Mental Health and Wellbeing in Schools

– in Westminster Hall at 2:30 pm on 4th December 2018.

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Photo of Layla Moran Layla Moran Liberal Democrat Spokesperson (Education) 2:30 pm, 4th December 2018

I beg to move,

That this House
has considered mental health and wellbeing in schools.

It is a pleasure to serve under your chairmanship, Mr Stringer. I am delighted to have secured today’s debate on mental health and wellbeing in schools. I am sure that many hon. Members will know that I am a former teacher. My interest in this subject comes from the link between mental health and wellbeing and learning. I will come later to all sorts of issues surrounding children’s mental health and the lack of services out there, but I hope that today’s debate will focus on how this issue affects children, and indeed teachers, in schools.

Schools are not just places where we help students and children to learn resilience and the skills that they need to build themselves up so that they become adults who can cope with all sorts of pressures that are thrown at them; schools themselves can influence the mental health of children. Some of the debate so far has focused too much on the outside influences on children coming into school. Today I will focus on aspects of the current schooling system that exacerbate that problem.

Let us look at the scale of the issue. The National Society for the Prevention of Cruelty to Children says that the number of schools seeking help from mental health services is up by more than a third in the last three years. The number of referrals to NHS child and adolescent mental health services by schools seeking professional help for a student was 34,757 in 2017-18. That is the equivalent of 183 every school day. To say that this is anything other than a crisis would be wrong. We are facing a crisis of mental health issues in our schools.

The National Education Union further found that 49% of education staff said that secondary school pupils had been suicidal as a result of the stress that they were under, and more than half of professionals surveyed said that funding for support for pupils’ mental health in schools was inadequate.

Photo of Stephanie Peacock Stephanie Peacock Opposition Whip (Commons)

I congratulate the hon. Lady on securing this important debate. In my constituency of Barnsley East the local clinical commissioning group has been working with schools to try to embed support in a project called “MindSpace”. Does she agree that projects such as MindSpace that get trained counsellors into school, to be there every day, need more funding?

Photo of Layla Moran Layla Moran Liberal Democrat Spokesperson (Education)

I thank the hon. Lady for her contribution. Funding is part of it, but a number of interventions are taking place in schools, and they have to be critically evaluated. We have to look at the evidence to see whether they work. To my knowledge, only one—the Bounce Forward intervention programme—has been shown to have had a positive impact. I am not saying that the intervention that she mentioned does not, but we need to be careful that what we are doing in schools works. It is incumbent on the Government to ensure that that critical evaluation happens.

Photo of Jim Cunningham Jim Cunningham Labour, Coventry South

I congratulate the hon. Lady on securing this timely debate. Just before the 2010 general election, I introduced a Bill, which I discussed with the then education Ministers, that provided for somebody with medical knowledge, for want of a better term, to be available who would be able to spot mental illness, or other illnesses. In a way, that would have helped teachers as much as parents to do what would probably be called early intervention. Unfortunately, a general election came along, and the rest is history. Had that Bill passed, it could have been a great starting point.

Photo of Layla Moran Layla Moran Liberal Democrat Spokesperson (Education)

I thank the hon. Gentleman for his intervention. He makes an important point, and I will get to what the Government are suggesting in a moment. I also add a note of caution: I do not think that we should over-medicalise being an adolescent. There is a grave difference between that and ensuring that there are proper services for those on the acute end of the spectrum.

Coming back to funding cuts, one of the best bits of being a teacher in my day was having time to get know the students, and develop a level of trust with them, very often after a class was finished, or during an after-school club. Those are the kinds of things that are going. There is pressure on teachers, with cuts to the number of teaching assistants and a narrowing of the curriculum. Teachers have to teach more lessons and do more prep, meaning that they have less and less time for that critical pastoral support. What are the Government doing to measure how pastoral support in schools—the time that teachers have to spend with students—is changing?

It would be remiss in a debate such as today’s not to talk about teachers. Mental health in schools is not confined to the children; there is a crisis among teachers as well. A report by the charity Education Support Partnership, including a survey of 1,250 education professionals, showed that a huge majority—75%—of the UK’s education professionals had suffered from either mental or physical health issues in the last two years due to work. Some 50% of those who took part in the study said that they had experienced depression, anxiety or panic attacks due to work, and the charity has warned that unless urgent action is taken over rising mental health problems, there will be a severe retention and recruitment crisis. We already know that that is one of the issues that our schools are facing, and it exacerbates all the issues that I was describing regarding pastoral care.

The impact of Ofsted on the mental health of teaching professionals also needs addressing. The way in which Ofsted operates under its current inspection framework drives the wrong kinds of behaviour in schools. I believe, and the Liberal Democrats have now made this party policy, that the brand of Ofsted is so broken in the teaching profession that it needs scrapping and replacing with another inspectorate that does that job. Critically, the job of school improvement must be separated.

I sit on the Public Accounts Committee, and in a recent hearing we heard how school improvement is being lost amid academies’ governance structures and the lack of services provided at local authority level. Representatives from the Department for Education could not definitely say that it was their job, and neither could those from Ofsted. The Liberal Democrats believe that it is time to have an arm’s-length body that focuses on school improvement for all schools, no matter their governance structure, and a separate inspectorate that does that specific job.

Further to that, we need to change the framework for school inspections. It should not just be about numbers. I am the school governor at a primary school. I sit on the performance and standards committee of that school, and it is all about numbers. We are reducing children to single numbers; we look at their progress but do not allow teachers the time to look at broader issues. We believe that we should have an inspectorate that looks closely at wellbeing in schools and measures that part of what a school delivers as critically as attainment and progress. Having said that, I welcome much of what Amanda Spielman is doing in terms of drawing together the issues in education, particularly where she has spoken about the narrowing of the curriculum and off-rolling. That role is vital, so I do not want that to be lost in today’s debate.

Another thing that I want to bring up is league tables. Early in my career, during my first couple of years of teaching, in the early 2000s, I was a fresh-faced, brand-new physics teacher and I absolutely adored my job. I went into a school where I lost my faith in the profession very early on. We were teaching GCSEs and all the science students had been put up on a wall and colour coded. This was when we had A to F grade. The reds were the ones who were never going to get to the C boundary, and the greens were the ones who looked as if they were going to pass. We were told in no uncertain terms that we had to focus on the middle group, who were coloured yellow. That did not make any sense to me. I thought that I should be able to focus on those who needed it the most. When I asked why, I was told, “League tables.”

What can the Government do about league tables? I am not saying that we should get rid of any of the data; we should publish it. However, on the DFE website one of the first things that people can do is click on performance tables data. They are then encouraged to compare schools in their local area. Comparing schools is not a bad thing; parents need to have the right information. However, it should not just be about numbers; there needs to be a full sense of what the school offers, including its extra-curricular stuff and its ability to deal with wellbeing and mental health issues. That is not what people get; they either get performance tables data, or a link to the school’s Ofsted report, which, as I just mentioned, is inadequate in that form. The Liberal Democrats have therefore said that we would stop the Government doing that, even if we cannot stop the press doing it. In Ofsted’s annual report, which was published today, Amanda Spielman noted that, shamefully, thousands of children are being let down by off-rolling. The off-rolling epidemic in schools is a direct result of schools’ desire to push up numbers. It is about numbers, not about the children, and that cannot be right.

The Government are fostering a culture of senseless competition among schools, in which results from a single set of narrowly focused high-stakes exams are the be-all and end-all. That is not good enough. Amanda Spielman wrote to the Public Accounts Committee in October about the narrowing of the curriculum:

“Where we do have clearer evidence of a decline in the quality of education are in the narrowing of the curriculum in schools and an endemic pattern of prioritising data and performance results, ahead of the real substance of education…schools must work to make sure that pupils leave school with the qualifications and examination results that set them up for future success…However, our research has found evidence that an overly data-driven accountability system is narrowing what pupils are able to study and learn.”

My worry is that rather than encouraging children to flourish at every turn in their lives—which can often be one step forward and two steps back; that is how life works—we have a curriculum that encourages multiple levels of failure. It starts with baseline testing as soon as children get into schools, moves on to SATs and continues with exam after exam. Every young person whom I have asked about high-stakes testing tells me that it has got worse and worse.

I was an experienced teacher before I came into Parliament, but I am still one of the youngest MPs. We have to remember that the school system that we MPs went through is not the same as the system that students are going through now. There is much more high-stakes testing in the curriculum now, and we have to stop it, so the Liberal Democrats have committed to getting rid of SATs. We are not saying that data is not important, but we can collect it in other ways. For the record, as a physics teacher I loved exams—they were great—but they do not have to be so high-stakes. They can be part of learning well; they do not have to be the be-all and end-all. I am seriously concerned.

Photo of Andrea Jenkyns Andrea Jenkyns Conservative, Morley and Outwood

I thank the hon. Lady for securing this debate. I, too, have worked in education, so I understand the challenges that our young people face. Does she agree that the Government are making a step in the right direction by ensuring that young people will be prioritised with school-based mental health support available in every part of the UK?

Photo of Layla Moran Layla Moran Liberal Democrat Spokesperson (Education)

I will come on to the Government’s proposals in a moment, but yes, I do call that a step in the right direction.

To come back to the thrust of the debate, what does my speech so far have to do with mental health? Lisa, a mum of three children in my constituency, writes:

“I had a chat with my 6-year old’s teacher about the amount of homework they get. Her response was that parents needed to see the SATS papers the children would have to sit in May. They would then understand how much work the children needed to do to reach the expected standard. The problem with the ‘expected standard’ is that it only looks at certain aspects of the curriculum and then puts children into boxes”.

If they do not meet that expected standard, they can only interpret that they have failed. Lisa goes on to say that

“putting children in boxes which suit a government body is, in my humble belief, creating mental health issues at a very early age.”

I would like our debate to focus on that toxic culture.

Let me move on to what the Government have announced. We now have a plan, at least, which I would call a step in the right direction, although it is not sufficient. We are looking at having health professionals in schools—a massive workforce of thousands. My question, which was shared with some scepticism during the Public Accounts Committee inquiry, is where those professionals will come from. The professionals whose roles we are looking to create are the same people we cannot get for nursing or midwifery, because it is the same type of person who might want to do the job.

I am seriously concerned that we are creating a parallel system, while the problem could have been solved by having school nurses in the first place. To return to the subject of funding cuts, school nurses were a valuable part of schools’ wider pastoral care. Many schools have lost their school nurses, which is a crying shame.

Photo of Andrea Jenkyns Andrea Jenkyns Conservative, Morley and Outwood

Does the hon. Lady agree that mental health should be treated in schools with the same importance as physical health and that it should be central to the Government’s health agenda? I agree with what she says about nurses; we need to ensure that that is central to future policy.

Photo of Layla Moran Layla Moran Liberal Democrat Spokesperson (Education)

I completely agree. In fact, I would argue that if mental health is the Cinderella service in the NHS, children’s mental health is the Cinderella of the Cinderella service. That is brought into stark relief by child and adolescent mental health services across the country, although I will focus on Oxfordshire. My postbag is full of letters from parents who are desperate to get their children to CAMHS for all sorts of reasons. We have to remember that CAMHS is there for the most acute mental health needs; it does not cover the mild to moderate needs that so desperately need solving in school at an early, preventive stage. In Oxfordshire, children can wait for a referral for up to two years; extraordinarily, they are then often pushed back.

The Education Policy Institute reports that the number of referrals to specialist children’s mental health services has increased by 26% over the past five years, although the school population has increased by 3%. Something is clearly going on, whether it is lack of early intervention in schools or increased pressure.

Photo of Stephanie Peacock Stephanie Peacock Opposition Whip (Commons)

Does the hon. Lady agree that it is quite concerning that people need to be in absolute crisis even to get a referral? Often young people need to be suicidal before they can get a referral. That is absolutely shocking. Surely earlier intervention would be much better.

Photo of Layla Moran Layla Moran Liberal Democrat Spokesperson (Education)

I completely agree. It is especially shocking with respect to issues such as depression and eating disorders. Parents seek referrals, but when—after a waiting time of six months at the very least—they see a professional, they are told, “I’m sorry, but your daughter’s not sick enough.” They despair, because they do not know what to do any more. We need a much more joined-up service. A lot of these things are picked up in schools, so schools have a part to play.

There is a lack of resources for CAMHS across the country, and unfortunately the new commissioning service is not going to solve it. The funding problem for mental health services shows that we do not have parity of esteem between mental health and physical services; I know that the Government want it, but they cannot pretend that it has happened. If they say that children’s mental health is a priority within that, I ask people to look at the evidence given to the Public Accounts Committee’s inquiry into children’s mental health services and see for themselves that that is absolutely not the case. The Government know that there is not enough money for CAMHS.

The EPI study further points out that as many as a quarter of local authorities have phased out vital support services around schools, including school-based mental health services, family counselling and support for those living with domestic abuse. The median waiting time for treatment is 60 days, but I am well aware of many constituents who have had to wait as long as two years. That is extraordinary.

Last but not least, I want to discuss the impact of cuts, particularly on local government and on the support available in the wider community. As we know, schools never exist in a vacuum. As today’s Ofsted annual report points out, schools cannot fix everything, but for a lot of children they are often where the buck stops. Cuts elsewhere in the system, particularly in local government, have a massive impact.

I have secured quite a number of debates in Westminster Hall, but of all of them, this debate attracted the most responses when I tweeted about it. I would like to share one with hon. Members, from Vanessa Whitcombe, headteacher at Castle Manor Academy:

“Just emailing following your Facebook post regarding tomorrow’s debate. We are trying so hard to prioritise mental health and wellbeing in schools, applying for grants, paying for school nurse service as ours has been withdrawn, participating in Anna Freud school mental health award, peer mentoring programmes, reducing workload for teachers and putting in wellbeing support, and we are really proud of the small steps we are taking forward. But they are small, as they are against a backdrop of dwindling external services and decreasing budgets. External service provision and early help is only available at such a high threshold we feel like we are firefighting, and it is the most vulnerable children and families that are not accessing what they need. Amanda Spielman spoke wisely of the need for schools to be able to stick to their core business, and in our school we try to make sure that classroom teachers are able to do that as much as possible, but the surrounding investment that is needed to be put in to safeguarding, emotional support, educating parents, feeding students is not going to go away without more provision outside school.”

We have seen that for ourselves in Oxfordshire. Every single one of the children’s centres in my constituency was closed by the Conservative county council, and the more than 40 across Oxfordshire have fallen to just eight. We were able to help families in children’s centres, at an early stage, before there were problems. I have not even started to go on about youth services and youth provision and the issues there. All the wraparound services for young people have gone from the local community, and that leads to all sorts of issues. It is not just about social media—in fact, there is some evidence to show that a little bit of social media for teenagers is a good thing, although a lot is very definitely a bad thing. The debate often focuses too much on that point and less on the much more intractable issues that surround the child.

In conclusion, I believe that this is an issue of deep concern. Even on a day such as today, when the shenanigans of Parliament might make us forget that there are big issues in the country, this is one of the biggest issues we have, and I am concerned that the Government response is simply a sticking plaster. What they are not doing is looking at the core issues that are driving the problem. Unless they do that, they are always going to be playing catch-up; I am not convinced that the laudable aims in the White Paper are actually deliverable. We need to change the culture in schools. We need to stop the pressures on young people. I am grateful in advance for the contributions from other Members, because I am sure that I have missed many of those issues out of my speech.

It is time for change. I am so proud that my party has managed to take a massive step forward in our conference debates. The issue I had in my early years of teaching was under a Labour Government. That has happened again and has got much worse under a Conservative Government. I am not blaming anyone; we have reinforced bad practice across the political spectrum. It is time that we made it stop. This is our next generation and there is nothing more important than that.

Photo of Daniel Poulter Daniel Poulter Conservative, Central Suffolk and North Ipswich 2:52 pm, 4th December 2018

It is a pleasure to serve under your chairmanship, Mr Stringer. I commend Layla Moran for bringing the debate to Westminster Hall today, when there are many other pressing demands on our time, because this is an important matter. She rightly highlighted a number of the challenges facing young people in our schools. I draw attention to my declaration in the Register of Members’ Financial Interests; I am a doctor practising in mental health services and a member of the Royal College of Psychiatrists.

We need to analyse first why the problem is happening. Is it down to the increased challenges facing young people—the stresses and strains of exams and the need to perform in tests at schools, as the hon. Member for Oxford West and Abingdon outlined, and general increasing distress among young people—or is it also due to increasing awareness and recognition of mental ill health among young people, and the fact that more young people are therefore prepared to come forward because there is generally a greater recognition of their needs? Perhaps it is a combination of the two. We do not fully know or understand the reasons for greater pressures presenting in services, but they are happening. It is right that the Government are beginning to turn their mind to the issue and have put forward a number of initiatives.

I entirely agree with the hon. Member for Oxford West and Abingdon that, in addressing young people’s mental health, it is important that we do not over-medicalise issues such as teenage angst or normal patterns of growing up. It is important that we do not follow the American system, where—in my view and, I am sure, that of many psychiatrists in this country—a lot of young people are on medication without there necessarily being a good evidence base for that. We have to be very careful about over-medicalising problems, or medicalising problems too quickly, which is perhaps how we should look at it.

The Government are making strides in this area. They are rolling out training for every school and college to ensure that a designated mental health lead will be in place by 2025 and that there will be greater mental health awareness training for teaching staff. There has also been a lot of talk by some, including the Secretary of State for Health and Social Care, about the dangers of social media and its potential impact on young people’s mental health. However, as the hon. Member for Oxford West and Abingdon outlined, eye-catching announcements will do little to deliver the meaningful expansion and improvements in care that young people need and deserve. Although such announcements may make good media headlines, I am afraid the lack of provision on the ground for young people is the real problem. I know that it will be one that the Minister will want to work with colleagues in the Department of Health and Social Care to address.

I want to look at some areas of challenge. The coalition Government had a commendable focus on improving special educational needs provision. We know that a lot of children with special educational needs may also suffer from poor mental health. There is a correlation between some conditions that are associated with special educational needs and psychosis or other mental illness. However, far too often the joint care plans that should exist between the NHS and schools take a long time to come to fruition. Schools are far too often frustrated by the identification of a problem that they have recognised for which the NHS does not have the resources available to support the school in meeting the needs of the child in the way that was envisaged when those joint care plans were legislated for in this House. That speaks very much to the issue of lack of workforce, which the hon. Member for Oxford West and Abingdon outlined in her remarks.

Photo of David Drew David Drew Shadow Minister (Environment, Food and Rural Affairs)

That is no more evident than with the huge problem of eating disorders, where all the medical evidence shows that what is needed is early intervention. The NHS has got to get much more involved with schools on that. Does the hon. Gentleman agree?

Photo of Daniel Poulter Daniel Poulter Conservative, Central Suffolk and North Ipswich

Certainly, eating disorders are an area of great challenge. One of the difficulties is that very often young people present in great distress after their illness has taken hold for quite some time, and the prognosis can be less good in those situations. A lot of young people may have to travel many miles or even out of area to get the specialist care they need, and that does need to be addressed as a matter of urgency. I know that my right hon. Friend the Minister will be raising such issues with his counterparts in the Department of Health and Social Care, because a number of the answers to the challenges raised in this debate have greater priority, and there is greater understanding of what the challenges are in that Department rather than in his.

Photo of Layla Moran Layla Moran Liberal Democrat Spokesperson (Education)

Does the hon. Gentleman agree that it is not just about talking; it is active co-ordination between the two Departments that will solve this? If they end up working in silos, as we know Government Departments often do, none of this is going to work.

Photo of Daniel Poulter Daniel Poulter Conservative, Central Suffolk and North Ipswich

I completely agree, but it is also about breaking down the silos on the ground. It is all very well Government Departments coming together to work together and the silos being broken down—that did help between the Department of Health and the Department for Education on special educational needs under the coalition Government, but in reality the levers or mechanisms do not exist on the ground to deliver meaningful change for young people in the timely manner that was envisaged by the legislation passed in this House. We must make sure that whatever legislation is passed and whatever co-operation there is at Whitehall level translates into the right levers on the ground to deliver the co-ordinated and joined-up approach to more integrated care that young people need, across health, education, social services and other statutory services as may be required.

On the broader issue of child and adolescent mental health, a key challenge is the lack of workforce to deliver the care needed for young people. We know that the number of full-time mental health nurses has fallen by more than 6,000 between 2010 and March 2018, with a reduction of 1,832 learning disability nurses alone during that period. The number of CAMHS and learning disability consultant psychiatrists has slightly declined over the past decade. Many parts of the country, particularly outside London, are struggling to fill higher registrar training posts in CAMHS and learning disability psychiatry. That is a real problem, because without the workforce to deliver care we will not have the bodies on the ground to make a difference for young people.

Perhaps more concerning is the fact that the recent rhetoric on child and adolescent mental health still bears little resemblance to the reality facing many children and their families. Given the shrinking CAMHS and learning disability workforce, it is difficult to see how current levels of care can be maintained, let alone how the step change in mental healthcare provision for young people, which the hon. Member for Oxford West and Abingdon and I—and everybody taking part in this debate—would like to see, can take place.

The focus on healthcare apps and the talk of fines for social media companies are no substitute for having enough trained professionals on the ground to deliver frontline care to young people and their families. The NHS is far too often viewed through the prism of A&E. As a result, acute hospitals often receive a disproportionate level of funding compared with primary care and community services. In child and adolescent mental health services, as in other parts of the NHS, community services are often understaffed and poorly resourced. In fact, we are hearing about reductions in staff levels and not about the increase that the Government talk about as being desirable. My message to the Minister today is that we need more staff in child and adolescent mental health services, whether they are working in schools or in the community. Without those staff, all the media announcements and well-wishing announcements to improve in this area will come largely to nothing, and young people will still be struggling.

On the issue of fragmented commissioning, which the hon. Member for Oxford West and Abingdon raised, we see silos not just in Whitehall but on the ground. CAMHS, social services and education providers do not always work in a joined-up way. Although there can be some good initiatives at local level, and there are examples of good, co-operative working, there is nothing to compel the providers of different services to work in a joined-up way for the benefit of young people. Unless we get the commissioning of services right in providing better mental healthcare for young people, and actually compel joint working rather than just encourage it, we will not make a meaningful difference.

I know that the Minister will want to pick up some of these issues with his colleagues in the Department of Health and Social Care. Unless we have a joined-up approach that we can compel at local level, all the announcements on improvements in tackling young people’s mental health will come to very little. We will still be having these debates in this place in 10 years’ time—those young people will have lost 10 years of their life and will still be struggling.

I know that the Minister has a great commitment to all he has done on schools and in education. He has been a very good Minister, and I hope that he will redouble his efforts to get joined-up working and collaboration with the Department of Health and Social Care in addressing some of these problems.

Photo of Rachael Maskell Rachael Maskell Shadow Minister (Transport) 3:04 pm, 4th December 2018

It is a pleasure to serve under your chairmanship, Mr Stringer. I want to focus on my constituency in particular, and I will certainly echo comments made by hon. Members today. I thank Layla Moran for securing today’s debate.

We have some real challenges in York. The severity of the challenges facing young people is the one thing that keeps me awake at night. There have certainly been challenges with funding and staffing, which I will refer to. We have a service that is seriously overstretched. We had 1,930 referrals to CAMHS in the past year, and we are seeing some of the challenges increasing in York. Young people in the city are very vulnerable, and research is being undertaken to ascertain what challenges they face—I am sure that the Minister will tell us about the results—but what is the school system doing to our young people?

One issue that has been raised is the narrowing of the curriculum. The perfectionism that is expected of our young people—and the exam methodology itself—is putting incredible strain on them. That has been seen particularly in our schools, but also in York College, where there has been a 23% increase in the number of young people with mental health challenges in the past year. At Askham Bryan College there has been a massive increase in the number of young people experiencing mental health challenges.

This challenge is very real. Much can be put back into the methodology that is used in the education system, which is why it is really important that in today’s debate we look at how that discussion can move forward. Transition points for young people between primary and secondary school, and between school and further or higher education, are places of vulnerability in our system. We need to ensure that we do not make just the educational connections; the health connections for those young people are essential for driving that forward and supporting them. We also need to address bullying in our school environments. Some 30% of children in York have experienced bullying in the past year, which is serious indeed.

I have read through the Vale of York clinical commissioning group’s “Transformation Plan for Children and Young People’s Emotional and Mental Health 2015-2020”, which has been revised due to the scale of the challenge in York to start to address some of the issues. Across the whole of York we have only six wellbeing members of staff in our schools. They might not be professionally trained in mental health, but they have had training in those roles—four are funded by the CCG and two by the schools—to address some of the low-level areas of mental health that children face. They have had more than 300 consultations with children over the past year and have made 36 referrals to CAMHS. As we have heard already, the threshold for accessing CAMHS is extraordinarily high. If a child has an eating disorder—sadly, York is one of the worst areas in the country for eating disorder services—they are often told that their BMI is too high for them to be able to access those services. We need to ensure that we make early interventions so that children do not become so poorly. Sadly, should they be refused at that point, then we have problems.

This service has been evaluated, and it is helping. Staff across our schools have gone through some training, which has helped them to deal with children who face mental health challenges, but there is so much more to do. Essentially, we need to look at health professionals being in place in our schools; we should not be relying more and more on our teaching staff to try to address many of these issues. Something that really disturbs me is the level of high risk that children have—it is generated particularly from trauma in their life—and the lack of wrap-around care and support services.

I was in a school on Friday, where I talked to the chief executive of York’s mental health services. I also had discussions with parents in my surgery about the level of self-harm that children are experiencing—including repeated suicide attempts in some cases—not having support workers, and the interventions around them being processed in a system, as opposed to putting the child at the heart of the equation. We need to change the system so that education and health services wrap around the child, as opposed to the child being in a process of services. That can be demonstrated where children have been discharged from acute care. They might not be poorly enough to be in acute care, but they have got real challenges that they try to deal with and they cannot see a way forward. The system as it works at the moment does not address that.

I want to mention the funding issue. York’s schools, as I have mentioned many times, are the worst funded in the country. That has an impact because schools cannot supply the additional support services required, as demonstrated by a school I visited on Friday. It therefore has an impact on the children’s wellbeing. We have to address the issue of school funding. Likewise, our health authority is one of the worst funded. The money that was given to the CCG to address mental health issues in our city has been used to clear the deficit. As a result, money is being pulled away from the partnerships that are so essential for addressing the wellbeing agenda. Money therefore matters in this equation. The Minister will need to answer my question one of these days about the challenges we face. Clearly the funding formulas are not working. They cut across multi-agencies and the demographics of our city. We are therefore being failed.

I want to mention briefly the national shortage of staffing. Although we can recruit for the medium and longer term, we must look at what we do in the short term. We need to look at overseas recruitment to try to fill some of the skills gaps with immediacy, because it takes time to address such issues. We also need to make sure that we have the right facilities in place. School is one location to have good mental health facilities for young people. Off the school campus is also important. We need to see that moving forward.

Our Labour group will propose a motion to our council next week highlighting the real challenges facing local authorities and the local area around mental health in our schools. Despite the number of debates that they and we have had, it seems that we go round and round in circles. In conclusion, would the Minister be willing to have a meeting with the mental health Minister and the Members who have participated in this debate to discuss the serious issues in our constituencies and to see whether we can find some real solutions between us?

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 3:12 pm, 4th December 2018

I am conscious of the time, Mr Stringer, so I will make sure colleagues have the same amount of time to speak as I have. First, I thank Layla Moran for securing this debate. I spoke to her earlier today and decided to come and make a contribution from the Northern Ireland perspective.

School can either be the best or the worst days of your life—that’s a fact. I attended a boarding school for five years or so. Although I enjoyed it, I can remember having things thrown at me when, as a Christian, I prayed at the side of my bed. I remember such things very well. I was—and still am, or I probably would not survive in politics—of a disposition where I can let things slide off my skin, just as those items that used to be thrown at me bounced off. However, I am also aware, as both an elected representative and a father, that that is a particular gift, and that even the strongest person can be wounded by the words of a peer. I have three children and two grandchildren, so I am aware of the issues.

More than 1 million of our young people admit to being affected by bullying. We can be sure that for every person who speaks out, another is suffering in silence. I read an article in the Belfast Telegraph that outlined the latest figures from Childline. They revealed that the NSPCC supported service delivered 4,636 counselling sessions for loneliness in 2017-18—a 14% increase on the previous year. Of that total, 105 counselling sessions were carried out with children from Northern Ireland, up from 71 in the previous year. Across the UK, girls received almost 80% of sessions, with some pointing to the harmful effects of social media. Among the reasons they cited for their being made to feel increasingly isolated was watching people that they thought were friends socialise without them. Children are sensitive.

Our children are struggling in a world that is increasingly “nothing hidden and all show”. Although social media can be wonderful to connect people and perhaps spread positivity, I agree with Prince William and the Duchess of Cambridge in their campaign to address cyber-bullying. In June, Prince William launched the online “Stop, Speak, Support” code of conduct in a bid to tackle the problem. He spoke of the social media giants being “on the back foot” when it comes to tackling fake news, privacy and cyber-bullying. He said that technology firms

“still have a great deal to learn” about their responsibilities, and he challenged them to fight harder against the poison that is spread online. I agree very much with what he said.

Increasingly, teachers report that much of the bullying now takes place outside the playground, in what should be the safety of one’s own home. However, that does not take away from the responsibility to promote good mental health and make help available in schools.

I spoke in the main Chamber last Thursday—the Minister was there to answer the debate—about the financial difficulties that schools are facing and the cuts that have been made, as a result of which all teachers are under more time pressure. It also means less time to build up relationships with students and to supervise their interactions. We are seeing the rise of pastoral teams from churches in some schools, which is a good thing as it emphasises to children that there is someone there for them to talk to. Sometimes they need someone to listen and possibly help.

The End Bullying Now campaign, run by the Northern Ireland Anti-Bullying Forum, has said there is a basic level of good practice that all schools must achieve. There are strategies that empower young people, parents, carers and practitioners to know what bullying is, what to do and how to stop it. There are strategies that demonstrate a reduction in incidents of bullying; strategies that demonstrate good intervention if and when bullying behaviours occur; a whole-school consultation, including school staff, parents, carers and pupils in the development of an anti-bullying practice—everyone has to be involved in it—and strategies that include integrating an anti-bullying ethos into relevant areas of the curriculum.

It is my belief that schools are attempting to play their part, but I must come back to the budget cuts that see a reduction in teaching staff, classroom assistants and all those in the frontline defence who are in the right place to tackle bullying.

Kids are under more pressure than ever to have the right look inside and outside of school: to have the top clothes, the latest tech and the perfectly angled selfie—a perfect face of make-up and a perfectly ripped body. The weight of those expectations is too heavy for any child to bear and we must have support in schools to address that. My belief is that it must come by means of additional funding and assistance for key support staff on site in school.

The stories of children who have taken their own lives before they have begun are heartbreaking. Every one of us, as elected representatives in close contact with their community, will be aware of such cases. I am aware of some cases. I declare an interest as a member of the board of governors at Glastry College, where there were children that I knew personally who took their life. Indeed, because of my age I knew them from the day they were born—that is a fact of life—and in those circumstances the reality hits home.

To a generation increasingly asked, “Are you fit enough—rich enough—pretty enough—bright enough—social enough?”, there must be people to say, “You are loved as you are. You have the opportunity to write a new chapter and change your ending tomorrow.” There is an onus on us, with the Minister here, to put that in place. Will we do it?

Photo of Luciana Berger Luciana Berger Labour/Co-operative, Liverpool, Wavertree 3:17 pm, 4th December 2018

It is a pleasure to serve under your chairmanship this afternoon, Mr Stringer. I congratulate the hon. Member for Oxford West and Abingdon (Layla Moran) on securing this vital debate. The speed at which Members are speaking this afternoon and the interest shows that we could have spoken for at least three hours and still had more time and more interest. If it was not for what was going on in the other Chamber, even more colleagues would be here with us this afternoon.

There is much that I could reflect upon, but I particularly want to reflect on the Government’s Green Paper—their strategy, and their actual plan for young people’s mental health between now and 2030. The Green Paper was called “Transforming children and young people’s mental health provision”. That is the key intervention in which the Government set out their plans. It is important that we consider it in the context of this afternoon’s debate.

I agree with the hon. Member for Oxford West and Abingdon when she says that—let us not mince our words—we see a mental health crisis in our young people. I do not use those words lightly. We have only to reflect on the prevalence study that came out the other week, a repetition of the study that tells us how many young people are affected by one or more mental health conditions. We saw in that repeat of the study—last done in 2004—that there has been a 28% increase in the number of children affected. We used to use the statistic one in 10, or three in every classroom. It is now one in eight children, which for me is a very serious consideration. The Government need to urgently reflect upon and revisit their Green Paper, which was predicated on data that is now 14 years old. We now have the results that give us a reason to see the Government come forward with revised plans. Unfortunately, I do not believe that it is good enough.

I am a member of the Health and Social Care Committee; together with the Education Committee we produced a report on the Green Paper. We heard from expert witnesses, students in schools, and teachers. Many points reflected on the Government’s plans and set out what was missing, and what needs to be addressed to make a real difference. There are many points that I could reflect on, but I want to focus my remarks on the most salient points. I urge Members, but particularly the Minister, to reflect on the joint Select Committee report, because it contains many recommendations. It is fair to say that we were disappointed by the Government’s response, which did not adequately respond to serious concerns raised by many people throughout the country.

When I reflect on the experience of young people in my constituency, I am aware that a previously exemplary service in which young people were seen within three weeks—from referral to assessment and then treatment—now has hundreds waiting 24 weeks just for an assessment. That is not good enough. A special educational needs teacher, who wrote to me previously, came to my constituency surgery on Friday and said that the threshold to get access to services is now even further out of reach, even for children under 11. There are children aged four who cannot get access to any services. That is not peculiar to Liverpool; it is replicated across the country. We had a 43% cut to our service, and not in just one year—it was repeated in the second year; that was the main service for young people. Thresholds for access to care are rising, and I reiterate the point that children have had to self-harm or attempt suicide to get in. That is not good enough.

Colleagues have touched on the issue of resources. It is not just about money, but let us be honest: some resources are needed to ensure that children are properly supported. Schools are an important place. I want to reiterate what I said when I asked the Minister a question in the Select Committee. It is an important point, and gets to the crux of the matter. My greatest concern about the Green Paper and the Government’s plans for now until 2030 is that they will only replace what has already been lost, because the Government have no idea—no assessment has been done—how many peer mentors, counsellors, educational psychologists, pastoral care workers and school nurses have been lost from the country’s schools. Those are just some of the roles—vital services—that schools that are passionate about students’ mental health no longer have the funds to invest in. Schools in my constituency had access to a service called Seedlings. It was pulled from all those schools. The only ones that could afford it were those that met a threshold of a certain number of children on free school meals, in relation to pupil premium. Those just below the threshold could no longer afford it.

Those cuts have combined with other cuts, not just in schools but in local authorities. They affect children’s centres, the educational psychologists previously funded by local authorities, Sure Start centres and youth centres—because it is not only what happens in school that is relevant, but what happens afterwards. Many young people would turn to youth workers as a trusted adult if their mental health was suffering. The combination of all those things is the toxic situation we are in. Young people are now seen only when they are in a crisis; the system is geared only to what we do then. We need proper early intervention and prevention, to keep young people well. Schools cannot be expected to do it all.

From the teachers’ representations that we heard in evidence, it was clear that they want to do everything possible to support students in the classroom, but many demands are made on them and the current academic system adds many pressures, not only for students but for teachers. A staggering 81% of teachers say that they have considered leaving teaching in the past year because of the pressures of their workload. The combination of those factors means that there is every reason to think it is not good enough to expect every school to have just one designated mental health lead—one teacher who is trained for two days—when the Government accept, in their own evaluation, that that arrangement has an opportunity cost, in taking those teachers away from other activities that they are expected to do in school.

The social media issue is something that the Government definitely need to address, but even if we removed all the challenges of social media we would not solve the problem because, judging by the evidence that we heard, there are so many other challenges, but particularly issues to do with the social determinants of health and poverty.

I shall draw my remarks to a close because other Members want to speak. We cannot expect our schools to do it all. Young people are really suffering; this is a crisis, with a 28% increase in the figures, even going by those that came out the other week. I urgently request that the Government look again at the Green Paper strategy, because it is simply not good enough.

Photo of Tim Farron Tim Farron Liberal Democrat Spokesperson (Environment, Food and Rural Affairs) 3:24 pm, 4th December 2018

It is a pleasure to serve under your chairmanship, Mr Stringer. I congratulate my hon. Friend Layla Moran on securing this vital debate.

Early intervention and preventive work on mental health are massively important and schools play a colossal part in it. Fifty per cent. of mental health problems in adult life take root before the age of 14; 10% of schoolchildren today have a diagnosable mental illness, which means that in an average class of 30 young people three will be living with a mental health condition. That is three children in every class. Stress about exams, fear of failure, concern about body image, bullying, and the crushing weight of the aspirations and expectations of materialism have a huge impact on people’s mental health. Unchecked, those concerns can spiral into acute long-term mental illnesses that will lead to serious problems all the way through adulthood.

The Prime Minister characterised the colossal failure to treat mental health conditions as a “burning injustice”, but that is an injustice that the Government have failed to fight in practice. There are few things more frustrating than a Government who speak the right political language in a debate but fail to deliver. Investment in preventive measures and early intervention has only got worse in recent years. Councils’ public health budgets, which include funding for school nurses and tier 1 mental health services, have been reduced by £600 million between 2015 and the present. In my constituency central Government cuts to the public health budget mean that the NHS in Cumbria currently spends only £75,000 a year on tier 1 mental health preventive care. That is just 75p per child per year. In 2015 the coalition Government agreed to allocate Cumbria £25 million a year in public health money. Now it gets only £18 million a year. That is a £7 million cut—a huge proportion. It is not just unacceptable; it is an insult. As a direct result, we no longer have any school nurses directly attached to schools anywhere in the county.

Alongside the situation I have described, there are additional pressures. Many young people with special and additional needs are at greater risk of acquiring mental health difficulties. We have a special educational needs funding system that punishes schools that take children with additional needs and rewards those that do not fulfil their responsibility; so the system compounds the difficulties. Like the rest of the hon. Members present, I get letters in my postbag about many issues of great emotional significance. They weigh heavily on all MPs as we seek to help people out of difficult situations. However, nothing keeps me awake at night like the plight of young people with mental health conditions. I have noticed in recent years that the volume of my case load taken up by that issue has rocketed. We are clearly a society that breeds poor mental health.

I am proud of the young people in Cumbria with whom I have worked and who are determined to fight for better mental health provision for themselves and their friends. In my constituency, for example, CAMHS was not available at the weekend or after school hours in south Cumbria until our community ran a campaign and forced local health bosses to change that. What an outrage that we had to fight for those changes. Alongside a focus on the provision of timely, top-quality treatment, there needs to be a focus on preventive care. That is why 2,500 mostly young people in my constituency signed the petition that I shall soon present to the House, calling for a mental health worker to be allocated to every school in Cumbria, so that we can manage to prevent problems before they arise and get out of control.

Perhaps the biggest single issue affecting young people’s mental health is eating disorders. In South Lakeland, three quarters of children reporting with an eating disorder are not seen within the target time of a month. Not a single one of those children presenting with an urgent need is seen within the target time of one week. The most appalling aspect of the situation is not just those statistics but the fact that the number of children they represent is 15 in a year. That is utter nonsense. I deal with at least one new eating disorder case among young people every single week in my constituency. Children are clearly slipping through the loopholes and are not being pushed into the system. As Rachael Maskell said, they are told that they have to come back when they are more sick as they have not yet lost sufficient weight to enter the system. That is an outrage. In 2016, the Government promised Cumbria a specialist one-to-one eating disorder service, and it has failed to materialise. Wonderful people work in CAMHS, but they do not have the support that they desperately need. As others have said, young people’s mental health is the crisis of our age. It needs more than platitudes; it needs real action, and it needs it now.

Photo of Marion Fellows Marion Fellows SNP Whip, Shadow SNP Spokesperson (Small Business, Enterprise and Innovation) 3:30 pm, 4th December 2018

It is a pleasure to serve under your chairmanship, Mr Stringer. I congratulate Layla Moran on securing this very important debate. I will not run through all hon. Members’ contributions because we are running very short of time, but I have a few words to say. The hon. Lady’s knowledge and breadth of experience shone through her contribution, and her clinical dissection of the high stakes in the school system was informative and chilling.

As a member of the Education Committee, I am aware that the UK Government are not responsible for education matters in Scotland, Wales or Northern Ireland, but that does not mean that I or anybody else in the House have no desire to improve the mental health and wellbeing of children right across the UK. Schools are on the frontline of supporting children and young people’s mental wellbeing. We can shift the focus on to preventing mental health problems and building resilience through simple methods. In one of my granddaughter’s schools, children are being taught to think not, “I can’t do this,” but, “I cannot do this yet.” That is a huge step forward. It was never done in schools in my and my children’s time.

Increasing the availability of learning tools and experiences in health and wellbeing ensures that children and young develop knowledge about mental health and understand the skills, capabilities and attributes that they need for mental, emotional, social and physical wellbeing now and in the future. The Scottish Government’s mental health strategy focuses on early intervention and prevention, which feeds into this issue.

Over the course of their education, children spend more than 7,800 hours in school. Emotional wellbeing is a clear indicator of academic achievement, success and satisfaction in later life. Combining mental health awareness and coping mechanisms is critical for prolonged resilience. The Scottish Government have spent quite a bit of money recently. I spoke to Clare Haughey MSP, the Minister for Mental Health, who had recently taken on the recommendations of the “Children and young people’s mental health audit” report, which was produced by the Auditor General and given to the Public Audit Committee on 22 September.

It is important that we do not just throw money at these problems. There has to be a change in attitude. Money helps by making counselling available. In Scotland, our hope is that £20 million will provide 250 additional school nurses, and that £60 million will provide 350 counsellors. There will be other counsellors in further and higher education.

In Scotland, we are also doing mental health first aid programmes for teachers so that the early signs of mental health problems are spotted and children can be moved forward into services. In the package of money given by the Scottish Government, there is also provision for community support. The Scottish Government have set up a Mental Health Youth Commission, which is working with the Scottish Association for Mental Health and Young Scot to put young people’s issues front and centre. The Scottish National party Government are committed to meeting their commitments to ensure all children are given the tools they need to achieve a happy and prosperous life.

The UK has signed up to the UN convention on the rights of the child, but has stopped short of making it part of its legislation. That has been done in Wales, and the First Minister of Scotland is committed to making it part of domestic law in Scotland. Article 19 of the UNCRC says:

“State Parties shall take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violence”.

The First Minister’s commitment will better enable positive mental health and wellbeing practice in Scottish schools.

Will the updated guidance, which is intended to come into force in September 2020, apply in academies and free schools, as well as local authority-maintained schools? It is my understanding that those types of school do not have to follow national school curriculums.

Photo of Nick Gibb Nick Gibb Minister of State (Education)

We have changed the basic curriculum, rather than the national curriculum, to ensure that it applies to academies as well as local authority-maintained schools.

Photo of Marion Fellows Marion Fellows SNP Whip, Shadow SNP Spokesperson (Small Business, Enterprise and Innovation)

I am very grateful to the Minister for that response.

It is necessary that children across the UK are able to access timely and helpful support when they need it.

Photo of Emma Lewell-Buck Emma Lewell-Buck Shadow Minister (Education) (Children and Families) 3:36 pm, 4th December 2018

It is a pleasure to serve under your chairmanship, Mr Stringer. I thank Layla Moran for securing this important debate on mental health and wellbeing in schools, and other hon. Members who have made valuable contributions.

Despite all the warm rhetoric about this issue, the reality is that, when it comes to real action and real change to children and young people’s mental health, the Government are failing children and setting them up for future struggles. Schools are integral to the mental wellbeing of children and young people. They are where a lot of children spend a large majority of their time. For children for whom home is not a good place to be, or is a cause of distress, it can be the only safe, consistent element of their lives.

Last December’s Green Paper, “Transforming children and young people’s mental health provision”, seemed to signal, at last, a joined-up approach and a commitment between the Department of Health and Social Care and the Department for Education to address the crisis in children and young people’s mental health. As the report of the Education and Health Committees said, the Government’s strategy lacks ambition. The Committees said that it was narrow in scope and would put significant pressure on the teaching workforce. The report was entitled “Failing a generation”.

Sadly, just weeks ago, the NHSMental Health of Children and Young People in England” survey, referred to by my hon. Friend Luciana Berger, who has long been a champion of improving mental health provision across the board, confirmed the failing of that generation. It found that one in eight five to 19-year-olds had at least one mental health disorder. That means that, in an average classroom, almost four pupils will be suffering. The Royal College of Psychiatrists estimates that that equates to about 1.23 million children and young people. The survey also found that 400,000 children and young people identified as being in need of support were not getting any whatever.

The proposed mental health support teams for schools have been heavily criticised, including by Barnardo’s, which accused the Government of

“sleep-walking into the deepening crisis in children’s mental health.”

As they stand, the plans are piecemeal and will serve only to deepen the existing postcode lottery. It is anticipated that just 20% to 25% will benefit from the support by 2022-23. I would appreciate it if the Minister explained to us how recruitment for the teams is going, what the arrangements for the designated mental health leads in schools are, where the first set of trailblazers are, and what the rationale was for choosing those trailblazer areas.

Furthermore, the teams will be for mild to moderate mental health issues. What happens to children who desperately need intervention from child and adolescent mental health services and specialist trauma-based support, such as the children my hon. Friend Rachael Maskell referred to who are suffering from eating disorders and suicidal thoughts?

What about children looked after in kinship care, care leavers and child refugees? The Children’s Commissioner noted that only 104,000 of more than 338,000 children referred to CAMHS in 2017 received treatment in that year. That should come as no surprise to the Minister, when we know that the number of doctors working in child and adolescent psychiatry has fallen in every single month this year; that less than 1% of the NHS budget is spent on children’s mental health; and that CAMHS funding was cut in each of the four years following 2010.

Underfunding and the stripping back of provision in the name of austerity have led to a crisis in our schools, where £2.7 billion of budget cuts, an overriding focus on competition instead of collaboration, and fragmentation and marketisation of education, have left gaping holes in accountability, provision and support. In that environment, it is little wonder that children are not getting the support that they need.

The situation is far worse than that because, as we have already heard, on schools, the Government are acting in a manner that exacerbates poor mental health in children and young people. The Minister has said on the record:

“we do not want children to be under pressure with exams”, and stated that nothing that his Department has done makes things worse. Yet children are being placed under unbearable pressure because of the high-stakes exam culture fostered by the Government, resulting in feelings of chronic low self-esteem and stress.

In a study commissioned by YoungMinds earlier this year, 82% of teachers said that the focus on exams had become disproportionate to the overall wellbeing of their students. Similar concerns have been raised by the Education Committee, while some headteachers said that their students had attempted suicide over exam pressures. Now that we have evidence, what will the Minister do to change that approach?

For children with special educational needs and disabilities, those feelings of low self-esteem are amplified. I know from my own experience of having dyspraxia that I suffered from low self-esteem and confidence and, as a result, I would often isolate myself. I cannot imagine how much more difficult it must be for the thousands of children with special educational needs who are missing out on support.

Today, the chief inspector of schools revealed the national scandal of 4,000 children with official education, health and care plans receiving literally no support at all. She also raised serious concerns about the children missing from the education system altogether. The Government have created an environment in which, to improve exam results and league table ratings, off-rolling and illegal exclusions are used at whim to such a degree that today, the chief inspector’s report identified a possibly 10,000 children who cannot be accounted for. As the Education Committee’s report noted:

“young people excluded from school or in alternative provision are…more likely to have a social, emotional and mental health need”.

Can the Minister explain what provision—beyond the review of alternative provision that is progress—is being made for those missing children, and when that review will be concluded?

Children now grapple with a range of issues that we in this Chamber did not face at their age, in particular the all-pervasive nature of social media, where bullying, abuse and grooming are no longer confined to the physical space. Some young people cannot escape and have no respite from the harm they endure online. I was pleased that, in the passage of the Children and Social Work Act 2017, the Government bowed to pressure, but I would urge them to get moving on Personal, Social, Health and Economic education. A wealth of evidence suggests that it improves children’s resilience, wellbeing and safety, both online and offline.

In my former career, I saw the heartache and pain that delayed support and help could cause children, their families, their carers, and those who work with them, both in and out of the school environment; teenagers who regularly cut themselves or make attempts on their own lives because they were victims of child sexual exploitation; little boys and girls who had been so severely abused and neglected that they gouged out their own skin and spent their lessons rocking back and forth in an attempt to self-soothe; and children who had fled warzones, who were stoic and motionless in the playground and completely unable to interact with their peers.

As we discuss these matters, teachers, wider school staff, social workers, mental health workers, parents and carers will all be trying their absolute best for those children in the face of the worst cocktail of cuts—coupled with regressive policies—from the Government, right across the board. Those people, and the children and young people that they are fighting for, need to know what the Minister will do to halt that crisis now. I hope that he will not disappoint us all in his response.

Photo of Graham Stringer Graham Stringer Labour, Blackley and Broughton

Although we are a little ahead of schedule, before I call the Minister, I ask him to leave a minute or two at the end for Layla Moran to sum up.

Photo of Nick Gibb Nick Gibb Minister of State (Education) 3:45 pm, 4th December 2018

Certainly, and thank you, Mr Stringer; it is a pleasure to serve under your chairmanship. I congratulate Layla Moran on securing the debate and introducing it so well.

Mental health can have a profound impact on the whole of a child’s life; it is not just about the effect that poor mental health can have on their attainment at school. We worry about the whole life ahead of them. Improving mental health starts with promoting good mental wellbeing and ensuring that children and young people have the help and support that they need. Schools can play an important role with the right support from specialist services, which is why the Government have made mental health a priority, with a shared approach between the Department for Education and the Department of Health and Social Care.

The hon. Members for Oxford West and Abingdon and for South Shields (Mrs Lewell-Buck) mentioned exam stress in schools. Tests and exams have always been times of heightened emotions for pupils and teachers, but they are not meant to cause stress and anxiety. As the hon. Member for South Shields acknowledged, I have said on many occasions that schools should encourage all pupils to work hard and achieve well, but that should not come at the expense of their wellbeing. Schools should provide continuous and appropriate support as part of a whole school approach to supporting the wellbeing and resilience of pupils.

The hon. Member for Oxford West and Abingdon also mentioned GCSEs. We have reformed GCSEs to match the expected standards in countries with high-performing education systems, so that young people have the knowledge that they need to prepare them for future success and the skills that Britain needs to be fit for the future. We are determined to ensure that no child has an inadequate education that reduces their life chances; we want to ensure that every child has an education that helps them to fulfil their potential. That is the key driver of all of our education reforms since 2010. Better education means better prospects of quality employment and better health outcomes for those young people in the long run.

As a psychiatrist, my hon. Friend Dr Poulter brings serious expertise to the debate. He said that it was important that Departments did not work in siloes. I can assure him that I worked very closely with the Under-Secretary of State for Health and Social Care, Jackie Doyle-Price, in whose portfolio mental health resides. We worked particularly closely on producing the Green Paper on children and young people’s mental health.

We know that mental health is also a priority for teachers, because of the challenges that many children face in the modern world; a fact that has been referred to by other hon. Members. To get an up-to-date picture of children’s mental health, this Government commissioned the first national survey of children and young people’s mental health since 2004, which was cited by Tim Farron. The results published last month show that in 2017, 11.2% of children and young people aged five to 15 in England had a diagnosable mental health disorder. That figure stood at 10.1% in 2004, so the latest results show that there has been a slight increase since then. They reinforce what we have heard from schools and colleges about how many children face issues and about the need to act. We have listened to what schools have told us and are already taking steps to help schools to support children and young people with mental health problems. The findings of the survey will help us to ensure that the action that we take is informed by the most up-to-date evidence.

I understand the important points made by my hon. Friend the Member for Central Suffolk and North Ipswich about the number of staff in children and young people’s mental health services. The Government are already taking significant steps to improve specialist children and young people’s mental health services with £1.4 billion of funding to ensure that an extra 70,000 children a year receive the support that they need by 2020-21.

We recognise, however, that we need to do more, which is why the NHS will invest at least £2 billion a year more in mental health, including children’s services, under the recently announced Budget proposals, increasing NHS funding by an astonishing £20.5 billion a year in real terms by 2023-24. As I said, from that the NHS will allocate £2 billion a year to mental health services. The Budget also included a commitment to set up specialist NHS crisis teams for children and younger people in every part of the country.

Photo of Daniel Poulter Daniel Poulter Conservative, Central Suffolk and North Ipswich

The extra money is of course welcome, but the focus on crisis intervention is perhaps wrong. We should try to stop children getting to that point in the first place, and invest more in early intervention and community teams. In order to do that, we need to reverse the decline in the mental health workforce. I wonder whether that is an issue the Minister will raise in particular, challenging his counterpart in the Department of Health and Social Care on how to improve recruitment and retention of CAMHS professionals.

Photo of Nick Gibb Nick Gibb Minister of State (Education)

My hon. Friend makes a crucial point, which I will come to when I talk about the mental health Green Paper. It is absolutely crucial that we are able to devote resources and expertise to intervening early, before a child’s mental health problem escalates into something requiring medical intervention.

Photo of Nick Gibb Nick Gibb Minister of State (Education)

I will, but this will be the last intervention, I am afraid.

Photo of Luciana Berger Luciana Berger Labour/Co-operative, Liverpool, Wavertree

What percentage of that £2 billion extra for mental health services will go to young people’s mental health services? To what extent will it replace—I asked this question before—services that have already been lost, not just from the NHS but from right across education in schools throughout the country?

Photo of Nick Gibb Nick Gibb Minister of State (Education)

I have already mentioned that £1.4 billion will be put into young people’s mental health services. I do not have the precise figure that the hon. Lady asks for, but I am happy to write to her with it. I suspect that it will not have been determined precisely at this point, but our plan is to increase that spending, and we can only get to that through careful marshalling of our economy, because our economy of course produces the wealth that enables us to provide such a level of funding.

In the debate, there was a reference to eating disorders. The Government are on track to meet, or are exceeding, waiting-time standards for eating disorder services and early intervention in psychosis.

Photo of Nick Gibb Nick Gibb Minister of State (Education)

I will not give way now, because we only have a few minutes left. I have already given way a number of times.

Schools have an important role to play in supporting the mental health and wellbeing of their pupils by putting in place whole-school approaches tailored to the particular needs of those pupils. Our 2017 survey, “Supporting Mental Health in Schools and Colleges”, was commissioned to derive robust national estimates on activities to promote and support mental health and wellbeing. It found that about half of schools and colleges already had a dedicated lead for mental health in place, that 61% of schools offered counselling and that 90% of schools and colleges offered staff training on supporting pupils’ mental health and wellbeing.

The Government are committed to supporting schools and colleges to do more to promote good mental wellbeing in children, to provide a supportive environment for those experiencing problems and to secure access to more specialist help for those who need it. To support schools to build the capability to identify and promote awareness of mental health needs, we have committed to introduce mental health first aid and awareness training for teachers in every primary and secondary school by the end of the Parliament. To date, we have trained more than 1,300 staff in more than 1,000 schools.

Photo of Nick Gibb Nick Gibb Minister of State (Education)

I will not give way. I am sorry, but I want to leave time for the hon. Member for Oxford West and Abingdon to respond to the debate.

We have recently published updated guidance to help schools to identify pupils whose mental health problems manifest themselves in their behaviour, and to understand when and how to put in place support.

The hon. Member for South Shields raised the issue of PSHE. As part of an integrated, whole-school approach to the teaching and promotion of health and wellbeing, we are making health education compulsory for pupils receiving primary and secondary education, alongside relationship and sex education in all secondary schools—

Photo of Nick Gibb Nick Gibb Minister of State (Education)

All pupils will be taught about mental health, covering content such as understanding emotions, identifying when someone is experiencing signs of poor mental health, simple self-care, and how and when to seek support.

The hon. Lady asked when health education would be made compulsory. We have already published draft guidance and consulted on it—the consultation closed on 7 November. It was well received, and 11,000 pieces of evidence were supplied to it. We will respond in due course. Our plan is to roll out the subject as compulsory in the academic year beginning in 2020. We hope for and expect early adopters from September 2019, but it will be compulsory a year later. We want to ensure that all schools have a proper lead team so that they can implement the policy as well as they can.

On the mental health Green Paper, while schools have an important role to play, teachers are not mental health professionals and they should not be expected to act as such. When more serious problems occur, schools should expect pupils and their family to be able to access support from specialist children and young people’s mental health services, voluntary organisations and local GPs. The £1.4 billion that we have already made available will play a significant role, but we want to do more and to provide a new service to link schools to mental health services more effectively, with swiftly available and clinically supervised support.

To enable that, our Green Paper set out proposals to support local areas to adopt an ambitious new collaborative approach. The cornerstone will be new mental health support teams to improve collaboration between schools and specialist services. We expect a workforce numbering in the thousands to be recruited over the next five years to form such teams. They will be trained to offer evidence-based interventions for those with mild to moderate mental health needs. The teams will be linked to groups of schools and colleges, and the staff will be supervised by clinicians. They will work closely with other professionals such as educational psychologists, school nurses, counsellors and social workers to assess and refer children for other specialist treatments, if necessary.

Photo of Nick Gibb Nick Gibb Minister of State (Education)

I will not give way because, literally, there are only three minutes to go.

The roll-out of the teams will start with about 25 trailblazer sites, each with at least two teams, to be operational by the end of 2019. The first trailblazer areas will be announced imminently. They will test and evaluate a range of ways to set up and run the new mental health support teams to see what works. The overall ambition is for national roll-out of the teams, to be informed by evaluation of the trailblazers. The detail will be considered further as the long-term plan for the NHS is developed.

We also want to ensure that we have a designated senior lead for mental health in every school to oversee the delivery of whole-school approaches to promoting better mental health and wellbeing. The Department will provide up to £95 million to cover the cost of significant training for senior mental health leads. It is an ambitious programme, and I am optimistic that it will help to deal with a number of mental health problems that are emerging among young people in today’s society.

Good mental health remains a priority for the Government. It can have a profound impact on the whole of a child’s life, not just on attainment. We want all our children to fulfil their potential, and we want to tackle the injustice of mental health problems so that future generations can develop into confident adults equipped to go as far as their talents will take them.

Photo of Layla Moran Layla Moran Liberal Democrat Spokesperson (Education) 3:58 pm, 4th December 2018

I thank the Minister for his response. I am sure that many people out there will be heartened to hear that students should not be feeling the stress of exams, but the fact is that they do. It is also a fact that the stress is definitely worse even than when I started teaching, which is well over 10 years ago. It is a shame that the Government will not take responsibility for the part that they have played in creating that culture.

I thank all Members for their contributions to the debate. I am sorry that there is not time to go through them all individually, but there was a range of expertise and the constituency stories that we heard were not only heartbreaking but heartening, because we know that there are people in this place who care.

I also put on the record my thanks to Oxfordshire Mind, the university’s Oxford Mindfulness Centre, Oxford Mental Health Campaigners for Change and a host of other national bodies that contacted me about the debate. Finally, I thank all members of the public who wrote in in such large numbers. I promise that the Liberal Democrats and I—in my role as the education spokesperson for my party—will continue to bang the drum for putting children’s mental health wellbeing at the heart of everything that we do in this place.

Motion lapsed (Standing Order No. 10(6)).