My Lords, I thank the noble Baroness, Lady Royall, for this debate and for her opening speech, which was fantastic.
As the Royal College of Psychiatrists says:
“A mental health crisis in our children is developing”.
So let me ask the Minister straight off: why then are we seeing a 3.7% fall in the number of child and adolescent mental health services providers in our schools?
The Government have responded to the mental health crisis in much the same way that most Governments react to problems or crises. The NHS Long Term Plan, which includes children’s mental health, is excellent. The Government have set targets in their Five Year Forward View for Mental Health. The Green Paper proposes to bring schools and NHS services closer together. Mental health support teams have been set up and pilot schemes rolled out. Champions have been appointed. Targets have been set. That is all very laudable, but we need action for all children and young people.
As we have heard, one in eight children and young people aged between five and 19 has a mental health disorder in England, and 400,000 children and young people are not getting any professional help or support at all. We can establish mental health champions in schools, train staff to be able to identify mental health issues and embed mental health in teacher training programmes, and it is vital that we do so, but if the resources are not there it is all for naught. It is like pulling a lever and it does not connect with anything. Nothing happens. If a child or young person is diagnosed with a mental health problem, we must have the resources to respond and to support them immediately.
The NHS Long Term Plan says:
“Mental health support for children and young people will be embedded in schools and colleges”.
The Government claim a success in that,
“We are delivering on our commitments to expand mental health services for children and young people”,
as set out in the Five Year Forward View for Mental Health. That may be true, if success is defined as 30% of those with mental health conditions being able to benefit from treatment and support, which is still less than one-third of those who need treatment. Could noble Lords imagine the headlines and the outcry if only 30% of people with serious heart conditions were being treated?
I go back to the NHS plan. The NHS will be funding new mental health support teams working in schools and colleges, which is welcome, but not until 2023—nearly five years from now. Only one-quarter, at most, of schools and colleges will have such a team. There is no indication of when, if ever, there will be a team in every school and college. Will the Government be encouraging schools to add a section to their school prospectus and website along the lines of, “Our academy is the only one in this area to have a Mental Health Support Team. If your son or daughter has a mental health problem, or you think that he or she may develop a mental health problem in the next five years, make this academy your choice”? While this idea is obviously ridiculous, what will the 75% of schools without a mental health support team be able to tell parents when a student needs support? I look forward to the Minister’s reply.
The lack of robust data about the mental health of children and young people is a matter that should shame the Government and, indeed, all of us. The teenagers who were part of the last exercise in, I think, 2004 are now in their 30s. The Department of Health claimed repeatedly that there was not enough money to undertake a full-scale assessment, and undoubtedly money was tight. Another explanation of failure to collect robust data is that the Government were content for the true picture to remain a “known unknown”, because knowing the extent of the challenge would have proved uncomfortable and expensive.
The past decade has seen a whole range of new pressures on children and young people—we have heard some of them from the noble Baroness, Lady Royall—many of which contribute to more of them suffering from mental health issues. The internet, which admittedly has opened up the world to children and young people, also has a dark side. The ubiquity of social media can lead to children being bullied by their friends or groomed by predators. Social media also promotes an image of perfection to which no ordinary person can aspire. Those who have a poor image of themselves can easily find “help” in self-harming and encouragement to starve themselves. All of this, of course, is available 24/7 since the internet never closes, even on bank holidays.
I would like to move from the macro picture to the micro picture. We have all read what reality is like for many mentally ill children and young people, with suicide a too common occurrence. I cannot imagine what it is like to have a son or daughter with a developing mental illness, for whom support only becomes available when a crisis occurs, and only then if you are a danger to yourself or others. For those acutely ill and needing in-patient treatment, a bed is often only available hundreds of miles away, which can make it almost impossible for family and friends to be in contact at the very time when these contacts are most needed.
Training school staff to spot the early signs of mental illness—and the new programme to train all sports coaches—is welcome. However, if there is not the support needed to follow up the issues identified, it will lead to even higher levels of frustration by those teachers and other professionals who work on the front line.
The need to provide better support services is universally acknowledged. Noble Lords will probably have seen from the Treasury minutes in the briefing pack that every single recommendation in the Public Accounts Committee report on the mental health of children and young people was accepted by the Government. Let us hope that the actions really will speak louder than the words.
In concluding, I would like to say a little about what should be done to try to promote well-being and good mental health among children and young people. In February, the Secretary of State for Education and the Secretary of State for Health announced,
“one of the largest trials in the world to boost the evidence about what works to support mental health and well-being”.
This is a welcome development in prevention, and will be much more effective than even the most effective cures. However, what we really need is a study that looks at the multitude of pressures which contribute to mental illness and young people. This study could then make radical recommendations for strategies to minimise those pressures. We have heard about pressures of young people at universities and colleges, but there are pressures right—