Schools (Mental Health Professionals) Bill [HL]

Baroness Berridge Excerpts

2nd reading
Friday 1st March 2024 Lords Chamber

[Baroness Berridge (Con)]

My Lords, I thank the noble Baroness, Lady Tyler, for this Private Member’s Bill, which enables your Lordships’ House to focus once again on the mental health needs of young people. The figures of the increased prevalence in young people of mental health symptoms and illness are alarming and I dare say that there is no one in today’s debate or in your Lordships’ House generally who does not know of a young person struggling like this.

The underlying mischief that the Bill seeks to address is to get mental health support early through school counsellors to avoid those mild to moderate symptoms deteriorating and therefore to sustain access to education, which is vital. Whether through the mental health support team, designated senior lead, school nurse, educational psychologist or school counsellor, mental health services need to be accessible via schools. I suggest that the school counsellor could also be the person who co-ordinates the education provision when a child is so mentally unwell that they can no longer access education in school, a cohort that I think is even beyond that outlined by the noble Baroness.

Within the statistics on this issue, one of the most startling is the rise in the prevalence of eating disorders. Among 11 to 16 year-olds, the incidence rose from 0.5% in 2017 to 2.6% in 2023, while among 17 to 19 year-olds it rose from 0.8% to 12.5%.

When the Mental Health Act was passed in 1983, it was not envisaged that children would be detained, save possibly under the Part 3 criminal justice provisions of that Act, but many children are indeed detained under the Act. NHS Digital recorded 997 detentions under the Act of people aged 17 and under in 2022-23, although the true figure will be higher, as not all providers submitted data. The figure also did not include those children who consented to be admitted, or whose parents consented to them being admitted, to a secure institution. The Children’s Commissioner report in 2020 outlined not only racial disparities in admissions to secure facilities, but more girls being detained and consenting to admissions than boys, which may of course be due to the rise in eating disorders that I outlined, which are more prevalent among girls.

Continuing education for those in secure units is so important. Although education can be provided remotely, it may be more difficult if the child has been placed out of area—an issue that I know His Majesty’s Government have been grappling with for years. Can my noble friend the Minister outline whether out-of-area placements of children and young people have ended if they are detained under the Act? If you are so detained, do you then come out with an EHCP, or is it the obligations under Section 117 on aftercare that help you get additional resources to catch up on lost education?

In 2018 the Department for Education prepared a very helpful research paper into the education provided for children in secure mental health institutions, but only 58% of units providing education in the secure estate responded to the call for evidence. Encouragingly, in most units that did respond, discussions with home schools were reported to take place at all points during the pupil’s time in the unit—their admission, their stay and as part of reintegration to the home school. But units had mixed experiences when obtaining sufficient information on baseline levels and progress from pupils’ home schools, with only 60% indicating that this was provided for more than half their pupils. That is 60% of the 58% that replied, so less than half of those trying to teach children in these units have significant information.

We need to ensure that teachers whose careers are dedicated to teaching in the secure mental health estate—I pay tribute to them—have all the necessary information about the child’s previous education. The Bill’s suggestion of every school having access to a school counsellor would provide a person who could ensure that secure units have sufficient information about a child’s current education. It could reassure noble Lords that someone is informed or aware of what is happening in the 42% of institutions that did not respond to the research paper. That represents hundreds of young people whose education we do not know about while they are in the secure mental health estate. It is a gap that I believe needs to be filled.

While the need for mental health expertise in schools is obvious, I am not convinced that legislation is needed to achieve this. It could, in fact, be counterproductive. What if one school has a major event, such as the school next to Grenfell Tower? If that had been part of a multi-academy trust, which it was not, could not all the mental health professionals be reassigned to that school for a period of time? Sadly, that could not happen under the Bill as currently framed, for fear of acting unlawfully.

What is the sanction if a school does not provide access to such support? Sadly, recourse to the courts by way of judicial review looks like the only enforceability option. Do we really want to encourage that? Is a school leader not free to say, “I will spend my resources elsewhere, as my school is in one of the 75 local authority areas that has a family hub and students have access to mental health support and counsellors there”?

I also wonder why the requirement in the Bill is not proposed to extend to the independent sector, as to provide such services would match the requirement to provide PSHE in independent schools. While arguably, of course, some will have access to private mental health support, often late diagnosis there will put the same strain on resources in the NHS that the noble Baroness seeks to avoid, and it will have similar adverse effects on the student’s prospects. As 70% of secondary schools and 52% of primary schools in England already offer counselling services, this causes me to doubt the wisdom of needing to legislate.

It is so encouraging that 14,400 settings have claimed a grant to train a senior mental health support lead. Can my noble friend the Minister reassure me that she has used her well-known expertise with data to look at the settings that have not applied? Are they in areas of deprivation? Is there cross-referencing with NHS data for areas where young people are most at risk of poor mental health outcomes to check whether these are the settings that have not applied for the grant and to enable them somehow to do so?

I am grateful to the noble Baroness for giving your Lordships’ House the opportunity to focus on the mental health of children and young people. While the progress by His Majesty’s Government could perhaps be quicker in its rollout, I regret that I cannot support legislation as the appropriate means to fulfil this important aim.