My Lords, the Government are aware of the appalling rise in self-harm in children and young people and the misery this reflects. The Government are also acutely aware that self-harm is a leading indicator of risk of suicide and recognise that much more needs to be done to address this issue.
I thank the Minister for his reply. The research from the World Health Organization shows that around 20% of British 15 year-olds report some sort of self-harm. In the past five years, research shows that hospital admissions associated with self-harm have gone up by nearly 93% among girls and 45% among boys. Having recently visited the outstanding charity selfharmUK, in Luton in my diocese, I have seen what a concerted and systematic approach to this problem can have on a very difficult issue, and we need something similar at a national level. Will Her Majesty’s Government commit to publishing guidelines for schools and colleges about preventing and responding to self-harm?
I think the right reverend Prelate has raised an incredibly important issue. Around 300,000 young people go to A&E every year through self-harm, after cutting or burning themselves very badly. The right reverend Prelate asked about advice and guidance. In 2004, NICE put out explicit guidance that all those people should receive, at the very least, a psychosocial assessment; today, only 53% of those people—young people in the main—receive such an assessment. That means that 100,000-plus people are going to A&E with this very nasty self-harm and are really being sent home with very little. That is quite an indictment of our system and the words that we have about parity of esteem. I entirely take on board exactly what the right reverend Prelate said. There is a lot more we can do, and perhaps in response to subsequent questions I shall try to say what we are doing.
The Minister will know that the mental health service is in crisis. He says on a regular basis that the Government are putting more resources into the area of mental health for young people. He also knows that that money is not getting spent by the trusts. When is he going to sack the trusts, or sack the chief executives of the trusts, for failing to spend that money on vital services for young people?
Last year, the rate of spend by CCGs on mental health went up by 8.6%, compared to 3.7% across the board, so the money is starting to get through. The fact is, though, that there are nooks and crannies in our NHS—which we all love—where we have fundamentally let people down for many years. The issue of self-harm and the suicide risk that derives from self-harm is a very black hole at the heart of the NHS.
My Lords, is not the ultimate tragedy for any parent the suicide of their child? Has the Minister seen or talked to ministerial colleagues about the suicide sites on the internet and the chat rooms that are often visited by young people who may be facing depression, mental illness or low levels of self-esteem, and the terrible tragedies that have occurred as a result of a visit to those sites? Is not there more that can be done by the Government to force those providers and servers to stop making such sites available on the internet?
Unquestionably, there is more that can be done. Some of those sites, certainly some of the pornographic sites, are being addressed in the Digital Economy Bill that is going through the House at the moment. But we are working with the national council and the Samaritans, which in turn are talking to people like Google and YouTube and the digital providers to see what we can do in this area. We have also commissioned a new prevalence study to look at cyberbullying and all those sorts of issues, which will, unfortunately, not produce its results until 2018. So we are very much apprised of this, but, frankly, there is always more that we can do.
My Lords, over half of all adults with mental health problems first had them diagnosed in childhood, yet fewer than half of those people diagnosed in childhood were treated appropriately at the time. Does not the Minister think that something is seriously wrong when, according to the Royal College of Psychiatrists, 25 clinical commissioning groups are spending less than £25 a year on child mental health issues and 10 CCGs are spending less than £10 a year?
My Lords, I think something is seriously wrong, and something has been seriously wrong since 1948. Mental health has been a Cinderella service, and children’s mental health has been, if anything, even worse. We are committed to spending an extra £1.4 billion; we are spending more money on mental health liaison services in A&E departments; and we are putting in 56 new beds in CAMHS units to prevent the out-of-area treatments or what have you. But we have a huge way to go, frankly.
My Lords, is the Minister aware of a new report by the Children’s Society on adolescent neglect, which suggests that parental and societal failure to admit to the needs of adolescents and address those needs is having a detrimental effect on adolescent health, especially mental health? Does the Minister agree that it is the case that parental and societal neglect is vitally important and should be addressed? Does he have any comments on how to address it?
There is no question about it that parents and society are a critical part of any way to tackling childhood mental health problems. There is no doubt about that. We have just published a work for parents on how to deal with the issue of self-harm, for example, when it is your own child. It is a hugely complex area, frankly. Social media are a big part of this and family break-ups are a big part. I am not a psychiatrist, but when you are going through a period of huge emotional turbulence, cutting yourself or inflicting physical pain on yourself gives you some form of control. It is too complicated and too difficult for me to answer that question as well as I would like to.
My Lords, the House will know exactly where the Minister stands on this, and I am sure that the House is very grateful to him for that position. Would he accept that this House will do everything that it can to support him in getting the message across that self-harm, particularly in a young person, is a sign of desperation and a sign to be taken that help is needed instantly—and that help needs to be substantial and speedy? We should never be relaxed about self-harm, in any circumstances.
I completely agree with the noble Lord. That makes it even more shocking that we do not provide these poor, miserable people, who are suffering horrendously, with even a counselling session. How much is a counselling session—fifty quid; a hundred quid? Maybe it is a series of them and it costs £500: we do not even do that for over 100,000 young people every year.