Mental Health: Children and Young People

Baroness Chisholm of Owlpen Excerpts

Wednesday 30th January 2019 Lords Chamber

[Baroness Chisholm of Owlpen (Con)]

My Lords, I thank the noble Baroness, Lady Tyler, for initiating this debate because it is such an important issue, as there seems to be an epidemic of mental health problems among young people. It is impossible to read or watch the media without seeing and hearing of mental health issues among this group. There are many reasons for the increase, including poverty, neglect, stress, bullying, poor physical health, social media and trauma.

Most children attend primary care. Children in the UK see their GP probably on average once a year, usually even more often. GPs have an understanding of the context of the issues of the families on their books and they are in a strong position to discover childhood mental health problems, but there are barriers which more often than not make this a difficult process. Parents may not realise that their child has a problem. Their attendance to see the GP may be for a physical health reason and, as an appointment usually lasts for only nine minutes, it is clearly difficult for the primary care specialist to get a clear picture in that time. GP recognition is the key step in assessing specialist services. Indeed, GPs are the main referrers to specialist services and failure to detect disorders may delay effective interventions. Parental perceptions of problems play an important role. Their awareness of a possible mental health issue is then relayed to the GP, which is a great advantage, and we know that GPs’ recognition of a mental health problem increases when parents express concern. There is a need for an awareness campaign for parents on the signs of possible mental health issues, along with increased training for healthcare professionals.

The majority of mental health issues start in childhood so early identification has not only a financial benefit but, much more importantly, the quality of life for the sufferer is substantially increased. Once an issue has been picked up there are gaps between mental health and childcare services creating a barrier for effective help for both children and parents. Services are patchy, with no access to psychiatrists and long waiting lists for CBT and counselling. There is a need for a community psychiatric nurse and a social worker in every practice along with an accessible community psychiatrist. There is a requirement for a joined-up approach between the department of health and the Department for Education, where career guidance at schools and colleges can be given to encourage students to go into these professions. Specialist training for GPs to identify problems, along with an expansion of primary care-based mental health services, would clearly relieve the pressure on GPs.

I can only touch on social media, but the Secretary of State issued an urgent warning on the potential dangers. They cannot be blamed for all mental health problems, but the platforms have a responsibility to sort themselves out along with an awareness campaign for parents on the dangers, signs of problems and safe use. Technology can be a force for good but how many more young people must be harmed or die before we get a grip on the problem?

I welcome the Government’s plans for new mental health support teams over the next five years working in schools and colleges, bringing early intervention opportunities along with better information and data sharing. I also welcome the fact that spending on children and young people’s mental health must increase as a percentage of CCGs’ overall mental health spend.

As mental health teams are rolled out, we need co-ordination with the child health workforce to avoid replication of the existing fragmentation, along with an increased frequency of data capture and improved transitions from children’s services to those for young adults. In the end it comes down to more highly trained professionals on the ground, joined-up thinking with the Treasury, the department of health and the Department for Education, leading to more students training in the required professions. That in turn requires financial backing to make sure that training places are available in all areas of the country. I have run out of time.