Children’s Mental Health Week 2024

Dan Poulter Excerpts

Tuesday 30th January 2024 Westminster Hall

[Dr Allin-Khan]

I thank the hon. Member for that intervention. Yes, I wholeheartedly agree that there is definitely space for more research. Adverse childhood experiences are the single biggest driver of mental ill health in children and, later on, in adults. I will touch on that later.

I want to know today when the Government will finally get their act together to end the wait for children’s mental health services. We are sick and tired of the same old meaningless platitudes from the Government. I know the Minister: I had the pleasure of working with her in my role as a shadow Minister. I know she is decent, good and kind, and she absolutely wants the best for children. I believe that. I also understand that her hands, regardless of what she might want to do, will be tied. However, in my role as shadow Cabinet Minister for mental health over three and a half years, the number of times the Minister and her predecessors have harped on, quite frankly, about the £2.3 billion they have put into mental health services! They have used that figure no fewer than 90 times in five years for many different things, depending on the focus of the debate. Whenever we have a debate about eating disorders, the £2.3 billion comes out. Whenever we have a debate about access to IAPT—improving access to psychological therapies—the £2.3 billion comes out. Whenever we have a children’s mental health debate, it is again rolled out. I understand that, but we really need tangible answers because the waiting lists grow, children are let down and families suffer.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I commend the hon. Lady for securing a debate on this important issue. She is absolutely right to highlight the fact that we have known there are challenges in CAMHS for many years: we know there are problems with commissioning CAMHS and we know there are workforce challenges. We know there has been a failure to properly recruit mental health doctors and nurses to posts across CAMHS. Does she agree that we need to hear proper answers from the Minister today? We have known about these challenges for a long time. It is time we got on and did something about it.

May I apologise, Mr Pritchard? I should, at the beginning, have drawn the attention of the House to my entry in the Register of Members’ Financial Interests as a practising NHS psychiatrist.

[Dr Allin-Khan]

I thank the hon. Member, whom I would like to call my hon. Friend, because we have worked very closely on this issue for a number of years. He speaks not just as a politician, but as a practising NHS psychiatrist and I take my hat off to him. He speaks from a position of authority. We also sat together on a pre-legislative scrutiny Committee for a number of months, where we heard how black people and those with autism and learning disabilities are affected by current policy. We made cross-party, cross-House recommendations, but all of that has been scrapped. The Bill has not been introduced to the House and we are wondering how, with such cross-party agreement, that can be.

--- Later in debate ---

[Tim Loughton]

There is something in that, and people from better-off backgrounds may have recourse to the private sector as well, but the point is that the illness impacts on everybody, although I certainly agree that the capacity to get early help for that illness is differentiated across families.

The impact of covid should not be underestimated. During covid, we saw the impact on new parents, particularly new single parents. One of the biggest impacts was the absence of health visitors able to go across the threshold of new parents’ homes, particularly on single parents having a child for the first time. There were the other horrors of covid going on, and people were detached from the normal family networks they might have, such as grandparents coming along to share their experience and give support. On top of that, they did not have a health visitor coming to visit them physically, because about three quarters of health visitors were diverted to the frontline of dealing with covid. It was only in the most deprived cases, where there were concerns, that health visitors physically got to go and visit.

On top of that, we had a decline in the numbers of health visitors, which reversed the position that the coalition Government produced, where we had an additional 4,200; quite rightly, that was a pledge by the Government, and it was actually delivered in the lifetime of one Government. Since then, numbers have declined again. I think there is absolutely a false economy.

[Dr Poulter]

I agree entirely with what my hon. Friend said about health visitors. I think I was actually the Minister who oversaw that increase in the number of health visitors. The change to commissioning by local authorities has been a very big mistake in the provision of health visitor services. I wonder more generally—after reflecting on the link between poverty and poor mental health—whether he would also reflect on family nurses, who provide significant support to deprived families and families with challenges. That workforce also struggled to do its good work during the pandemic, which has had a consequential effect on those families and indeed the mental health of young people.

[Tim Loughton]

My hon. Friend is absolutely right. Family nurse partnerships were another great success story, for which he can take part of the credit. There are various ways of providing that support, in particular to new families, but a lot of it was not available during covid.

I have a real concern about babies born during covid. We are only starting to see the consequences. I remember well one of our own colleagues in a debate in this Chamber during covid saying that she gave birth during that time and it was five months before her own baby got to meet another baby, and the baby did not react well—“What on earth is this? Another baby?” There were no mum and toddler classes available then, and there were no support networks of grandparents and others coming in. If there were no health visitors or other professionals there as well, it was difficult to spot signs of attachment disorder or safeguarding issues within a household—and we are only starting to see the consequences now. It has compounded the issues for these children. Now at last, they are at least being diagnosed with a mental illness, but it might have been prevented earlier if all that support was there. That really needs to be on the radar of the Department of Health and Social Care and the Department for Education.

Then there is the impact of school lockdowns, which should also not be underestimated. There is a strong correlation when it comes to children, particularly younger children, not being able to go to school and socialise with their friends, or go through all the normal disciplines of what school brings. There are also safeguarding concerns that teachers and early warning exercises can pick up. We are seeing the impact of children being cooped up at home and not able to get on with the ordinary day-to-day business of growing up and being a child, and there were many safeguarding problems as a result of the schools lockdowns.

I will not apportion blame here, but it was a big mistake that the schools were closed down, and the unions forced those closures in the early days. We are seeing the consequences now. I agree with many of the solutions. Of course we need more investment. The Government have been investing, but they need to invest more, and we need more professionals to come into the system, because they do not grow on trees. It is absolutely right that awareness is needed of mental health first aiders and the mental health support available in schools—and we need more of that.

The trouble is that when somebody’s mental health problem is spotted in school, the thresholds for getting the treatment, therapy or whatever they require are so high that it takes too long, and in too many cases the condition worsens over that time. It really is a false economy. We need far quicker referrals, and without having to go through so many hoops. As the hon. Member for Tooting said, parents are waiting weeks or months on end to get a referral—in many cases, just to get the diagnosis before they can actually get the appropriate treatment.

I also have big concerns about eating disorders. The Government have put a lot of investment into increasing eating disorder specialist placements, but they are full up. I had a particularly tragic case in my constituency. The father rang every hospital in the country, including all the private hospitals because he could afford to fund treatment for his daughter, but everywhere was full. Eventually he secured a bed on, I think, Christmas eve. This was a teenage girl who was suicidal and had been through various episodes before. Eventually she got good treatment in hospital.

But there is a problem when people come out of hospital; often it is a case of falling off a precipice because the support services are no longer there. We need a much better system where people who need residential intensive support can be supported when they come out of that residential environment, which is a particularly tricky time because too often they end up having to go back into that intensive residential environment.

[Dr Poulter]

rose—

[Tim Loughton]

I will give way one more time. I have one more point to make and then I will finish.

[Dr Poulter]

I thank my hon. Friend for giving way. He is making an excellent contribution to this debate. His points about eating disorders are absolutely right. On the arrangements that are in place for discharge from in-patient units and also on preventive care such as community services for eating disorders, does he agree with me that one of the challenges is that there has been a failure to develop the workforce in that area? There are many unfilled posts in community eating disorder services. Unless we get that right, we will not address the challenges of eating disorders that he has outlined.

[Tim Loughton]

Again, my hon. Friend reinforces my point. I think we have done better on the provision of beds for that intensive care, although there are still not enough of them, but we have not done nearly enough on picking up afterwards and on preventing people from getting to that stage in the first place. The issue disproportionately affects young girls, who have all the pressures of social media. The Media Bill is being discussed in the main Chamber at the moment, and we are clamping down on sites that pretend to be there to offer support but that actually encourage vulnerable teenagers into obscene eating disorders as though they are a badge of honour. So much more needs to be done. It is so expensive—financially, as well as socially—when we do not act at the appropriate time.

My final point comes back to early intervention and prevention. The Best Start for Life project, pioneered by my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), really is a game changer. It has had the buy-in of all the political parties. I was a part of the various advisory research groups that we had in this place working with Members across the Floor, and we now have the roll-out of family hubs. This is all about supporting families, particularly mums, but not exclusively mums because fathers have a role; too often they are neglected and yet they are a part of the support mechanism. There are mental illness problems affecting new fathers, which are quite severe, as well as the perinatal mental illness around women. We need to do much more to make sure we have happy mothers and that we attack domestic violence problems, a third of which happen during pregnancy. If we have a happy mum, we have a happy baby, who is likely to grow up well attached, happier, well balanced, and more resilient against all the pressures and problems of mental illness in society that are manifested in schools and beyond.

It is not true to say that the Government have done nothing and have not invested in this issue. We need them to do more and invest more. The Best Start for Life project is one of the most exciting and fundamentally important projects for attacking a problem right at the beginning, before it becomes a much bigger problem for children, families and society as a whole.