Infant Mental Health Awareness Week

Thursday 16th June 2022 Westminster Hall

[Mrs Sheryll Murray in the Chair]

14:59

[Dame Andrea Leadsom (South Northamptonshire) (Con)]

I beg to move,

That this House has considered Infant Mental Health Week 2022.

It is a great pleasure to serve under your chairmanship, Mrs Murray—I think for the first time. I am delighted to have secured this debate.

Infant Mental Health Week is an annual opportunity to highlight that human beings are the most underdeveloped creatures on earth at birth. Our brains, and therefore our responses, our reactions and our knowledge, are completely undeveloped. In fact, many people would say that we are born about two years premature. What other animal cannot do anything for itself until it is at least a year old? That is the plight of human beings.

Infant mental health is therefore, without any shadow of a doubt, more important than mental health throughout the rest of a person’s life. It is in that critical period when a person is so small and does not know what’s what or where’s where that their ability to have secure lifelong mental health is laid down.

From conception to the age of two, a secure and loving relationship between a baby and his or her carer literally shapes the way the baby’s brain develops. That is when the building blocks for lifelong physical and emotional health are laid down. Like a sponge, the baby’s developing brain will soak up the atmosphere around them and the environment that he or she is born into. In the womb, a baby whose mum is terrified of childbirth or is being treated with violence by her partner, or who is misusing alcohol or drugs, will be profoundly physically and mentally impacted by that experience.

Infant mental health, or, more specifically, early intervention in the first 1,001 critical days of life, from conception to the age of two, has been a passion of mine for more than 25 years. I chaired the Oxford Parent-Infant Project in 1999 and set up NorPIP, the Northamptonshire Parent Infant Partnership, providing parent-infant psychotherapy to families who are struggling to form a secure bond with their babies. I established national charity PIPUK—the Parent Infant Partnership—which went on to establish and support a number of other parent-infant teams right around the country. I also wrote the 1,001 critical days manifesto, which went on to become the First 1001 Days Movement. Infant mental health is a subject incredibly dear to my heart.

Science tells us that a secure and loving relationship with the key carer will shape the way in which the baby’s brain develops, with long-term and positive consequences for that baby’s mental health. Fundamentally, it is about self-regulation. A baby who is secure in his or her earliest relationships will later on be able to experience anger, fear, jealousy and disappointment, and will be able to regulate their own responses appropriately. It is the earliest relationship between parents and their babies that constructs that ability to self-regulate and hence delivers that pathway to good lifelong mental health.

Research released today by the Royal Foundation shows that 91% of parents and carers agree that early years are important in shaping an adult’s life, but only 17% recognise how uniquely important the period from birth to five is. As the Duchess of Cambridge has said,

“Our experiences in early childhood fundamentally impact our whole life and set the foundation for how we go on to thrive as individuals, with one another, as a community and as a society.”

In 2015, the National Childbirth Trust found that one in three first-time dads were worried about their mental health following their baby’s birth, and according to the Maternal Mental Health Alliance, up to one in five mums, sadly, suffer due to the lack of focus on support for mental health in the perinatal period. Unfortunately, we do not really have the granular information on perinatal depression among parents and carers that we would need to properly impact-assess the mental health effect on babies, but the mental health of the parent clearly impacts on their baby’s development. A good example is that a pregnant mum who, for whatever reason, suffers from stress will produce more cortisol—the stress hormone—in her bloodstream, which will pass through the placenta into the unborn child. The more stressed the mother, the more frequently the foetus is exposed to higher levels of cortisol, and we know that exposure to high levels of cortisol in the womb can lead to modifications in gene expressions before the baby is even born, so even in the womb, the potential for lifelong emotional and physical health is already being determined.

Once out of the womb, being left to cry unattended for continuous, lengthy periods of time, or being terrified by witnessing violence and anger within the family or loud and aggressive behaviour in their environment, will have the same impact on the baby: raising their levels of cortisol. Over lengthy periods, there is evidence that this damages the baby’s immune system and will give him or her a lifelong predisposition towards higher risk-taking behaviour. When a baby is born, they have no cognition at all: they can only cry, sleep or look around. They do not know if they are cold, hungry, bored or in pain. They only know that something is wrong, so a baby cries to attract the attention of a loving adult carer. When that carer turns up and takes the time to soothe, change, feed or sing to the baby, the impact of that tender and loving response brings the baby back to a state of calm and reduces their level of stress. This continues until the baby is old enough to understand how to regulate his or her own feelings.

Even more important is the fact that at birth, a baby’s brain is only partially formed. It is understood that a baby’s brain puts on up to a billion neural connections every minute during the first year of life. Those neural connections are stimulated by the quality of attention of the principal loving carer and the baby’s experiences of the world around them, which is why parental attunement and loving attention are fundamental for the healthy brain development of a baby. Simply put, what we do with a baby from conception until the age of two is about building the human and emotional capacity of that infant; what we do after the age of two is almost all about trying to reverse damage that is already done. A wealth of evidence demonstrates that poor mental health, substance dependency and domestic abuse among parents lead to significantly poorer outcomes for babies and young children. Research from the Maternal Mental Health Alliance highlights that the locations with some of the greatest levels of socioeconomic deprivation are also those where poor maternal mental health is at its highest. When they start school, children from such disadvantaged backgrounds are on average four months behind their peers, and it gets worse from there.

The quality of attachment that a baby has to their principal adult caregiver therefore has a profound impact on their lifelong mental health, and our society’s ambition should be for every baby to achieve a secure attachment to that caregiver, be it mum, dad, kinship carer or adoptive parent. Secure attachment is the foundation for good lifelong mental health, its possible effects having an impact on parenting from one generation to the next: if a person was well parented, there is a high likelihood that they will become a good enough parent, and their baby will form a secure attachment to them. Examples of insecure attachment are therefore found where care giving is inconsistent.

Babies who suffer from insecure attachment are not given the consistent, loving care that they need in order to feel that the world is a good place and that people are generally kind. Neglect of a baby has a very damaging impact. The baby with insecure attachment will of course have other chances in life; we never write anyone off. Babies who are insecurely attached in the very early stages will have lots of other opportunities to make good friends and to have other key adults in their lives who might help to turn things around and help them build their own emotional capability, but there is no doubt that insecurely attached infants will always struggle a bit more in later life to deal with life’s ups and downs. It will be those babies who might struggle to keep friends and relationships and also to cope without help with parenting when their time comes. This is sometimes known as the cycle of deprivation, where a general lack of good mental health is passed down from one generation to the next.

The most challenging early mental health impact is reserved for babies who develop a disorganised attachment with their principal caregiver. That is where the person they rely on to look after them, soothe them and keep them alive is also the most dangerous person in their life. The person they turn to for comfort might one moment hurt them and the next moment hug them. Such babies often find that making sense of the world becomes very difficult, and many of the most damaging outcomes in society—criminality, suicide, self-harm, sociopathic behaviour—are enacted by those who suffer disorganised attachment as a baby. It should be blindingly obvious to all that whatever we do to invest in giving every baby the best start in life will pay us back a million times over—a billion times over—in terms of general wellbeing, healthy communities and a stronger society.

We had a long way to go before the covid lockdown, but there is no doubt that Infant Mental Health Awareness Week is vital because it shines a spotlight on the huge damage done by two years of pandemic lockdowns: dads and co-partners not permitted to be with mum and the new baby; face-to-face health visits and other support such as family hubs moving to virtual only; wider family and friends unable to meet the new arrival and provide support; babies not able to meet other babies; and an exacerbation of existing problems such as addiction, domestic violence and poor mental health.

Above all else, there was the devastating isolation at a time when we all know that new parents are desperate to get out of the house to go and chat to another parent about the sleep that they did not get last night, what size nappies the baby should have, what they are doing about weaning, and whether the baby has had its first tooth yet. All the chats, empathy and consolation that new parents give each other were missing during the covid lockdown. A report carried out by the Parent-Infant Foundation, Best Beginnings and Home Start, titled “Babies in lockdown”, revealed that six in 10 parents were concerned about parental mental health in lockdown, and two thirds said that covid had affected their ability to cope with caring for their baby.

We know that health visitors provide a vital support service to families who are struggling. Every family in England should be offered five mandated reviews from a health visitor between pregnancy and age two and a half as a minimum. Local authorities, many of which are still using phone and virtual appointments to count as reviews, have reported in their latest quarterly data, from May, that 18.6% of babies missed out on their nine to 12-month review and more than a quarter of toddlers missed out on their two to two-and-a-half-year review. That includes all those who got the telephone-only service. There were still many who did not get anything at all.

Data, again published in May, shows that only 85% of children in England were at or above their expected level in communication skills, compared with 89% before the pandemic, and 79% were at or above the expected level in five key development assessments at the review stage, compared with 83% pre pandemic.

A report by Ofsted in April 2022 found:

“The pandemic has continued to affect young children’s communication and language development, with many providers noticing delays in speech and language…The negative impact on children’s personal, social and emotional development has also continued, with many lacking confidence in group activities”

and

“social and friendship-building skills have been affected.”

There continues to be an impact on children’s physical development, including delays in babies learning to crawl and to walk. Lockdown has caused many challenges and exacerbated many existing ones.

The early years healthy development review, which I chair, could not have come at a more important time. Since the summer of 2020, the review has focused on ensuring that every baby gets the best start in life. Its vision sets out six key action areas, which were made Government policy in March 2021. The action areas will deliver, first, a joined-up set of Start for Life services for every family in England; secondly, the roll-out of family hubs as a welcoming place, providing physical, virtual and outreach services for every family in England; thirdly, trusted digital, virtual and telephone support designed to meet the needs of the baby and their carers, as well as the development of the digital red book, which will allow much greater continuity of care for every baby; and fourthly, a modern, mixed-skills workforce that will provide much greater continuity of care and that works, with the baby at the centre of everything we do, to deliver wraparound, empathetic support.

Fifthly, we need much more understanding of the impact and potential of early intervention, so we will improve data collection and evaluation, and outcomes for the mental health and wellbeing of babies and their families, and we will develop proportionate inspection of services. Sixthly, these action areas will require real leadership locally and nationally. Fundamentally, we need to ensure that the Treasury will continue to fund the “Best Start for Life” vision in the long run.

I am delighted that the vision is shared cross-party, and I have no doubt that the spokespeople here today on both sides of the Chamber will want to support giving every baby the best start for life. It is a fantastically cross-party issue, and I pay tribute to the many colleagues here today, as well as to those who could not be here, who have lent their support to this agenda over so many years.

The views and lived experiences of babies and their carers have been at the heart of the early years review. From Blackpool to Stoke-on-Trent, from Worthing to Bexleyheath, from Camden to Cornwall, parents have shared with us the good and the bad. My “1,001 Critical Days” podcast has highlighted the mental health journeys of parents and their babies, and an LBC phone-in made clear the challenges faced by so many dads and co-parents, and the particular support they need, which is currently lacking, in their amazing journey to parenting.

Time and again we have heard that every parent wants to know how to be a good a parent, where they can access early years support, what is on offer for them and why they might need that support. They want companionship and not to be isolated, and they want to be able to share their stories with parents in a similar situation.

We heard from parents of babies with disabilities that they do not want to be left out, stigmatised and treated as different. We heard from many parents from different ethnic backgrounds, as well as LGBT parents, single parents and foster parents, that they do not want to be treated any differently from other parents either. All parents, of every type, asked for a seamless, joined-up approach to accessing the support they need. Face-to-face support is a priority, but in this 21st century, parents and carers also want access to services virtually when things are urgent, they are pressed for time or they just have a quick question.

Parents also want to avoid telling their story over and over again to different early years professionals, and there is huge support for a digital version of the red book, where parents can keep a permanent record of their baby’s birth experience, first tooth and first photo with Granny, along with all the other lovely records that parents want to have, as well as communicate with the professionals who are supporting them.

The positive to take away from today’s debate is that if we provide support and reach out to make sure that every family knows where to go to get help, and we educate families as to what good looks like, we can transform our society for the better. To end, in this platinum jubilee year, I would like to use the words of the Queen, who said:

“in the birth of a child, there is a new dawn with endless potential”.

[Mrs Sheryll Murray (in the Chair)]

I intend to call the Front-Bench spokespeople at a few minutes before 4 pm. I hope Members will bear that in mind. I call Munira Wilson.

15:20

[Munira Wilson (Twickenham) (LD)]

It is a pleasure to serve under your chairmanship, Mrs Murray. I congratulate the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) on securing the debate and for championing this issue with such expertise and passion for so many years. It is great to see her commitment and the support she has managed to secure from the Government recently. There is always much more that we can do, which is why we are here debating that today.

I will not take up much time—others can expect to have plenty of time to speak—but I want to touch briefly on the social care system for children and mental health, and how poor mental health affects infants in contact with the children’s social care system.

As we have heard, according to the Parent-Infant Foundation, a major predictor of the effect of an adverse childhood experience on a child’s development is how strong and secure their relationship is with their parents. For looked-after children or for children in kinship care, the relationship with their birth parent may be strained or non-existent. Abuse and neglect by caregivers will sometimes be the reason why babies are not living with their birth parents in the first place.

The foundation notes that this relational trauma can be more damaging than other forms of early trauma. The independent review of children’s social care—the MacAlister review—published a couple of weeks ago makes the same point. As we have heard, safe, stable and nurturing relationships serve as a buffer to adversity, build resilience and support children to develop skills to cope with future adversity in an adaptive and healthy manner. It is vital that the children who are most likely to have suffered early trauma are able to access the therapeutic support that they need.

I want to mention a couple of points. The first is NHS child and adolescent mental health services support for infants. I was struck by a Health Committee report, which found “highly concerning” the findings of a Parent-Infant Foundation survey of CAMHS professionals. Some 26% of respondents had not been trained to work with children aged zero to two, and only 36%—just over a third—agreed that there were mental health services in their area that could effectively work with children aged zero to two. Given that the NHS long-term plan commits the Government to achieving 100% access to specialist support for all children and young people aged zero to 25 by 2029, I would be interested to hear from the Minister how she expects that goal to be achieved for the under-threes.

Outside of the NHS, there are some fantastic voluntary sector organisations that are doing amazing work, and I particularly want to call out to an amazing charity in my own constituency. It is based in Twickenham itself and is called the Purple Elephant Project. The word “Elephant” is there because family bonds within a community of elephants are very strong apparently—more so than among other animals. Elephants display emotion when they are grieving or when the herd is under threat.

The charity was founded by a fantastic, inspirational woman called Jenny Haylock, who is a therapist herself. On their small site—they have just been able to install a beautiful little sensory garden thanks to funding secured from Richmond council recently—they offer play therapy, art therapy and other categories of therapy, including filial therapy, which is where parents and caregivers are part of the therapy with the children. The whole ethos is that parents and carers come in with the child. Even if the child is having separate therapy, there is a lovely space where parents can go to relax and recharge or have somebody to talk to. The charity is looking after the whole family, not just the child who has suffered whatever trauma. Jenny is also a specialist in adoption support.

I welcome the Government’s extension of the adoption support fund until 2025. Several of my constituents have told me how vital it is. We and the Minister are all well aware of how difficult it is to access CAMHS and therapy—that is well documented and we regularly hear examples in the main Chamber. I know that the adoption support fund has been a lifeline for a number of parents in my constituency whose children have needed therapy and support and have used the ASF to buy it in when they cannot access it in a timely manner from the NHS. Although the fund has been extended to 2025, I urge the Government to put it on a permanent footing.

Most of the 150,000 children in kinship care in England and Wales are not eligible for that funding, however. The ASF supports children who were previously in care but who are now subject to a special guardianship order or a child arrangement order, but those eligibility criteria are clearly nonsensical, because the majority of SGOs and CAOs are entered into by grandparents. Again, there are examples in my constituency of grandparents looking after their grandchildren because something has happened to the parents, who are no longer able to care for the children. That stops those children going into the care system, which saves the taxpayer a lot of money. We all know that the outcomes for children who enter kinship care—as opposed to care by people with whom they have no connection—tend to be better.

Kinship carers are unsung heroes. They save the taxpayer money, but they do not have the same rights as foster carers to weekly allowances or the entitlement to the ASF that adoptive parents have. There are almost twice as many children in kinship care as there are looked-after children—many would be in the care system were it not for their kinship carers—but many of them will have suffered the same or worse experiences of early trauma.

I urge the Minister to support Kinship’s campaign to widen the eligibility criteria for the adoption support fund. That is probably a matter for the Department for Education, so the Minister might not be able to give me a commitment today—the Chancellor might have something to say about it if she did—but I hope that she will take my request and see whether her colleagues at the DFE will consider widening the eligibility criteria for the ASF so that all children in kinship care can access the therapeutic support that they need.

The right hon. Lady said that every party believes that every child, regardless of their background, deserves the best start in life, and I echo those comments on behalf of the Liberal Democrats. Too often, money spent on children’s services, the education system and therapeutic support for children and young people is viewed as a cost. To my mind, we should look at those as huge capital investments. We are not investing in buildings or roads, but we are investing in tiny little people who could be our future entrepreneurs, teachers, doctors and politicians. The return on investment from investing in children is huge, and I do not think that the Treasury fully appreciates that.

If there is another campaign that we can all gather around and make the case for, it is investment in children and young people. Although we would not see the return on investment in one, two or perhaps even three election cycles—it is a long-term thing—I hope that we can all come together to make the case for that investment, which will pay huge dividends. We all want our children to grow up happy and healthy, and to thrive and reach the very best of their potential.

15:29

[Jim Shannon (Strangford) (DUP)]

It is a pleasure to speak in the debate. The right hon. Member for South Northamptonshire (Dame Andrea Leadsom) deserves every credit. She and I came to this House in 2010, and she has spoken about this issue in Westminster Hall and in the main Chamber on many occasions since. She will correct me if I am wrong, but I do not think that there has been a time when I have not supported her in such debates.

I do that for a number of reasons: first, because of our friendship as MPs, but secondly, because I fully support and endorse the right hon. Lady on this issue. I am always challenged by her contributions because they are so full of detail and knowledge about the right way to do things. The input of mothers is so much greater than the input of the dad. As a father and not as a mum, I cannot take any credit for how my children turned out; it is really down to my wife. She is the lady who did all the hard work—I was very rarely there—so I recognise the role of the mother in particular is critical, and it moulds the child for the future. For that reason, I am really pleased to come along to this debate.

[Munira Wilson]

Will the hon. Gentleman join me in saying that it is a wonderful thing to see cultural change and dads taking a much more active role? My husband is the primary carer of our two children and is very much the dad at home, and he has been since they were tiny, while I have always been out there working.

[Jim Shannon]

I was reminded when the hon. Lady mentioned that that I was at a function last Friday for the centenary of the Royal Ulster Constabulary. One of the councillors of my party is a house dad and he looks after two children. I will not mention his name, but he said to me last week, “Jim, I’d rather be working.” I said, “You are working, you’re just looking after the children. It’s slightly different.” But yes, the hon. Lady is right; society is changing, and sometimes that is the way it is. I have to say that I do think the role of the mother is much more important. That is just me; maybe I am old fashioned. I just see a slightly different and more critical role for the lady.

A growing body of evidence from the fields of clinical and social science shows that the areas of the brain that control social and emotional development are most active during the first three years of a child’s life. The hon. Member for Twickenham (Munira Wilson) referred to that, and referred to three to five years as well. That is important. Careful nurturing of a child’s social and emotional health during their early years is vital to provide them with the skills necessary to form relationships and interact with society later in life. It is so critical to get that right in those first few years. The hon. Lady has always said that in debates in the Chamber and elsewhere. I am my party’s health spokesperson, so I am pleased to be here, given my personal interest in the issue and as a grandfather with five grandchildren. The sixth is on the way, so we will shortly have a sixth one to nurture and look after. It means that the Shannon name will live on, and more so when the sixth grandchild arrives.

Developments start during pregnancy, and the choices and experiences of the mother during that period can have a significant impact on maternal and infant social and emotional health. With that in mind, Northern Ireland has a dedicated mental health strategy. I know that the Minister is aware of all those things, not just because some of her ancestry comes from that part of the world, but also because she makes it her job to be aware of what is happening in the regional Administrations. Although we have a mental health strategy in place, the pressures of lockdown and covid have greatly impacted child mental health, and any strategy must take that into consideration.

I want to focus on that issue, which the right hon. Member for South Northamptonshire referred to in relation to covid. Covid has put extra pressure on what the right hon. Lady is trying to achieve, and what we are trying to achieve in this debate. We have more children than ever who, as we say in Northern Ireland, make strange with strangers. I will try to explain what that really means. The right hon. Lady referred to isolation during covid, and it is as critical and stark as that. Covid babies were literally prevented from seeing other children; that is a fact of life. “Being strange with strangers” means nothing more than not knowing how to act with wee children of their age or how to react to adults who want to be friendly and acknowledge them. Children being strange with strangers, having not seen other children and adults during formative periods of their lives, is a critical issue that needs to be addressed.

Ever mindful that health, education and so on are devolved matters—although the issue for Northern Ireland will be similar to here—I have a major ask of the Minister, which I will be happy if she can respond to. What extra assistance, help, funding or advice can be given to parents whose children were born or were between two and five during covid—those two stark years when life was so different and we could not interact? What can be done to address that issue as we come out of covid and move forward in a constructive way?

Naomi from my office—who is my speechwriter, by the way; I keep her busy and make sure that she is across all these things—and I are of a kindred mind and spirit, so it is easy for us to discuss the issues that I want to speak about, because we look at how to do things the same way. She helps with the creche and the children’s church on Sunday morning, and she has told me, based on her personal experience, that it is only after a full year of being back that some mothers can slip back into the main service without their children getting upset. Let me explain what that means, Madam Chair. In the last two years, the covid pandemic put pressures on families like never before, which meant that the children probably did not leave their mum very often. Now that the creche and the children’s church is back, the children are able to stay there and their mums are able to leave.

That wee period is an example. In Naomi’s opinion, it has taken a year for those children to feel safe, even in a safe place—wow!—if their mother is not there. My fear is for those mothers who have been unable to leave their children—those who do not attend church, do not have a creche or nursery, or do not have access to other adults who could help. The right hon. Member for South Northamptonshire said how important it was for mums to have another mum to talk to, and even that was partially lost in the pandemic. I also wonder about pre-school and nursery children.

We must consider the effect of lockdown in a very detailed way. It is a genuinely big question to ask the Minister, but I see it in my constituency, and I am sure that everyone in this debate will be on the same page. I recently read a report by the National Children’s Bureau that highlighted the post-covid position. Although support for babies and infants, and their families has always been critical, the unprecedented covid-19 pandemic has refocused efforts on prevention and early intervention to address new or increasing risks, which is what this debate is really about.

Although it will be some time before the long-term impact of the pandemic is known, evidence already suggests a number of areas for concern, including the rising cost of living. The pandemic has moved on, but other things are impacting on young children, from babies right through to five-year-olds, including the cost of living and increasing fuel poverty. These are real things that every mother and every dad has to look at every day. I am no different from anybody else in this Chamber; I think that we are all the same. We are hearing regularly from our people and our constituents about these issues, and we worry about that. Again, that is not all the Minister’s responsibility; it is just to show the impact that these things are having.

Many people and families are increasingly reliant on food banks, which comes on top of already unacceptable child poverty rates, and against the evidence about the links between poverty and adverse childhood experiences. I never fail to get quite upset when I read those stories in the press about wee children who have been abused or, in the cases that make the press unfortunately, killed. I just cannot understand how those things can happen. I cannot understand the mindset of anybody who does that, and I cannot understand how social services did not step in earlier. This is just me, speaking from the outside. I find those stories quite painful to read, Madam Chair; I think we are all the same in that regard. Sometimes, you just have to flick over the page—not that you are disregarding it, but because it is so awful that you just cannot read it all. Those are some of the things of the day, along with concerns about parental mental ill-health, which is being driven by isolation, job uncertainty or the loss of a job, the loss of loved ones, illness and anxiety, among other factors.

I will just make a couple of quick points—I am coming to the end of my remarks; time is flying on here. I am greatly encouraged by foster families. The right hon. Member for South Northamptonshire is absolutely right about that. I know foster families who do some fantastic work, and they have a love for their children. Although they are not their biological children, they are their children. Those children get the love they did not have in their own homes, for whatever the reasons were. I know some foster families who have adopted maybe 20 or 30 children—that is incredible. They give affection and love, which is so necessary for a wee baby or small child between three and five, which are such important years.

Increased pressures in the home and the rising incidence of domestic violence—which is unfortunately another issue that happens with a regularity—are putting young children at risk of witnessing or experiencing abuse, and it impacts parental wellbeing. They see their mummy or daddy—let’s be honest, more often their mum—getting beaten, and that affects the child. The right hon. Lady is right: the experience of that three to five-year-old seeing that will have an impact for years to come. That is why this debate is critical and why over the years, when she has brought us to Westminster Hall and the Chamber, I was always there. I understand—not as good as the right hon. Lady does—what she is trying to achieve.

Services are facing pressure as they seek to continue the delivery of essential support to infants, parents and their families within the constantly changing environment that they find themselves in. The environment is changing all the time, and the pressures are great. There have been delays in access to services and support during lockdown and the pandemic, particularly for isolated and vulnerable families with newborns. Sometimes mothers have difficulty dealing with their children—it happens. It is a fact of life, but having someone to speak to and to help at that early time is so important.

The hon. Member for Twickenham is absolutely right about the need to invest in our children and young people. I see it as an investment and an opportunity to get it right, so that the children of the future can grow up to be Ministers, Chairs of Committees, doctors, teachers or MPs. We should give them the opportunity to do that. Let us get things right at the early stages. Every child deserves a good start in life, as the right hon. Member for South Northamptonshire said. I agree wholeheartedly with that, and I hope the debate can in some way move us towards that.

The need is clear, and we need to be just as clear in our pathway to support and help and in how this will be funded and promoted in every area of this United Kingdom of Great Britain and Northern Ireland. I am pleased to be an MP here and part of a nation that is united across the four regions. I say that to the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron)—she and I are good friends. It is important that we have a strategy and a way forward for all four regions to achieve what the right hon. Member for South Northamptonshire said: giving every child a good start in life. If we could do that, we would be doing well.

15:43

[Sarah Olney (Richmond Park) (LD)]

It is a pleasure to serve under your chairmanship, Mrs Murray. I congratulate the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) not just on securing the debate but on her ongoing passionate advocacy for our youngest citizens. It is a mission I am always happy to support her in.

One of the things that awoke my interest in this area was during the covid lockdown; both the right hon. Lady and the hon. Member for Strangford (Jim Shannon) have spoken movingly about the impact that lockdown had on many families. I spoke to mums in my constituency who were having their first child in lockdown, with all those pressures on them, such as not having contact with their partner or their family during labour, or with informal or formal networks afterwards. I reflected on how different their experience was from mine over a decade ago, when I had my babies. My first impression was of the impact of that on maternal mental health—I was pleased to secure a debate on that topic in March 2021—but the issue of infant mental health is so closely linked to that. I am grateful to the right hon. Member for South Northamptonshire for her really detailed opening speech. We have the data and the evidence, and it very much underpins the anecdotal evidence from our own personal experiences and those of our constituents.

A number of great points have been made about how much the baby’s mental health is based on the quality of the parent-infant relationship, and how the parent’s responses shape how babies experience emotions, regulate their own emotions and express themselves. We have referred a great deal to the research, but 15% of children—more than four in an average classroom—will have developed a problematic relationship with their main caregiver as a result of unpredictable or hostile care. As we have already debated, that troubled start increases the risk of children having poorer social and emotional wellbeing across their lives, and the ongoing and lasting impact that that can have.

My constituency neighbour, my hon. Friend the Member for Twickenham (Munira Wilson), talked about some of the gaps in services to support infant mental health. We really must focus on that. There are currently 42 specialised parent-infant relationship teams in the UK, which focus on strengthening and rebuilding those early relationships. That means that most babies live in an area without access to such a team. They are multidisciplinary teams led by mental health professionals with expertise in working with babies and families.

A key area of focus is working with families that have experienced intergenerational trauma. With the right care, the trauma experienced by parents does not have to inform their infant’s development. However, it is so important that specialised services are there to detect such instances and are equipped with the skills and funding to intervene and support families where needed.

I will briefly touch on the experience of dads, which has been raised on a couple of occasions. I recently visited my local maternal mental health crisis unit, and I was surprised to find that there is no systematic care given to dads who experience mental health problems when their partners are pregnant. It might get picked up if their partner is coming for care, but it very much flies under the radar. In particular, we know that domestic violence can often commence during pregnancy. I see that as a direct result, perhaps, of men’s struggles with mental health as they become fathers. I therefore think it is a matter of real urgency that we pick up the matter of dads’ mental health, particularly from the beginning of pregnancy.

It is also important that mental health professionals can spot the signs of poor mental health in our youngest children, who cannot express their emotions in the same way that older children are able to. The hon. Member for Strangford mentioned the reviews of some of the horrific cases of child death that have been carried out recently—I am thinking of Star Hobson and Arthur Labinjo-Hughes. I do not want to talk too much about them, for the same reasons as he did not. I just cannot—it is just too much. But I really hope that someone is looking at that and thinking about what could have been done to detect the signs of mental distress in those young people who could not express it for themselves. We must be training people for some of these crisis situations, so that they can pick up on the mental health of young people who have difficult, damaged or problematic relationships with their caregivers and do not know how to express themselves, but are at risk of real harm if that mental distress is not picked up on.

Whenever I get the opportunity, I like to highlight the importance of health visiting. That is something that I picked up when I spoke to the first-time mums during lockdown. For full disclosure, my own mother is a health visitor, so I have been raised to regard health visiting as a wonderful thing, but that has been my experience as well. The importance of health visitors is that they visit—or should visit—every new mother, and her family, in her home. For those mothers who are finding it hard to reach out, it is an invaluable service to have somebody coming to them and asking if they are okay. We really must continue to support it. On infant mental health in particular, health visitors are uniquely placed to identify concerns, spot issues in early relationship and attachment forming, and identify where infant mental health may be an issue.

Families should receive a minimum of five mandated reviews by a health visitor between pregnancy and age two and a half, but even before the pandemic, many children were not receiving those core contacts. Over the course of the pandemic, the number of missed contacts has increased further, despite the fact that many reviews were conducted online or over the phone. One thing I am really concerned about is that we must not allow telephone or Zoom visits to become the new normal, because we will miss out so much from not visiting mothers in their home. Evidence of domestic violence and, in particular, the subject we are discussing today—those attachment disorders—will not be so evident if health visitor visits move to some sort of digital contact.

In 2015, responsibility for health visiting was transferred to local authorities. Since then, it is estimated that 30% of the health visiting workforce has been lost, with further losses expected. As with many local services, there is something of a postcode lottery in the availability and quality of support. My team and I have spoken to health visitors in north Kingston—the team that supported me when my children were babies—and they reiterated that currently, their biggest challenge is workforce issues. Almost 25% of their current health visiting team is due to retire in the next few years, and they are struggling to find candidates for the vacant roles. They recently advertised a vacancy that received just one application, and that person then decided that they would not take the post.

Health visitors work in relatively small teams with large case loads; in north Kingston, there are about 600 cases for every health visitor. That is unsustainable, not least because it forces health visitors to focus their resources on the most at-risk families. As we know, these problems can occur in all kinds of families from all backgrounds and income groups, so it is really important that we push for health visiting to remain a universal service with home visits.

I will end by stressing the importance of face-to-face contact, and that the health visiting service needs support and investment in its workforce. More than anything, we want to join up the agencies, so that the Department of Health and Social Care is working closely with the local authorities to make sure that the right information is being passed between agencies. If health visitors pick up anything concerning, they must be able to speak immediately to the other agencies surrounding the family, so that we do not have to read too many more distressing case reports like those I mentioned. The £300 million Start for Life programme that has recently been announced is wonderful—it will be great—but there is no funding in it for health visiting services. The funding sits within the DHSC, which is separate from health visiting; again, joining that up would make a huge difference.

With fragmentation, there is a risk that things will fall through the gaps. The one thing that we have all said clearly today is that the consequences of allowing that to happen are too big, both for our individual children—all those future MPs who we are looking forward to welcoming to this place—and for our society as a whole. We want to do everything we can to give little babies and children in every corner of the United Kingdom—in every part of the country—the best possible start. That includes supporting their mental health from the earliest days.

[Mrs Sheryll Murray (in the Chair)]

I call the Scottish National party spokesperson, Dr Lisa Cameron.

15:53

[Dr Lisa Cameron (East Kilbride, Strathaven and Lesmahagow) (SNP)]

Thank you, Mrs Murray; it is a pleasure to serve under the chairmanship of such an esteemed lady and parliamentarian, who is friendly to all.

I thank the right hon. Member for South Northamptonshire (Dame Andrea Leadsom), and congratulate her on securing such a vital debate. Having worked all my life as a psychologist prior to coming to the House, I think it is fantastic that there are champions for this issue in this place, because setting the right foundation right across the United Kingdom and giving people opportunities to thrive from their earliest days is a fundamental premise for creating a healthy society. The right hon. Lady should never underestimate the value of the work she is doing in this House, not just today but for generations to come. I wish her all the best with her early years review, and will gratefully give any support that I can offer.

We also heard from the hon. Member for Twickenham (Munira Wilson), who spoke about the social care system for children and the particular plight of children in care, which goes back to the disorganised attachment styles that were mentioned. In fact, this debate has taken me right to my psychology days—I trained a long time ago—and Bowlby’s theory of attachment, which is the foundation for much of what we are speaking about today. It is so important that if a parent is not there, there is a trusted and secure caregiver. It does not have to be the mother. As the hon. Member for Strangford (Jim Shannon) said, it is often the mother, but it can be the father or another trusted adult. The important thing is that there is a secure attachment.

The hon. Member for Twickenham was spot on when she spoke about why having disruption in early childhood—particularly for children who go into care settings—can have an adverse impact. We must make sure that trusted, secure and stable relationships are built and provided throughout every child’s life. That is vital, and we must support it.

The hon. Member also spoke eloquently about CAMHS support for infants and why it is so crucial. Helen Clark, a former MP who leads on the child mental health charter, is doing vital work on that through the charter with Play Therapy UK. There are many therapies that should be open and available to families with infants, including family therapy, behaviour therapy, which I used to do when I was practising many moons ago with very young children, and play therapy.

I will never forget the feeling of looking out of the window during covid when the council was opening up the playpark across the road from my house and seeing the children, including my own, running to it. There is something very therapeutic and nurturing about peer support and being able to play in a positive environment. I experienced that exact sentiment when I visited refugee centres in Lebanon. One of the most fundamental changes for those young children was the building of a playpark in the refugee centre. They were able to smile and laugh and play. Therapeutic involvement is vital, as is having natural environments that enhance wellbeing. I thank the hon. Member for Twickenham for her contribution.

The hon. Member for Strangford is an absolute stalwart of this issue and so many others in the House. He spoke about the impact of covid-19 on children’s development. There will have to be a lot of research done into that, because we may not see the full impact for years to come. Longitudinal studies will be needed to address that. We must all come together to ensure that funding, support and programmes are put in place so that children have every opportunity to catch up with the socialisation and education they have missed during this critical period.

The hon. Member for Richmond Park (Sarah Olney) made an important contribution about gaps in service and maternal mental health. She also gave a shout-out for dads’ mental health, which is rarely mentioned but is so crucial. When I first came to the House, my husband took on many more of the activities I had usually done. The first week I came back from Parliament, I opened the fridge door and there were a whole host of Tupperware dishes in the fridge. I said, “What’s this? Where did it come from?” The neighbours had very kindly handed him food for himself and our children, because they assumed that they would be reliant on me and not him. I do not think he needed the food, because he stepped up to the mark, but it still shows that we cannot value fathers enough. They are all-round heroes when it comes to early childhood development.

The hon. Member also mentioned health visiting and face-to-face contact, which is extremely important. As chair of the all-party parliamentary health group, I know that face-to-face contact is vital for people. Particularly when they are speaking about mental health and wellbeing, they find it very difficult to do that over Zoom. They often do not bring it up at all in that format or over the phone. It is important that they have a personal relationship that is built up over time. The same can be said for GPs: it is vital that people can get back to seeing their GPs face to face, and we will be carrying out an inquiry into those issues.

I want to quickly mention adverse childhood experiences. I worked in and out of young offenders institutions and prisons for adults for a number of years, which involved visiting people because of their mental health issues and doing mental health assessments. Very few of the people I assessed after they had ended up in the criminal justice system did not speak of some trauma in childhood. The more we can do at the earliest stage, the better, in order to give people a path that will lead them to a fulfilling life. Early difficulties do not always lead to criminal justice problems, but there is a significant correlation, if not causation. We know the risk factors, and we must do all that we can. The British Psychological Society has highlighted that preschool children of parents with poor mental health are three times more likely than the general population to have mental health difficulties, so there is an intergenerational aspect, and we have to help with wellbeing more generally and across the lifespan for families.

Having come from being a psychologist to working as an MP, I see that we are not picking up young people who have autistic spectrum disorder or learning difficulties early enough. Those assessments can be done before they start school. The people who come to see me at my constituency surgery often tell me, “I have been saying for years and years that I need an assessment,” yet the waiting lists preclude that happening at the right time. Two years is a long time in the context of childhood development and the developmental milestones that children may not reach at the correct time because they do not have additional support to help them catch up, so we need to get early diagnosis through children and families hubs, or through community health services. As chair of the all-party parliamentary health group, I can say that this is an issue right across the UK, because I hear about it from people right across the UK. Parents are asking for help, and they need to have it.

Parenting programmes are vital. Our school system has become so dynamic that some of the things that we did when I was at school have been lost. Yesterday I spoke to a nutritionist, who told me that he is having to do a lot of work with parents on nutrition for infants. He said that some parents never undertook any kind of cooking at school—it was called home economics when I was there—and are blitzing McDonald’s to feed young infants. These are things that are fundamental for parenting support, and we need to make sure that we put them in place. We need access to paediatric care, including psychology and types of therapy such as play therapy, and we need parity between mental health and physical health. Looking at the wellbeing recovery from the covid pandemic will be key, and parenting programmes for parents who feel that they need a bit of extra support will be vital.

It would be lax of me not to quickly mention some of the work that the Scottish Government are doing. We have the baby box, which has been delivered to more than 200,000 families since 2017. It ensures that we in Scotland welcome every child, and that children have a basic provision for the first few months of their lives. We are saying very positively, “You’re welcome. We want to do our best for you throughout your life.” The Scottish Government also recognise the significant impact of the covid-19 pandemic and are doing work to address the issues that I have raised. We have the Best Start five-year plan for neonatal care, and perinatal and infant mental health programme boards have been set up. A number of increased payments and grants have been made too.

I concur with what I have heard in the debate, and I want to work wholeheartedly with everybody who is working in this vital area. It has been nice to be taken back such a long time—many decades—to my education as a psychology graduate and to Bowlby’s important theory of attachment. We should ensure that the work of Infant Mental Health Week is taken forward every week of the year, and especially that we hold infant mental health as a key issue in our work in Parliament.

16:05

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is a pleasure to wind up for the Opposition with you in the Chair, Mrs Murray. I thank the right hon. Member for South Northamptonshire (Dame Andrea Leadsom) for securing this extremely important debate for Infant Mental Health Awareness Week, and all hon. Members for their thoughtful contributions this afternoon.

I know I say this sometimes in Westminster Hall debates, but there really are some debates that unite us all. Infant mental health is one such issue. I am delighted to say that I have learned a lot and am filled with the powerful advocacy that has come out of every single wonderful contribution today. It is good to know that there are such powerful advocates in this room. I thank the right hon. Member for South Northamptonshire for all the work that she has done in this space.

We are all here today because we recognise that adverse childhood experiences are the key driver of mental illness in later life. We have many experts in the room today. The last two years have shone a light on the problem. The pandemic has hit the poorest and the most vulnerable children the hardest, highlighting the inequalities in our society that are very hard to escape—children with chaotic home lives; children in overcrowded, noisy housing; and children from black and ethnic minority communities who suffer disproportionately from worse outcomes and worse mental health provision than white communities.

In 2018 it was estimated that 50,000 children aged zero to five lived in homes where domestic violence, adult drug or alcohol dependency and adult mental illness were all present. Children and adults living in households in the lowest 20% income bracket are two to three times more likely to develop mental health problems than those in the highest.

There was already a crisis in child and adolescent mental health provision in this country, even before the pandemic, and the virus has undoubtedly made it worse. The latest report by the Children’s Commissioner shows that demand for child and adolescent mental health services increased, with one in six children suffering from a probable mental health condition, up from one in nine in just 2017—that is one in six. Yet only a third of children were able to actually access treatment, and 42% of child and adolescent mental health services in England do not accept referrals for children aged two and under.

Why should someone’s ability to access preventative services or treatment be determined by where they live? Poor mental health in childhood is carried into adulthood. As we have heard many times, what happens today will impact on demand for mental health services tomorrow. As the old saying goes, prevention is better than cure. That is why we have a range of public health measures in place for children—check-ups for eyesight, hearing and growth; vaccinations to protect against measles, mumps, and rubella. Yet we ignore the wisdom of the ages when it comes to children’s mental health.

Improving infant mental health is all about prevention. With early intervention in those critical 1,001 days, families and infants can be supported. As a doctor, I know that adverse childhood experiences are a key contributing factor to poor mental health in adulthood. In A&E, I see increasingly younger children coming in who have self-harmed or who are living with eating disorders. It is simply heartbreaking. For parents, it is absolutely agonizing.

It should be a badge of shame for the Government that three quarters of children were not seen within four weeks of being referred to children’s mental health services. Imagine being a mum or dad whose child is self-harming or presenting with symptoms of depression, anxiety or phobias, and being without special support for more than a month.

There has been a 77% rise in the number of children needing specialist treatment for a severe mental health crisis between April 2021 and October 2021 compared with the same period in 2019. According to the latest report from the Children’s Commissioner, waiting times depend on where someone lives. When they eventually are seen, services may be hundreds of miles away.

I invite the Minister to please tell the House what new measures the Government are taking in relation to infants and their parents—I am looking for new measures. What new money is being allocated to child and adolescent mental health services, and where is it going? How many new mental health staff will be recruited? Are there plans for specialised parent-infant relationship teams for the infants most at risk? How will they tackle mental health inequalities along the lines of place, race, class and income? With respect, in every mental health debate we hear about the £2.3 billion allocated to mental health, but it seems to get spent five to 10 times over. I would like specific answers to my specific questions.

The Labour Government are committed to improving infant and child mental health. We will guarantee mental health treatment within a month for all who need it, ensuring that patients start receiving appropriate treatment—not simply an initial assessment of needs—within a month of referral. We will recruit 8,500 new staff so that 1 million additional people can access treatment every year by the end of Labour’s first term in office, and we will provide specialist mental health support in every school and put an open-access mental health hub for children and young people in every single community, ensuring that every child has somewhere safe and secure to talk about their mental health.

As it stands, our children are being failed on prevention, on access to treatment and on funding, and we are failing to support their families. The system is stretched to breaking point. The staff are exhausted, the children are suffering, and parents do not know where to turn. I plead with the Minister today to take action before it is too late for another generation of children.

16:11

[The Minister for Care and Mental Health (Gillian Keegan)]

It is a pleasure to serve for the first time under your chairmanship, Mrs Murray. I thank my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom) and congratulate her on securing the debate. I soaked up her speech—when she used that phrase, I felt that that was what I was doing. It was insightful and educational, and all of us got the benefit of her 25 years of experience and understanding of what we need to do and how we should do it. As we know, in this place quite often we can appreciate the problems, but it is much harder to come up with the solutions. I know that her work has been vital in doing that and in helping the Government shape policy in this area.

I thank all hon. Members for their contributions and their support for this initiative. We are at the very beginning of this journey and we want to keep that collegiate approach. We have a real opportunity to shape this and, as in many of the areas that I am responsible for, it is not particularly party political. It is really about how we impact real people’s lives, and in this case babies.

It is clear to us all that the development of babies is incredible and needs lots of vital support in the first years. They are born with more brain cells than there are stars in the Milky Way galaxy. If a baby is loved and receives care, their brain flourishes, laying the foundations for good future physical and mental health. That is why the first 1,001 days have been described as critical for development. There is a real understanding of that now, and that is undisputed. It is also why I am delighted to speak about this important topic and also work on developing the new services. I welcome being able to do so during Infant Mental Health Awareness Week.

Infant mental health refers to social, emotional and cognitive development. For good infant mental health, babies need parents or carers who will consistently meet their needs, as outlined by my right hon. Friend, because that leads to secure attachment relationships. Over 60 years of research tells us that that is related to positive long-term developmental outcomes, from improved emotional development and school readiness to reduced rates of offending, as mentioned by the shadow spokesperson for the SNP, the hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron).

Having a baby can be a time of great joy, but also a time of challenge and change. Many new parents get the support that they need from midwifery and health visiting teams, as was mentioned by the hon. Member for Richmond Park (Sarah Olney), whose mother I thank for her service. I am sure she has helped a lot of parents and families in her time. Many new parents get support from family and friends as well. We talked about how a lot of that could not happen during covid when it was a very difficult time for many new parents. We know that having a baby can be a time of great challenge. With or without a pandemic, it is a time of great change. There are many reasons why a new parent may struggle, from social isolation, as has been mentioned, financial stress, a traumatic birth, relationship difficulties or their own experiences of early trauma. Without the right support this can impact parents and babies alike.

Perinatal mental health difficulties are common. Approximately one in five mothers and one in 10 fathers experience mental health difficulties during the 1,001 critical days. They are critical days, but also difficult days, which is why the numbers are so high, and parental mental health difficulties are associated with increased rates of mental health difficulties in children. As has been mentioned by a number of hon. Members, these difficulties can be passed on.

Parent-infant relationship difficulties are common. They can involve a parent struggling to bond with their baby, or may relate to a perinatal mental health difficulty. Although exact prevalence is difficult to establish, some estimates indicate that approximately 40% of babies have insecure attachment and 10% have a disorganised attachment style. Both are associated with an array of long-term developmental outcomes.

I recently visited Knowsley’s building attachment and bonds service, which is one of the new services being trialled and introduced. It is on the same estate where I went to school—I literally passed my old school—so the area was very familiar, and I was familiar with the problems the service was trying to deal with. I saw at first hand that relationships are everything and that early intervention is crucial. I met a mum there, with her baby. She had had several children and had problems, and she was no longer with the children. With this baby, the service had put in a lot of effort to keep mum, dad and baby together, and to make sure that they built that family. It was making a massive difference, and her other children have since come back to join her. The service was changing everything about the outcome not just for the baby, but for the other children in the family as well. These issues are why ensuring that every baby gets the best start in life is of central importance to this Government.

As all hon. Members said, this is an investment in the youngest and most vulnerable members of our society, and it is part of our ambition to level up health outcomes and opportunities across the country. Our vision is for every parent and carer to have access to high-quality universal services in their local area. That is set out in “The Best Start for Life: A Vision for the 1,001 Critical Days”, published by the early years healthy development review in March 2021. I thank my right hon. Friend the Member for South Northamptonshire for her inspirational work enabling us to support the implementation of this vision.

The Government are investing £302 million to improve start for life services and to create a network of family hubs in 75 local authorities in England. The funding will help bring services for families together into one place, improving their access to support, advice and services. This funding package includes £100 million for perinatal mental health and parent-infant relationship support, £50 million for breastfeeding support and £50 million for parenting support. This significant £100 million investment will improve access to mental health support for babies from conception up to the age of two, as mentioned by the hon. Member for Twickenham (Munira Wilson). It will help us build the workforce in order to fill the gap we see at the moment.

The funding will tackle entrenched inequalities in communities, as mentioned by the shadow Minister, the hon. Member for Tooting (Dr Allin-Khan), and we announced the 75 local authority areas that are eligible for a share of this funding in April. The funding will be targeted at local authorities with disproportionate poor health and educational outcomes, and I am pretty sure that Knowsley, where I am from, has been included in that group. Indeed, my right hon. Friend the Member for South Northamptonshire once stood for election in Knowsley. Since that announcement, we have been working with the eligible local authorities and a range of expert stakeholders to further develop the programme. We will share a draft programme guide, detailing how local authorities can make the most of the funding, in the coming weeks.

The investment will complement the ambitions set out in the NHS long-term plan, as referred to by the hon. Member for Twickenham. It will deliver the fastest expansion in mental health services in NHS history, with 345,000 more children and young people having access to specialist, NHS-funded mental health care. That ambition is backed by the additional £2.3 billion a year for mental health, but we have not actually spent a penny of it yet, because it is by 2023-24. That is when this amount kicks in, and it will be for years thereafter.

Obviously, the workforce is vital. It is clear that we have to invest in developing the modern, diverse and highly skilled workforce that we will need to support babies and families by trialling and evaluating innovative workforce models in five local authorities. That is what we will be doing to ensure that we have the right mix and blend. Obviously, health visitors are also a key part of that; they were mentioned by the hon. Member for Richmond Park.

With regard to 2029, we obviously know that the training of more clinical psychologists, child and adolescent psychotherapists, psychiatrists and the perinatal workforce will require additional capacity across the current education and service providers, all of which are currently operating at full capacity or are limited. We have immediate action —at the moment—to model the workforce to support the development of new roles, new ways of working, and upskilling, particularly with regard to the perinatal, primary and community workforce, including health visitors. We are working with Health Education England, NHS England and NHS Improvement to ensure that we have this workforce plan to sit alongside the new 10-year mental health plan. When we publish that, we will be putting that together, so we absolutely recognise that this is critical. The training time, as the hon. Lady will be able to vouch for, is a long time, so we have to innovate; we have to do things differently. Otherwise, it will take too long and too many people will not benefit from what we all know is required.

We have heard from families that stigma is a real barrier to their seeking support. I really identify with that; I definitely saw it growing up in Knowsley. My friend used to run the Sure Start centre there, and it was clear that she found it very difficult to access the people that she knew she needed to access, because stigma got in the way. To reduce the stigma associated with perinatal mental health difficulties and parent-infant relationships, we must have a multifaceted approach. That includes ensuring that the family hub is a welcoming place for all families; sharing key messages about perinatal mental wellbeing and good parent-infant relationships; and enabling the workforce, paid and voluntary, to feel comfortable and confident to have conversations with families about mental health, bonding and attachment. Those are difficult conversations to have.

Needless to say, there is little point in tackling stigma if not enough support is available. As has been mentioned, there is currently huge variation in the availability of early intervention and preventative support across the country. Some areas have robust and very good offers, including universal antenatal education classes, peer support services for breastfeeding and mental health, and drop-in sessions at the local family hub. In other places, support may be available only if difficulties become particularly severe. That feeds into the stigma, because only when something is going wrong do people get access to the services. That is why the universal nature of the services is vital.

There is also a discrepancy in the perinatal mental health support that is available for mothers and for fathers and co-parents. That was mentioned by the hon. Members for Twickenham and for Richmond Park. We know that more than one in three new fathers are concerned about their mental health in the perinatal period. We identified that gap in provision of support for fathers or co-parents experiencing perinatal mental health difficulties, particularly if the mother is not experiencing any difficulties—then they will not be picked up in the same way. That inequality of access has an impact on the baby’s mental health and wellbeing. A positive relationship with both carers would lead to better long-term developmental outcomes. That is recognised; it is identified as a gap, so support will be provided.

Lastly, none of this will be achieved and achievable without a knowledgeable, skilled and confident workforce. This investment is an opportunity to improve workforce capability and capacity. We understand the workforce challenges and will encourage local areas to create capacity by incorporating greater skill mix in clinically led teams, relieving the pressure on existing teams. The funding available through the Start for Life programme will enhance capacity across a range of professions and volunteers, and improve capability through training. That will build the knowledge and confidence of the workforce needed to provide mental health support. The family hub model will enable families to receive support with perinatal mental health and parent-infant relationship difficulties. That investment will build on existing provision while responding to local needs.

Before I draw my speech to a close, I want to acknowledge the important contribution of two other Government initiatives. First, there has been an additional £200 million investment in the supporting families programme. That will enable local authorities and their partners to provide help earlier, and promote better outcomes for an additional 300,000 families, including families with babies. Secondly, we have launched a consultation to develop a new 10-year plan for mental health. The consultation is open until 7 July. We are concerned to try and get more people responding to that, particularly from black and ethnic minority backgrounds. Members could help to spread the message, to ensure that we get more representations from people with those characteristics. The mental health plan includes specific questions relating to babies and their parents or carers, in recognition of the distinct needs in the first 1,001 critical days. We look forward to seeing the results of that consultation. As I have said, please spread the word.

I will end by reassuring my right hon. Friend the Member for South Northamptonshire that early intervention and prevention sit at the top of this Government’s mental health priorities. We are committed to ensuring that babies and their families get the support they need to make sure they get the very best start in life.

16:26

[Dame Andrea Leadsom]

What a fantastic debate. We need to keep doing this—it is wonderful. Every time we get together, we have the most positive and constructive discussion about what is, in my view, the most significant contribution we can make to building a happier, healthier and more successful society.

I pay tribute to the hon. Member for Richmond Park (Sarah Olney), who recently held a Home-Start celebration. I remind her that one of the people there trying to get money from all of us told a wonderful story about how, sadly, he had lost his mum when he was quite young. His mum was on her death bed, and he was thanking her for being such a wonderful mother, and she said to him, “I’m not a wonderful mother; I was just well parented and I passed it on.” I thought that summed it up. That is what we need to do—we need to make sure that every family gets well parented so that they can parent well.

As a postscript, I will admit to something weird. I chair the review, so all the stuff that the Minister is talking about is well known to me. However, it is so lovely to hear her saying it. It feels like it is actually happening—it is not just a figment of my imagination. I thank colleagues for a wonderful debate.

Question put and agreed to.

Resolved,

That this House has considered Infant Mental Health Week 2022.

16:27

Sitting adjourned.