Children's Mental Health Services: Lincolnshire

Tuesday 7th February 2023 Westminster Hall

15:59

[Gareth Davies (Grantham and Stamford) (Con)]

I beg to move,

That this House has considered children’s mental health services in Lincolnshire.

As a parent, I know how strong and how special the bond that connects us to our children is. We give our time, our energy, resources and a hell of a lot of sleep without a second thought to nurture, guide and raise them. It is a love that knows no limit, and we all want our children to have the best opportunities in life and for those opportunities to be just as limitless. That is why I can only imagine the distress and heartache felt by some families in Lincolnshire and across the country when a child is suffering from mental ill health.

As parents, we feel a deep sense of responsibility and a duty to get help for our children whenever it is needed, and we will do anything we can to get it, so it is vital for families to know that they have access to a network of support and to professionals dedicated to providing the best help and treatment available. Over the last decade, our country has made great strides in recognising the importance of mental health, placing it in parity with physical health both in law and in practice. There has also been a notable cultural shift, with more and more young people reaching out and seeking support with their mental health.

To be fair, Government have recognised and actively encouraged this change. Since 2015, the mental health investment standard has mandated that mental health spending at least match any overall increase in NHS funding. The Government also commissioned the independent mental health taskforce, accepted its recommendations in full and put an extra £1 billion towards introducing the first ever mental health waiting time standard, committing to providing 70,000 more children with mental health care and guaranteeing access to a 24/7 community-based crisis response. That has had an impact and it is a vast improvement on what has gone before, but those national numbers will mean very little if they do not translate into positive experiences where help is most needed.

In Lincolnshire, children and young people have access to a broad range of support. Lincolnshire has a strategy centred around care at home. While hospital care is lifesaving for those in most need, the majority of children with mental health problems can and should be seen in a familiar and comfortable setting at home. That is why I welcome Lincolnshire’s early help strategy. The mental health, learning disability and autism alliance, which includes NHS leaders, Lincolnshire County Council and district councils, and the police and crime commissioner, has developed the plan to promote early intervention and support. That ultimately means that more children are provided with help before their illness requires hospital support, and Lincolnshire has far fewer in-patient stays than the regional and national averages.

I want to use the rest of my time today to speak directly, in this Children’s Mental Health Week, as a voice for a number of my constituents who have reached out and contacted me over the past year to share their experiences and highlight particular issues that we face in the county of Lincolnshire. On early intervention, the earlier mental health issues are reported, the stronger the chance of recovery. There are two ways in particular in which we need to focus more attention to achieve these early interventions.

The first is through schools. School is where many children feel most comfortable, familiar and safe. As such, school is exactly where children are not only supported, but can be taught how to better look after their own mental health and recognise when classmates are struggling. The Department for Education has, therefore, rightly committed to providing mental health training to a lead member of staff in all eligible schools and colleges by 2025. Lincolnshire County Council has rightly commissioned four mental health support teams in various educational settings in Lincoln, Gainsborough, Boston and Skegness. Obviously, my constituency is missing from that list. I hope that Grantham, Bourne or Stamford will be included in the months and years ahead.

The second area of focus for early intervention is about training for medical professionals. Although some training is available, some of my constituents feel that it should be mandatory for all medical staff on paediatric wards, in A&E, for GPs and for GP nurses, so that issues can be identified earlier and faster. I am interested to learn the Minister’s views on that point, because it has been raised a number of times.

There is another big issue that I would like to highlight. Although we have some excellent people involved in mental health services in Lincolnshire, there are frankly not enough of them. We have to recognise that we struggle to recruit specialist staff to operate mental health services in Lincolnshire, because of the rural nature of our county. It also means that attracting specialists, such as psychiatrists, from more populated towns and cities is difficult. I know the Government are fully aware of the issue but, without more specialist staff, local providers find it difficult to expand services and provide a more immediate response to the children who are in most need.

That staffing issue creates a need for local providers to make occasional use of agency cover. Not only is that expensive, but it brings a significant churn of personnel into the system, when children and families need a consistent and familiar touch point they can get to know and who can get to know them. Another main workforce concern is that, after covid, a significantly higher number of people need help. It is estimated that across the UK, 1.5 million children might need new or additional mental health support as a result of the pandemic. Before the pandemic, one in nine children in the UK suffered with their mental health. That figure was high enough, but it has since risen to one in six children. With more children to treat, Lincolnshire needs more specialist staff to go alongside the clear increases in monetary investment.

My final point is about the important third area of after-hours care. In Lincolnshire, we have a crisis and enhanced treatment team. It is targeted at helping children, through assessments and home treatment, aiming to avoid the need for hospital admission. The full extent of that in-person service is available from 8.45 in the morning to 7 pm. As we know from many cases, the greatest need is during the night. For that, there is a telephone number for parents to call for advice, and they might be referred to an A&E department, if it is deemed necessary.

Although that is, of course, welcome, some families have not been aware of the out-of-hours service and have presented to A&E, sometimes without calling the crisis team, only to struggle to find any specific mental health support at the hospital when they arrive. Locally, I know that those responsible are aware of that, and improvements are on the way. For example, a new mental health liaison post has been appointed and will start soon to offer routine face-to-face support at A&E. Going forward, there is a review of the entire crisis model. Plans are currently being explored, including for a child and young person crisis assessment centre. I will definitely follow that closely.

Providing for our children is the driving force in parents’ lives. We love, care for and protect them as best we can with whatever means we have. I hope that, in some small way, my speech today has helped highlight the challenges that children’s mental health services in Lincolnshire face. Some are similar to those faced by other areas across the country; some are perhaps more unique to us in our county. I thank all who work so hard to deliver mental health services in Lincolnshire. I pay particular tribute and send my thanks to the families who have shared their stories with me—they know who they are. I look forward to the Minister’s response.

16:10

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Grantham and Stamford (Gareth Davies) for securing this debate and for the way he continues to champion children’s mental health services. I recently discussed many of the issues with him and some of his constituents. The experience that they brought to me has helped to influence the work we are doing. I reassure my hon. Friend that there is a huge focus on improving children’s mental health services, both nationally in terms of funding and, as he indicated, in terms of staffing. In his local area, much of the work will be in the major conditions strategy, which includes mental health, and also in our suicide prevention strategy—[Interruption.]

[Sir Christopher Chope (in the Chair)]

Order. There is a Division in the House, so the sitting is suspended. If there is one vote, it will be for 15 minutes; if there are two votes, it will be for 25; and if there are three votes, as expected, it will be for 35 minutes. I look forward to seeing Members back here then.

16:11

Sitting suspended for Divisions in the House.

16:48

On resuming—

[Sir Christopher Chope (in the Chair)]

The Minister will now resume her speech.

[Maria Caulfield]

Thank you, Sir Christopher, for allowing me to continue what I was setting out to my hon. Friend the Member for Grantham and Stamford, who has been campaigning so eloquently on the issue of children’s mental health, particularly from a constituency point of view. He is quite correct that we are investing record levels of funding into children’s mental health services. We are trying to recruit as many staff as possible to expand those services, which are being extended to support children’s mental health. I will touch on how that is happening, both at a local level in Lincolnshire and nationally across England.

Lincolnshire’s children and young people’s mental health services have always been rated as outstanding by the Care Quality Commission. Pre-pandemic, the average wait for child and adolescent mental health services assessments was 4.4 weeks, and the Healthy Minds Lincolnshire early-intervention service helped to reduce referrals to child and adolescent mental health services by 5%. Lincolnshire has always had an excellent track record in delivering services and supporting young people in particular with their mental health, compared with the figures nationally. I know that is not necessarily much consolation for those parents and children waiting for services, but Lincolnshire mental health services have traditionally been very good.

However, the pandemic has had an impact, as it has across the country. In Lincolnshire, referrals to CAMHS have increased by 15.7%; nationally, the increase was 35%. Although Lincolnshire has not had the same increase in the number of referrals as other parts of the country, it has still had a significant increase. Lincolnshire has had 15% more clinical contacts than the national average, and 92% of children who sought an emergency telephone response received one within four hours as a result. We can see, then, the scale of the pressures that services are facing. Lincolnshire has performed relatively well compared with most other parts of the country but is experiencing challenges. That was very much the point that my hon. Friend made: his constituents are now struggling with waiting times, the sheer scale of the number of referrals is putting pressure on the service, and although a lot of work is going on to improve things, his constituents are feeling the pressures on the service.

The loss of workers in this field is particularly high in my hon. Friend’s area, as it is in other parts of the country. I assure him that we are recruiting more staff, but it takes time to train them up and get them providing services at a local level. Lincolnshire does not have a children’s and young persons’ in-patient unit, and I have heard from his constituents about the impact of that and the difficulty of a child being placed out of area. We fully recognise that and want to work with his local team on it. His local integrated care board is standing up to the challenge—it has increased funding to CAMHS by £1.2 million in this financial year to help to reduce waiting times, which has had a positive impact—but the workforce is probably the single biggest issue in terms of trying to improve services further.

By September of last year, 67% of children and young people who were assessed for CAMHS were assessed within six weeks. If early-intervention and emotional services are included, 72.5% of young people who were assessed were assessed within four weeks, with the national average being 68%. The big concern for Lincolnshire is the length of time that children are waiting for support and the workforce capacity to change that, so I am committed to working with my hon. Friend’s ICB to see how we can address that concern.

My hon. Friend touched on the out-of-hours service. Such services are available throughout the country—there are 24/7 helplines available—but he is quite right that many people do not know how to access those services, and that applies in respect of emergency services as well. We hear from ambulance trusts throughout the country that very often ambulances have to attend to someone with a mental health crisis, and they are not always able to access a 24/7 service. It is not because it is not there but because sometimes it just not clear how it can be accessed. There is, then, a lot of work to do.

Let me reassure my hon. Friend about what we are doing from a national perspective; this will be replicated in Lincolnshire. We are on course to deliver 399 mental health support teams in schools and colleges, and we already have 287 of them in place. They are making a significant difference to children and teachers. They are able to support children who have mental health concerns, mental illnesses or conditions at an earlier stage and get young children into the system much more quickly, before they reach a crisis point, to get them the help and support they need. They also take the pressure off teachers, who until now have done a significant amount of the heavy lifting when it comes to children’s mental health.

We are providing £79 million to boost capacity in children’s mental health services and to help 22,500 more children and young people to access those services. Also, we are specifically expanding access to services that address eating disorders. The funding has increased significantly to try to match our level of ambition, with £53 million of support in 2021-22, which will rise to £54 million in the forthcoming financial year. All that work sits on top of record levels of investment in NHS mental health services in England and the unlocking of support for an extra 345,000 children and young people.

I recognise from the points that my hon. Friend made that where we are making a difference that is great, but for the children and parents who are waiting it is still very difficult. Although Lincolnshire is probably performing better than most parts of England, it is facing some significant pressures with workforce capacity and the lack of an in-patient facility, which also puts pressure on community services.

The Government hope to reform the Mental Health Act 1983 fairly soon. That will support mental health services and make them much more community and crisis team-led, rather than letting people get into crisis and their needing much more extensive services. We have recently announced our major conditions strategy, which includes mental health, and we will also publish our national suicide prevention strategy, in which we will focus on children and young people in particular, because we recognise that significant work needs to be done for them.

It is also about ensuring that we have the workforce capacity in place. The Chancellor and his team will specifically include mental health in the workforce strategy, which is being worked on. We know that when we expand community services to get people seen much more quickly and avoid crisis situations, we will absolutely need the workforce at a community level to meet the demand.

I hope I have been able to reassure my hon. Friend. The Government recognise that there are challenges, particularly with things such as out-of-hours support and rapid access into services. I thank my hon. Friend for the work he is doing by constantly raising the situations his constituents face, because it does make a difference. It means that we are able to assess whether we are making progress in supporting not only children and young people in particular but everyone who wants to improve their mental health or has a mental illness and is in need of support.

Our ambition is that children and young people, wherever they are from in England, whatever their background and whatever their mental health condition, will be able to get the support that they need in a timely manner. I know that my hon. Friend will be holding our feet to the fire to make sure that that happens, particularly in Lincolnshire.

Question put and agreed to.

[Sir Christopher Chope (in the Chair)]

Because the Minister responding to the next debate is not present, I have to suspend the sitting until 5.7 pm. We will then have one hour in which to debate the next motion.

16:57

Sitting suspended.