Mental Health Services

Baroness Tyler of Enfield Excerpts

Wednesday 25th February 2015 Lords Chamber

[Baroness Tyler of Enfield (LD)]

My Lords, in a rapidly changing world, children and young people face a wide range of risk factors for mental health problems, both now and later in life. It is salutary to note that in an average classroom, 10 children will have witnessed their parents separate, eight will have experienced physical violence, sexual abuse or neglect, and seven will have been bullied.

Those in the particularly vulnerable group, children in care, are typically in care precisely because they have experienced neglect or abuse, and these traumatic experiences can affect them for the rest of their lives. The recent Barnardo’s report, The Costs of Not Caring, showed that children in care are five times more likely to develop childhood mental health problems and, shockingly, are five times more likely to commit suicide later in life.

Despite the widespread concern about the current state of mental health services for children and young people, it is important to acknowledge what the Government have done to improve things, including investing £54 million into the children and young people’s IAPT programme and the recent announcement by the Deputy Prime Minister that £150 million will be invested over the next five years to improve treatment for eating disorders. It is welcome, of course, but nothing like enough.

We are all aware of the impact of budget cuts on CAMHS services. As a consequence, children have too often been transferred far from home or placed in adult wards that are ill equipped to take care of them. Services provided by the voluntary sector have picked up some of the slack, but there is often a lack of awareness about these services and they may be ill equipped to deal with serious mental health problems.

In reality, the help that is available can be hard to find. A 2013 YoungMinds study found that one in three young people does not know where to turn for mental health support; and, as the National Children’s Bureau pointed out, only a quarter of five to 15 year- olds with anxiety or diagnosable depression are in contact with CAMHS. By the time young people do get support it can be too late. More than 80% of parents said that children and young people were at crisis point before they managed to get support.

What is to be done? I greatly look forward to the findings and recommendations of the Government’s Children and Young People’s Mental Health and Wellbeing Taskforce. What is on my wish list? First is far more joined-up commissioning for CAMHS, with young people’s voice at the heart of service design. Secondly, counselling in schools can provide an alternative and valuable route for young people to get therapeutic help. Schools in Wales and Northern Ireland are already required to provide counselling. In my view, children in England should have the same opportunity. Can the Minister say what practical steps the Government are taking to ensure that all children have access to school counselling?

Thirdly, as already stated, children in care are not only more likely to experience mental health problems in childhood, they are also more likely to experience the sorts of problems—emotional instability, substance abuse, self-harm—that lead to worse outcomes later in life. That is why I think that CAMHS, IAPT and school counselling should explicitly prioritise the needs of children in care as part of the corporate parenting role that government plays.

When we think about children’s mental health we should think not only about the 10% who already have a diagnosable condition. Relatively minor problems in childhood often snowball and develop into fully fledged mental health disorders in adulthood. There are good examples of effective early intervention, such as specialist support to help parents develop a healthy connection with their young babies, and parenting programmes, as we have already heard.

I believe that schools should have a responsibility to prepare children not only for exams but for the difficulties they may face in later life. That is why I would like to see PSHE programmes to address issues such as bullying, drugs and alcohol, and mental health being compulsory for all primary and secondary schools.

Finally, preventive mental health support should be offered to all children in care and care leavers so that they can access the support they need to overcome past trauma and achieve stability later in life. I thank the noble Earl, Lord Listowel, for having secured this debate.