Children’s Wellbeing and Mental Health: Schools

Baroness Keeley Excerpts

Tuesday 10th January 2017 Westminster Hall

[Barbara Keeley (Worsley and Eccles South) (Lab)]

It is a pleasure to speak in this debate with you in the Chair, Mr Nuttall. I, too, congratulate the right hon. Member for North Norfolk (Norman Lamb) on securing this debate.

We have heard from Members of all parties: my hon. Friend the Member for Liverpool, Wavertree (Luciana Berger), who was here for a short while; my hon. Friend the Member for Bridgend (Mrs Moon); and the hon. Members for Taunton Deane (Rebecca Pow), for Bury St Edmunds (Jo Churchill), for Dwyfor Meirionnydd (Liz Saville Roberts), for Macclesfield (David Rutley), and for North Ayrshire and Arran (Patricia Gibson). We have heard much today much about the state of mental health services for children and young people, which was the focus yesterday, and about some of the causes and challenges. I, too, welcomed the Prime Minister’s intervention on children’s mental health yesterday. It was a step in the right direction, but inadequate without work on existing resources, which I will come on to. If mental health treatment is a burning injustice, it needs more than what I have seen summarised as teacher training, a review and a Green Paper.

Providing mental health first aid training in secondary schools will help some young people, but given that 50% of mental health problems start by the age of 14, why is that training not being extended to primary schools? A further commitment could fund a counsellor in every school, as we have heard in this debate when it was discussed by the right hon. Member for North Norfolk. We have also heard about the excellent results of school counselling in Wales.

The Children’s Society has stated that school-based counselling is seen as accessible, non-stigmatising and effective by children and pastoral care staff. As we have heard, it estimates that the additional cost of ensuring a counsellor in every school would be around £36 million; that is an overall £90 million cost when we include the current use of counselling by schools. That is not a great sum and it could make a great difference.

Personal, social, health and economic education should be statutory in our schools. That already has the support of the House. The Chairs of four Select Committees, including the Health and Education Committees, supported that as a

“crucial part of preparing young people for life.”

Importantly, the most recent Ofsted report on PSHE provision found that in two fifths of schools where learning was weak, pupils have gaps in their knowledge

“in the serious safeguarding areas of personal safety in relation to sex and relationships, mental health, and alcohol misuse.”

Does the Minister agree that if the Government are serious about tackling the stigma around mental health, making high-quality PSHE lessons statutory would be a good place to start?

Clearly, schools can play an important role in identifying vulnerable young people who may be living with mental ill health, such as those in care or those who have experienced abuse and neglect. Schools need to be supported to identify and respond to the safeguarding and emotional needs of young people affected by abuse and neglect, yet according to the Children’s Society, less than half of mental health trusts have clear pathways set up for referrals of children who have experienced sexual exploitation. If we think of the number of places in this country where that has been an issue, that is a serious gap.

Given the emphasis on the role of schools, it is deeply worrying that the National Union of Teachers’ analysis of Government figures for the national funding formula consultation found that funding would be cut from a very large percentage—98%—of England’s schools. My hon. Friend the Member for Liverpool, Wavertree, referred to the impact of cuts on schools’ budgets and their ability to fund counsellors. Some Conservative Members feel that their budgets will improve, but for many schools, they will not. Does the Minister agree that putting greater financial pressure on schools will, as we have heard, damage their ability to employ counsellors and take on other vital work to link schools with mental health services?

If schools and teachers take on a role in mental health, they need to be able to make a referral to mental health services quickly. On average, nearly one in four young people are turned away due to high thresholds for accessing services. It is unacceptable that vulnerable young people are turned away from the services they need. When young people do get access to services, they can still experience wide variations in waiting times across the country; average waiting times for treatment range from two weeks in Cheshire to 19 weeks in north Staffordshire. Such disparities must be addressed.

I turn briefly to the issue of young people in crisis waiting long periods for a bed, or being admitted to units hundreds of miles from home; as we know, that includes young people with eating disorders being sent to Scotland for treatment. It is clear that the stress and sense of isolation that that causes can damage a young person’s chances of recovery.

The Prime Minister said yesterday:

“By 2021, no child will be sent away from their local area to be treated for a general mental health condition.”

That is simply not soon enough. Will the Minister tell us whether that target of 2021 for out-of-area bed placements can be brought forward?

I turn now to CAMHS funding and the £1.4 billion of extra funding promised from 2015 to 2020. YoungMinds found, through freedom of information requests, that in 2015-16, only just over a third of clinical commissioning groups had increased their CAMHS spending by the full amount allocated to them, and this year only 50% of the CCGs had increased their spending to reflect the additional funds. As we have heard in this debate, it is totally wrong for such funding to be used for other NHS priorities. We have also heard that it is important that we know what commissioners are spending the CAMHS funding on. The hon. Member for Bury St Edmunds was right to talk about Members of Parliament being able to drill down into CAMHS spending.

There has been an issue with the way that CCGs have reported their CAMHS spending to NHS England. The Royal College of Psychiatrists reported that CAMHS funding ranges from £2 per child per year in NHS Luton to more than £135 per child per year in NHS Birmingham South and Central. When pressed, the CCGs with the lowest expenditure levels said that they had reported only the figure for the additional spending allocated to them, rather than their total CAMHS spending.

In our debate on children’s mental health in October, the Minister talked about delivering “accountability through transparency” on spending. I wrote to her on 7 December about the confusion among CCGs on the figures that they should be reporting on their CAMHS spending. I asked her to investigate and, if necessary, issue guidance so that we have the accurate figures on CAMHS spending that we need if we are to monitor that important area. I have yet to receive a response, so perhaps the Minister will respond on that issue.

Given that one in four young people are being turned away from services, we should be prioritising practical and measurable solutions to make sure that young people who need to access mental health services can do so. The Government can start the improvements, as a springboard from what the Prime Minister covered yesterday, by ensuring that the entire £250 million that was promised in each year of this Parliament is spent as intended. This spending should be ring-fenced for CAMHS and not used elsewhere in the NHS. If the social care precept can be ring-fenced, why not funding for children’s mental health?

Some schools in some parts of the country are doing excellent work on the “Future in mind” programme. In Salford, we have an emotionally friendly schools programme to support our teaching staff. We have approved registers for schools counselling. We have established school champions and young ambassadors for peer support. We are doing a review of transitions from primary to secondary school. We have developed an emotional health directory of services for children and young people, which sets out the services available and resources on websites. We are establishing a rapid response advice line for frontline professionals in schools to give them advice and guidance in times of crisis or if they lack understanding.

So much is going on, but as the right hon. Member for North Norfolk said, things are not even across the country. The Government should make it a priority to ensure that young people have timely access to clinically effective mental health support when they need it. “Future in mind” set out

“A five year programme to develop a comprehensive set of access and waiting times standards”

to bring rigour to mental health. I feel that a five-year programme is too long. It does not seem fair to spend so long developing access and waiting time standards when young people are not receiving the treatment that they need. Does the Minister agree?

Yesterday’s announcement could have been of a counsellor in every school, statutory PSHE and the ring-fencing of funding for children’s mental health. The things that we have discussed in this debate and to which I have just referred would have more impact on the burning injustice of mental health treatment than what has been summarised as teacher training, a review and a Green Paper.