Mental Health Services in Schools and Colleges
Lord Storey
To ask Her Majesty’s Government what proposals they will bring forward regarding mental health services in schools and colleges.
Lord Storey (LD)
My Lords, I think that this is the fourth or fifth time in almost as many days that we have talked about mental health, which perhaps shows how important the matter is to your Lordships and that there is a need for action. No doubt there has been and will be repetition in what we all say but, again, that tells me how important the issue is. I also put on record my thanks to the numerous organisations that feel passionately about the issue and have sent a whole series of briefings.
Despite having one of the most advanced health systems in the world, child health outcomes in the UK, including for mental health, are among the poorest. Just 6% of the NHS budget for mental health is spent on children and young people. I know we have heard them on a number of occasions in the various Questions and debates, but we should remind ourselves of some of the facts. One in 10 children and young people aged five to 16 suffer from a diagnosable mental health disorder, which equates to three children in every classroom. One in every 12 to 15 children and young people deliberately self-harm, and nearly 80,000 children and young people suffer from severe depression. Alarmingly, all these figures are on the increase. Yet despite these figures, a freedom of information request from YoungMinds sent to every NHS clinical commissioning group and every upper-tier local authority in England found that 74 out of 96 NHS clinical commissioning groups have frozen or cut their CAMHS budgets in the last two years, while 56 out of 101 local authorities in England that supplied information to YoungMinds have cut or frozen their budgets, or increased them by less than inflation, during the same period. We ignore the situation at our peril.
Half of those adults with mental health problems had symptoms by the age of 14, yet there is little urgency in getting a child into treatment and support. What needs to be done? We all recognise that early intervention among schoolchildren is so important in helping to identify and address potential mental health issues. We need to ensure that every teacher has some form of professional development training to help them understand the problems and recognise the possible symptoms. This is not difficult and costs next to nothing. The Department for Education should include a mandatory module on mental health in its initial training, with mental health modules forming part of ongoing professional development in schools for all staff. Would the Minister consider a request to discuss this matter with her noble friend the Education Minister?
We need to have a school and college referral system which is fit for purpose. These young people’s lives are too important for them to be pushed from pillar to post. The SENCOs—the heads or co-ordinators of special needs in schools and colleges—need the training and the ability to refer cases speedily. Those referred should not have to wait for months and months to be seen. What does the Minister think is the minimum time within which a pupil or student who is referred should be seen by a professional? You would not expect somebody who is diagnosed with, say, cancer to wait months, let alone weeks, before they are treated.
I said that early intervention is crucial. The transition from school to college is complex and is when many health difficulties often arise: examinations, employment pressures and of course the influence of social media can all contribute to mental health issues. I was grateful to the Association of Colleges, which sent me the results of a recent survey it carried out. Of the 123 colleges which responded, 67% said the proportion of students with disclosed mental conditions had significantly increased year on year over the last three years. Alarmingly, 100% of colleges that responded said they had students who self-harm and have depression or anxiety. Worryingly, 60% of the colleges that replied to the survey did not even have their own college mental health policy. That is not difficult to do.
Then, of course, there are some fantastic examples of good practice in our colleges. Take Highbury College in Portsmouth: for several years it has developed its programmes and support for students with mental health conditions. As one student said:
“It helps me to believe in my own ability—I hope that I will be able to achieve things better in future. I’m a student again, and not just a mental health service user”.
Hackney Community College has developed mental health services since 1997. It is a beacon of best practice that can be disseminated to support the work of other partnerships. In my own city, Liverpool Community College works closely with the local authority and commissioning boards. Will the mental health prevalence survey include 16 to 18 year-olds as well?
Of course, for many young people education is not just building-based and many will be in educational training. That includes apprentices or trainees. They may not realise they are developing mental health problems and may be afraid of what is happening to them, not having the understanding, language, insight or ability to tell others what they are experiencing. Friends, parents or carers may not have experience of mental health problems and may not realise or recognise that they are developing them. We need a co-ordinated and joint approach between the Departments of Health, for Education, and for Business, Innovation and Skills, issuing guidance to learning providers and employers about their roles and responsibilities to apprentices and trainees regarding their mental well-being. An 18 year-old should have access to the same quality of service whether they are an apprentice or full-time undergraduate.
When the Children and Young Families Act passed through your Lordships’ House, one of the many issues that drew concern was that of young offenders, which we also talked about when discussing the secure college. In the debate, we discovered that 80% of young offenders had special educational needs and 20% were on statements, as they were then called. Also—I did not realise this—95% of imprisoned young offenders have a mental health disorder and many of them struggle with more than one disorder. Just think how their lives could be turned round with proper mental health interventions.
Finally, I again highlight the issue of children in care. A staggering half of looked-after children in England and Wales have a diagnosable mental health disorder—four times higher than the figure for the general child population. I was very taken by a report from the NSPCC, which had worked with local authorities and their health partners to explore how we can improve mental health support for children in care. That report makes important reading. In particular, it argues that rather than being the responsibility of only specialist services, every professional working with looked-after children should understand what they can do to support their emotional well-being resilience. I am absolutely sure that there is a real will and determination to ensure that children and young people with mental health and well-being disorders are given the maximum support, that early intervention becomes the norm, and that professionals are fully trained so that these young people can thrive and prosper, and enjoy their lives to the full.
The Earl of Listowel (CB)
My Lords, I thank the noble Lord, Lord Storey, for tabling this debate. Of course, he has a lifetime’s professional experience in this area and we heard that in what he said.
I begin with his final point, on the mental health of looked-after children and the NSPCC report that he referred to. The Minister may recall from our discussions on early years childcare recently the emphasis put on high-quality early years care and in particular the discussions on the importance of a secure attachment between mother and infant, and of the nursery guarding that secure attachment. Relationships in that early period are key to the mental health and success of these children. What we hear from children in care who have not had that experience is that it becomes vital for them to have a stable foster placement, adoption placement or residential childcare worker and to stay in the same school and build a relationship of trust with an adult who is interested in their welfare over time. The NSPCC report and other reports on looked-after children emphasise that children who enter care have been traumatised. Care’s purpose should be to help them recover from that trauma and fundamental to that is the relationship with the people they value most in their lives—their foster carer and so on. The aim of the health service should be to support that relationship between the teacher and the looked-after child, the foster carer and the young person—although it is important to provide therapy directly to the child—by providing expert support to the parents, social workers and residential childcare workers.
I shall speak about interventions to prevent children needing mental health services in schools and about an important intervention that can be made. I am a patron of a charity called the Institute of Recovery from Childhood Trauma. It had one of its regular seminars yesterday. Dr Robin Banerjee of the University of Sussex showed a diagram that highlighted that the more popular a child is, the better their mental health and the better they do in school. It also showed that the less popular a child is, the poorer his mental health and the less well he does in school. He developed a project with the Mulberry Bush School, of which the Prime Minister is patron, looking at how creative activity can strengthen the bonds between children in school and therefore help unpopular children to manage relationships better and become happier and more successful. It has had very positive results.
I have emphasised the importance of relationships with their peers in stopping children becoming ill, and now I shall concentrate on relationships with adults, particularly teachers but with the whole staff of the school. They are very important in protecting children against poor mental health. The evidence is very clear about the importance of resilient relationships with teachers. Finland is often held up as a great example of an education system. An interesting facet is that from the age of seven, when children start school, they have the same form teacher to the age of 14, I think, but it might even be later. For seven years, they have the same teacher in their lives. It was a great pleasure recently to talk to a Finnish migrant to this country about her experience. She spoke about her affection for her form teacher, whom she knew throughout her development, and the fact that her teacher knew her so well.
To step aside for one moment—I shall come back to this—there is real concern about setting boundaries for young people. If you talk to head teachers, they will talk about the change in our culture. Years ago, if they punished a child, the parents would be right behind them. Today, very often, if they punish a child, the parent will say, “Why are you picking on my child?”. Children and young people going into the criminal justice system often have never had proper boundaries set for them. They do not know what is right or wrong. It is far more effective to have boundaries set by someone one loves than by someone one just fears, so a teacher, a prison officer or a residential childcare worker who has developed a bond of affection and trust with a young person is in a much better position to say, “No you can’t go out tonight”, “No you mustn’t mix with people like that” or “No you shouldn’t drink”, than someone who does not really know them and has to use force and fear to get them to do what is necessary.
I encourage noble Lords to think back to their own schooldays. In my own experience at primary school there was Mrs Dunon; she was beautiful and intelligent, and I was absolutely infatuated with her. I still remember today her pointing to the ring on her finger and explaining to us that by heating the ring up, the atoms vibrated faster, the ring expanded and she could remove it from her finger. I do not know whether that started my love of science, but I certainly developed one over time. I then think back to my science teacher, Mr Brown, and particularly my housemasters, Mr Woolett and Mr Jones-Parry. Mr Jones-Parry was an exceptional teacher and was wonderful in setting boundaries for us. I encourage your Lordships to think about their own relationships with teachers and how important they were in terms of their emotional well-being and in setting boundaries.
I turn to the intervention that I spoke of. This is the consultation and liaison model that is referred to in the Future in Mind report that the Government commissioned. I pay tribute to the charity YoungMinds, of which I am a patron, and which was very much involved in that report. The chapter dealing with the most vulnerable children talks about this liaison and consultation. To paraphrase what it says, often the most effective way to help children with the most complex needs is to have the best professionals working with staff members on building a relationship with the child, so the foster carer, social worker or whoever gets help from a child psychotherapist or clinical psychologist. I shall give your Lordships an example of this: when Emil Jackson, a child psychotherapist, was at the Brent Centre in north London, he provided such a consultation and liaison service to 10 schools in Brent. This meant that school staff—not just teachers, but all staff—could attend seminars and consultations every two or three weeks, and for an hour or two they would take it in turns to present a particular child, talk about their relationship with that child, have the other professionals in the school group help them to think about their relationship with that child, and have that discussion facilitated by Emil Jackson. He found, first of all, that head teachers found it made a real difference to the culture of the school and, secondly, interestingly and importantly, this particular group had a lower sickness absence rate than the rest of the school.
The principal reason for teachers leaving teaching is because they have difficult relationships with their children. If one had this sort of excellent support for teachers, our valuable and experienced teachers would be more likely to remain in the profession. That is another reason why this approach is really important. I remember speaking to a former Teach First graduate—Teach First teachers went into the toughest schools—who said how much he wished they had had that kind of support to help them to manage those kinds of relationships.
I emphasise the fact that we need to support children in their relationships if we want them to be healthy. I am really concerned about the increasing numbers of children growing up without a parent in the family or with one absent parent. When I worked with children I found that I was befriended by boys because they had no father figure in their lives. We need to think about how to engage fathers and keep them engaged, and how to find good male role models where there is no father. I wonder whether Ofsted might be charged with looking at all children’s services, schools and others, to see how effectively it could engage fathers and, where fathers are not available, provide good male role models who would be well supported to make relationships with children who do not have such good male role models in their lives. I look forward to the Minister’s response.
Baroness Tyler of Enfield (LD)
My Lords, I am very pleased that children and young people’s mental health is garnering so much attention in your Lordships’ House, and I congratulate my noble friend Lord Storey on focusing our attention this afternoon on mental health provision in schools and colleges. I declare an interest as vice-president of the charity Relate, which provides counselling to children and young people in various schools, children’s centres and GP surgeries.
As we have already heard, schools have a critical role to play in supporting pupils by promoting positive mental health and emotional well-being as part of their overall school ethos, as well as spotting and addressing minor problems before they escalate, and helping to connect pupils who have more serious problems with the more specialist help they need. We know that 75% of adult mental health problems emerge before the age of 18, and in recent debates in this House we heard about the difficulties that children and young people face in school such as bullying, relationship and family problems, the impact of domestic violence in the home, academic stress and other things that often trigger or exacerbate mental health problems, including self-harm. Why is this issue so pressing? My noble friend Lord Storey set out the key statistics, so I will not repeat them. However, I will just mention, picking up on what the noble Earl, Lord Listowel, said, that 72% of children in care have behavioural or emotional problems.
I want to acknowledge that in recent years we have seen progress in embedding a commitment to positive mental health within schools. It is encouraging that over 90% of schools now address mental health and well-being in the personal, social and health education curriculum, and that a similar proportion also do so in other lessons—a point I will return to in a minute. This past spring, the Department for Education has published new guidance for the PSHE curriculum and an evidence-based counselling strategy that encourages the use of counselling in schools. Moreover, the new draft Ofsted framework Better Inspection for All includes a new judgment on personal development that will help ensure that schools will be held accountable for providing good mental health services.
However, despite all these good things, much more work still needs to be done to ensure that all students are able to access good mental health services in schools. Research from the think tank CentreForum published late last year shows that 86% of secondary schools provide access to a qualified counsellor—which in some ways sounds quite good—but provision is patchy. For example, special educational needs schools are much less likely to provide counselling than mainstream, maintained schools, even though children with SEN are more likely to have mental health problems.
In addition, as the British Association for Counselling and Psychotherapy has pointed out repeatedly, England lags behind Northern Ireland and Wales in providing access to counselling for all secondary students. The simple reason for that is primarily because there is a statutory requirement in Wales and Northern Ireland for local authorities to provide school-based counselling in all secondary schools. In short, it is not seen as an optional extra. What plans do the Government have to ensure universal access to school counselling across England?
Work must also be done to make these services more widely known and welcoming to students. Only about half of schools advertise or promote their services, and perhaps as a consequence, according to the charity YoungMinds, which does such excellent work in this area, one-third of children report that they do not know where to turn for mental health support. This must be a matter of real concern for us all. Equally worrying, there is evidence to suggest that children who belong to various minority groups are less likely to take up school-based counselling. Schools could learn a lot from successful examples from the voluntary sector about how to encourage take-up of school counselling among children who need it, particularly in a non-stigmatising way.
Moving on, these measures are most effective as part of a whole-school approach to good mental health and well-being. Part of this means that school staff must be equipped with the skills and feel confident to identify students who are having difficulties and to provide some level of support. Yet, according to CentreForum—a point already raised by my noble friend Lord Storey—there is no mental health and well-being training in 17% of mainstream maintained schools. Can the Minister say, either now or perhaps by letter, what plan the Government have to act on the recommendations of the CentreForum report and the recent Carter review of initial teacher training, and improve training for teachers on mental health?
Of course, in some cases the services within schools will not be enough to tackle the challenges that children with mental health problems can present. So it is critical that children who need them are quickly and effectively referred to CAMHS services, and it is equally critical that CAMHS services are resourced to respond promptly—something which has been spoken about many times in your Lordships’ House but which patently is not happening.
While the vast majority of schools have a referral pathway in place, only half of these were referred to in the CentreForum report as being effective. More concerningly, schools typically do not have the resources to properly determine when students need to be referred to a specialist service. Indeed, CentreForum found that only about a third of schools used screening tools to gauge the severity of need of their pupils. For that reason, I very much welcome the Department for Education’s proposal for a pilot programme that will place a CAMHS contact in 15 schools across the country to help develop good communications and links between CAMHS, school staff and students. If implemented effectively, this programme has the potential to provide more direct entry points into specialist mental health services and, equally importantly, to allow school staff to gain real insight into how to cultivate a healthy learning environment. Such joined-up thinking is key in giving children the support that they need.
At the same time, as others have already said, we need to focus on prevention and early intervention—in short, how we should promote positive mental health for children and young people. We really do need a joined-up approach across government here. At present, the Department for Education promotes mental health support as a form of early intervention and as part of the broader goal of emotional and academic development—something that I support—while the Department of Health uses a more medical, diagnosis-driven approach that requires children to be diagnosed to a certain level in order to receive support. While having increased contact between CAMHS and schools, as I have just referred to, may help identify children who already have pressing mental health issues, we should be wary of applying this very medicalised approach to every student.
I also ask the Minister what conversations are taking place between the Department of Health and the Department for Education about the best ways of marrying together these rather different approaches to children’s mental health and well-being. Given the expertise that resides in this House on the issue—as we have heard this afternoon—would it be possible to convene a meeting with both departments and a few of the noble Lords who have spoken in this debate to discuss further how these rather different approaches can best be reconciled?
Of course, the 16 to 18 year-olds with mental health issues include a large number of young people studying in FE colleges, and it is really important that they are part of the equation. I shall not repeat what my noble friend Lord Storey has already said about this area but FE must be central to a mental health strategy moving forward. I join my noble friend in calling for FE students to be included in the prevalence study that the noble Lord, Lord Prior of Brampton, outlined to this House on 23 June.
It is clear from today’s debate that schools and colleges have an indispensable part to play in promoting good mental health. This means providing accessible services such as counselling in all schools and colleges, and ensuring that the PSHE curriculum is taught effectively in all schools, irrespective of their status. For my money, that must include academies and free schools. I would like to ensure that high-quality sex and relationship education—which has just been referred to by the noble Earl, Lord Listowel, and which is so important for positive mental health and emotional well-being—is integrated within the provision of counselling in schools and statutory PSHE. That is something that we have called for from these Benches on many occasions.
In conclusion, despite the progress that we have heard about and which I very much welcome, there is still much to do. The life chances of many pupils and students depend on these services and we must not let them down.
Lord Addington (LD)
My Lords, this is one of those debates when you realise that just about everything that you were going to say has been referred to and that, in the case of my noble friend and the noble Earl, much of the heavy lifting has already been done. So I simply say that it is quite clear that this is a real problem which we have probably underestimated for generations. The linkage between failure in life and education and mental health problems is absolutely clear but we really have not brought the two together.
Much of my interest in education has been driven by the problems for certain groups in the special educational needs sector. We have established that these groups are even more vulnerable than the rest of society to mental health problems, almost certainly due to the greater stress that having these problems can cause within the education system. Take dyslexia, the one that I know best. If a child with dyslexia is placed in a classroom, they are placed in a situation where they are bound to struggle with the basic building block of our education—that is, the acquisition of written language. We then wonder why they acquire a greater stress level that leads to problems. Those problems might have been there anyway, but they are exaggerated and exacerbated by the entire system—it is almost inevitable. However, as was referred to by the noble Earl, Lord Listowel, if a parent intervenes early and does something about it, everything is great.
How does this relate to mental health problems? Here, once again, the parent is the linchpin. If a parent identifies problems and moves around between services, they will, at the moment, get a reasonable outcome. The problem is that most parents do not know. We then come back to who else might spot this—it will be either a doctor or a teacher. However, when we go to the doctor, do they look for mental health problems? They are probably better than they were, but I imagine that the average GP will look to physical problems first. Can teachers do this job? Teachers become the poor bloody infantry of every problem facing the under-18s. They are required to intervene, know, get on with everything, identify and bring together. The least we can do is give them some form of basic training about the recognition of problems. This applies to special educational needs and will apply equally to this sector. If experts are built in to the education structure, teachers—when I say teachers, I mean every educational professional, right up to university level; it would not hurt—can refer young people on to the expert. If we do not do that, we do not have linkage points and are relying on the good luck of the parent involved being prepared to admit that their child has a problem. How many parents want to admit that? How many will try just about anything to avoid that? They have to be given support.
Basic awareness packages do not take for ever to implement and are not the most expensive thing ever to be placed in schools and colleges, but there is always room for another one. We must look at increased amounts of time for training for those involved in the process. If we do not, we will build up an expectation that cannot be delivered.
Legally, that duty is already there. The Children and Families Act is almost a year old now. I hope that, when looking at the implementation of the Act, we will get some guidance on special educational needs and the accessing of plans. It is something that was almost universally accepted, if not universally praised, when it went through. Have we identified where the problems are in getting the plans that call for all these bodies to work together? There will be problems; it would be ridiculous if there were not. We would not have passed the legislation if there was not the potential for problems—at least I hope we would not have. I hope that, when she answers, the Minister will give us some idea how the Government have looked at and indentified these problem areas. How do the pockets of expertise and excellence relate to the rest of the system? How do the various bits go together? It is quite clear that this is about linkage and moving through because, to refer back to my original point, if somebody fails in education, it is very likely that they will fail in the rest of their life.
The Children and Families Act says that anybody with special educational needs or problems should be educated until the age of 25 to catch up. Once again, that was almost universally accepted. What are we doing to make sure that, in those extra few years, we actually are doing this? Are we making sure that we are bringing people together and making those links? Without it, we are wasting that person. We are turning them from someone who is an economic good for society to someone who is a drag on it, and making their own life just that little bit more unpleasant—if not, in some cases, unbearable. We have to do something here; it is about bringing the points together.
If we fail, we are making our own lives that little bit worse. If we succeed and bring together those people who have shown a great interest in this field to look at the system, we make things a little bit better. We do not want to waste the people; we do not want to waste the time; we do not want to waste the money. Surely just by making sure that those services are co-ordinated and that people are a little better prepared to do what they are told by law they have a duty to do, we will make things a little better. I hope that the Minister will give us a good example of how we are co-ordinating services and developing models of good practice. Without those, I can see us having to address this issue again in legislation and having another long and boring battle over making sure that those services implement this. I hope that we do not have to, because I have a nagging suspicion that my life is far too short.
Baroness Jones of Whitchurch (Lab)
My Lords, I am very grateful to the noble Lord, Lord Storey, for tabling this debate today and for enabling us to share our concerns about the lack of support for young people with mental health issues. I am conscious, as other noble Lords have said, that we have had several debates here on the broader issues in recent weeks, but it is useful for us to have the opportunity to look specifically at the educational aspects of the crisis. It is clear that we have the same concerns as other noble Lords and I may raise the same issues, but I hope that they will register with the Minister none the less.
It is an issue that has forced itself on to my radar through the simple fact that it is so frequently raised with me when I have been out and about visiting schools. Teachers, without any prompting, when I want to talk to them about other issues, want to talk to me about the stresses and strains that they experience when trying to deal with mental health issues among their pupils. There is a real sense of frustration and abandonment from them. They feel that they have been left alone to cope with increasingly complex cases, where in the past the children and adolescent mental health services would have stepped in to help.
As noble Lords have said, schools are seeing a rise in mental health problems and a drop in available support. As the noble Lord, Lord Storey, and the noble Baroness, Lady Tyler, pointed out, there is also an alarming delay in getting access to professional help even when a problem has been identified.
In a recent study conducted by the Association of Teachers and Lecturers, almost 90% of teachers said that they had had to provide more support for such pupils in the past two years, while 43% said that they were finding it harder to access services. The noble Lord, Lord Addington, made the point that teachers need more support, as responsibility seems to be falling increasingly on their shoulders at the expense of anyone else. But only 9% felt that they had been given enough training to help them spot the signs of mental illness, 43% said that the training was inadequate and 32% had received no training at all—again, a point that I know a number of noble Lords have already made.
Noble Lords have given a number of examples of the rising incidence of young people’s mental health problems. Mention has been made of the report produced by the charity, YoungMinds, which showed that the number of young people with depression nearly doubled between the 1980s and 2000s. As the noble Lord, Lord Storey, said, one in 10 young people has a mental health disorder. In an average classroom, 10 young people will have witnessed their parents separate; eight will have experienced severe physical violence, sexual abuse or neglect; one will have experienced the death of a parent; and seven will have been bullied. It is becoming a more complex and stressful world for those young people.
Then there are the more recent trends towards self-harm and eating disorders. During the past 10 years, the number of young people, mainly women, needing hospital treatment for an eating disorder has increased by 172%. These are some of the real challenges for the school and college community to manage, and so far we have not been doing enough to help and support them.
Sadly, we have been dealing with the legacy of the previous education Minister, Michael Gove, whom Paul Burstow, a former health Minister said recently was,
“just not interested in mental health and wellbeing”,
and I endorse that assessment. Obviously, I welcome the Government’s announcement in the Budget that mental health services for young people will receive an extra £1.25 billion over the next five years. There is a considerable amount of catching up to do since CAMHS have been starved of cash so long. I also welcome the Government’s report, Future in Mind, which includes some excellent first steps for improving school support. But more needs to be done.
The point has been made consistently that early intervention is key. Many young people, for example, do not have the language or confidence to talk about their anxieties. The PSHE curriculum is an excellent forum for giving young people the understanding, resilience and life skills to cope with pressures in the modern world, so it continues to be a source of frustration that the Government are not prepared to make PSHE compulsory in all schools. Will the Minister indicate whether the current Secretary of State is prepared to review that decision?
Does the Minister also see the advantage of counselling in schools as an effective early intervention strategy for young people, which can help to prevent mental health problems from developing? What are the Government doing to end the postcode lottery of access to counsellors? Does she also agree with the point made by the noble Baroness, Lady Tyler, that we need universal access to counselling services in school?
Does the Minister also accept that encouraging women’s sports and building body confidence can play an important role in boosting the health and self-esteem of young women? Does she share our frustration that the Olympic legacy has been squandered, with fewer young people doing sports at a senior level? What more are the Government doing to promote healthy living and fitness throughout the school curriculum, particularly in light of the recent public health cuts?
At the same time, we could be doing more to educate young people about the physical changes that their brains undergo in adolescence. For example, during this time, the connections that develop empathy, rational thought, attention, concentration and judgment become more strained. Does the Minister agree that young people need help to understand their mental as well as their physical development? As the noble Earl, Lord Listowel, said, understanding the part played by role models and boundaries in adolescent development is really important.
Does the Minister acknowledge that the Government’s obsession with passing exams is adding stress and anxiety to young people who are already struggling to survive in a complex and demanding world? Does she recognise that a strong cultural offering of art, drama, music and literature can often offer an important release for young people struggling with ways to express their identities and anxieties? What are the Government doing to put these subjects back at the heart of the curriculum?
Will the Minister agree to revisit the mandate given to Ofsted so that it measures a school’s success in promoting emotional well-being as well as academic success? This should include evidence of a whole-school approach to mental health where children are encouraged to talk about their feelings and seek help when necessary, and where good relationships exist with counselling services, educational psychologists and CAMHS.
The role of schools and colleges in enabling early intervention in mental health is absolutely critical. As has been said, more than half of adults with long-term mental health issues were diagnosed as children, but less than half received treatment at the time. The economic and personal cost of leaving young people’s mental health to deteriorate without support until it becomes an acute illness is vast. For every young person in a bed costing around £25,000 a month, we have to ask whether the money would not be better spent on early intervention and prevention. That should start with young people in schools. These are the challenges that face every Government, but particularly this one today, and I look forward to the Minister’s response.
Baroness Evans of Bowes Park (Con)
My Lords, I join others in thanking the noble Lord, Lord Storey, for securing this debate. As we have heard, this is one of a number on mental health issues that have taken place in the past few weeks, and I welcome the chance to concentrate on education and what we are doing to rise to the challenges set out in the Future in Mind report.
Within the Department for Education, the Secretary of State has spoken about her own personal commitment to improving the mental health of children and young people. Last week she was at Upton Cross Primary School in Newham, looking at the work it does with Place2Be, one of the 17 voluntary organisations that are benefiting from nearly £5 million that the department is providing this year to support mental health projects. Place2Be works to provide early counselling support in a non-stigmatising way that is effectively part of the day-to-day life of the school, taking the whole-school approach the department has promoted through its guidance in this area.
In further evidence of the Government’s commitment, Sam Gyimah was the first DfE Minister with a specific responsibility for mental health issues, and is continuing in this role. He worked very closely with Norman Lamb in the previous Government—I pay tribute to the work he did there—and is now working with Alistair Burt, the Health Minister, who has also made this area a top priority. Last Friday they appeared in front of the Youth Select Committee and next week are jointly hosting an event with stakeholders from across health, education and the voluntary sector about how to take forward Future in Mind. The noble Baroness, Lady Tyler, asked about organising a meeting between Members of this House, the Department of Health and the Department for Education. I am happy to take that proposal back to colleagues.
As we have heard, schools and colleges play a key role in the lives of young people and in helping them become well-rounded, successful individuals in adult life. This means ensuring that students achieve academically but also helping them develop the attributes, behaviours and skills they need to get on in life. Qualities such as self-control and the ability to work well with others, to persevere, to have boundaries and to bounce back from adversity, coupled with values such as tolerance and respect, underpin future success and well-being. Schools and colleges have an important role to play in building this character and resilience, as well as promoting an understanding of mental health and respect for those with mental health issues.
To support this, we have already invested £5 million in character education, including £3.5 million in grants to support 14 projects, and held a national awards scheme, which attracted 550 applications from all different types of schools. For example, Tapton School, a high-performing academy in Sheffield, has developed “Learner Levels” to track students’ progress in five key character traits: resilience, reflectiveness, reciprocity, resourcefulness and respect. Percy Hedley School in Newcastle, a special school for children with cerebral palsy and/or speech and language difficulties, has developed a variety of programmes focusing on social communication to develop a problem-solving and can-do attitude in pupils.
I agree with the noble Baroness, Lady Jones, about the importance of PE and sport. The primary PE and sport premium ensures that primary schools focus on PE, and the Government have already provided more than £300 million of ring-fenced funding for the academic years 2013-14 and 2014-15. A full report on the impact of this will be published in the autumn but I can provide a taster of the key findings, which are very encouraging. For example, 91% of schools reported an increase in the quality of PE teaching; 96% reported improvements in pupils’ physical fitness; 93% saw improvements in behaviour; and 96% thought the funding had contributed to a healthier lifestyle for their pupils.
The noble Baroness and the noble Earl, Lord Listowel, also highlighted how art, music, drama and literature can help young people with self-expression and identity. The Government strongly believe that every child should experience a high-quality arts and cultural education throughout their time at school. Art, design and music are all compulsory subjects within the national curriculum for five to 14 year-olds, and at key stage 4 all pupils in maintained schools have an entitlement to study an arts subject if they wish.
Encouragingly, schools and colleges already recognise how good mental health can support success. A report published last December by the think tank CentreForum, which has already been referred to, found that 94% of secondary schools already promote positive mental health through lessons such as PSHE and drama or through school assemblies. In response to the noble Baroness’s question about PSHE, I say that we are considering the findings of the Education Select Committee report carefully and will respond in due course.
However, we also recognise that not all teachers are confident about what to cover in mental health lessons and how to lead discussions. That is why we funded the PSHE Association to produce guidance on teaching about mental health, which was published in March. Example lesson plans for key stages 1 to 4 will also be provided to schools. These will cover age-appropriate teaching on how to describe emotions and talk about anxieties and worries. As children grow older, the curriculum will cover more specific teaching about mental illness.
Of course, teachers are not mental health professionals and they need access to specialists and to be able to refer students quickly, when necessary. The Department for Education is contributing £1.5 million to a joint training pilot with NHS England to train mental health leads in education and specialist CAMHS to test how we can make professional links as effective as possible—an issue that has been raised by a number of noble Lords.
As the noble Lords, Lord Storey and Lord Addington, highlighted, school and college staff need to know about mental health to be able to identify issues. While it is up to schools to decide what training their staff need, the Government have made sure that training is available for all adults working in schools. MindEd, a free online portal funded by the Department of Health, has been developed to enable adults working with children and young people to learn more about mental health problems and how to support them. Again, the CentreForum study found that 91% of secondary schools felt they had access to training for their staff. We want to encourage all schools to examine and take up opportunities.
The noble Lord, Lord Storey, and the noble Baroness, Lady Tyler, asked about initial teacher training. As noble Lords know, Sir Andrew Carter chaired an independent review and the report was published in January. Following that, the Secretary of State has appointed an expert group to develop a framework of core initial teacher training content. This group is due to report at the end of the year and will consider the importance of including child development, as recommended by the review.
Students value being able to talk about issues and concerns in a safe environment, and as both noble Baronesses, Lady Jones and Lady Tyler, rightly said, school counsellor-linked services are often rated by both young people and school staff as an effective means of supporting mental health and emotional well-being, and a way of enhancing capacity to engage with studying. Most secondary schools in England offer access to counselling, where 50,000 to 70,000 sessions are delivered each year. The noble Baroness, Lady Tyler, asked about universal access to counselling in England and it is certainly our strong expectation that over time all schools will want to make services available to their pupils. That is why we worked with schools and experts, including Place2Be, to publish a blueprint for school counselling services in March this year, which provides schools with practical, evidence-based advice on how to deliver high-quality school-based counselling, and to raise awareness of such services.
In our increasingly digital world, it is also important to help children to deal with online abuse, cyberbullying and websites that promote negative approaches to coping with issues. The new computing programmes of study, introduced in September 2014, ensure that e-safety is taught at all four key stages. The Government continue to make tackling all forms of bullying, including cyberbullying, a priority.
The noble Baroness, Lady Jones, asked about Ofsted inspections measuring well-being and mental health. Changes to inspections from this September were announced in June. The new inspection handbook sets out that inspectors should evaluate the experience of particular individuals and groups, including those with mental health needs.
It is vital that schools are given freedom to develop approaches that can best support their particular pupils. The capacity to innovate through the free schools programme is proving particularly valuable for young people with complex needs. For instance, both Stone Soup Academy in Nottingham and City Gateway in Tower Hamlets are alternative-provision free schools that bring together a range of support with a focus on getting disengaged and hard-to-reach learners back into education and training. Other developments are under way. For instance, the recently opened Family School, through collaboration with the Anna Freud Centre, is looking to incorporate the most up-to-date mental health practice in its provision for children with problematic behaviour.
As the noble Lord, Lord Storey, said, further education plays a vital role in educating a large number of students aged over 16, many of whom are some of the most disadvantaged and who have complex needs. Colleges have considerable experience of providing the support students need to help them progress into employment and further learning. The noble Lord highlighted several colleges that are leaders in this area. On his question and that of the noble Baroness, Lady Tyler, about the mental health prevalence survey and whether it could include 16 to 18 year-olds, the answer is yes. It is still being put in place, but it should produce results next year.
The Government are committed to helping our most vulnerable young people, which is why the Children’s Social Care Innovation Programme is providing £100 million to projects across the country to develop further effective ways to support children who need help from social care services, as highlighted by the noble Earl, Lord Listowel. Among the projects being undertaken are the Priory’s education services, which are working to pilot a new type of residential home; Action for Children, which is transforming the support available for teenagers in west London; and the National Implementation Service, which is helping young people to tackle problem behaviour and substance abuse, and prevent their entering care.
The noble Lord, Lord Addington, asked about the SEN reforms. We have been working hard to identify problems faced by local authorities and to put them in touch with specific support, including from pathfinder authorities that tested the reforms. We are also supporting the voluntary sector to develop practice and support.
I hope that noble Lords will recognise that what I have set out represents a significant programme of activity. Of course, we will continue to look at what more can be done to support schools and colleges in the important role that they play as the wider transformation of mental health services continues to happen.