Schools (Mental Health Professionals) Bill [HL]

Earl Russell Excerpts

2nd reading
Friday 1st March 2024 Lords Chamber

[Earl Russell (LD)]

My Lords, it is a great pleasure to speak in this debate in support of my noble friend Lady Tyler’s Bill. I pay tribute to the years of work that she has done in this area.

The first line of the House of Lords Library briefing reads:

“This private member’s bill would require every school in England to have access to a mental health professional”.


My first reaction to this was: why is this not the case already? I declare my interest to the House again as a parent of a child who has gone through a past prolonged period of very poor mental health. In her case, the illness arrived like a freight train on the level crossing of her life. I am pleased that she is better now, and I am aware and, frankly, feel profoundly guilty that perhaps the only reason that she is better is because we, as parents, were able to find and financially afford the means to pay many tens of thousands of pounds for a prolonged period of private residential care.

I am all too aware that many other children are also suffering, often in silence. Too many children are struggling right now to keep themselves safe and well. Equally, too many parents and carers are not getting the help and support that their children need. Poor mental health is a trauma that affects and impacts whole families. I speak only as a parent and, I hope, as a voice for other parents who are going through similar situations and are struggling to find access to the support and care that they need.

I want these children and young people who are suffering to understand that we, as politicians, get them, and that we are here to work together to try to make their lives better. I shall probe and pressure, but my voice is intended to be a constructive and helpful one. I know that Ministers in this place and across government are not only aware of this issue but are working on it and have already provided significant resources to meet these needs.

I will run through some of the arguments again here very briefly, as I have made them before. We face what I call a children and young people’s mental health emergency. There is an unprecedented crisis in children and young people’s mental health. As we have heard, one in five young people now has a probable mental health condition, up from one in nine in 2017. The causes are many and complex, but the headlines are clear, and they are that our young people are suffering. The demand for services is at an all-time high: nearly half a million young people require help, and 2023 saw the highest number of emergency referrals ever. Despite this, many children—perhaps two-thirds—do not have any contact with the NHS.

CAMHSs suffer from chronic underfunding. The average wait time is 21 weeks for a first appointment, and 80% of CAMHSs say they are not able to meet the demand. Many young people are effectively denied treatment, even after episodes of self-harm and attempted suicide. I have called on the Government to accelerate the rollout of mental health support hubs to all schools and colleges nationwide. I ask the Government to commit to bringing forward their target of 50% access by 2024-25 and making it 100%. While I recognise that resources have already been delivered, I hope that the Budget next Wednesday brings some extra much-needed money to this important issue.

The Bill, put simply, is about plugging a service-level gap, the physical health equivalent of which would be only doing blood pressure checks and urgent cancer operations but not providing any other healthcare in between. The rollout of mental health support hubs is welcome and vital, but their intended purpose is for lower-level issues, such as mild depression and low self-esteem. Treating these issues before they worsen is essential. At the same time, many children with already moderate to severe needs are either waiting far too long for access to CAMHS treatment or are being denied any treatment at all.

This is exactly where the Bill comes in, to plug this real and considerable service-level gap in the system. Frankly, it is a very innovative and clever proposal, and I ask the Government to give some serious consideration to it. Even with the rollout of mental health support hubs, it has been estimated that some 6 million children with moderate-to-severe needs will remain in this treatment no man’s land. The Bill will cover what is known as the missing middle—those children with moderate to more complex needs, such as those experiencing trauma, abuse, self-harm, and suicidal ideation. These matters require help to be provided by therapists and councillors with a higher degree of training.

Filling this missing middle under a whole-school approach, in combination with mental health support teams, begins to get us towards the united service delivery system that we need. This system will help to provide early access to treatment, to help to prevent matters escalating and to help to keep children in school, where they need to be. This would also help to relieve the pressure on CAMHSs and help them to specialise as well in the most urgent and challenging cases of all—providing the more immediate treatment that is so desperately required. The number of briefings provided to Members on these issues shows the level of interest in the wider professional community, where these measures carry support.

Finally, while I am aware that there is extra cost associated with these measures, this comes against a background of chronic underfunding in these areas. Only 8% of mental health services spending was allocated to children and young people’s mental health in 2021-22, despite children and young people’s referrals accounting for 18% of the overall NHS mental health demand.