Child and Adolescent Mental Health Services

Adam Afriyie Excerpts

Tuesday 3rd March 2015 Commons Chamber

[Mr Robinson]

Easington. I beg my hon. Friend’s pardon. The CAMHS budget has been cut to £716 million, which is a cut of £50 million. That is an enormous cut.

[Adam Afriyie (Windsor) (Con)]

The hon. Gentleman is making a powerful case, particularly on resourcing. Clearly, we would all like to see more resources going into adolescent mental health challenges, but does he share my view that if we get this right, with proper standards, proper implementation and early intervention, there could be a net saving to the Exchequer overall?

[Mr Robinson]

I absolutely agree with the hon. Gentleman. I think the whole House would agree with his intervention, which was short and to the point. As in so many situations, prevention is better than cure. It is also a lot cheaper. We all know that, and there is a case for it in this context, but it will require investment up front. That is where the Government do not get it, because they usually take a short-sighted view of these matters.

I wish to make two points in closing. First, if local councils do not have the resources at the moment, we cannot look to them to provide these services and so they are likely to get overlooked. Lastly, will the Minister confirm something about the leak—I am sure he will have read about this in the press—from his taskforce, which speaks of the perverse incentives that have arisen, particularly in relation to mental health, from the Government’s reorganisation? Have they exacerbated the problem? As a result, is the real cost of that reorganisation to the mental heath services not £50 million, but possibly a much higher figure?

In any event, we all know from our constituency experience that we have had losses. Last night, I saw in a television programme that we have lost hundreds of doctors and thousands of nurses, and the prospect in the next few years is an accelerating trend on both. So the Labour party’s commitment for 20,000 new nurses and 8,000 new doctors is a bold one, but it is manageable. It is also absolutely necessary if we are to deal with any of our current problems. That is the message I would like to leave the House with. We need early intervention; a commitment to increase the number of doctors and nurses; parity of treatment—and even ahead of that— in the integration of mental health services; and the restoration of the CAMHS budget as soon as possible.

--- Later in debate ---

[Adam Afriyie (Windsor) (Con)]

I apologise for not arriving for the first part of the debate; sadly, I was detained elsewhere. I wanted to say a few words about this excellent report. I commend the Chair of the Health Committee and its other members for producing a very well-balanced report that does not appear to be partisan in any way but does point to some of the problems that still exist in our child and adolescent mental health services, and to some of the possible solutions, if any future Government were to adopt its recommendations. The other impressive thing about the report is that it does not apportion blame. It merely observes that there are challenges, without attributing blame on a partisan basis or to a particular group or individual. It can often be hard to implement the recommendations in these reports if it is felt that a finger is pointed at a particular body.

Clearly, mental health challenges are widespread. As other Members have observed, they generally start when people are younger; it is unusual for a mental health challenge suddenly to appear out of the blue. That is why this report and looking at early intervention is very important if we want to tackle mental health services for citizens and mental health outcomes for our constituents. The mental health unit at Heatherwood hospital in my constituency has been transferred to Reading. It strikes me that that is very positive in many ways, because it enables more integrated services to be provided in a larger establishment, which has more resources and is better able to deal with the people who present themselves there.

I want to focus on a couple of positives that I very much welcome among the recommendations. One is the recommendation to develop, implement and monitor minimum standards. It seems to me that that is exactly what we do in every other area of health care. When I was shadow Minister for Science and Innovation, it was precisely what the Medicines and Healthcare Products Regulatory Agency and the then National Institute for Health and Clinical Excellence intended when it came to interventions requiring medical trials and proper evidence. Minimum standards are an absolute minimum, to put it that way, if we are absolutely serious about ensuring that care is consistent and does not fall below a well defined level in services and the way in which they are provided.

It is clear that the recommendations on intervention and recognition in schools and GP surgeries are already very well known among Members. In the 10 years that I have been here, I have heard debates in which such points have been highlighted. It is good to see a recognition in print that there needs to be more awareness in schools. I thank my hon. Friend the Member for Brigg and Goole (Andrew Percy), who was a teacher for many years before he entered this place, for his words on this subject. Without the relevant guidance, it is quite tricky to distinguish between children who, just from their background or families, one thinks are just being tricky, and children who are presenting with a diagnosable and observable emotional or clinical mental health condition.

On in-patient care for people under section 136 of the Mental Health Act 1983, times have moved on. The days when the idea was that somebody in such a unit should feel that it was akin to a prison must be well behind us. I very much welcome much of the work already done in the NHS and elsewhere to make sure that although such units are secure and can protect the vulnerable young people housed in them, they are developed not just as a location in which to keep them safe, but as a place with the services—the cognitive behavioural therapy, the psychiatrists and the psychologists—required to reintegrate them into society.

Without criticising the report, I would have liked it to go a little further on online resources and the digital world. It seems to me that we often see Twitter, social media and technology as a huge danger with all sorts of negative consequences, and that we seldom see the positive applications that could be made in the online and digital world. I very much welcome the acknowledgment of the extra stresses and burdens that social media place on young people in particular. I also welcome the allusion to how, perhaps with more resources and more proactive health care providers and more proactive people with an interest in mental health conditions, technology could be made part of the answer. When somebody is being bullied on Twitter or social media, technology could be used to create a little pop-up saying, “Hey. This looks like bullying. Would you like to analyse how you’re feeling about that?”

There could be all sorts of excellent uses of digital technology to help people through a process, through a partial process of CBT or in identifying the problems they face, and online resources could be exceptionally helpful in that regard. A lot of the process is about acknowledgment and recognition and then of leading people on to the next step, but if they do not feel that fulfilling the criteria for having a mental health challenge will be an embarrassment or that stigma will be attached to them, such technology could guide and lead them to getting additional help. When the Government look at the report, perhaps they could look even further into using the online world and digital technology as part of the cure.

As a former shadow Minister, I would like to say that if we had a pill that cured 50% of people of any illness or mental health condition that they had after six weeks, we would say that it was a miracle cure. Certainly for less acute mental health conditions among adolescents, cognitive behavioural therapy is that wonder pill. We need to see more investment in, further roll-out of and quicker access to such services.