Mental Health Education in Schools Debate

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Department: Department for Education

Mental Health Education in Schools

Chris Ruane Excerpts
Monday 6th November 2017

(3 years, 11 months ago)

Westminster Hall

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Department for Education
Catherine McKinnell Portrait Catherine McKinnell (Newcastle upon Tyne North) (Lab)
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6 Nov 2017, 4:31 p.m.

I beg to move,

That this House has considered e-petition 176555 relating to mental health education in schools.

It is a pleasure to serve under your chairmanship, Mr Brady, and to lead this debate on behalf of the Petitions Committee, given the importance of this issue for society as a whole and because of the frequency with which young people raise it with me whenever I visit local schools and youth organisations in Newcastle upon Tyne North. The e-petition, entitled “Make mental health education compulsory in primary and secondary schools”, has been signed by more than 103,000 people. It reads:

“Mental health education is still not part of the UK curriculum despite consistently high rates of child and adolescent mental health issues. By educating young people about mental health in schools, we can increase awareness and hope to encourage open and honest discussion among young people.”

I am pleased that many hon. Members are present today. That reflects the importance and timeliness of the debate. Many other hon. Members would like to be here but are unable to attend, and I am happy to put their concerns on the record. My hon. Friend the Member for Gedling (Vernon Coaker) asked me to convey his constituents’ concerns, even though he is unable to be here himself.

I congratulate the e-petition’s creators—Tom King, a student mental health nurse, and Adam Shaw, the chairman of the Shaw Mind Foundation—on securing more than 100,000 signatures in the three months before the e-petition was closed just before the unexpected general election. Adam Shaw launched the e-petition as part of his charity’s wider HeaducationUK campaign. He explained why he established it:

“Currently mental health is only taught as an optional component of PSHE—but this is not good enough. It needs to be compulsory. Understanding mental health is an absolute life skill, and should be just as fundamental within the school curriculum as reading and writing. There needs to be a compulsory collaboration and integration between mental health education and physical education, so that children and young people can understand that maintaining good mental health is equally vital to their wellbeing.”

The HeaducationUK website states:

“The UK national curriculum puts a lot of emphasis on teaching our children about how our bodies work, physical illnesses, and how exercise and nutrition can keep us healthy. These are taught in mandatory subjects such as PE (physical education) and biology…Currently, mental health education is taught inconsistently in the UK, and only in secondary schools—despite 1 in 5 children experiencing a mental health difficulty before the age of 11.”

Chris Ruane Portrait Chris Ruane (Vale of Clwyd) (Lab)
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6 Nov 2017, 4:33 p.m.

Will my hon. Friend pay tribute to the mindfulness pioneers in the UK who developed the .b curriculum for secondary schools and Paws b for seven to 11-year-olds, which was developed at Bangor University? Bangor is already working on a curriculum for three to seven-year-olds. Most importantly, will she commend the work of Oxford University’s mindfulness centre and the Mindfulness and Resilience in Adolescence—MYRIAD—project, which hope to prove scientifically the benefits of mindfulness for young people aged 11 to 18?

Catherine McKinnell Portrait Catherine McKinnell
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6 Nov 2017, 4:34 p.m.

I am more than happy to join my hon. Friend in congratulating those organisations. He has campaigned hard on that issue in this place for many years.

HeaducationUK continues:

“Mental health education is delivered via the non-compulsory subject PSHE (Personal, Social, Health and Economic), or sometimes during school assembly or drama lessons. As PSHE is a non-compulsory subject, this means that not all schools teach it, and that in turn means that mental health education isn’t always taught.”

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Catherine McKinnell Portrait Catherine McKinnell
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6 Nov 2017, 4:41 p.m.

Absolutely. The hon. Lady is right that the Select Committees on Health and on Education undertook a joint inquiry and report into these very issues because, crucially, health and education are intertwined when we look at mental health and physical wellbeing. The outcome of that inquiry was that I was very keen to lead in this debate, because I share her view that it is crucial to improve outcomes for children in care as well as for all our children and young people.

The statistics are startling. HeaducationUK highlights some of them: 850,000 UK children and young people aged five to 16 have mental health problems, which equates to around three in every classroom; more than 75% of mental illnesses in adult life begin before the age of 18; the number of young people attending accident and emergency with a psychiatric condition has risen by 106% since 2009; reports of self-harming among girls aged 13 to 16 rose by 68% between 2011 and 2014; and suicide is the biggest killer of young people aged under 35, with an average of 126 suicides a week and more than 200 children of school age dying by suicide each year.

Chris Ruane Portrait Chris Ruane
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6 Nov 2017, 4:43 p.m.

Is my hon. Friend aware that 32.3% of 15 to 25-year-olds have one or more psychiatric conditions? The wider point about all those terrible statistics is that even people who are not adversely affected by mental ill health can be taught in school through modern positive psychology and mindfulness to lead flourishing lives. The whole wellbeing curve of mental health could be shifted if we took that root-and-branch approach to putting mental education into our schools.

Catherine McKinnell Portrait Catherine McKinnell
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6 Nov 2017, 4:43 p.m.

My hon. Friend makes a powerful point. It is about not just shifting the life experience of an individual, but the knock-on effect of shifting the life experience of everyone around the individual and the whole community. We know that the lack of support and mental health education affects not only individual young people, perhaps for the rest of their life, but those around them. The potential returns from investing in our young people in that way are significant.

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Catherine McKinnell Portrait Catherine McKinnell
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6 Nov 2017, 4:51 p.m.

I am delighted that hon. Members on all sides of this debate are making my case for me. I just hope that the Minister is genuinely listening and taking that on board, so that change and something positive can come from putting on record the cross-party agreement on the need to do something for our young people on this issue.

Chris Ruane Portrait Chris Ruane
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6 Nov 2017, 4:52 p.m.

The figure that I mentioned of 32.2% of 15 to 25 year-olds will include trainee teachers. After they finish their training, 40% of teachers do not continue in education after the first year, largely because of stress, so does my hon. Friend agree that perhaps one way to square the circle would be to train those 18 to 21-year-old potential teachers in ways of getting their own equilibrium, which might be a gift that they can pass on to tens of thousands of children over the course of their career?

Catherine McKinnell Portrait Catherine McKinnell
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6 Nov 2017, 4:53 p.m.

My hon. Friend makes a key point. It is not just children and young people who face mental health difficulties as a result of the stressed environment in our education system, but the teachers, too. One has a huge impact on the other. Taking a whole-school approach to the issue could transform the lives of everybody in that school environment, all the families who surround it and are connected with it, and the local community.

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James Morris Portrait James Morris
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I thank my right hon. Friend for that intervention. I totally agree: clearly, it will not be possible to involve the family in all cases. I have seen examples in my constituency, particularly in the primary school environment, in which headteachers and teachers have taken really interesting and creative decisions to replicate the family environment for children who have not been brought up in a stable family environment and have not entered primary school in a properly socialised way. They have replicated the family environment and tried to create those kinds of structures because they have been absent, so I completely agree with my right hon. Friend on that.

Other hon. Members have talked about CAMHS and I want to make a few comments about early intervention. If you look at the spectrum of what we are talking about, it could be argued that by the time children get to school any mental distress and difficulties they suffer from will have been baked in for many years. There has been a debate about early intervention and mental health for years; it is what I would call a policy no-brainer. Everybody agrees we should intervene earlier. Everybody agrees that in principle that is a good thing. Yet we are still debating about whether we are doing it sufficiently well and how it should be done. The truth is that we should shift resources to where the evidence points us.

The evidence points to the joint Green Paper on children’s health and education, and adolescent mental health, which other hon. Members have mentioned. The evidence suggests that interventions at an early age, sometimes pre-primary school, are the most effective interventions that we can make on a therapeutic level. From the evidence, it looks like working with children from birth to the age of two, working with families, and working with parents is the most effective intervention we can possibly make. I urge the Minister to be bold in terms of what we will do in that Green Paper. If we can do only one or two things from that Green Paper, we should focus on the really important one, which is shifting resources to genuinely effective early intervention based on evidence. Everything else we have talked about, such as mental health first aid and so on, has a role to play in this debate, but it will not solve the problem we are trying to confront. We will solve this problem by focusing a lot more resources in a laser-like way on early intervention—even before school. That is the critical part of this debate. The one bold move for the Government would be to focus their attention on that. Then we might be able to make significant progress.

Other hon. Members have mentioned CAMHS. If we were designing a child and adolescent mental health service today, we would not design it in the way it currently operates. We have had several reviews of CAMHS over the last decade. Other hon. Members have mentioned Future in Mind, the CQC has just done its review and there have been other reviews. We know that CAMHS is currently not fit for purpose. That is not to say that people working in CAMHS are not doing an excellent job in delivering the services they do, but we need a more integrated service. We need to move away from the tiering approach, which means we concentrate on tier four—that is children with the most severe mental illness. If we can get rid of this metaphor of tiering and focus on access to the appropriate level of care required by a child or young person in a place appropriate to them and deal with it across the spectrum, and integrate it with initiatives that are being taken in schools and the initiatives I have been talking about in relation to early intervention, we can make significant progress.

We have come a long way. People use the word “crisis,” which I am always very wary of using. It is not as if this crisis started today. The debate about children and young people’s mental health has been going on since about 1962 when Enoch Powell, then the Public Health Minister, made the decision that we would no longer put people in asylums but would move towards a community model. That was in 1961 or 1962. We are only now beginning to have a real debate about how we really tackle some of the underlying issues that we face in society in terms of the mental health of children and young people. We are much better at talking about it, but the debate actually is only just beginning and the Government have an opportunity to take some really bold steps, which would have a lasting legacy.

Chris Ruane Portrait Chris Ruane (Vale of Clwyd) (Lab)
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6 Nov 2017, 6:15 p.m.

I apologise, Mr Wilson, for dipping out for an hour. I had to meet Carwyn Jones, First Minister of Wales, at a Welsh group meeting, but I was here for the first 30 minutes and I did intervene on many occasions on my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell).

The World Health Organisation says that by 2030 the biggest health burden on the whole of the planet will not be heart disease or cancer; it will be depression. The term “burden” is not a pejorative but a descriptive term for the burden on the individual, their family, society and the economy. This tsunami of mental ill health is coming our way, and I believe that we are ill-prepared for it—ill-prepared for how we treat our adults and especially our children and young people.

In the 19th century, Frederick Douglass said:

“It is easier to build strong children than to repair broken men”—

he definitely should have said, “and women.” That is the situation today. If we can build strong children and give them that resilience, it benefits the individual child and their family, and the knock-on effects of building in that resilience from an early age will benefit our economy and health service down the decades.

I am speaking today about mindfulness. I am co-chair of the all-party parliamentary group on mindfulness— I draw hon. Members’ attention to my declaration of interest. I gave the statistic in an intervention earlier that 32.3% of 15 to 25-year-olds experience one or more psychiatric conditions. That is while they are studying for their GCSEs, A-levels, degrees or post-graduate degrees. They are studying and living sub-optimally, and their suffering is magnified because we have not put the strategies in place to help those young people to cope with the modern stresses of society. Our Ministers and health service say that oral hygiene is very important, and we must brush our teeth three times a day; that nutritional health is very important, and we must have our five fruit and veg a day; and that physical activity is very important to keep our bodies healthy. But how much time is allocated to looking after our own minds, our own brains and how we actually view the world?

There are many stresses out there affecting young people. There are the stresses of advertising. Young people have Maccy D’s telling them to “Go large,” and the fashion industry saying “No, no—size zero.” The average child will see 120,000 adverts a year and the messages are well researched and well honed, especially in a digital age, when every time a young person goes on a computer an algorithm calculates what is going on inside their head and sends micro-messages to them. The point of adverting is to make people unhappy with what they have, so that they will purchase something else.

The impact of social media has already been mentioned by many speakers. When I went to school in the 1960s, if I had a fall-out, it was with five or six people. Now it could be 5,000 or 6,000 people. Being tested at school— at the ages of five, seven, 11, 14, 15, 16, 17, 18 and 21—produces massive stresses on young people. We are not equipping them with the capability to deal with those stresses; in fact we are adding to those stresses. There are many other factors that are bringing stress to our children and young people today.

We as politicians should be doing something about that, and I am pleased that this is an area we can agree on. I pay tribute to the former Prime Minister David Cameron for measuring wellbeing and saying—he was quoting Robert Kennedy—that GDP and wealth are not enough; we must look at the wider benefits to society and what makes us click as a society and as individuals within that society. I pay tribute to the Prime Minister for declaring in January that mental health, and children’s mental health, will be right at the top of her priorities. Our own shadow Chancellor, my right hon. Friend the Member for Hayes and Harlington (John McDonnell), quoted Robert Kennedy at the Labour conference in saying that the wellbeing of society is important. This is an area where we can, and should, come together.

I want to stress the impact that I believe mindfulness can have. Mindfulness has been freely available on the national health service since 2004. Some people might think that it is a bit woolly, but the copper-bottomed science has been proven to the National Institute for Health and Care Excellence by Professor Mark Williams, John Teasdale and Zindel Segal from Canada. Mindfulness has been available, but the take-up is minimal. The science has been proven for this intervention, which puts the individual in control and is cheaper in the long term than antidepressants or talking therapies, yet the take-up has been minimal. Again, I pay tribute to the Government, because they have promised to train an extra 200 or 300 mindfulness-based teachers over the next two years, and that is progress. We have been teaching mindfulness to MPs, peers, their staff and civil servants in Westminster.

Lucy Allan Portrait Lucy Allan
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6 Nov 2017, 6:21 p.m.

The hon. Gentleman is making a very interesting point about the benefits of mindfulness. I have had the great pleasure of participating in the MPs’ mindfulness training, and have to say that it is quite a challenge to get MPs to turn off their phones and concentrate. Does he agree that we need to encourage more people to understand the benefits of mindfulness and to participate in it?

Chris Ruane Portrait Chris Ruane
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6 Nov 2017, 6:22 p.m.

Absolutely. Ghandi said, “Be the change you want to see.” We are change-makers in this room, and we need to make our personal, political and parliamentary decisions from a position of personal equanimity and balance. If we do that, we will be doing tribute to ourselves and our society. Some 150 MPs and Lords have had the training, and we instituted a parliamentary inquiry on mindfulness in health, education, criminal justice and the workplace. We have put forward recommendations.

Wera Hobhouse Portrait Wera Hobhouse
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6 Nov 2017, 6:23 p.m.

I appreciate the benefits of a healthy mind, a strong child and preparing children and young people for the challenges in life, but does the hon. Gentleman see that even though someone might have been brought up in a happy, healthy family, mental health issues can hit them at any point? There is not prevention for mental health in the same way as for other things, because we never know what will happen or come round the corner. We need to monitor mental health throughout the years, again and again and again.

Chris Ruane Portrait Chris Ruane
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6 Nov 2017, 6:28 p.m.

I absolutely agree with the hon. Lady. That is what is happening in mindfulness research. Bangor University is looking at mindfulness for the baby in the womb. The biggest cause of low birth weight babies is maternal stress—either directly or through legal and illegal drugs, tobacco or alcohol—and it is working on a curriculum for babies in the womb. Bangor University is looking at a mindfulness curriculum for three to seven-year-olds; it already has one for seven to 11-year-olds. The .b course has been devised for 11 to 18-year-olds by top mindfulness experts who actually teach in the Palace of Westminster. There is another £7 million study into the effects of mindfulness on 11 to 18-year-olds at Oxford University called the MYRIAD project. Hopefully, the interim report will be published around 2020. If that scientific evidence is proven, as decision makers and policy makers we should look carefully at it. If we can get on top and provide that resilience to children and young people from the age of three, we should be implementing that.

I want to draw hon. Members’ attention to what we are doing in mindfulness to help us in our initiative to ensure that the proven science of mindfulness is taken up in the national health service, the education service and the criminal justice service. Some 85% of prisoners have one or more mental health issues, and some people are incarcerated from a very young age. Again, we owe it to them to look after them and to give them the best provision available.

I mentioned this in an earlier intervention, but the bell curve of wellbeing includes people who are well below that curve, the majority who are somewhere above that position of mental ill health, and a few who are flourishing. If we can shift the whole of that wellbeing curve along, the biggest beneficiaries will be those with the poorest mental health, but it will also help everybody on the curve. Mindfulness can be used not just to give people back their equanimity, but for human flourishing. This question has been posed for thousands of years, but something seems to have gone wrong in society over the past 30 years. We have had a tsunami of mental ill health washing over the whole of the world, and especially the western world. We give more credence to the pursuit of money and wealth than to individual, family, societal and community wellbeing. It is time that we took stock and asked ourselves what is important in life. The most important thing for me is to think from a position of balance. There are curricula and courses that can be taught to young people, and we are failing if we do not put those provisions in place.

Again, as I said in an earlier intervention, there is a way that we can help those students who go to university at 18 to become teachers in three or four years’ time, or who go at 18 to be medics or doctors and come out at 25 to be GPs. Many of those young people are in stress themselves—“Physician, heal thyself”. If those young students can be given the skills to get their own personal balance, when they go through their career as a GP, nurse, midwife, teacher or lecturer, they will remember the benefits that they have had—the equanimity and the ability to concentrate, to focus, to improve their grades and to improve their way of living—and they will be able to touch thousands of minds over the course of their medical or educational career. It is a huge problem that is out there, and some of the answers could be quite simple.

Phil Wilson Portrait Phil Wilson (in the Chair)
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Before we move on to the Front Benchers, the mover of the motion has indicated that she would like two or three minutes, if we get that far, at the end to wind up.