Children and Mental Health Services — [Mark Pritchard in the Chair]

– in Westminster Hall at 11:25 am on 16th July 2019.

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[Mark Pritchard in the Chair]

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton 2:30 pm, 16th July 2019

I beg to move,

That this House
has considered children and mental health services.

It is a great pleasure to serve under your chairmanship, Mr Pritchard. We could not be in better hands. It is a delight to have the Minister here. I know she comes to this issue with great personal interest and a commitment to deliver for all our constituents. It is fantastic to see so many right hon. and hon. Members from across the House here to take part in the debate. That is testament to the interest in this place and the concern across the country about mental health, particularly that of children.

I praise the Government for what they have done to date. When it comes to mental health, there is no doubt that this Government get it, making it a priority like no other. They have tackled the stigma of mental health and put in much-needed resources, but although they have done great work, like Oliver, we would all say, “Please, Minister, can we have some more?” because although we are getting on board with the issues, and royals, TV stars, politicians, and people from sport and all spheres talking about mental health, the problem is snowballing, getting bigger and bigger. Such are the pressures and stresses placed on our children’s mental health that this is an ever-increasing problem, which demands our attention, resources and commitment as a Government.

One in eight five-to-19-year-olds—12.5%, or 1.25 million children across the country—have a mental health difficulty, according to the Government’s own survey of November 2018, “Mental Health of Children and Young People in England”. The Local Government Association says that children’s services are seeing more than 560 cases of mental health issues every day. Some 75% of adult mental health illnesses begin before the individual turns 18 and over 50% start before the age of 14. Some 23% of the population are affected by mental health difficulties at some point each year. The economic and social costs of mental illness in England total £105 billion.

Photo of Jim Cunningham Jim Cunningham Labour, Coventry South

I congratulate the hon. Gentleman on securing the debate. About 10 or 11 years ago I introduced a Bill that would have provided a specialist to a cluster of schools, to help teachers to identify children with health and mental health problems. Does he agree that the Government should think about that? Secondly, and most important, employers do not recognise the problems young people have with mental health when they start out in industry, nor do they recognise adult mental health problems. Does he agree that more could be done in that area?

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

I could not agree more with the hon. Gentleman. It is a pity that more people did not share his foresight, so that we could have acted sooner. We are laying the foundations for mental health problems in adulthood. Childhood mental health has a lifelong impact, so it is important that we do not waste a moment. Rates of depression and anxiety among teenagers have increased by 70% in the last 25 years.

Photo of Gloria De Piero Gloria De Piero Shadow Minister (Justice)

I thank the hon. Gentleman for securing this important debate. My constituent Elodie Fleet, who is now 18 years old, experienced anxiety, which came to a head at the age of 13. She wanted to see the school counsellor, but her needs were not deemed to be urgent enough because “she hadn’t tried to hang herself or taken a blade to her wrists.” I hope the Minister will say how we can get more counsellors in our schools to deal with people such as Elodie, because she is not alone.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

The hon. Lady makes a powerful point. It is true that her constituent is not alone. When I publicised this debate on my Facebook page, I was amazed by the number of parents who got in touch. I was overwhelmed by parents who have either battled through and managed to get to the other side, or are in the midst of fighting to keep their children alive, safe and well. As a parent, I realise what a scary thought that is.

Photo of Rosie Cooper Rosie Cooper Labour, West Lancashire

To reiterate that point, does the hon. Gentleman agree that this is a state of emergency? In my constituency, the parents of a 12-year-old boy are being advised that there is a 72-week wait for their son to get help, even though there is a risk of serious self-harm.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

I agree that we are in a crisis. The Government are putting record amounts of money in, but the hon. Lady is absolutely right to say that that is an unacceptable wait. I will discuss waiting times leater in my speech. Any parent would be terrified at the thought of that long wait and their child being further harmed by it.

Photo of David Simpson David Simpson Shadow DUP Spokesperson (Environment, Food and Rural Affairs), Shadow DUP Spokesperson (Business, Energy and Industrial Strategy)

The statistics the hon. Gentleman is outlining are horrific. Some years ago figures were released showing that across the whole of the United Kingdom, over 10,000 young people under the age of 10 were manic depressives. That is a horrendous figure. Such a situation puts horrendous pressure on parents and carers.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

I have spoken about my own mental health challenges and my battle with depression and anxiety. As an adult it was very difficult to cope with, but for a small child it must be an incredibly hard to have to deal with.

Photo of Andrea Jenkyns Andrea Jenkyns Conservative, Morley and Outwood

On the social and economic effect, does my hon. Friend agree that we need a more joined-up approach across Departments? Earlier this year, I met chief superintendent Paul Hepworth of West Yorkshire police, who is a fantastic guy. He mentioned that nationally there is a lack of forensic beds for children with severe mental health issues. He told me the story of a young girl who was in police custody with a severe illness; she was suicidal, self-harming and violent towards others. Does my hon. Friend agree that the Government must address this issue, to offer safe space and support for people in dire risk?

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

I point my hon. Friend to some of the work done in my area by Matthew Ellis, the Staffordshire police and crime commissioner, and the work done by the Prime Minister when she was Home Secretary on how we treat mental health in our police stations. That is very important, but it is even more important for vulnerable young children. She makes a valid point. I will canter through some more points before taking more interventions.

The Government’s own survey shows that one in four children with a mental health disorder are seen by a mental health specialist and over 400,000 children are receiving no assistance at all. The NHS is managing to see only a fraction of the young people who have problems. My hon. Friend talks about cross-departmental working. I am delighted that the Minister is here, because she has done a huge deal to bang heads together and make this a priority. It involves the NHS, local government, the police and so many different areas, which we need to bring together.

The Children’s Commissioner’s analysis of NHS figures from 2017-18 shows that 325,000 children were treated by community services, while another 5,000 are in hospital—less than 3% of the population. Around £700 million is spent on child and adolescent mental health services and eating disorder support. By comparison, services for adults received 15 times more, despite the fact that children represent 20% of the population. While it is important that we are putting money into mental health services, we are turning it on its head. We need to put more money into children’s services, not only because there is such a great demand, but because if we can nip problems in the bud by making that early intervention, we can avoid those services being needed later in life.

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

I congratulate my hon. Friend on securing the debate; he is making some very good points. As he recognises, CAMHS are the Cinderella services of the Cinderella service—mental health is still woefully underfunded in comparison with many other parts of the NHS. Does he also recognise that CAMHS recruitment is a real challenge? The August 2019 fill rates for higher trainees in the UK stand at only 63% for those entering CAMHS specialist training and at only 23% for learning disabilities, which means that almost 80% of new posts in learning disabilities for new trainees will be unfilled. Does he agree that that is a key issue for the Government to address if they want to improve CAMHS provision?

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

I absolutely agree with my hon. Friend, whom I congratulate on his work in our NHS; I am grateful that he does such a great job on mental health work in the community. He raises the very important point that it is all very well wanting to deliver these services and putting the money in place, but if we do not have the staff to deliver on the ground, we will always be running to catch up.

Photo of Rachael Maskell Rachael Maskell Shadow Minister (Transport)

The hon. Gentleman is giving an excellent speech. In York, we have seen a 26% increase in referrals into CAMHS over the past five years. As a result of such high demand, one referral in four is turned away from the service, including children who are self-harming and have experienced abuse. Surely we need to focus on investment in the workforce, as well as on funding.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

The hon. Lady is absolutely right, and we must not underestimate the immense added stress and pressure for families whose child is self-harming. She makes a very good point.

Photo of Julian Sturdy Julian Sturdy Conservative, York Outer

I congratulate my hon. Friend on securing this important debate. May I follow up on the point made by my colleague Rachael Maskell about the figures for York? Are not parents under huge stress because of these referral figures? In York, CAMHS referral times are peaking and troughing, which has a lot to do with not getting the resources needed. Sometimes referral times are down to six months, but at other times they are longer than 12 months, which has a huge impact on the children involved. It also means that schools are having to take action and exclude young people before they can get the treatment they need.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

My hon. Friend is absolutely right, not only about the impact on schools—I will say more later about what we can do in schools—but about the pressure on CAMHS and the massive importance of getting children seen as soon as possible. Just imagine if one of us were having a mental health episode and were told that we could see someone in 12 months who would then refer us for treatment. CAMHS are not the doctors or the psychiatrists who see the patient. They are not the help; they are the doorkeepers to getting help—the triage, as it were. Even when someone gets through the CAMHS door and jumps over the very high bar for getting treatment, it could be many months before they receive it.

It is a great challenge. I know that the Government take it seriously; their 2017 Green Paper “Transforming Children and Young People’s Mental Health Provision” outlined their ambitious new plans for delivering mental health support in schools, and the announcement this week of the mental health services trailblazers is a welcome part of that strategy. I am delighted that my area, Burton, is to be in the second phase of those trailblazers, which I genuinely believe will make a difference. However, figures from the Children’s Society suggest there has been little expansion in the provision available in schools since 2015, so we are starting from a low base. In particular, the figures point to a worrying lack of awareness among parents about the counselling offered in their children’s schools: just under a third are not aware of what is available at all.

I am pleased that the Government have announced that every school, college and alternative provision across England will be offered training as part of the £9.3 million mental health services and schools and colleges link. However, even though my area is one of the trailblazers, priority access to mental health training for schools and colleges will not be available in my constituency until next year. It is clearly needed now. There are so many MPs, constituencies and constituents who want access, so how can we roll it on quicker? To use my “Oliver!” analogy again—

Photo of Anne Marie Morris Anne Marie Morris Conservative, Newton Abbot

My hon. Friend is making an excellent speech. May I ask him to reflect for a minute on the particular issues for rural communities, including the distances? The lack of broadband means that the opportunities for dealing with those distances are missed. It seems to me—perhaps we will hear more from the Minister about this—that the Government could use technology more effectively in rural areas. We will certainly not get the help we need in time otherwise. My schools will not be getting help under the new scheme any time soon—we are not even one of the pilots. My teachers are very concerned that they will have more burdens, rather than an added resource.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

My hon. Friend, who is always a champion for rural communities, makes an important point about rural isolation. We have known for a long time about the mental health challenges of farmers and rural communities, but it is all the more difficult for young people who are isolated from their friends. We talk about the social media pressure on young people with Facebook, Twitter and so on, but it is even more difficult for kids in isolated rural communities, because they are even more separated. That social media connection is often their only chance to talk to their friends.

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

My hon. Friend is making one of the best speeches that I have heard in this Chamber for some time, and is going into granular detail to make his case. In the medical workforce, the numbers of mental health nurses have fallen nationally over the past decade, and we know that there are challenges with CAMHS and LD recruitment. We cannot deliver mental health care without bodies on the ground. Unless we get the workforce challenge right, it will just be rhetoric. We need to start turning rhetoric into reality by recruiting the right number of staff on the ground to deliver high-quality mental health care.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

My hon. Friend is absolutely right. It is about not just the psychiatrists and the doctors, but the mental health nurses out in the community. I have witnessed their great work at first hand, so I know just how important they are.

The extensive roll-out—as the Government rightly claim it to be—over the five-year pilot is great, but it will address just 20% to 25% of the country’s need. So many young people will miss out on support until at least 2023 or perhaps even later. The mental health training for schools and colleges announced in the past week is fantastic, but under the NHS long-term plan, an extra £2.3 billion is due to be put into mental health services by 2023-24. That is a lot of money, and I want us to make sure that as much of it goes into children’s mental health services as is humanly possible. If we spend it wisely, it can have a double-whammy effect.

Photo of Louise Haigh Louise Haigh Shadow Minister (Home Office) (Policing)

Does the hon. Gentleman agree about the importance of bereavement counselling for children with mental health issues? As shadow Police Minister, one of the most common factors that I see among young offenders is a close family bereavement in their childhood, yet so many children languish on waiting lists for bereavement counselling. Indeed, I had a young constituent who waited for bereavement counselling for three years. Unfortunately, his life was taken by another teenager. That just shows the absolute importance of getting in there and delivering that mental health care.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

The hon. Lady is absolutely right. Trauma in young people’s lives is often the trigger, whether it is sexual abuse, domestic abuse, violence perpetrated by other young people, or bereavement. All those triggers set off a train of deterioration in young people’s mental health that is often lifelong. It is so important that they get the access they need.

Several hon. Members have mentioned waiting times for CAMHS. I have certainly found that my constituents cannot get on Facebook quick enough to tell me about their CAMHS experiences. I do not want to denigrate CAMHS, which have great people doing great work; the problem is that there are just not enough of them and they are under too much pressure. As Rachael Maskell noted, CAMHS are turning away nearly a quarter of children who are referred to them. In 2017-18, they turned away 24.2%, meaning that at least 55,800 children were not accepted for treatment. Of those who were referred, the average waiting time was 34 days for an initial assessment and 60 days for treatment—significantly longer than the four-week standard set out in the Government’s Green Paper. We can all point to examples of much longer waiting times in our constituencies.

One constituent contacted me to say that her son had been self-harming for years. It took them months to get an appointment with CAMHS, and when the appointment happened, her son suffered a meltdown. That is not unusual, due to the pressures that those appointments put on young people. Because he is 15, their GP cannot prescribe anything for him. My constituent has had to watch her son throughout the night to make sure he does not do any permanent damage to himself. Another parent told me how her daughter was discharged from CAMHS, with it saying there was nothing more it could do to help with her anxiety.

Young people have told mental health charity Mind—I am very lucky to have Burton and District Mind in my constituency, which does a great job—that the wait for support is one of the most difficult issues they face. They say that sometimes, they find that their mental health deteriorates while they are waiting; the wait actually makes it worse. In England as a whole, half of those accepted for treatment during 2017-18 were still waiting for treatment at the year’s end. That proportion was lower in my area, east Staffordshire, where it was just over one third. However, that is still a substantial figure.

A school counsellor from my constituency contacted me to say that the waiting lists for referrals to child services outside of school can be months long. She believes that when it is established that a child needs help, a counselling session needs to happen within 48 hours. She goes on to say that too much red tape is preventing children from getting the help they need. I think we all recognise, as the Government have done, that support in school, delivered in a way that is accessible to young people—they feel comfortable asking for it, and know of other young people who have accessed it—is a real help.

One parent told me that she decided to fight to get her son’s care commissioned outside of the county they lived in because of her disappointment with the support she had received. She says that early intervention is key, and that there have been too many endless reports and not enough action has been taken. Another parent in my constituency said that she took her daughter to the GP two years ago. She was referred to That Place in Burton, which is a fantastic facility; she took her for assessment, only to be told that her daughter was not old enough to be accepted. Yet another constituent told me that after a referral for her daughter, aged nine, it took three years for them to see a psychiatrist. That kind of wait is difficult, and all the time, the young people are getting worse.

There is also a problem with the transition from childhood to adulthood. According to the British Psychological Society, about one in six 17 to 19-year olds have a mental health disorder; according to the Children’s Society, 16 to 17-year-olds are the biggest service users of mental health services. However, young people often face barriers to accessing support, and end up falling through the cracks of adult and children’s services as they transition. Some young people who are discharged from children and young people’s mental health services at 18 find it can be very difficult to get a referral to adult mental health services at all, and can end up completely isolated. In some circumstances, young people are not accepted into either children and young people’s or adult mental health services, due to them falling between the gaps.

Again and again, I hear that CAMHS discharges young people on their 18th birthday, and that there is no provision at all for them. The challenges those young people are facing do not magically disappear when they become adults. Just last Friday, I met with a constituent who was getting ready to leave CAMHS and had been left to organise her future on her own. She was not automatically transferred to adult services, and had to organise a private therapist in order to get the ongoing treatment that she needs.

One of my constituents sums the problem up better than I could:

“All the time the kids are getting no support, becoming suicidal, becoming adults with even more complex issues, families are breaking up because of the pressure, parents quitting work to do the job of education/social care/health, and all of this causes more and worse financial pressure later on. No one sees the bigger picture because they can’t afford to. No one sees long term because that’s too expensive. Early interventions are crucial but they aren’t funded. We will reap the whirlwind then wring our hands and say ‘how could we have prevented this’”.

That is absolutely pertinent.

The Government have set a five-year forward view for mental health, which is for one in three children and adolescents with a mental health disorder to access NHS mental health community services by 2020-21. In the new long-term plan, they have set a target that 100% of children and young people who need specialist care will be able to access it by 2028-29. However, that is so far down the track.

Photo of Anne Marie Morris Anne Marie Morris Conservative, Newton Abbot

I totally agree with my hon. Friend: it is so far down the track. Does it not further concern him that in that same 10-year plan, the NHS talks about “parity of esteem”, but that is in 10 years’ time, and it is very unclear what will be done about the timelines for getting there? As my hon. Friend has said, 10 years is much too long to solve the problems we have today.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

My hon. Friend is absolutely right. During that time, babies become children, children become adults, and the problem gets worse and worse. I do not deny the Government’s commitment and determination in this, but it is just not happening quickly enough.

The other thing we need to bear in mind is that, although we have heard about CAMHS and the pressures on the workforce, a huge number of brilliant voluntary sector organisations are also delivering these services. I am very lucky to have in my constituency an organisation called Youth Emotional Support Services, which delivers in schools in Uttoxeter, as well as Burton and District Mind. There are so many great organisations. However, even in my own patch, I have heard that a tendering process is currently going on in which the bar is so high, the requirements so difficult and the boxes to tick so numerous that third sector organisations simply feel unable to compete. The challenge is that the tender to provide the facilities goes to a private company, and the experience, dedication and benefits of those voluntary sector organisations are lost.

I was staggered to learn that some of the children’s mental health charities operating in my constituency are providing 85p of frontline services for every pound they receive. That is tremendous value, representing help for young people, and few businesses could get anywhere near matching that. However, the tender process that we go through makes it impossible for voluntary sector organisations to compete. I hope the Minister will look into that; I will be raising with her my particular issue in Staffordshire.

I think the Minister recognises that in this place, we are simply voicing the real concerns and fears of parents up and down the country. Like a snowball coming down a hill, young people’s mental health is under greater pressure than ever before, and as a result they are self-harming, committing suicide, or getting themselves into a situation in which they will, in future years, suffer from greater mental health disorders, addiction, and so many other long-term problems. I hope that the Minister will go away feeling that she has great support across this House for her campaign to get even more resources and focus on mental health services, particularly for children, because quite frankly our children’s lives depend on it.

Photo of Mark Pritchard Mark Pritchard Conservative, The Wrekin

I do not propose to enforce a formal time limit of four minutes, but I ask colleagues to be mindful of the number of people who wish to contribute to the debate.

Photo of John Woodcock John Woodcock Independent, Barrow and Furness 2:58 pm, 16th July 2019

Thank you for calling me early, Mr Pritchard; it is a pleasure to serve under you. I apologise to Andrew Griffiths for arriving late. I was in the main Chamber for the domestic abuse statement, which unfortunately ran over a little. I commend him and those who made interventions on what I heard them say. I am sure that throughout this debate, we will be given shocking examples of how this is truly a nationwide crisis. Any Government of any hue must, as a first step, be honest about the scale of the problem and how much is being stored up for future generations, as was said eloquently by the hon. Gentleman.

I will give the Minister and the Chamber a couple of the many examples I have received from constituents who have got in touch. Drew is a nine-year-old boy whose mother contacted us in March last year in a desperate state. On a weekly basis, Drew talked about killing himself; he would regularly go so far as to put a rope around his neck. Obviously, they were seeking urgent medical help for Drew.

Fifteen months later, Drew had his first appointment with CAMHS. That was 15 months when that child was at risk and that family was going through something—it is really hard for parents to imagine their child in distress, desperately reaching out for help and just being put on an interminable waiting list. Drew’s mum is left wondering how best to house her family. Her benefits have been reduced because of the bedroom tax. The need for Drew to have a separate room is not acknowledged, despite the fact that he is aggressive and sometimes violent towards his sibling. His mum is now forced to confront the prospect of Drew sharing a bedroom with her. That is deeply inappropriate and a sign of a system that is broken locally.

Another example is a child who was deemed to be a clear suicide risk. A significant amount of resource was placed into multidisciplinary team meetings for the child, but in meeting after meeting, for whatever reason, CAMHS did not show. The process to provide appropriate help for that child could not go ahead and deeply scarce resources were being burned up. It was only after the intervention of our team that we managed to bring CAMHS to the table.

Professionals want to do things. No one goes into this field wanting to do the wrong thing; they go into it to help, but the resources are not there and often the system is inefficiently resourced. I briefly pay tribute to the work of the local commissioning group, which as of last week has put in some resource for mental health professionals to work across schools, but it does not come close to the level needed. I beg the Minister to listen and to do what she can to get the Government to act.

Photo of Steve Double Steve Double Conservative, St Austell and Newquay 3:02 pm, 16th July 2019

It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate my hon. Friend Andrew Griffiths on securing this debate. I concur very much with all that he said in his opening speech.

Because we have only a small amount of time, I want to address one specific issue that has been brought to my attention. We all agree that we have a growing challenge with mental health conditions among young people across the country. It is right to acknowledge that the Government recognise that and are acting. We are grateful in Cornwall that, as I speak, a residential unit for children with mental health conditions is being built, after many years of not having a residential unit and our children having to be sent all over the country to be cared for. That unit will be open soon, which is very welcome.

I am particularly concerned about the amount of pressure we are putting on our schoolteachers when it comes to caring for children with mental health conditions. We are expecting more and more of teachers in that regard when it is not their role or responsibility. I am concerned about the impact that is having on our teachers.

I am also concerned about another aspect of education, which is authorised absence. I know that is not the Minister’s direct responsibility, but I hope she will take the remarks on board and feed them back to the Department for Education. Many parents are coming to me saying that they are struggling to get the school to support them as a family when they need to take their children out of school because of mental health concerns and conditions, including to attend appointments with CAMHS or other organisations.

In one case, the school was refusing to recognise absence from a particular child who was suffering from a mental health condition until that condition had been formally diagnosed by CAMHS. As we have heard today, it can take many months—I have heard it is up to 18 months—to get a diagnosis from CAMHS. The school was sending warning letters home to the parents about the amount of time the child was having away from school and threatening to take legal action against them. All that was doing was exacerbating the problem and putting more pressure, more stress and more distress on the family at an already difficult time.

Through the Minister, I appeal to the Department for Education that we need our teachers, and our headteachers in particular, to be more understanding and more compassionate. They are being driven by a heavy-handed approach from Ofsted in meeting attendance targets. It seems that those targets, above all else, are the most important thing for schools. No recognition or allowance is given for the real challenges many families face when they have a child who is suffering with mental health conditions and is therefore unable to attend school regularly. They are being put under huge pressure.

Many children are aware of what is going on, and I am concerned that they are encouraged to bury the issue and go to school because they do not want the pressure put on their parents, rather than opening up and getting the help and support they need. We need to ensure that schools work with parents and families when they have a child facing these issues. They should not add to the problems or the pressure that the family is under. I ask the Minister to take that on board. We can do better in getting schools to recognise the concerns and conditions that many families find themselves facing and in working with families, rather than exacerbating the problem.

Photo of Marie Rimmer Marie Rimmer Labour, St Helens South and Whiston 3:06 pm, 16th July 2019

It is a pleasure to serve under your chairmanship, Mr Pritchard. I applaud Andrew Griffiths for securing this debate. Children and young people’s mental health is incredibly important. I appreciate the contributions of other Members. I have similar situations of children suffering in my constituency, but I will not repeat them.

I want to focus on three issues that are important to the mental health of our young people. First, I want to raise the issue of young people’s mental health within our judicial system, which I spoke about in this Chamber only a few months ago when I highlighted how young people with mental health issues had been forgotten in the Government’s response to the Justice Committee’s report on the disclosure of youth criminal records. I emphasise that when we look at the Government’s funding plans for young people’s mental health—they are welcome, but could stand to go further—we should not forget the vulnerable young people who have been taken out of mainstream schools and placed under the care of the UK’s judicial system. Many of those young people may not understand why they are there, and they are placed under stress and pressure that even we as adults would struggle to cope with. We must ensure that does not lead to the degradation or further degradation of their mental health, which may damage their chances of rehabilitation.

Secondly, I want to raise the issue of personal, social, health and economic education—also known as PSHE, and formally known as citizenship—for those young people still within our education system. Frankly, the provision is woefully inadequate for the issues it is trying to tackle. There is little to no guidance from central Government, and how the provision is conceived and delivered is almost completely up to the school. That has produced an almost laughable system where each school can have a completely different interpretation of the curriculum and its requirements. One school might require just 15 minutes a week during form time, yet 30 minutes down the road, another school might give an hour’s lesson once a week.

Within that time, teachers are expected to cover everything from mental health to how mortgages work, to sexuality, to how Government and this place works, all with little to no guidance. Many schools simply do not provide the time required to tackle the subjects properly. The lesson material is often put together by a teacher who happens to have the time or by a third-party company that knows little to nothing about it. Neither of them may have the necessary subject matter expertise. I call on the Government to get to grips with the issue and make PSHE a statutory subject with guidelines on the content of the subject area, so that the situation does not essentially amount to, “It’s up to you.” There should be a key focus on mental health, which is too important to have such vague guidelines.

Finally, I want to touch upon the subject of loot boxes in video games. For those who do not know, loot boxes are a mechanic in video games that require someone to pay money to get a box or a pack. Within the box, they might get a piece of very good equipment, a rare boost or a character that will give them an edge when playing online against other people, or they might get something that is rubbish. If they already have it, it is virtually useless to them. To put it in plain English, loot boxes or “surprise mechanics” are essentially gambling. The mechanics also have no impact on the age rating for a game, meaning that young people of all age ranges can be exposed to what are basically gambling mechanics.

I am not someone who believes that video games are bad for young people and rot their brains, as some would put it, but such gambling can have a negative effect on young people’s mental health and cause addiction. There is a reason why we have age restrictions for fruit machines and gambling websites. Even then, we can see the negative effect on adults. I therefore call on the Government to follow the lead of countries such as Belgium and step in to deal with gambling mechanics and their impact on the mental health of our children.

Photo of Gillian Keegan Gillian Keegan Conservative, Chichester 3:11 pm, 16th July 2019

It is a pleasure to serve under your chairmanship, Mr Pritchard. One in nine young people aged between five and 15 has a diagnosable mental health condition, so I thank my hon. Friend Andrew Griffiths for securing this vital debate. The issue becomes more pressing as figures suggest that those children are twice as likely to carry mental illness into adulthood. However, the Government are taking some action and have invested £1.4 billion to improve specialist services for mental health, but we are playing catch-up.

Pressures on the younger generation are at a new high with the advent of social media. There is a constant pressure to keep up on platforms such as Instagram, Snapchat and Facebook, which is compounded when we look at their exposure to image and celebrity culture. Although social media can be a power for good, it is clear that such platforms can have a detrimental impact on children’s mental health. We have already had some truly devastating cases such as that of Molly Russell, whose suicide sparked this important conversation nationally. I welcome the current review by the chief medical officer, Dame Sally Davies, who is assessing the impacts that social media has on a child’s mental health.

Another mental health condition on the rise, especially in young people, is eating disorders. I recently met a constituent, Lizzie Speller, here in Parliament, with the charity Beat UK, which supports people with eating disorders. Lizzie spent several years fighting anorexia. She overcame her long battle and got the help that she needed. It is fantastic that four fifths of young people with eating disorders now receive treatment within one week. Lizzie is doing a lot to help others. She has set up Mental Health Mates walks, a Chichester community group that has a monthly city walk. My husband and I joined them earlier this year. It is an opportunity to meet and talk about things that concern people. The role of Beat is important in spreading the network across the country.

Another Beat ambassador is my goddaughter’s sister, Isabella Tee, who worked hard to overcome anorexia as a teenager and now works to support others at York University. Schools have a vital role in offering support and spotting the signs when people need help. Many schools in my constituencyChichester High School and Bourne Community College, to name just two—have done a lot to support mental health in schools and have trained mental health first aiders and pupil mental health ambassadors. On the ground, visible services are exactly what we need, and I look forward to seeing the impact of the new mental health support team pilot in my area, as the Coastal West Sussex CCG is taking part in the first wave.

Getting to grips with mental health is important, as the consequences of not doing so are unimaginable. On 17 July 2017, one of my constituents, Jo Marsden, had her life turned upside down when her 20-year-old son, Ned, took his life at Witley station. Ned had been excluded from school earlier in his life, and over the years had withdrawn from his family and friends. His mental health issues were well masked and not identified at school or later when his doctor tried to identify signs. I have met Jo several times now, and she is an inspiring woman. She has created Ned’s Fund, which offers vocational courses to young people who drop out of school. She said,

“My dream is to help as many children as I can by funding vocational training. I’m not a fairy godmother but nothing would bring me greater happiness.”

The impact of suicide on a young person is truly devastating, as my family knows from personal experience because my young cousin, Sallie Gibson, took her life some years ago.

People across Chichester continually come together to improve each other’s lives. Tackling mental health issues needs a comprehensive approach where, in every part of a young person’s life, someone is available to give a much needed helping hand.

Photo of Kevan Jones Kevan Jones Labour, North Durham 3:15 pm, 16th July 2019

I thank Andrew Griffiths for securing this debate. It is important because the simple way to change attitudes around mental health in this country is to talk about it. The more we do it in Parliament, the better. I pay tribute to all those, including charities such as Rethink Mental Illness, that have made a real step change in the way that we consider mental health in this country. I also give credit to the Minister. She obviously does not know what will happen next week in terms of the change in Prime Minster, but she has been a great champion for mental health in not only doing the work that she does, but caring about it. Sometimes we get a Minster who simply goes through the motions, but this Minister cares deeply about the subject and has made a real difference.

The point about finance is important in mental health. That point has been made over the years not only in respect of adult services, but in respect of children’s services, and it has been made again today. Having the proper workforce is also important. I do not want to relegate those two issues because they are very important in this debate, but the other thing that often does not get spoken about is having a proper pathway into a service, which is a mess at the moment, partly as a result of reorganisations in the health service. We have also had cuts to local authorities and they can no longer afford to fund voluntary sector organisations. Sure Start centres have been cut, and the cuts are having an impact on people’s access to services.

I pay tribute to CAMHS. They get a bad name, but they are trying their best in the impossible job that we give them. We have to try and turn down the pipeline of people going into CAMHS services. The only way we can do that is if we have a proper triage system before going into CAMHS, so that people know whether they can get help elsewhere. We often over-medicalise mental health conditions. The Tees, Esk and Wear Valleys mental health trust in my area has a good pilot that pays for a psychiatrist to sit in a GP’s surgery so that a mental health professional can triage cases as they come in. I do not want to criticise GPs, but they are not mental health professionals. They should have a mental health professional who can triage the cases that need to go through to CAMHS or other adult mental health services and then they can try to help the others.

We need a local network of support organisations, whether it is the voluntary sector, as the hon. Member for Burton rightly pointed out, or others that do fantastic work. He put his finger on the issue of how we tender for mental health services. I am sorry, but the ones that I speak to in County Durham have contracts that are too big and they do not have the capacity to take them on, but they do valuable work in the community. In some cases, it is a way of taking pressure off the pipeline going into CAMHS and adult mental services. Parents want to know where to go, so we need signposts and pathways so that people do not wait 12 months or longer to get into CAMHS, thinking that will somehow answer their questions.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton

I thank the right hon. Gentleman for giving way and for his great speech. Does he agree that one of the reasons why they tender in that way is because they want to have a uniform approach across the whole country? In reality, if someone wants access to a service, people understand the local charity and are much more aware of it, and more likely to go to it for that very reason.

Photo of Kevan Jones Kevan Jones Labour, North Durham

I do agree. In my experience the best local examples of mental health support are what is being done by local charities, most of which, frankly, run on a shoestring. They do not ask for huge amounts of money. I think it would be cost-effective for the taxpayer if we directed services into that, but we need that joined-up system. If we do not have it, we can pour as much money as we like into the system and it will not work.

I want to mention one last thing—students’ mental health, which is being highlighted in universities. Will the Minister contact Northumbria University, which is doing innovative work on using new technology to track students and highlight those who are vulnerable? I saw it a few weeks ago on a visit to the university. It is a new model, which could have implications nationally, and I think it is worth looking at. I will finish by just saying, let us keep on talking about this subject.

Photo of Faisal Rashid Faisal Rashid Labour, Warrington South 3:20 pm, 16th July 2019

I thank Andrew Griffiths for obtaining this important debate. I imagine that not a single Member of the House would diminish the importance or severity of this issue. We all want every child to get the best possible start in life, but that is an empty commitment if we do not make sure that the right level of support and help is available for children who suffer from mental health conditions, just as we would for children with physical injuries. We would never allow a child with a broken leg to suffer alone, without professional treatment. Nor should we fail to provide a child suffering from depression or anxiety with the support they urgently need. In the past, the issue has not been given the priority it clearly deserves, so I am glad that finally a consensus is starting to build around the importance of improving mental health services for children and young people.

Despite the acknowledgement of how much needs to be done, the Government have failed to act decisively on the issue. Identifying a problem is all well and good. What we need is real leadership, concrete solutions and properly funded services. At present they are failing on all three fronts. Not enough has been done to address the inadequacy of funding for services or to reduce the number of children who do not have access to mental health support at all.

The Government’s children’s services early intervention grant has been reduced by almost £600 million since 2013. It is projected to decrease by another £100 million by 2020. Children’s services now face a funding gap of £3 billion by 2025. That underfunding is taking place in the context of a rising demand for children’s mental health services. Underfunding leads to a vicious cycle, as the support necessary for good mental health—provided through services such as housing, education and family support—is gradually cut away. When those resources are unavailable, early intervention becomes impossible and mental health problems are left to fester and deteriorate, until finally they require urgent medical intervention. Children are not suffering from more mental health problems at random: the conditions for mental ill health are being created by austerity.

That is why I support the recommendations of the Local Government Association’s “Councils Can” paper, which calls for the empowerment of local government to lead communities and improve young people’s mental health and wellbeing. The point about signposting pathways and helping charities is important. Properly funded housing, education and family support services need to be given priority to ensure the wellbeing of children and young people. Councils are uniquely placed to do that. That is why they need to be properly funded and at the heart of our efforts to address the issue.

Inequality is also a huge issue in the delivery of mental health services for children and young people. Research this year from the mental health charity Mind found that vulnerable people in some regions struggle with little more than half the NHS funding of those in the best-resourced areas. For example, in Surrey Heartlands health and care partnership, the average annual spend on mental health services per head of population is just under £125, but in South Yorkshire and Bassetlaw sustainability and transformation partnership the figure is over £220. The Government need to act as soon as possible. The crisis is absolutely huge.

Photo of Ruth Cadbury Ruth Cadbury Labour, Brentford and Isleworth 3:24 pm, 16th July 2019

It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate Andrew Griffiths on obtaining the debate and on his excellent speech, which I almost wholly agree with.

I carried out a constituency survey on mental health services for young people and the responses showed that my constituents are worried and concerned and feel that the situation is getting worse. Of the top issues when we analysed the results, No. 1 was long waiting times, No. 2 was that people get care only after self-harming, and No. 3 was that the police were having to intervene to protect at-risk young people. The young people were coming to the notice of the services far too late. For example, a parent said they had had to visit the GP three times and it was only after their child self-harmed that they were referred to CAMHS. Another, speaking of her daughter, said:

“Her future has been robbed by mental illness and the NHS didn’t have the staff or resources to make a difference when it counted.”

The hon. Member for Burton and others have clearly outlined the need for more funding. If the Minister needs ammunition to help her with her arguments in the spending review, just think of the cost to the nation of not adequately funding early intervention and CAMHS before things reach crisis level for young people.

I want briefly to discuss early intervention in schools. Universal services—in education, family and youth services, as well as voluntary services—are a vital part of early intervention, identifying at-risk children and signposting them towards dedicated services. That is why we need fully funded universal as well as specialist services. However, cuts to Sure Start centres, youth services and school funding mean a loss of welfare support and other forms of support. The people in those services are the ones who pick up issues, give support and make referrals. That is why austerity in the context of mental health is not just an issue affecting CAMHS; it is about all those services. My local authority, the London Borough of Hounslow, has lost 40% of its total income through a cut of more than 80% in Government grants. That has meant that it has had to cut direct and commissioned services. Now we can see that cut after cut has a detrimental impact not just on young people’s life chances but on their physical and mental health.

Schools are a vital part of early intervention, as other Members have said. When we discuss the role of education in relation to mental health, we need to remind everyone that our schools are facing a funding crisis. They have had to implement a real-terms funding cut of 9% since 2010. In further education it is worse. FE colleges are losing an average of 20% in funding. That is certainly happening at my local FE college. It affects their ability to support young people in crisis. Teachers and school staff are already overworked, and welfare and teaching support have had to be cut. Often teachers can spot problems, but they are not trained to treat mental health issues. In addition, because of the nature of teacher training, there is often no space for teachers to learn about neurodiversity—dyslexia, dyspraxia, autism, ADHD and so on. It takes even teachers a while to recognise what the problems are. That in itself causes mental health problems. Even when they do identify at-risk students and refer them, those students face long waiting times.

We are lucky in Hounslow. We have been successful in getting £820,000 in grant funding for specialist mental health staff based in hub schools, which is good. It is one of 25 pilots. However, that is not enough and I am afraid I do not agree with the Government when they say they are spending a record amount in this area. There have been so many cuts that I believe a lot less is being spent than was funded under the Labour Government.

Photo of Hugh Gaffney Hugh Gaffney Labour, Coatbridge, Chryston and Bellshill 3:28 pm, 16th July 2019

It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate Andrew Griffiths on securing this important debate, and my hon. Friend Mrs Hodgson, who secured a debate on the issue in the main Chamber last week.

Good mental health is important to us all, especially in childhood and adolescence. If mental health problems in childhood and adolescence are not properly treated, they can continue into adult life. It is not a problem for just one part of the country. It is truly a national crisis. I appreciate that much of the debate will focus on children’s mental health services in England, but I want to highlight the situation in Scotland. The number of young people in Scotland who took their own lives increased by 50% last year—I repeat: there has been a 50% increase in suicides among young children in Scotland. We are losing young people, who have so much to offer, but who find themselves suffering in silence. It is a national tragedy across the UK. The Scottish Government pledged to reduce the number of suicides in Scotland by 20% by 2022. If that pledge is to be met, there needs to be some serious action to improve mental health support for children and young people in Scotland.

The children and young people’s mental health taskforce made a series of recommendations, including joint working between the Scottish Government and local government, to reform the way that mental health support is provided. I urge the Scottish Government to enact those recommendations in full. I back the call of the Scottish Children’s Services Coalition for an increase in investment in specialist mental health services and I hope that the Scottish Government respond positively.

Investment alone is not the answer, however; we need to tackle the underlying causes of mental health issues among children and young people. Some 60% of young people in Scotland say that the pressure to succeed has led them to feel overwhelmed or unable to cope. One in five young people say that they are ashamed of the way they look. Others have experienced mental health issues as a result of their school environment.

We have to look for new ways to support the mental wellbeing of children and young people, which is why I welcome the “Give Youth A Chance” petition, started by the families of three young men who took their lives in Lanarkshire. The petition calls for suicide prevention and mental health support programmes to become mandatory in schools across England and perhaps the UK. That would be a positive step to ensure that the mental health support needed by children and young people was more readily accessible.

The state of children and young people’s mental health services is a national crisis. They are being let down across the UK by inadequate funding for specialist services and growing waiting lists. It is time for the Scottish Government and the UK Government to listen.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 3:32 pm, 16th July 2019

I congratulate Andrew Griffiths on securing the debate.

It is a tough time for children to be children. When I was a child, which was not yesterday, I went to school, came home and did my chores, then went out to play with the rest of the children. We did not have much, but it was all we knew. That is not the case now. Children are under so much pressure to have the best gear, go to the right places and look and behave a certain way. There is no closing the door at night to get away from the pressure; social media follows them everywhere.

I was horrified, but not surprised, to read that one in 10 schoolchildren in Northern Ireland has a diagnosable mental illness, and that 35,000 children had been treated by child and adolescent mental health services in 2018. The Northern Ireland Affairs Committee has just done an inquiry on education and health that reinforced those figures. Indeed, I have had parents in my office whose child is on the waiting list for the CAMHS team and who cannot get on it, and there are many more who should be on the list and are not, so the real number must be well above 35,000.

Schools find themselves on the frontline of dealing with day-to-day anxiety and trying to help, but it is not enough. An article quotes Dr Phil Anderson, a consultant psychiatrist in CAHMS with the Belfast Health and Social Care Trust, who says:

“The research shows there has been an increase in the emotional difficulties in children, a 50% increase since 2004.”

That is an absolutely horrendous figure. He continues:

“There are various reasons given for this. One is social media and the rise of cyber bullying and screen time. Some people have said it’s as a result of rising economic inequality and, of course, academic pressures.”

We do not have the tools to deal with that, but our young people are crying out for help.

A young lady in my constituency, Katie Graden Spence, who recently shadowed me in this place, has been open about her struggle with anxiety and mental health. She published a poetry anthology, “Searching for freedom”, which paints the scene of emotion in many young people. Katie was a finalist in a prestigious category of the Pramerica Spirit of Community awards in recognition of her poetry and fundraising for Action Mental Health, as well as her work to outline her proposals on peer-led mentoring in schools to the Department for Education and the all-party parliamentary group on mental health. She is inspirational and inspired. She is fighting those battles for herself and for others her age whom we are failing. We must ask ourselves about that.

I am thankful to the hon. Member for Burton for raising the issue, but I will be more thankful to learn how we are going to radically change how we deal with children’s mental health in the UK. Children are struggling. They need us to do more. I look forward to hearing how we will put funding in the right places and guarantee controls on social media to prevent cyber bullying and trolling, to ensure that young people know that they are loved and important, and that they matter in their home, their community and here in this place.

Photo of Lisa Cameron Lisa Cameron Shadow SNP Spokesperson (Mental Health) 3:34 pm, 16th July 2019

It is a pleasure to serve under your chairmanship, Mr Pritchard. I thank Andrew Griffiths for securing this extraordinary debate, in which there have been many contributions from both sides of the House and many interventions, which shows that the issue is a high priority in our constituencies. It is important that the subject was brought to this Chamber. His speech was detailed, extensive and passionate. I congratulate him on being an assiduous representative of his constituents.

We have heard about the main issues; I will not go through them all again but point some out. Workforce is obviously a problem, as are training, access to services, prevention, treatment, trauma and eating disorders. We have also heard about social media and how technology can be helpful in signposting people, but can also undermine mental health in young people, so appropriate safeguards must be put in place.

We have heard constituency cases from across the United Kingdom. The Office for National Statistics shows that the highest rate of suicide is in north-east England and Wales, but all Governments across the United Kingdom need to make tackling suicide a priority. I thank the Minister, who has been working hard on it and has made significant progress. The problem is, however, that we had such a long way to go that we are not yet where we want or need to be.

I thank the British Psychological Society and the Paediatric Psychology Network UK for sending me their updates and views. They pointed out the problem with access to child and adolescent mental health services and that the services continue to be run on medical models, so if a young person presents with suicidal thoughts or behaviours, unless they have a concomitant mental disorder such as depression or an eating disorder, they do not always gain access to the treatment part of CAMHS. That is wrong, because not every young person will be medically classified as having a disorder, but may need access to coping skills, treatments, counselling and perhaps family therapy. They may have social issues, rather than a condition that requires a medical diagnosis, but they still need access to crisis care to prevent suicide.

That has been brought home to me in the last couple of weeks, as we have suffered our own tragedy in East Kilbride. Ryan Coleman, a young man with his whole life ahead of him, took his own life. This weekend, I am going to a tribute event to mark his life and what he had accomplished in such a short space of time, and to support his family and friends. Families should not have to go through such tragedies, however, and Parliament must do more.

I thank the Trust Jack Foundation in Stonehouse, which has set up young people’s services to bridge the gap and make sure that something happens between a referral to CAMHS and being seen by CAMHS. It gives young people access to support from other young people who experience mental health issues and to support-based activities and therapies. Again, that came out of a personal tragedy—the loss of Jack—which his mother, a wonderful woman, has turned into a positive thing for other children across the area. I cannot thank her enough.

Transitions are important; we need to focus on the transition from child to adult mental health services, and services in colleges and universities. Will the Minister think about the children who have lost a parent serving in the armed forces, and update me on that? A couple of weeks ago, I went to an event with the armed forces parliamentary scheme where I found out that there is a lot of work going on in the US to support young people who lose a parent in service, but there is no much support, treatment and access to services in the UK. Obviously, children who lose a parent serving in the armed forces also lose their home and support network. They have to make dramatic adjustments, and for young people, that is a critical time.

Governments across the United Kingdom are trying their best to improve services, but we have a very long way to go. I want to help everybody in Westminster and the other Governments to achieve the progress we need.

Photo of Steve Reed Steve Reed Shadow Minister (Education) (Children and Families) 3:40 pm, 16th July 2019

It is a pleasure to serve under your chairmanship, Mr Pritchard. I congratulate Andrew Griffiths on securing this important debate. I thank hon. Members on both sides of the House who have contributed some extremely moving testimony from their own lives and their experience as constituency MPs. I will refer to some of their contributions during my speech.

Fundamentally, children’s mental health services are in crisis because the funding is inadequate and prevention has been cut at a time when the pressures on children are higher than they have ever been. Difficulties in childhood, such as growing up in poverty or experiencing neglect, abuse or childhood bereavement, which my hon. Friend Louise Haigh spoke about, can have a huge impact on a child’s mental health. There are also new pressures that affect all children, which many of us did not experience, such as the increase in exams and tests at school and the rise of social media, which has created new forms of bullying and has put new pressure on children in relation to their self-image and how they feel about their bodies.

I want to explore the issue of childhood trauma a little more, because it plays an important role in developing higher incidence of childhood mental ill health. There are three high-risk factors that indicate that a newborn baby’s life chances will be dramatically reduced: having a parent who is addicted to drugs or alcohol, having a parent with severe mental ill health, or witnessing a parent being subjected to domestic violence. Any one of those three factors creates a significant risk for the child, but shockingly 16,000 babies are born every year in this country to parents with all three of those risk factors.

Without intervention and support, those children have very little chance in life. They will become the young people committing knife crime. They will end up in the care system. They will fill our prisons, as my hon. Friend Ms Rimmer pointed out. They will end up living on the streets, develop mental ill health and die younger. My hon. Friend Hugh Gaffney pointed out the alarming increase in the rate of suicides.

One in three mental health conditions relates directly to adverse childhood experiences. A study by Safelives shows that more than half of children who witness domestic violence develop behavioural problems and have difficulty forming relationships later in life. Their fragile young minds are deeply traumatised by seeing their mother beaten up by a violent and abusive partner in their home, which should be a safe space in which to grow up. Professionals do not always recognise that the problem underlying what they may term “difficult behaviour” may be mental ill health caused by traumatic experiences in earlier childhood. Professionals who work with children are not routinely trained on how trauma can affect behaviour, so the child does not get the help they really need. We need services to get dramatically better at identifying when challenging behaviour comes from trauma so we can treat the problem at source, rather than continuing to fail the child, who had precious little chance from the moment they were born.

Mental ill health affects not only the most vulnerable young people, of course. As we have heard, one in eight children experiences mental ill health, yet the recent NHS mental health prevalence survey found that only one in four young people with a mental disorder is seen by a mental health specialist. My right hon. Friend Mr Jones is right to call for better access to care. As my hon. Friend Ruth Cadbury said, on average it can take three visits to a GP before a child is referred for specialist assessment. They then have to wait an average of six months for treatment to start. Of course, there are far worse waiting periods. My hon. Friend Gloria De Piero spoke about a 72-week wait, and my hon. Friend John Woodcock spoke about a young man, Drew, waiting 15 months for a CAMHS assessment. In that time, the child’s mental health condition gets worse. It is a very long time for the child, with very serious implications for the rest of their lives.

Many more severe mental health problems could be avoided if we invested more in early help and prevention. We know it works, but the cross-party Local Government Association points out that children’s services face a £3 billion funding shortfall, to which my hon. Friend Faisal Rashid referred. That means that the lack of early intervention work is now reaching an absolute crisis point. This country is failing some of the most vulnerable children in our society and then blaming them for our failure to provide the help that they needed. Thousands of young people did not have a chance from the moment they were born.

I have the highest regard for the Minister from our previous interactions on related issues. I know that she is deeply committed to these issues, so I hope she will act on what she has heard today. I have some questions of my own to ask before she responds. Will she ring-fence NHS mental health budgets and require that they be spent on mental health services, rather than being reallocated elsewhere, as we are currently seeing? Will she invest in prevention and early help, rather than waiting for mental health problems that develop early in a child’s life to turn into crises as they grow up? Will she ensure that children’s services professionals are trained to recognise trauma and provide appropriate care that meets the child’s needs, rather than blaming them for behaviours that have arisen because of the trauma that they have experienced? Will she make sure babies born to parents with the highest risk factors get the support they need from the moment they are born, rather than allowing their lives to be written off and wasted? I hope very much that we will hear positive responses from the Minister, because no country that loves its children can keep treating them like this.

Photo of Jackie Doyle-Price Jackie Doyle-Price The Parliamentary Under-Secretary for Health and Social Care 3:46 pm, 16th July 2019

I thank all hon. Members who have contributed to this afternoon’s debate, which has given me a lot to think about and a lot to address. I pay particular tribute to my hon. Friend Andrew Griffiths, who gave an excellent exposition of the challenges before us. I welcome the contributions of all Members. We have covered a lot of content, and I will do my best to address all the points that have been made—there are a hell of a lot.

As Mr Jones said, for a long time we have not talked about mental health enough. It has been a taboo subject, and these issues have been left to fester. As a consequence, mental health has been a Cinderella among public services. People with mental ill health have suffered discrimination at the hands of the state in many ways.

We have identified that children’s mental health services have been underfunded for generations, and we will have to fix that—of that there is no doubt. Unfortunately, that takes more than a magic wand. It requires investment and all commissioners to step up to the plate. It requires good partnership working between NHS organisations, local authorities, schools and everyone involved in the system. It is, frankly, a massive culture change, but we need to deliver it. We have heard examples this afternoon of individual children who are being failed by poor service. Frankly, that is the state’s failure, and we are all duty-bound to put it right.

I am grateful that hon. Members have given me these examples, challenging though they are, because they are a helpful reminder to the system that these are individual people. People like Drew should not have to wait 15 months for an appointment. John Woodcock, Tim Farron and I have talked about the challenges in Cumbria. In terms of delivering the transformation and improvement we are aiming for, we are seeing a real lack of consistency in the speed and quality of services as they are rolled out. Again, that is a challenge for us as a system. In my contacts with NHS England, I am keen to ensure that we get more uniformity in provision.

In answer to the point Mr Reed made about ring-fencing funding for mental health services, NHS England will challenge CCGs very directly about how much money they spend on mental health services. We are very clear that they should spend more than the increase in their budgets. Although we have always rejected the suggestion of a ring fence on the basis that they can often be seen as a ceiling, which we do not want, there is now room for some very challenging comments. We really need to start thinking about whether what we have in place is delivering the outcomes that we in this Chamber and we as a society ought to be able to expect.

There is so much to cover that I am sure I will miss something, but there are some points that I really want to emphasise. The right hon. Member for North Durham talked about the role of the voluntary sector. That was music to my ears. I have said repeatedly that good support for people with mental ill health does not necessarily have to be medical—in fact, the wrap-around service that can be provided by just company and comfort is far better delivered by organisations in the voluntary sector, but it is part of our health offering. I am very challenging in telling CCGs and commissioners that they should be thinking about commissioning services from the voluntary sector. Taxpayer funding should deliver the outcomes we want, and the voluntary sector can do that better and cheaper than we can by medicalising the problem. I cannot emphasise that enough.

On delivering more efficient pathways, clearly, the ability to triage people to services that are not medical, are more fleet of foot and can react more immediately provides an opportunity for early intervention that will deliver the better outcomes we want for people.

Looking particularly at individual groups, we heard reference to people with neurodiverse conditions—people with ADHD, ASD and dyslexia. Often, those things go undiagnosed. We need to ensure that, in schools, those people are not just treated as difficult but signposted to places where they might get additional help. We know that earlier diagnosis of those conditions can be the difference between developing mental ill health and not, so we must do better on that. Obviously, the next wave of delivering a transformation for children will involve continuing our pressure on the need to deliver a better mental health service for children, but key to that for me is getting earlier diagnosis of autism and ADHD.

I am not shy about articulating the benefit of that for society; early diagnosis is not just for the benefit of those children, although of course they deserve the best services. We heard about the impact of trauma, and everyone who mentioned it was absolutely right. We have no excuse for failing those people and not putting support around them when they need it. Not only do they deserve that, but by doing so, we win as a society. As I said, those people end up in the care system at best and in prison at worst. Our prisons are full of people who have been failed by the state because we did not give them that hand up when we needed to. We must grasp this issue, and I am not shy about raising that challenge. Yes, it is good value for money—I am sure I speak for all hon. Members when I say that I would rather spend more on health than on prisons, thank you very much. We must ensure that we support people when they need it and recognise the impact of trauma.

Hon. Members will be aware of the work that my right hon. Friend Andrea Leadsom led when she was in Government on the support given to people in the first 1,001 days of life. She has a debate on that subject in the main Chamber later this afternoon—in fact, she is speaking now. I am sure she will echo some of the points the hon. Member for Croydon North made. We can see the children who are at risk. The state has every opportunity to support those people and, frankly, we should be a lot more assertive in doing so. As I said, those individuals will benefit, society will benefit and, of course, the taxpayer will benefit because we will not be spending money on failure.

Hugh Gaffney spoke movingly about the increase in suicide among young people. Collectively across Government, we need a better understanding of the pressures facing young people, which seem to be a lot more acute than they were when I was growing up. Bluntly, I used to play at “Charlie’s Angels”; I did not expect to look like them. That might seem a trite thing to say, but body image puts massive pressure on our young people.

We used to think that kids would be safer in their bedrooms than if they went out to play on their bikes. That is no longer true, because the way people are routed through content when tackling social media leaves them very much at risk. Although we can celebrate the revelations and opportunities that the internet and social media have given our young people, they bring with them risks, and we need to be a lot more on top of those. I am glad to say that I am now in regular dialogue with those companies. To be fair, they are stepping up to the plate at this stage, but that is not to say that we should not consider legislation where we can see that that would bring value in protecting young people.

Obviously, we have made commitments to increase funding. We will continue to do that, because we need to ensure that we meet the unmet need that was alluded to. As I say, money spent early is money spent wisely and money spent less, so we must absolutely continue to do that. The value of early intervention is totally unarguable when expenditure on acute service is so much costlier.

Waiting times were mentioned, and I will take that away. We need to get a much better handle on areas with particularly long waiting times. We have set targets. Some 80% of young people with urgent cases are seen within a week. Again, this comes back to the extent to which we triage services. The really important thing about early intervention and getting support to children at an early stage is our proposals for mental health support teams to work directly with schools—my hon. Friend the Member for Burton alluded to the project starting in his constituency. Those teams will be able to equip the schools themselves with more material and support to help them embed mental wellbeing throughout the curriculum, but they will also be the place for additional support and the place where services are referred.

I thank all hon. Members who contributed to the debate. We are on it, but I would be the first to admit that we still have a long way to go to deliver mental health services for children that we can all be proud of.

Photo of Andrew Griffiths Andrew Griffiths Conservative, Burton 3:58 pm, 16th July 2019

At a time when the public look in on this place often with derision and sometimes with desperation about how we behave, this debate has shown Parliament at its best. There was lots of consensus, lots of cases were mentioned in a heartfelt way, and we heard lots of determination to make a difference. I think we all recognise that these issues involve young people in a desperate state and parents who are equally desperate about the future of those children. If we can come together and deliver the early intervention and support mechanisms that can make such a difference later in life, we can literally save the lives of those young people. I thank everybody who contributed to this really positive debate. I hope it is just a springboard for us to go further and ensure we deliver for all those young people across the country.

Question put and agreed to.

Resolved,

That this House
has considered children and mental health services.