention. The year before last, we did a report on self-harm in children, and some of the things we looked at were about having really local, low-level assistance that people could access for support. Organisations such as YoungMinds, the Mental Health Foundation and others have been talking about having drop-in hubs for mental health services, as indeed we are, but that intervention needs to start quite early as well.
I want to praise two schools in my constituency —Whickham School, a secondary academy, and Kingsmeadow Community School; I have visited both and talked to the young people there—for the efforts that they are making to tackle the mental health issues among the young people they teach. I commend them very much for their efforts. I would like to see, as we are proposing, very much more support in schools to tackle mental health problems.
On inequalities, we cannot but notice that not all of us are affected in the same way. If people suffer deprivation, poor housing and all those other inequalities, the chances are that they may be affected worse. It is really important that we recognise that when we are developing strategies to deal with it.
Research by the Mental Health Foundation has found that young people experienced especially high levels of loneliness during the pandemic, peaking at 69% in the final month of 2020. There are well-established links between loneliness and poor mental health, and we must take steps to address that through schools and throughout our communities. Most of all, we must make it a public health priority to tackle all these urgent mental health issues. We do not want people to develop mental ill health. We want people and our children to be well. I urge the Government to take action to redress the lack of support currently being provided.
Order. If I am going to manage to get everybody in, I will have to take the time limit down to three minutes after the next speaker.
It is very clear that this is an incredibly difficult time for our young people’s mental health. Clearly the disruption caused to education has contributed towards their anxiety over exams, as has not being able to socialise and do the things that they love. That has all contributed towards the significant increase in our young people needing mental health support.
It is important to bear in mind things like social media. Only this morning, we were in the Education Committee talking to experts about the impact that social media is having on young people. When I grew up and finished A-levels, we had Facebook Messenger, and I had Facebook when I went to university. Let us imagine a situation where someone is being bullied at school: back in the day, at least they could escape, or kind of escape, in the evenings, but in this 24-hour social media age it can be increasingly hard to do that. Serious regulation and intervention will have to be made in this area, and we have to be open to that. We cannot be overly libertarian on the impact of social media on the mental health of our young people.
When we talk about the disruption that has happened and the stop-start nature of a lot of it, largely unavoidably, we must bear in mind that often those with special educational needs really struggle with the transitions and their anxiety levels have potentially been inflamed particularly highly by the uncertainty that has been caused. Getting special educational needs right matters for the education of those young people, their ability to achieve in school, and their ability to get a good job and get on. If we do not get special educational needs right, it can be incredibly bad for the mental health of those individuals if they feel they are in an education setting where there is not an understanding of them and their needs, and how they process information. If you have a learning disability, your brain is wired a bit differently, as I know from my own experience.
The point I am making is about the importance of getting young people diagnosed as early as possible, because it is only when we know what we are dealing with that we can begin to have an education system that speaks to all young people and caters for them. Otherwise, they may feel as though they are not being understood and the education system is not speaking to them because of their potential “disabilities”—we call them that, but I do not like to do so, because I think difference is good and being an unconventional, creative learner, given the right support, is good.
Some positive steps have been taken and the Minister who is closing this debate is making a fantastic start, so he deserves credit for that, but we still need to strive to go further. Getting special educational needs right is important for not just these people’s life chances, but their mental health. We see this when we look at the fact that about 40% of those in prison have special educational needs. If people feel as though the system is failing them, we can understand why some want to turn against that system. I often get the violins about my own experience, but I will mention it again. As somebody who at 12 had the reading and writing age of an eight-year-old, and had my eyes glazed over at the back of the classroom, I felt that anger as well. That is my point about children’s mental health: it matters for all young people, but let us think about those with SEN, because not getting it right for their education is about not just their getting on in school and getting a job, but their mental health.
Today’s Opposition debate on children’s mental health is timely, as children have been deprived of seeing their friends, unable to attend school and even told that they cannot hug their grandparents. Those circumstances have all fed into a wave of anxiety, and we have seen record numbers of children seeking mental health services during this pandemic. Current modelling by the Centre for Mental Health suggests that 1.5 million children and young people in England will need either new or additional mental health support as a result of the pandemic. The Health and Social Care Committee notes that 60% of young people with a mental disorder are not able to access mental health support. It also warned that without urgent action, mental health services are likely to slip backwards as a result of additional demand and the scale of unmet need prior to the pandemic.
Many of us, from across this House, have spent much of the past decade warning of the detrimental impact that cuts to local government budgets and Sure Start centres would have on mental health support for our young people, and far too often those warnings fell on deaf ears. A study by the Children’s Commissioner for England in 2019 found that about 60% of local authority areas have seen a real-terms fall in spending on low-level mental health services for children. We know that deprivation and economic inequality are strongly predictive of children and young people’s wellbeing.
My local council is one of the most deprived in the country and it is reporting that about 20% of new parents are suffering with mental health issues. Our local community cannot afford to wait, which is why Sefton Council and Mersey Care NHS Foundation Trust’s mental health team have created a new, groundbreaking early intervention programme to support parents and their babies, in an endeavour to break the cycle. In 2018, local health and social care professionals Dr Lisa Marsland Hall and Majella Maguire developed a bespoke specialist mental health service from work undertaken in Knowsley borough and in 2020 they were able to launch a 12-month pilot for a Sefton Building Attachments and Bonds Service—BABS. That has now been rolled out for a longer period of time. I will pass on the information to the Minister, because he may well use it, as it is an excellent service.
The Early Intervention Foundation has found that a failure to intervene early to avoid preventable mental health difficulties costs the NHS £3.7 billion per year, and a further £2.7 billion in relation to Department for Work and Pensions costs. The 10-year long-term plan is just that—it is over 10 years. We really do not have 10 years to sort this problem out for our children.
We have heard some very powerful stories in the debate. My constituents have written to me with similar very distressing tales of self-harm and attempted suicide, and I am particularly conscious of the crisis in eating disorder services. To the appeal for further services and further investment, I say yes; I recognise what the Government are doing in that space and I support that.
On the wider policy that the Government and the whole country adopted on covid-19, I think we have all been partly guilty of the abuse of language. Ideals of duty, sacrifice, community, and putting friends and family first have been suborned to a totally different imperative: to stay apart, to isolate, to cut off our relationships and our obligations, and to trust the agencies of a remote bureaucracy who knew better than we did what we should do and who we should see and what balance to strike between seeing a loved one and protecting them and others. I do not blame Ministers personally for any of that—I voted for it all. We did this together across the House and, indeed, with the support of most people in the country.
We outsourced social responsibility to the state and the state gladly took up the burden. We saw mass testing, including asymptomatic testing, which drove the figures so high, and that led us to mass lockdowns, despite the early evidence that the first lockdown, even if it was necessary to slow the spread of covid, had health costs that outweighed the health benefits in some respects, to say nothing of the economic and social costs, including those that we are debating today. Lockdown was so awful that it created the pressure for the vaccines, so after the mass testing and mass lockdowns we moved to mass vaccination. Despite the early assurances that it would only be for the elderly and the vulnerable, it was soon for everyone, even children, unnecessarily. Despite the early assurances that it would only be voluntary, we piled on the pressure with covid passes and, I regret to say, compulsory vaccination for health and care workers, which I am hugely pleased that the Government have now dropped.
I pay tribute to colleagues who resisted much of that, and to the Prime Minister and the Cabinet who, after the vote on
We have to lead the way. No more lockdowns, no more mass vaccination and, most of all, we must put children and young people first. We owe them all our help in the years ahead. I know Ministers agree with that and I hope we will work across the House to make things right.
There is a reason why on average every month since I became an MP just over two years ago, I have raised the issue of children’s mental health, including in my maiden speech: from the moment I got elected, a relentless stream of parents, carers and young people have come to me who have often waited a year or more—six months if they are very lucky, but more likely a year or more—to access desperately needed support.
I get warm words from well-meaning Ministers and promises about all the things they are doing, but the reality is that we are not seeing that on the ground. That is why accountability is key. I have been discussing with Ministers behind the scenes for two years the need for much more detailed operational spending at a local level on children’s mental health—and for reporting on waiting times, because we do not have the data to track progress. On that very issue, I hope that, next month, Ministers will back my private Member’s Bill for an annual report to Parliament on children’s mental health.
Behind every number we have heard today, there is a child who is struggling to do everyday, normal activities that every young person should be able to do—tragically, some take their own life, as happened with a year 11 pupil in my constituency last year—and parents who are tearing their hair out. The tragedy is that, if we intervened earlier, we would not end up with so many children in crisis. One mother came to see me a couple of weeks ago. Her 15-year-old was referred for anxiety in 2019; she is still waiting for treatment and now her needs are much worse, so she has to go to the back of the queue of another waiting list for a tier 3, instead of a tier 2, intervention. My local headteachers say that they are overwhelmed. They have seen a 50% to 100% increase in need since the start of the pandemic. They are buying in additional support, but their staff cannot cope with the volume and the complexity of need.
I witnessed, in a primary school, a seven-year-old having to be locked in a classroom because he was rampaging around with various items, attacking pupils and staff. That child is now on a CAMHS waiting list; in the meantime, he faces potentially permanent exclusion, and a mother living in fear at home. Is this acceptable for these children today? So many primary schools I speak to are relying on parental fundraising and donations to pay for mental health support.
It is no exaggeration to say that we need a wartime effort to tackle this crisis. We need a trained counsellor in every school—surveys have shown that they want to do more work, so there is workforce capacity—as well as community mental health hubs and more specialist provision. We owe it to those children.
It is an honour to follow Munira Wilson, who made a powerful speech.
I think we can all agree with the sentiment behind the motion. Indeed, it is similar to the 2017 Green Paper, similar to the NHS long-term plan, and, in fact, very similar to the report produced recently by the Health and Social Care Committee, of which I am a member. However, I listened carefully to what was said by the shadow Minister, Dr Allin-Khan, and I heard a great deal about targets but very little about how Labour plans to achieve them.
We have put a huge amount of money into this space. Mental health funding has increased from £10 billion to £14 billion in a matter of years. The problem is, as we have all recognised today, that the numbers are rising exponentially, particularly in respect of eating disorders. As a number of Members have pointed out, we need to look at why this is happening. Why are we seeing a referral rate for eating disorders that has risen by, I think, 80%? It is extraordinary.
As well as pouring in even more money and trying to get more mental health support teams into schools, and more professionals, we need to focus on social media reform. My hon. Friend Tom Hunt was right about that, as was Dr Cameron. Today, at an event involving the Internet Watch Foundation, I heard four teenagers talk about the pressures that they felt online, and how difficult they found it to talk to people about what was happening and where to refer it. We must fix this, and I think that the Online Safety Bill will be the key to that.
I want to make some points about the care system. When our Committee was taking evidence about referrals, we heard that the Royal College of Psychiatrists was receiving ever more referrals from children in care. I think it is important for us to look into the training received by social workers, and to consider what more we can do to ensure that there is support for young people within the care system. The NHS has staffing problems; we know that that is true across all professions. Our support for those staff will be critical, because we all know about the pressure they have been under and how difficult they have found it. They have been into schools, and they are struggling to deal with the number of people coming forward.
The approach we have taken so far has increased the money available and the number of people doing this work, but we need to look at the causes, and I hope that that is what we will see Ministers doing.
We should not be surprised that there has been a 77% rise in the number of children needing treatment for severe mental health issues since 2019. We have lived through extraordinary times, and the fallout from that will be with us for years to come. However, in respect of mental health services, as with much of the rest of the NHS and social care, we have been woefully unprepared for the challenges with which the last few years have presented us.
I had a conversation with someone who had been a clinical psychologist in CAMHS for more than 20 years, and who listed some of the reasons why we find ourselves in this position now. She told me that during the last decade, staffing had been hugely squeezed. Whenever someone left, their post was frozen and the money was used to meet savings targets; staffing levels consequently shrank considerably, adversely affecting service provision. She said that nearly all the staff were very hard-working, working far longer hours than they were paid for and well-motivated, but staff sickness levels became very high over the years because of the pressure on the staff, exacerbating the problems.
One respect in which the service suffered was the increase in waiting times for all referrals other than emergency risk assessments from three months to a year. At some points the waiting time did fall, but most young people were then put on another waiting list for therapy, so, overall, waits were still far too long. A year is such a long time in a young person’s life. The person I spoke to told me her particular concern about teenagers who were highly anxious and depressed to the extent of being unable to attend school and superficially self-harming: because they were not suicidal, they could not be assessed any more quickly. Imagine being in that situation—at times the feeling of helplessness must seem overwhelming. Concerningly, there were some young people who attempted suicide while on the CAMHS waiting list and were then risk-assessed when they got to hospital, which of course was too late. Of course, those are the children who actually got on the waiting list; last year, a third of young people were turned away altogether despite being referred by a professional.
It sounds very much as if rationing is in place. A child would not be turned away with a physical illness, but because mental health issues often do not manifest in an obvious way until there is a crisis, children can be shuffled around the system for months, if not years. That is not parity of esteem, and it is no way to treat vulnerable young people, but some of my constituents feel that that is what is happening to their children and that CAMHS needs to be continually chased before action is taken. Even when action is taken, it may be a referral to treatment but not what is needed, so another referral is made and the whole process starts again.
One constituent, who has had to give up their job to look after their daughter because she has been so let down, said:
“I think one of the biggest problems is no single person is responsible for her care so you never know who to speak to and who is doing what.”
That is heartbreaking to hear. I am afraid that it is symptomatic of a system that is stretched beyond breaking point.
We are facing a crisis in children’s mental health, as many hon. Members have outlined articulately in our debate. I welcome the Government’s mental health recovery action plan, but if we are serious about tackling this tragedy—and it really is a tragedy—we have to look at the root causes.
First, covid-19, or our response to it, has been a disaster for children’s mental health. Despite knowing very early on that covid posed almost no risk to children, we closed schools for months at a time and our children missed more face-to-face learning than in almost any country in Europe. However, covid measures have not been the only political threat to children’s wellbeing.
Over recent years, we have seen the increasing politicisation of children in schools. Parents across England frequently write to me about extreme gender ideology and other radical ideologies being taught in schools and reinforced by the internet. When gender non-conforming, autistic, same-sex attracted or troubled children are being told by trusted adults that their problems can be solved by changing sex, we have a serious safeguarding and wellbeing issue. The rise of the internet, particularly social media, presents a serious threat to our children’s mental health. There is a huge piece of work to do to keep children safe online, and tech companies must step up.
Family breakdown is a threat to children’s wellbeing. Children aged 11 to 16 who live with a lone parent are twice as likely to be diagnosed with a mental disorder as those who live with both parents. It is no surprise that our children are facing a crisis of mental health when we have one of the highest family breakdown rates in the western world. In recent decades, our social policies have made family life progressively more expensive and stressful, with more and more parents pushed into full-time work with less time and energy to devote to nurturing children. I pay tribute to my right hon. Friend Dame Andrea Leadsom for her amazing work in delivering the Start4Life offer that will strengthen families, but there is more to do.
We need to start by recognising that intervention through schools and through the NHS, as important as it is, is no substitute for strong families in which children have the opportunity to develop virtues and character traits that will give them the best chance of good lifelong mental health. We have to pursue policies that strengthen families and equip parents and communities to foster in their children values and virtues such as patience, resilience, perseverance, self-control and humility —the kind of virtues that are taught not only in school, but in families and communities—and to build the foundation for fulfilling and happy adult lives. As the proverb says:
“Train up a child in the way he should go: and when he is old, he will not depart from it.”
Mental health is at a crisis, but those on the other side of the House who stand up and say that it is because of covid, I am afraid, have their head in the sand, and those on the other side who say that it is because of family break-ups are looking in the wrong direction, because actually the problem is not covid.
The 369 people, most of them young people, who committed suicide between 2016 and 2020 in my NHS trust did not do it because of family break-ups or because of covid. I actually find it repulsive that those on the other side suggest that. They did it because of a failure of the last 10 years, with a destruction of youth work, a destruction of Sure Start and a destruction of counsellors in schools. Those on the other side praise themselves that they are reintroducing counsellors in schools, but let us be clear that it is a reintroduction, because under Labour last time we had those things that stopped the crisis of young people committing suicide in such large numbers. Of course it was not perfect—nothing is—but it was a hell of a lot better than what we have now, and to suggest otherwise is sickening.
I have constituents affected—hundreds of them—but I will mention three now. One who was diagnosed with autism in year 6 had to wait until year 8 at school before he got any support. That contributed to a mental health breakdown, and there was no psychiatrist in the local CAMHS to support him—a three-year wait and still no needed support. I have a constituent whose son is 13 and has been out of education for two years because of suicidal tendencies—a four-year wait for a proper assessment, including 16 months with no education, health and care plan put in place. Then, at the last moment, he was told he has another wait of 24 months, despite his parents having to take time off work in order to look after him around the clock. The son of another constituent was diagnosed in early 2019, and the first assessment was only in December 2020—three and a half years later he is still waiting for the final assessment and support.
The testimony I have had from an NHS nurse in a neighbouring trust says that there are 3,500 children waiting for an initial assessment, they have no CAMHS beds available, and routinely they have 10-plus children stuck in A&E. This is not covid or family breakdowns; this is a lack of funding and Government failure.
I welcome the general theme of the debate and recognise the importance of Children’s Mental Health Week. We have come an enormous way as a society on mental health. Although we have not erased the stigma of talking about mental health, we have come a long way. It was 10 years ago that the Health and Social Care Act 2012 enshrined duties on the Secretary of State for Health to improve physical and mental health, and it was a year later, in 2013, that the NHS constitution changed to bring parity to the two.
However, we have to recognise that the pressures on young people and children now are significant. Every generation has challenges, but this generation seems to be contending with more than most. First, there is the impact of social media. People can never switch off from Facebook, TikTok and Instagram—we know that—and platforms have to do much more to allow children and young people to take a step back. They have to do more to help children realise that unrealistic expectations are being put on them about body image, what relationships look like, and what careers and success look like.
Then we have to layer on top of that the impact of covid, and there has been an impact of covid on the mental health of children. It is not just the worry and anxiety that come from a pandemic, but the social isolation, the loss of learning and the loss of emotional development, whether children are four or five and just going to school for the first time, or 16, 17 or 18. These things are difficult to remedy, but that is what we must do.
Colleagues have spoken about the £500 million going into the mental health recovery action plan, and it is very welcome that £80 million of that is for young people. The long-term plan and the mental health leads going into schools are also very welcome, but I want to say a special thank you to Burnley FC in the Community, which does a really important job locally. Through its schools’ mental wellbeing project, working with the premier league, it puts mental health practitioners into local schools. They offer one-to-one sessions and group sessions. Between January 2019 and November 2021, more than 3,500 students were engaged. That helps to reduce anxiety, improve mood and build self-esteem. Lots of progress has been made and there are lots of schemes, funds and projects out there to make a difference, but because of social media and covid, now is the time to accelerate them.
I will focus on a few key points. On in-patient treatment for children in severe mental health crisis, the Health and Social Care Committee’s report last year found that
“there are too many children and young people in inpatient units subject to inappropriate care: far from home, without adequate understanding of their rights, and subject to restrictive interventions.”
Being far from home is a particular issue—so many children are being sent out of county and too far away for their families to visit. That is a particular problem for young people with eating disorders, because the beds are commissioned nationally, so even those who are clinically high priority may be sent out of county and isolated from their support networks. A recent BBC investigation found that children struggling with mental health problems during the pandemic faced agonisingly long waits for treatment, with more than one in five waiting more than 12 weeks, and doctors reported that distressed children ended up in A&E as they had nowhere else to go.
Another point that I want to make to the Minister—I know he is not a Health Minister, but I hope he will pass it on to his colleagues—is about the suitability of A&E for people presenting in mental health crisis. 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.
In Bristol we have a pilot of a separate room for autistic children who come to A&E, which is a hideous place to be, as hon. Members can imagine, even if someone has just burned their hand or something. There are bright lights, sirens and people rushing around—it is a whole sensory overload—especially at times when we know that A&E is full of people who are drunk, aggressive or violent. That can really add to a child’s distress.
Bristol is piloting a scheme where children are put in a separate place, but I would argue that A&E is not an appropriate place for anyone having a mental health crisis. For example, someone having a psychotic episode should not be sitting in A&E. I hope that the Government will look at that—I think Oxford is thinking about how it can separate that out. Connected to that, youngsters are often being treated for mental health conditions on general wards, because the beds are not available, but obviously they do not get the specialist support that they need there.
Adverse childhood experiences have been mentioned. We must look at prevention, whether that is children suffering abuse in the home, domestic violence, extreme poverty, neglect or abandonment—we have seen so many terrible stories recently. We need to recognise how traumatic that is for children and build that into our services.
I will give one example. When mothers and children are fleeing an abusive situation at home, they should not be put in temporary accommodation that they might share with people who are addicts or who have mental health problems and can be aggressive. We need to make sure that they have a safe place to stay.
I thank the Opposition for securing this debate. It is important that we shine a light on the issue. I have always said that it takes a village to raise a child, but it actually takes an awful lot more people than that. I thank everyone in Truro and Falmouth who helps children in their lives, such as council officers, health and care professionals, teachers, early year educators, child minders, charities, volunteers and, of course, parents and families.
I will highlight a few of the challenges that we are facing in Cornwall. The end of the national lottery HeadStart grant in July is a key issue for us. It has funded trauma-informed training in schools to support professionals to work directly with children. At the moment, it is not set to be replaced.
Cornwall gets money from the Department of Health and Social Care for health provision and from the Department for Education for schools, but nothing directly to the local authority. It uses its core budget to support emotional health and wellbeing. It invests in clinical psychologists to help the most vulnerable children and school nurses to help with emotional health and wellbeing in order to prevent the escalation of need. However, I am told that there is no defined budget.
Schools in Cornwall are training and becoming trauma-informed schools, which supports children and their parents in their journey around mental health and is good for their health and wellbeing. That is being supported by Cornwall Council wellbeing for education, which is led by educational psychologists to enable staff to promote and support pupils’ wellbeing. Cornwall has successfully set up the Bloom, which offers to support all professionals in advising children and young people around the county.
Children need routine. They also need stability, stimulation and ambition. Most Members in this Chamber will be shocked to hear that there are children in Cornwall who have never seen the sea. Cornwall is an important place where we can exploit our blue and green environment, with surfing, fishing, swimming and forest schools. Where these schemes are set up, they are life-changing for children with mental health issues and difficult home lives. They not only teach children practical life skills, but build confidence and resilience. For me, that is the opposite of being sat at a screen, continuously exposed to social media and the media-driven anxious society in which we find ourselves today. As a society we must do better. For example, rather than yelling at each other from one side of the Chamber to the other, we should work together to do better for our children. We must set an example and do much better in this Chamber.
I would like to see anyone and everyone who comes into contact with a child to inspire them; to let them know that they can achieve. If we do that from the start, from the very early years, I think we will do better in the future.
Children in Feltham and Heston and across the country face many challenges both online and offline against which they battle for their own wellbeing, their confidence and their achievement. Today, in Children’s Mental Health Week, I want to speak in support of Labour’s motion and thank my hon. Friend Dr Allin-Khan for her passion and leadership in bringing this debate forward.
We have all been concerned about the impact of the coronavirus pandemic on the mental health of young people, many of whom have also tragically lost loved ones. If covid has been scary enough for adults, just imagine how scary it has been for children. In truth, though, covid has only compounded the issues that were already there. I thank teachers, parents and all who work with children for helping to deal with this crisis that we face.
In north-west London, a staggering 71% of children are not seen within four weeks of being referred to children’s mental health services. The headline message from my local heads, including those from Reach Academy, Springwest Academy and Cranford Community College, is that the need for mental health support is very high. Timely access to the right support is a key challenge, and the support that exists could be joined up. That is why it is right that Labour is calling for a guarantee for mental health treatment within a month for children who need it, for a full-time mental health professional in every secondary school and a part-time professional in every primary school, and mental health hubs for children and young people in every community. These are vital to achieve three key things: support our young people, support our teachers to help them, and support parents to help their children.
Schools have sought to do what they can. In one school, 40 pupils—5% of the total cohort—are being seen weekly by an in-house counsellor. Such a resource that this school has introduced reduces pressure on external services and helps children and young people to get that support early. It is the business case for why we need these measures that we are debating today.
Professionals based in schools are critical because they can also join up work with parents and teachers so that support for children becomes more joined up and aligned. Far too much support is too siloed, and what teachers are telling me is that, in terms of catch-up, mental health treatment is the most acute need, but the support and the expertise that are needed are not there in schools.
We know that when children are waiting for weeks—even up to four weeks—for treatment, it is already too late. It is affecting their learning and their lives, and at that point they are already falling behind, exacerbating their mental health issues, causing anxiety for them and their parents.
In conclusion, we have shared some real stories today—stories of the real lives of children in my constituency right now. These are children who have not returned to school and who do not leave their bedrooms because of their anxiety. It is the same across the country. For goodness sake, let us step up to the challenge and bring forward the measures that we need today.
I thank Dr Allin-Khan for securing this debate. The subject is close to my heart. While we know that the most valuable time in a human’s development is during childhood, and that by setting the right foundations early in life, we can prevent and reduce issues that may occur as a person grows through to adulthood, we also know that mental health, just like physical health, can change at any point in our lives. We need to be bolder about how we tackle the advent of social media and the massively corrosive impact it has had, not just on young people, but on so many people across the age ranges—it does not discriminate.
Naturally, it is most welcome that this Government are acting on the early years healthy development review by asking all local authorities to publish a “Start for Life” offer for parents, backed up with a £500 million package for families. Staff and professionals in our local authorities, education settings, charities and health and community organisations work tirelessly to help our children and families. I thank them from the bottom of my heart for what they do. Yes, the pandemic has made that challenge all the harder, but they have tried their best in these unprecedented times.
The pandemic has also made things harder for parents and carers of children, whether they are living in homes not suited to the number of people in them all day, every day during lockdown, or struggling to balance working from home with caring responsibilities and home schooling. Families need to know that they are supported, and it needs to be as easy as possible for them to know where to get support for their children.
Parents want what is best for their children, and finding support when needed can often be difficult. Family hubs will provide one central point of contact from conception until the day that the child legally becomes an adult, providing a more holistic approach that combines virtual access with face-to-face support. As amazing as technology is in connecting us, we still face a barrier of digital exclusion in some areas of our communities, and nothing truly replaces the benefits that come with face-to-face support. We need to build more robust and resilient young people, who will grow into robust and resilient adults for the generations to come, and that must start as early as possible.
This morning I visited a school in my constituency, Harris Academy Clapham, and I had the opportunity to speak to young people about their mental health challenges during lockdown, to meet Mabel, the cockerdoodle support dog, and to find out more about what they are doing during their wellbeing week. It is one of the few schools fortunate enough to provide an onsite counselling service, and not just to children, but to parents and teachers where needed. That is through the organisation Place2Be, the founders of Children’s Mental Health Week. But even in schools such as that, that is simply not enough to meet the demand: the schools that are able to offer that take it upon themselves, stretching already slashed pupil premiums or sometimes funding from their local authorities, whose funding has also been severely cut. There is no dedicated funding from the Government specifically to provide that service at this time.
The reality is that we do not have the capacity to treat the rising levels of mental health issues, because this Government simply will not invest in it. Between 2010 and 2015, spending on children’s mental health services fell by nearly £50 million. That is more than 6% in real terms. The early intervention grant, which was originally set at £2.79 billion for 2010-11, has since been cut by almost £1 billion.
Listening to the Minister speak earlier, I was reminded of something that my hon. Friend Rachel Hopkins was saying. If someone has £10 and I take that away from them and give them £1 back, I do not expect them to be grateful, but that is exactly what the Government seem to do every single day. Cuts, with austerity, real-terms cuts, and privatisation that ends up costing more and delivering less all mixed in for extra measure—that is the complete sum of this Government’s economic policy.
In the sixth largest economy in the world, every crisis in public services, including this mental health crisis, is a political choice. We are seeing nearly 1,500 children a week presenting with mental health problems, while specialist services turn away one in four children referred to them. Around 75% of young people experiencing a mental health problem are forced to wait so long that their condition worsens, or they do not receive any treatment at all.
All Members will no doubt agree that our mental health services are as important as our physical health services, so why do we not treat them that way? While various announcements sound good on paper, they are all completely tokenistic if they are not combined with systematic support. There has to be long-term investment in mental health and education and the focus cannot be solely on training teachers, who are there to teach. We need specialist services.
For every £1 spent on intervening early, there is a cost saving to individuals and society of £6.20. At the moment, there is so much pressure on all our services, and preventive support is obviously the most cost-effective way of targeting funding. It is vital if we are to tackle the spiralling mental health crisis across the country.
There have been some excellent speeches, but in three minutes, I cannot cover all the points that I would like to cover in this important debate. Munira Wilson made an excellent point, if I understood her correctly, about local accountability. Too often in this place, we simply debate in terms of figures—£100 million, £80 million, £90 million—but we need to develop bespoke services that are available 24 hours a day, seven days a week to address the bespoke characteristics and the bespoke challenges that face people in our constituencies.
I will not recite a lot of facts. I just want to say that CAMHS in Bury is manned by two social workers with mental health training. There is a clinical psychologist post, for which we have been looking for somebody since 2020, and there is another full-time person. So for a borough of 200,000 people, we have two full-time social workers, one manager, one full-time person and no one else providing support for the young people in our constituency. It is no wonder that constituents contact me and say, “There is nothing and we are at the end of our tether” and all the other phrases they use. It is no good my standing here, going through a prepared speech with a lot of political soundbites about that. We have to find the solutions. Those solutions will be different in Bury, in Twickenham and in other places throughout the country. There has to be local ownership of that. The funding has to be invested in a way that gives the best support we can to local people.
I was very interested in the shadow Minister’s opening statement. For a long time, I have called for what I describe as a special educational needs and mental health hub for Bury because that model is very interesting, but we heard no details about it from the shadow Minister. I do not say that as a criticism, but what is the detail? Who will be housed in those hubs? What services will they provide? The idea of 24-hour holistic care covering not only education, health, social care, but employment opportunities and mental health care is an interesting and passionate idea that we should all join together to take forward. I do not think the Government can be criticised in that respect because family hubs are established on exactly the same principle. I welcome the Government’s commitment to that and I hope that more hubs will be rolled out and funded.
The Minister, who is an excellent man, would not forgive me if I did not say the following. I am chair of the all-party parliamentary group on nursery schools, nursery and reception classes. An early offer, early intervention in schools and an under-fives service: having support at that early stage is fundamental and I know he is committed to investing in that.
This debate on children’s mental health matters because half of adults with lifelong mental health conditions first experienced symptoms by the age of 14, so the sooner we identify, treat, cure some and build coping strategies for others, the less the cost of the crisis to their families, their schools and society, and the better we are.
In 2019, I carried out a constituency survey on children’s mental health and the top three issues raised with me were: long waiting times for specialist treatment; that children could access treatment only if they were severely ill or self-harming; and that the police were far too often the emergency service having to fill the gap. The situation during the pandemic is even worse. In the spring of 2020, I wrote to the Education Secretary to urge the Government to provide additional mental health care and resources for young people. We knew that the pandemic would have a huge impact and only increase the already acute and difficult pressures on young people and school staff.
Whatever help the Government have given, which Conservative Members have mentioned today, has hardly scratched the surface. Over the past week, I have heard from children and teachers what the covid situation has meant to them: missing families; not seeing grandparents before they died; primary-aged children missing play with friends; secondary school students worrying about their exam grades and their futures; particular problems for families in overcrowded accommodation—four children in a one-bedroom flat is not uncommon in my borough—money worries as parents lose their jobs; and no access to laptops or tablets to do schoolwork because other family members need them more. Many children have lost the ability to make new friends, particularly the very young and later teenagers. These children at critical parts of their lives, involving major transition, have lost the skills that they need to go forward.
Not surprisingly, the demand for services has increased massively. I do not have time to say everything I wanted to, but we are so lucky to have a really excellent youth counselling service in the borough of Hounslow, which provides not medication or treatment for young people in real crisis, but excellent professional counselling for young people who self-refer with anxiety and depression. Unfortunately, its staff are seeing too many children in crisis, a service for which they are not geared up and do not have the capacity.
I also want to mention the mental health ambassadors from the Gunnersbury Catholic School for boys. Those selected for this scheme have had direct or family experience of mental ill health and have now been given proper training to provide a listening ear for any student who needs specialist support. I hope that more schools can have that.
What I am going to talk about will surprise no one. We have heard a lot about the causes and whether it was lockdown or social media, but I am going to talk about the thousands of children I have met who have been victims of sexual violence and have lived in domestic abuse circumstances.
I used to run a counselling service—funnily enough, it was one of the first things that went in the cuts and then had to be paid for by the lottery—for children who had been raped. That lifeline was taken away. I want to remove this from what we can do in an educational or even an NHS setting and say that we need specialist trauma counselling for children who have been a victim of sexual abuse, violence and exploitation. Bear in mind that, this year, we are at the highest level ever of children suffering from exploitation. That went up by 10% last year—British children trafficked around the UK—and it is at the highest it has ever been, all while conviction and charging rates are falling. Each one of those children, many of whom I meet, are without any counselling or specialist support while they wait four to five years for justice to be served, for their child abusers to face any sort of justice.
I will speak briefly about my constituent, who I make come and see me every Friday because I am worried she is going to kill herself. She is 19. She was abused from the age of 10 and she first came forward to police forces when she was 14. She is awaiting the trial after coming forward at 14—she is 19, so that is five years she has been awaiting the trial. She is currently housed—this relates to the point that my hon. Friend Kerry McCarthy made—in unregulated, exempt accommodation for homeless women and bear in mind, she is a rape victim, a child abuse victim.
Suddenly, all the Ministers care about child abuse, one notes, this week. This child abuse victim has been housed with three men, two of whom are being released from prison. I have written to the Levelling Up Minister to say, “What would this do to your mental health, if you were a rape victim waiting five years for trial?” No counselling service was available to her when I tried to get it. Basically, I am going to pay for it myself, because there is nothing available to her—nothing. I might as well—I was going to swear then, Madam Deputy Speaker, but I will not—do something in the wind, trying to get her on to a waiting list. We are housing her in dangerous circumstances. When I asked the Minister to regulate that, they said we do not have the parliamentary time.
Children’s mental health has been ignored by the Government for far too long, way before the covid pandemic, although over the past two years, sustained periods of isolation, academic stress and uncertainty have taken a further toll on our young people. It is shocking that a third of children in need of support find themselves turned away from mental health services, despite a referral from a professional. For others, the waiting times can be agonising.
Across England in 2020-21, three quarters of children were not seen within four weeks of being referred to children’s mental health services. In my area, covered by BLMK ICS—the Bedfordshire, Luton and Milton Keynes integrated care system—60% of children referred to children’s mental health services are not seen within four weeks. We expect, and our young people deserve, better.
Early intervention and preventive services are vital to giving every child a healthy start in life and support for their future emotional wellbeing and good mental health. Yet during the last 11 years, in response to huge Conservative Government cuts to our local public services, charities and the voluntary sector have had to step up to ensure that our children have access to support services.
Across Luton and Bedfordshire, the charity Chums provides mental health and emotional wellbeing services to children and young people, and their families. Active Luton has delivered a range of holiday schemes for children up to 16 who are on income-related free school meals, encouraging them to play sports, and engage in arts and crafts, and other enriching activities, as well as ensuring that they receive a nutritious meal. On Monday, I was pleased to visit the KidsOut charity in my Luton South constituency to hear how it supports children who have escaped domestic violence. The charity works with domestic abuse charities such as Women’s Aid to provide toys and games to children who may be living in a refuge or safe house.
While the work of local charities makes a huge contribution to our children’s mental health and wellbeing, they, too, are overstretched and underfunded. Parents and guardians rightly expect their Government to deliver the support their children need, when they need it and on an equitable basis. Mental health and wellbeing are key parental priorities for children’s education and schooling. Parentkind’s annual parent survey in 2021 found that children from less advantaged backgrounds or with additional needs or disabilities are much more vulnerable to mental health issues. Also, the most serious mental health issues in children are more likely to be reported by parents of black, Asian or minority ethnicities, compared with those of white ethnicities. That is shocking and demonstrates how the Government are neglecting inequalities that drive mental health issues in towns such as Luton, which are super-diverse and have pockets of deprivation.
Finally, in this Children’s Mental Health Week, I fully support Labour’s plans to ensure guaranteed mental health treatment within a month, the recruitment of 8,500 new staff, an open-access mental health hub in every community and the provision of specialist mental health support in every school. Labour is ambitious for every child. Through our recovery plan and long-term support for children’s mental health and wellbeing, every young person could receive the support that they need.
I am speaking today, as I have done before, as the chair of the all-party parliamentary group on eating disorders. Eating disorders are the mental health disorders with the highest mortality rate. My hon. Friend Munira Wilson talked today with a breaking voice about cases in her constituency and Jess Phillips talked about the terrible things happening to our constituents that we see and hear about; I worry about the lives of a number of young people I know and about their families, who are worried sick about losing them. That is what we are talking about today.
Eating disorders are complex and potentially life-threatening, and the number of cases has increased fourfold in the last two years. They have no single cause and often start at school age. Recovery from an eating disorder takes on average three times as long as having the disorder itself. The fact that eating disorders all too often go undiagnosed—we have heard again and again about how long waiting times are—and that people are waiting so long to get treatment adds to the problem.
Eating Disorders Awareness Week is fast approaching. This year’s focus will be on training doctors to recognise these disorders. A 2019 report from the Parliamentary and Health Service Ombudsman identified a “serious lack of training” about eating disorders, which received just a few hours of attention on medical courses. That means that children, who often cannot adequately express their needs or condition, have been left on their own with these complex and debilitating conditions. Three years on, very little has changed.
Moving forward, we must recognise the importance of prevention and early intervention, which dramatically improve the chances of recovery. School counselling is an ideal form of early intervention. Scotland, Wales and Northern Ireland all have statutory school counselling services. England does not. Meanwhile, community services and the voluntary sector face a backlog of people desperate for urgent help. Our voluntary sector, such as the regional eating disorders charities network, has taken on the lion’s share of school counselling and shouldered the burden of addressing the mental health of our children. We must recognise the invaluable work that they are doing and make sure that they get more funding. Some £11 million has been allocated to improve eating disorder services, but only £1.1 million has been spent on the frontline. I have raised that worrying statistic with the Minister before, and I urge her to listen. We must make sure that every penny that the Government make available actually gets to the frontline.
Here on the Opposition Benches we often refer to a crisis—the cost of living crisis, the fuel crisis and the poverty crisis—but the dire lack of children’s mental health services is exactly that. I need a stronger word to describe the absolute gaping void where even the most basic help, support and accessible services should be. As mentioned by my hon. Friend Kerry McCarthy, I learned last week of a constituent whose 13-year-old daughter was sent from Whitstable to Manchester. Surely there can be nothing on earth more stressful or soul-destroying than being unable to get urgent help for your child when they are suffering.
In debates such as this, our respective parties will send around statistics. The ones that we received today say that three quarters of children are not seen within four weeks of being referred to children’s mental health services. As bad as that sounds, the reality is so much worse. In the almost five years that I have been holding regular surgeries I have seen case after case where parents are beyond desperate. They arrive, often a mum and a grandma, sometimes with the child in tow, with that all-too-familiar huge black folder rammed full of copies of emails, statements or education and health care plan paperwork, and report after report that makes it blatantly obvious that urgent help is needed immediately. I see parents crying in my office or over Zoom every single week without fail. Their health is affected as well. The stress and anxiety that those parents experience is off the scale. In some cases the young person has missed school for months, had problems for years, is self-harming or feeling suicidal. Parents have to leave their work and become full-time carers and campaigners just to secure an appointment for an initial assessment.
The Labour party has announced today that we want all children to be seen within four weeks, but that would be a miracle for most of the children and families that contact my office. When we first started taking on those cases, we were frustrated and upset to meet people who had been waiting for, on average, around 18 months. It then grew to two years. A few weeks ago, I met a desperate mother who had been waiting for help for her child for four years.
This is a huge crisis. The nation’s children and young people are being failed. What can we do? Is simply signing a bigger cheque the solution? We need to look at the systemic problems and the solutions we can get from health professionals. We have some brilliant professionals in Canterbury, but they are desperate and they need help. Surely we need to look urgently at the structure and provision and the lack of uniformity across the UK.
We must restore preventive mental health services in schools, hubs and communities, with professionals available to offer proper support to the currently more than 100 complex long-term cases I have. Many other MPs are desperate for help as well. I do not want to see any more parents crying in my surgery. Please let us get them some support before it is too late.
I am glad we are talking about this issue today, because the figures quoted at the beginning of the debate are shocking. In my area of south Yorkshire and Bassetlaw, three quarters of children referred to mental health services are not seen within the four-week period. I find that beyond belief, but in other areas of the country that rises to nine in 10 children. That is a horrific indictment of the Government’s approach and just goes to show that setting a target is only half the job. The energy and resources need to be put into meeting it too.
Other Members have eloquently outlined the broader picture of the crisis in children’s mental health, and Labour’s plan to address it. I want to use the opportunity of this debate to highlight a particular mental health problem and the effect that the lack of specialist services is having on children. The pandemic has seen soaring numbers of children suffering eating disorders. Some statistics we have not heard yet today are that between April and October last year 4,238 children were admitted to hospital with an eating disorder. That is an increase of 41% on the figures in 2020 and an increase of 59% on 2019, when the figure was 2,508. That is a dramatic increase in eating disorder inpatients, which should be incredibly concerning to all of us.
Of all the mental health issues, eating disorders are the No. 1 killer. It is perhaps even more concerning that, when these children and young people are admitted, the shortage of tier 4 beds and mental health practitioners means that they are often put in the wrong place in the system and do not receive support from people trained in eating disorders. These children are suffering from acute mental health problems and, unfortunately, restraint is regularly used on health wards, not mental health wards. That is not a good intervention, and it is not an appropriate therapeutic pathway for such acutely ill children. They all deserve a tier 4 bed, given how ill they are. At the moment, they are treated only for the physical consequences of their eating disorder and do not receive any kind of mental health intervention. That ignores the whole cause of their eating disorder.
Members have highlighted that we are failing our young people and children on the four-week target. It is also vital that the care that is finally provided is provided by the right people, not by people who are unqualified to meet their needs, as is happening to thousands of children with eating disorders up and down the country. There is a real danger that the system is actively contributing to making their mental health problem worse and harder to treat.
Does the Minister have figures on the use of physical restraint against children with eating disorders in acute wards that are not mental health wards?
When I was in school under the then Conservative-led coalition Government, I remember friends and classmates whose mental health was in crisis. They struggled to be seen, and they waited months, even years. Since then, the situation has only got worse.
I am regularly contacted by parents who are caught in the snare of long wait times for underfunded and non-specialist services when trying to access mental health support for their children. In Nottinghamshire, 78% of children referred to child and adolescent mental health services wait longer than four weeks to be seen. Between April and October 2021, just six months, more than 409,000 children were referred to CAMHS for self-harm and suicidal thoughts. I challenge anyone here to tell me that that does not constitute a crisis and that it should not be dealt with as such.
This motion calls on the Government to ensure that there is mental health treatment within a month for those who need it; specialist professional mental health support in schools; and the establishment of open-access mental health hubs in every community. These are moderate demands when we consider what is at stake. There has been a 77% rise in the number of children needing treatment for severe mental health issues since 2019. In my constituency, referrals for treatment for eating disorders—as we have heard, these are the psychiatric conditions with the worst mortality and morbidity outcomes—outstripped predicted levels last year.
Last Friday, I visited children and young people at Hopewood, an in-patient unit in Nottingham East. Many of them were far away from home and far away from their family and friends, and one remarked to me that they felt forgotten about and that no one cared. They were all concerned about mental health funding. Of course it is important for us to talk about awareness, but the sad truth is that people are already aware because they are living it. What they need is material change, and that cannot be provided by volunteers operating on a shoestring. There is no way around it. The only option is for the Government to invest significant amounts of money in proper mental health support and in children’s mental health services.
We must also tackle the root causes of poor mental health in children. The Mental Health Foundation highlights that living in poverty is a risk factor, and the Children’s Society has said:
“Reductions in family income, including benefit cuts, are likely to have wide-ranging negative effects on children’s mental health.”
This is not just a crisis of children’s mental health but a crisis of inequality, too. That inequality is exacerbated by the policies of this Government, who now have a duty to fix it.
I am grateful to all hon. Members who have spoken in this important debate. We have heard this afternoon many moving and devastating accounts of the ways in which children and young people who are struggling with their mental health are being let down by a system that simply cannot deliver the support they need, and by a Government who have no ambition for our children and young people and who refuse even to acknowledge the scale of the challenge.
There have been too many contributions this afternoon for me to mention everybody by name, but we heard from my hon. Friend Kim Leadbeater about the shocking figures on suicide and self-harm in her constituency. My hon. Friends the Members for Ealing North (James Murray), for Streatham (Bell Ribeiro-Addy) and for Feltham and Heston (Seema Malhotra) highlighted the importance of mental health support being provided in our schools. My hon. Friends the Members for Bootle (Peter Dowd) and for Luton South (Rachel Hopkins) highlighted the vital importance of early intervention. Munira Wilson spoke movingly of some appalling cases in her constituency, including the suicide of a year 11 student.
My hon. Friend Justin Madders highlighted CAMHS waiting times in his constituency, as did many other hon. Members. My hon. Friends the Members for Bristol East (Kerry McCarthy) and for Canterbury (Rosie Duffield) spoke about the terrible problems with out-of-area tier 4 placements, which are far too common. My hon. Friend Jess Phillips spoke powerfully, as she often does, of the impact of sexual violence and abuse on mental health.
Good mental health and wellbeing are vital for our young children, while poor mental health is a barrier to learning that prevents children from fulfilling their potential. It affects children’s sense of self and how positive they feel about the future. It can impact their whole lives and for some, poor mental health can, tragically, be fatal. For parents and carers, there are few experiences as devastating as watching their child’s mental health deteriorate, yet that is the experience of hundreds of thousands of families across the country. Parents are living with unbearable anxiety, having to stop work to keep their child safe and try to soothe their pain. No parent should be left in this position, without access to the support their child needs.
The covid-19 pandemic has taken a severe toll on children’s mental health, as children have been isolated from their peers, often unable to learn properly and at increased risk of online harms, with many suffering the trauma of bereavement or domestic abuse in lockdown. Before the pandemic, however, children’s mental health services were already in crisis, with waiting lists, acute admissions and out-of-area hospital placements far too high and with only around a quarter of children who needed mental health support able to access services.
We know what is needed to tackle the crisis in our children’s mental health. What is lacking is not the knowledge of what to do; what is lacking is the ambition of this Government for a country in which the mental wellbeing of our children is a priority and services are there for those who need them. We know that early support is key. While children languish on waiting lists, their mental health deteriorates and so does the length of their recovery and the impact that their illness will have throughout their lives. Delivering mental health support teams in just a fraction of communities is not a fit-for-purpose strategy. It is a half-baked plan that is worsening the postcode lottery of children’s mental health services.
Labour is pledging to end the postcode lottery. We will deliver specialist mental health support in every school, and open-access mental health hubs in every community. Hon. Members have asked about the detail of that service, and I would point them to one of my local authorities, Southwark, which has a service called the Nest. It provides open access to children who live in the borough and a really first-class standard of support for our children and young people, but we need such services to be available throughout the country to every single child who needs them.
We are also pledging an end to agonising waiting lists, with a new national commitment to mental health treatment within a month for every child who needs it. To those hon. Members who have questioned the value of targets I say this: if we do not measure it, it does not get done. Targets are not the whole solution, but they are a vital tool in ensuring that services are delivered to children who need them.
Today’s motion is for every child and young person who needs support for their mental health and for every parent and carer living with devastating worry for their child. It is a statement of Labour’s ambition for a country in which every child can thrive. I commend it to the House.
I start by thanking all Members in all parts of the House for their valuable contributions to this important debate. It is, I hope, one of those debates in which all of us fundamentally want the same thing, and I think we have heard an awful lot of agreement across the House today. In Children’s Mental Health Week, it is important that we raise awareness of this important issue. Like Dr Allin-Khan, I congratulate and thank Place2Be for all the work it does to raise awareness nationally. It is right that we have a spotlight on children and young people’s mental health, and I join hon. Members in thanking all those who work in mental health services up and down our country.
As many Members rightly pointed out, the pandemic has proved to be hugely challenging for children and young children, but they have shown incredible resilience in the most difficult circumstances. The pandemic has been difficult for many families. We all know this and many examples have been cited today, but we should not overlook the impact on children from not being able to attend school or go to after-school clubs, from not being able to see friends and family or play the sport they love, and from being stuck at home with their parents, as my children regularly said. There was disruption to their lives, and I thank teachers and support staff throughout the country for helping us to reopen schools and get children where we know it is best for them to be and they wanted to be. Whenever I visit a school, I ask about mental health and mental wellbeing. Immediately before this debate, I was in Trinity Church of England School in London, alongside Instagram and “Love Island” star Dr Alex George, to meet the mental health support team. They are doing incredible work, which I want to see rolled out further and faster; I will cover that in more detail later.
As Minister for Children and Families, I have a cross-Government role, but I hope the House understands that my focus today is on education. I will try to answer as many of the points raised by colleagues on both sides of the House as possible, but first—perhaps unusually for an Opposition day debate—I want to say how much I welcome the Opposition raising this subject and pushing the Government to go further and faster. As Children’s Minister, let me say that one child or young person waiting too long for mental health support is one child too many. The health, both mental and physical, of children and young people is something that I and this Government take incredibly seriously. Are we doing a lot already? Yes. Can we do more? Yes, and we must. Our children and young people deserve nothing less.
Does the Minister agree that mental health is not something we can consider under one umbrella? In my Dudley constituency, Priory Park boxing club is doing fantastic work with children who are excluded from school. It is a great place not only for their physical wellbeing but for their mental health. The new hubs need to be integrated with other stakeholders in the community.
My hon. Friend is absolutely right. I will come on to talk about family hubs and the role that they can rightly play.
I am no expert in this field, but I listen closely to those who are and I split mental health and mental wellbeing into three categories: resilience, identification and intervention, and specialist support. On the first, what can we do to help children and young people to be more resilient? We do that through our relationships, sex and health education, which is now compulsory between five and 16 years old, through our behaviour in schools guidance, through the sports and extracurricular activities that we have in schools throughout our country, and through things like forest schools, which have been mentioned and which are absolutely brilliant.
How can we identify emerging problems sooner and provide that all-important support? We can do that through measures such as mental health lead training and rolling out mental health support teams across the country. For access to specialist mental health support, we have the NHS long-term plan and additional investment of £2.3 billion a year by 2023-24, allowing at least an additional 345,000 children and young people to access NHS-funded mental health support, which of course comes under the Department of Health and Social Care.
Does the Minister agree that we must not forget the acute services as well? It is fantastic news that we are putting £4.8 million into building a new psychiatric intensive care unit at Tameside General Hospital, which will be a big boost for the fantastic staff at the Cobden unit at Stepping Hill Hospital too.
My hon. Friend is absolutely right: acute services, which are of course a Department of Health and Social Care lead, are very important. In the Department for Education, we have a role to play in doing as much prevention as we can and getting early identification and support in place for people so that they do not need to attend the acute unit, which then frees up space for those who desperately do need it.
Let me turn to some specific points made by hon. Members from across the House. Time is relatively short, but I will cover as many as I can. I remind the House that my door is always open; Members can come to see me if I do not address any of these points and I will be happy to meet them to discuss them in person.
Dr Cameron—I have probably pronounced her constituency wrongly, so I apologise for that—and my hon. Friend Antony Higginbotham made positive and constructive comments about how it is so important that we remove the stigma and break the taboo about mental health, and put children and young people at the heart of our recovery. My hon. Friend mentioned Burnley FC and its work through football in the community. It does hugely important work and I echo his comments about it. Those Members, along with my hon. Friends the Members for Sevenoaks (Laura Trott) and for Penistone and Stocksbridge (Miriam Cates), raised the issue of online harmful content, particularly about self-harm and suicide. They rightly said that the Online Safety Bill must tackle this issue, and I can certainly give the House the commitment and confirmation that the strongest protections in the Bill are on the safeguarding and protection of children.
My hon. Friend Rob Butler raised the issue of the Youth Concern charity in his constituency, rightly praising its work, and I echo his comments. He also rightly raised the issue of waiting times, which are too long in too many cases. We need to address them, and we are doing that in part with the NHS long-term plan. His experience of the Youth Custody Service is hugely welcome, and we will certainly be calling on him to discuss that further.
The hon. Members for Batley and Spen (Kim Leadbeater) and for Brighton, Kemptown (Lloyd Russell-Moyle) rightly referenced the serious point about suicide. Of course every suicide is a tragedy, especially so when it involves a child or young person. DHSC has a suicide prevention plan, and we are investing £57 million in suicide prevention by 2023-24, as part of the NHS long-term plan. I know that the Minister for Care and Mental Health, my hon. Friend Gillian Keegan will be happy to meet both of them to discuss that issue further.
My hon. Friends the Members for Milton Keynes North (Ben Everitt) and for Truro and Falmouth (Cherilyn Mackrory) discussed the importance of green open spaces—I am amazed at the number of people in Cornwall who have not had access to the sea, so we certainly need to look at that. They also mentioned the importance of being in school wherever possible, and I have to say that there are no greater champions for the people of Milton Keynes, and Truro and Falmouth than my hon. Friends. James Murray raised the issue of mental health professionals in schools. We are rolling out mental health support leads and mental health support teams up and down the country, and I welcome his interest in this area.
My hon. Friend Jack Brereton, a passionate advocate for children and young people in Stoke-on-Trent, has made a compelling case for family hubs and the family hub model and investment in Stoke-on-Trent, and we will no doubt discuss that further down the line. Liz Twist raised the issue of the importance of early intervention, and I totally agree on that; we are doing this in schools and colleges, and she was right to praise two schools in her constituency, in Whickham and Kingsmeadow.
My hon. Friend Tom Hunt is a passionate advocate for children and young people with SEN and disabilities, and I am happy to discuss this issue with him later at greater length. I agree with him on the importance of early diagnosis. My hon. Friends the Members for Devizes (Danny Kruger) and for Sevenoaks, and the hon. Members for Bath (Wera Hobhouse)—I wish her a happy birthday—and for Sheffield, Hallam (Olivia Blake) rightly raised the issue of eating disorders. We have put additional investment in, and there is a new waiting time standard, but I know we need to do more in this area, and I would be happy to work with the hon. Lady.
I am proud of our record in supporting children and young people, and I am grateful for the ongoing support that hon. Members have given to this agenda. Can we do more? Yes. Can we always do more? Yes. We must do more and we will do more. I welcome the spotlight on this issue. Let me assure the House that good mental health and wellbeing for our children and young people remains a priority for me and this Government, and it will continue to be a priority as we recover and build back better from this pandemic, improving children’s futures and the future of our country.
claimed to move the closure (
Question put forthwith, That the Question be now put.
Question agreed to.
Main Question accordingly put.
Question agreed to.
That this House
recognises the importance of Children’s Mental Health Week;
is concerned about the impact of the coronavirus pandemic on the mental health of young people and that there has been a 77% rise in the number of children needing treatment for severe mental health issues since 2019; calls on the Government to guarantee mental health treatment within a month for all who need it and to provide specialist mental health support in every school, including a full-time mental health professional in every secondary school and a part-time professional in every primary school;
and further calls for the Government to establish open access mental health hubs for children and young people in every community to ensure the best start to life for future generations.