Education and Adoption Bill

Baroness Benjamin Excerpts

Tuesday 17th November 2015 Grand Committee

[The Earl of Listowel]

My Lords, I hope it may be helpful to the Minister if I fill in a large omission that I made in my opening statement; I apologise to the Committee for not having alluded to this. One important issue is the cuts to local authorities over the last several years. One understands why those cuts have had to be made, but it is a particular dimension of child and adolescent mental health services that half the funding comes from health and half from local authorities—the noble Lord, Lord Hunt, might correct me if I am wrong. However, for some reason the cuts to local authorities have particularly impacted services under CAMHS, so there is very little CAMHS around. Therefore to target the CAMHS resource at the most needy children might be an improvement with regard to using a scarce commodity in the most effective way. However, in any case, because of the scarcity of resource and because of our particular responsibility for these children in the care of the state, we should take more steps to ensure that they get the appropriate specialist mental health service that they need.

[Baroness Benjamin (LD)]

I will quickly say why I support Amendments 32A and 34. I am very sorry for not having been here earlier, but I am on the Select Committee on Communications; we are looking at the BBC charter renewal and were just questioning John Whittingdale, the Secretary of State.

I am here because we must ensure support for all options for looked-after children that are considered, whether they remain in care, leave care independently or live with a special guardian. I support Amendments 32A and 34A because they will create provision in this Bill to improve the timeliness and quality of mental health assessment and support for all looked-after children. Looked-after children have significant needs, and improvements are needed to ensure that their emotional well-being is better promoted.

We have an increased focus on children and young people’s mental health, but we must not forget children in care, who are sometimes the most vulnerable children. One young person told the NSPCC recently that the trauma associated with the abuse that she experienced was not picked up on her early entry into care. She felt that she did not receive help until she reached crisis point. She said:

“We shouldn’t have to do crazy things before people notice we need support and do something”.

That is why I put my name to the amendment. I see that it is not on the list, but I did put my name to it because I feel very strongly that it should be given as much consideration as possible. It creates such provision in the Bill that will make sure that children’s mental health is assessed automatically and supported much earlier in the adoption system.

Another young adult, Liza—not her real name—told the NSPCC that before turning 16 she had around 15 placements and between 20 and 25 placement moves. This caused her so much stress and trauma because she had to travel around from place to place, which was extremely tiring, both physically and mentally. Reflecting on this experience, Liza made it clear to the NSPCC that she would have benefited from easier access to therapeutic services which would not have required her to travel long distances. Liza’s experience is not untypical of that of many children in care who struggle to find the right therapeutic support. Amendment 34A, which I support, would require the Secretary of State to oversee an increase in the quality and quantity of therapeutic support services and would create provision in the Bill to stop more children having the terrible experience that Liza outlined.

Almost two-thirds of looked-after children have experienced some sort of abuse or severe neglect, and 45% of children in care have a mental health disorder compared with just 10% of the general child population. We know that looked-after children are four to five times more likely to attempt suicide, less likely to attain good results at school and more likely to end up homeless. However, the mental health needs of children in care often go unassessed and unidentified and there is a substantial lack of mental health support for these children.

Current guidance from the Department of Health and the Department for Education on mental health assessments for looked-after children does not go far enough. The BBC—I have the BBC on my mind; I am sorry. The NSPCC believes that the important aspect of quality support in Amendment 34A relies on quality assessment as outlined in Amendment 32A, so the two go together. Looked-after children’s initial health assessments rarely include the involvement of mental health professionals, thereby reducing the chances of identifying their mental health needs. Furthermore, there should be direct contact with the child and their carer to fully explore the child’s emotional and mental health needs. We have to make sure that children know that they are being considered, no matter where they are from.

I welcome the Education and Adoption Bill but urge the Government to include specific measures around mental health in particular: all children entering care should receive an automatic mental health assessment in addition to the physical assessment that they currently receive; children in care should then immediately receive the subsequent necessary support to help them deal with issues of mental health identified in the assessment; and there should be regular monitoring of children’s mental health while in care to inform the support the child receives and ensure that it contributes to their improved well-being.

The NSPCC recently released figures which show that more than a fifth of all children referred to local specialist NHS mental health services, including children with problems stemming from abuse, are rejected for treatment. This cannot go on. Children who have been abused or neglected could face serious long-term mental health problems because of the lack of support. The NSPCC recently stated that this is a serious “time bomb” because it is getting worse, not better. So I hope that the Government will take on board the things that I have said and support this amendment. This is something that we need to address in the best way possible. I hope that the Government will consider the amendments in the constructive spirit in which they are intended as the Bill moves through Parliament.

[Baroness Evans of Bowes Park]

My Lords, Amendments 32A and 34A, spoken to by the noble Earl, Lord Listowel, and the noble Baroness, Lady Benjamin, raise important points about the mental health needs of children adopted from care.

I absolutely agree that the mental health of adopted children is a key issue, as all noble Lords who have spoken in this debate have said, and one that we expect to be central to the development of regional adoption agencies.

The Government have committed £1.25 billion to improve mental health services for children and young people over the next five years through the implementation of Future in Mind, the report resulting from the Government’s review of child and adolescent mental health services. The report included a section on vulnerable children and makes specific recommendations about looked-after and adopted children. This includes improving access to services, working better with parents and carers and support for children who have suffered trauma in their early life.

We are working very closely with the Department of Health and NHS England on the implementation of Future in Mind. Locally, clinical commissioning groups have been—