Mental Health: Children and Young People

Lord Bishop of St Albans Excerpts

Thursday 23rd November 2023 Lords Chamber

[The Lord Bishop of St Albans]

My Lords, I too congratulate the noble and learned Baroness, Lady Hale, on her excellent maiden speech, and the noble Earl, Lord Russell, on securing this debate on an area of huge importance for all of us. As has been noted by many noble Lords already, and raised in the Question asked in the House by the noble Lord, Lord Bradley, on Tuesday, the omission of the mental health Bill from the King’s Speech has caused a great deal of worry and concern. It seems that we have time to debate pedicabs but not the urgent need for this review of our mental health provision.

With the number of children and young people being referred to mental health services increasing, alongside increasing waiting times for treatment, it is clear how urgent and pressing the reform of the Mental Health Act is. The Government have said that the Bill would be published when parliamentary time allows. I would argue that this is of the highest priority. Improved mental health in our young people and children—and the rest of the population, more broadly—would not only decrease the huge levels of suffering and anguish but bring immense economic benefits, saving taxpayers’ money and bringing more people into the workforce.

Mental Health Foundation research shows higher levels of unemployment and in-patient stays and a higher likelihood of contact with criminal justice for those with mental health problems. The annual mean cost to the public purse is 16 times greater for those with mental health problems. We on these Benches and Members in the other place can all agree that mental ill health is extremely costly for our nation. At the end of August 2023, 414,550 children and young people were in contact with children and young people’s mental health services and waiting times have increased, as have the number of children referred who do not end up ever receiving treatment. The scale of the problem is not the only concern. The quality of care, and the conditions under which our children and young people are being detained, urgently need to be rethought, according to the recommendations set out in the Health and Social Care Committee’s report, many of which the Government have accepted but which have not yet been implemented.

Given that over 50,000 people were detained under the Mental Health Act last year, there are clear arguments that reforming the Act needs to be a government priority. Concerns that the report raised included inappropriate use of restrictive practices and many children and young people facing long stays in adult wards, or, as we already heard from the noble Lord, Lord Allan, in wards far away from their homes where they are not being visited. I ask the Government to consider how traumatising these conditions must be for children and young people who are already mentally unwell enough to be admitted to a mental health care ward.

The Commons Health and Social Care Committee report comments:

“The use of restraint against children and young people can be humiliating and cause unnecessary distress”.


This is the case for any child or young person, let alone a child who is already extremely distressed and suffering from a mental health condition. I am sure that His Majesty’s Government are aware, having responded to this report, that the use of restrictive practices remains very high in children and young people’s mental health services, with the use of restraint on children and young people being on average five times the level of the adult equivalent. This is deeply worrying.

There are also deep injustices embedded in the implementation of the Mental Health Act, with black people four times more likely to be detained, and, in 2021-22, girls making up 71% of all children detained. We desperately need to address these problems to ensure that our staff and services are educated in trauma-informed practice and to ensure that we are not retraumatising these children and young people during their treatment.

Many of these issues could be addressed, as was recommended, by expanding the legal right to support from an independent mental health advocate to all children and young people. The Government accepted this recommendation in their 2021 mental health White Paper, but even then this was subject to future funding availability. Children’s rights expert, Kamena Dorling, highlights how serious these current conditions are. As it stands, we have mentally unwell children as in-patients who do not have the right to advocacy, and many of whom do not understand their rights and worry that they must do as they are told or they may end up being sectioned. She writes:

“There is a real question about whether we have a section of children who are unlawfully deprived of their liberty”.


This is a very serious and deeply worrying situation, and one that I hope the Minister will reflect on.

Finally, I will stray into a related area which no one has mentioned so far but on which I have been campaigning for a number of years. I want to comment briefly on some of the problems encountered due to the lack of regulation of online gambling and gaming. Some 60,000 to 62,000 young people in this country are classified as having a gambling disorder—according to law they should not even be gambling. If 60,000 to 62,000 young people have been diagnosed with these problems, how many are gambling? Presumably hundreds and hundreds of thousands, which shows the level of the problem that we are facing.

Of the 15 gambling clinics that have now been opened, funded by the NHS, at a time of huge financial constraints, 12 are facing huge waiting lists for people to get specialist treatment—they simply cannot access this treatment. Fortunately, the Government are now moving on the need for better regulation, but this really is needed to protect vulnerable young people. We have evidence that there are aspects of the gambling industry taking advice on how to produce games that are very addictive and encourage people to keep returning to them. If you talk to a family who have a teenager with a gambling addiction, they will tell you it can ruin the whole family. It is so compulsive that children can be stealing and lying to feed this devastating addiction.

I turn briefly to gaming. The WHO has classified gaming disorder as a mental health disorder. In 2019, the National Centre for Gaming Disorders opened a clinic in London, again funded by the very hard-pressed NHS, and 70% of the patients are under 18 years old. Noble Lords will have seen, as I have, a series of stories in the papers about the devastating damage that this is causing in families, where children really cannot tear themselves away from these, in some cases, highly addictive games. We need to support our world-leading, brilliant gaming industry—it brings a lot of pleasure which many people enjoy, so I am told—but there is, nevertheless, a downside, which urgently need regulation. Surely the gambling and gaming industry needs to pay a compulsory levy on the principle that the polluter pays. The industry has brilliantly privatised the profits and nationalised the costs. We as taxpayers are picking up the problem, and although this is a much smaller and niche problem, it is growing and we need to attend to it.

Polling shows that the population now ranks mental health as a more important issue than unemployment, industrial action and Brexit. Those under 40 rank it as more important even than climate change. I believe this shows that the public are telling the Government what their priorities are, and I hope His Majesty’s Government will listen. I look forward to hearing the Minister’s reply on many of these complex but deeply worrying issues.