Children’s Wellbeing and Schools Bill

Baroness Tyler of Enfield Excerpts

Tuesday 16th September 2025 Lords Chamber

Moved by

[Baroness Tyler of Enfield]

462: After Clause 62, insert the following new Clause—
“Duty of school governing bodies regarding mental health provision(1) Subject to subsection (3), the governing body of a maintained or academy school in England has a duty to make arrangements for provision in the school of a dedicated education mental health practitioner.(2) In subsection (1) “education mental health practitioner” means a person with a graduate-level or postgraduate-level qualification of that name earned through a course commissioned by NHS England.(3) Where a school has 100 or fewer pupils, the duty under subsection (1) may be satisfied through collaborative provision between several schools.(4) The Secretary of State must provide, or make arrangements for the provision of, appropriate financial and other support to school governing bodies for the purposes of facilitating the fulfilling of the duty in subsection (1).”Member’s explanatory statement
This amendment requires the governing body of a maintained or academy school in England to make arrangements for provision in the school of a dedicated education mental health practitioner.

[Baroness Tyler of Enfield (LD)]

My Lords, Amendment 462 is in my name. I thank my noble friend Lord Storey and the noble Baroness, Lady Finlay, for adding their names.

This is a very important group. It is about the mental health and well-being of children, something that is, or indeed should be, central to the Bill. It is the name on the tin. My amendment would ensure a dedicated mental health practitioner in all schools qualified to a level—and this is the critical point—that they can deal safely with the problems that are more complex than those currently dealt with by early-intervention CBT—cognitive behavioural therapy—support, which is currently delivered by existing mental health support teams.

To be clear, I welcome and applaud the Government’s commitment in the spending review to expanding mental health support teams to all schools and colleges in England. These teams work with children, parents and wider school staff to promote good mental health and, funded through the health system, provide effective prevention and early-intervention support for children with a range of mild to moderate mental health needs, including things such as low mood and anxiety. They are doing important work.

These teams are staffed by education mental health practitioners. The terminology can be a bit confusing here, but it is a relatively new role within the children and young people’s mental health workforce system. As these mental health support teams expand, these practitioners in training are recruited for a work-based placement, while they complete a diploma or postgraduate qualification over a period of one academic year. During this time, practitioners are trained to deliver low-intensity cognitive behavioural therapy to children or, in some cases, to parents, to allow them to directly support their children.

While this approach has been effective for children with lower-level needs, CBT is not appropriate for all. Evidence has shown that some groups of children are less likely to benefit from these interventions; this includes those with special educational needs, younger children, and children experiencing moderate to more complex mental health needs.

The problem is—and this is specifically what my amendment is designed to address—that these children with more complex needs still do not meet the very high threshold for child and adolescent mental health services, because their needs are deemed to be not severe enough. In short, they are currently falling through a gap in support, and it is often referred to as the “missing middle”.

In the last 12 months, CAMHS has closed 28% of referrals without offering any support. This results in mental health support teams in schools often being asked to hold cases that they are not trained to work with safely, leaving children at risk. These children include those who are at risk of or have indeed self-harmed, those who have experienced trauma, bereavement or loss, and those who have thoughts of suicide. These things are real; these children are not making those things up. These children are often clearly visible to the professionals within schools and the health service through repeat presentation at health services. Often, they are struggling, not attending school or unable to engage with learning.

It is worth noting that respected voluntary sector providers, such as Barnardo’s and Place2Be, have recommended that, as part of the Government’s rollout of mental health support teams,

“the model is expanded to include provision of funded … school-based counselling”.

They say it would fill this missing middle

“to ensure that all children in mental distress can access timely support”.

A dedicated mental health professional qualified at the right level, such as a school-based counsellor, would normally hold a degree in counselling or psychotherapy. That would improve outcomes for children whose needs are not currently being met and—this is critical—should help to reduce pressure on CAMHS in a cost-effective way. These professionals are trained to deliver a range of different therapeutic skills and approaches that allow them to understand the unique needs of each child. One size does not fit all; I am sure we can all agree on that.

Evidence from other UK nations demonstrates how embedding school counsellors can indeed reduce pressure on CAMHS. In Wales, where school counselling services are statutorily funded, only 1.7% of those accessing counselling need to be referred on to specialist CAMHS. Existing mental health support team staff and school-based counsellors have different routes of training, different qualifications and different skill sets. They each fill a different mental health need and working together could offer more support to more children than is currently the case.

In conclusion, my amendment proposes that the skill mix of the mental health support team workforce should be expanded to ensure that all children have access to an appropriately qualified mental health practitioner as part of the rollout. I very much look forward to hearing the Minister’s response on this.

Finally, I want to express my strong support for Amendment 472 in the name of the noble Lord, Lord O’Donnell, to which my name is also attached, and to Amendment 479 in the name of the noble Lord, Lord Watson. I will make a just a few very quick points on Amendment 472. This is a Bill about children’s well-being but, frankly, with very few direct references to the broader issue of well-being and, certainly, without any provisions for measuring well-being. This amendment would provide for a single, optional online well-being survey, delivered annually in schools and with centralised support made available to schools that wished to take up the option.

That is a modest but important ask. School data from the surveys would not be published or used to penalise schools in any way, or be part of the formal accountability systems. In case of any misunderstanding, this would not be a stick with which to beat schools. The survey would be optional. Schools would not be mandated to participate. It would be up to them, as indeed it would be for parents, carers and pupils, to opt out should they choose. However, we know from a recent YouGov poll that 75% of parents agree that, to improve young people’s well-being, we need to measure it. Critically, the data collected would allow the whole system to respond, including children’s services, education, health and the voluntary sector, at both national and local level.

I end by pointing out what I think we all know: happy and healthy children are most likely to be present at school, to engage in learning and to achieve to their full potential. Surely that is what we all want. We have a real chance here to progress that aim. I beg to move.

[Lord O'Donnell (CB)]

My Lords, I will speak on behalf of Amendment 472, which is in my name and that of the noble Baroness, Lady Tyler, who has spoken very well, and the noble Lords, Lord Layard and Lord Moynihan. This is a modest proposal, but it is probably the most important one. I have sat through all the hours of this debate and I would say to all noble Lords who have spoken that, if this does not go through, they will not succeed.

The reason I say that is that I have not spent over two decades in the Treasury without knowing that you need evidence: you need to prove what works. Your Lordships have talked various things. The noble Baroness, Lady Spielman, mentioned various interventions and wanting to know whether the costs and benefits were worthwhile; that is absolutely right. She mentioned NICE. The key thing about NICE is that it works out whether a given medicine is worthwhile by doing a cost-benefit analysis based on QALYs—quality adjusted life years. We now have more sophisticated measures known as WELLBYs—well-being years.

To understand whether a thing makes sense, we need to do the assessment and for that we need data. Your Lordships have all made suggestions: we want more physical exercise; we want less bullying; and we want to think about what things in SEND work. As the noble Lord, Lord Lucas, said, we need some common definitions. We need a common definition of well-being that we can use; the department can give us that. Then we can work on the basis of exactly how important and how effective all these things are.

If we think about how this debate started, we all talked about our favourite brand of school: free schools, academies, you name it. How do we assess which one is better? Well, either implicitly or, in some cases, very explicitly, it was a matter of exam results or Ofsted rankings. Nobody talked about these schools’ impact on well-being, for the very good reason that we do not know. We do not have data. The only data we have is the world’s most embarrassing data of all, which nobody has mentioned yet: the PISA data. The PISA data shows us that, out of all of Europe, our young people have the lowest well-being. Of the 38 countries in the OECD, where do we come? In 37th place. My favourite football team, Manchester United, is not even that bad in the league.

--- Later in debate ---

I hope that, after this wide-ranging debate and with that response, noble Lords will feel able to withdraw or not press their amendments.

[Baroness Tyler of Enfield (LD)]

My Lords, I thank the Minister for her response to this, as she said, wide-ranging—you could even say “interesting”, in a certain sense—debate. I simply reflect that, in terms of the tone of the debate that we have had, there was a time not so long ago—perhaps a few years ago—when, if you were talking about children’s mental health and well-being in this Chamber, there would have been a certain sort of debate. There would probably have been a general consensus about the problem and what we were trying to achieve, and there would probably have been some disagreement over the best way of getting there.

I have to say: that is no longer the case. As with so many things in this current world, this whole issue seems to have become highly polarised and contested in a way that I find pretty unhelpful, but we are where we are. We can all quote our favourite bit of evidence or research report that backs up our own worldview but, frankly, unless you are looking at these things in the round, that rarely takes you much further forward.

I was pleased to hear the noble Baroness, Lady Barran, talk about the need to look carefully at the root causes of mental health issues. That was a very helpful perspective; personally, pretending that a problem does not exist rarely helps to address it.

I do not recognise that schools have turned into some sort of industrial complex of mental health with an excess of mental health professionals. All I can say is that the schools I have visited are not like that; they tell me what an issue mental health is and how they want extra help and support. That is all I am going to say in general terms.

I will respond to a couple of the points on the amendments. On my amendment, I was moderately encouraged to hear the Minister talk about the pilots, looking at the enhanced levels of support from mental health support teams. That is exactly what I was trying to get at in my amendment about the missing middle, as I put it. It is about the skills mix. There is a legitimate question to look at there. I hope that that we can return to that point on Report because, according to the people I have talked to—practitioners on the front line—it is important.

There was such a strong consensus. Well, it was not a consensus, but many people in the Chamber could see clearly the case that was being mounted for a national well-being survey—a voluntary survey. No one would be forced to do it. None of it would form any part of the accountability system of schools, but it would be something that those schools could have and use.

Having and being able to use that data will be fundamental if we are to increase the well-being of children and young people in schools. As far as I am concerned, there is no running away from the PISA data that tells us that the UK’s young people have the lowest well-being in Europe and the second worst in the OECD. That is what PISA tells us. We need to do something about it. To do something about it, we need to be collecting that data.

I am sure we will want to think about this again, and about putting it across—the costs would be very modest indeed—in a way that will be acceptable to the Minister and to this Government. Until we have that, we will not be able to address the fundamental problem of children who have poor well-being, are unhappy with perhaps poor mental health, do not learn well, do not achieve, and do not live the fulfilling lives that we all want them to live. However, at this point, I beg leave to withdraw my amendment.

Amendment 462 withdrawn.