Child and Adolescent Mental Health Services

Ian Mearns Excerpts

Tuesday 3rd March 2015 Commons Chamber

[Norman Lamb]

I am conscious that I need to get through quite a lot in the time available to me.

I thank my hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) for his kind comments. He was absolutely right about the potential for online access. The hon. Member for Windsor made a similar point. There is enormous potential. One platform is called Kooth. Good evidence is developing about the impact that online access can have. Given that so many youngsters with poor mental health get no support at all, we can do a lot to increase access, not as a replacement for other services, but as a complement. He, too, talked about the importance of the role of schools.

I worked in Parliament as a junior researcher in 1980, for a Labour MP. I shared an office with the secretary of the hon. Member for Coventry North West (Mr Robinson). He is still here 35 years later. He is clearly the great survivor. He referred to the most appalling wait of 44 weeks in Coventry, which is totally unacceptable. I do not know what is going wrong in that locality, but that is not matched in many other places. There may be particular problems that need to be faced. In a way, that makes the case I have been making throughout my time as Minister that the same access and waiting time standards for physical health should exist for mental health. That is the big discrimination against mental health, and it has existed for a very long time.

[Ian Mearns (Gateshead) (Lab)]

Waiting times are so much more crucial for children and young people with mental health issues.

[Norman Lamb]

I totally agree. When I embarked on the mission to introduce waiting time standards in mental health, I was very clear throughout that they must apply equally in children’s services, as in any other service. One of the first two standards we are introducing from April this year is a two-week standard to start treatment for early intervention in psychosis, where there is a wealth of evidence that quick intervention can lead to good results.

My hon. Friend the Member for Brigg and Goole (Andrew Percy) talked about the absolute importance of youngsters learning about mental health at school. It ought to be part of the curriculum, and we would benefit a lot if that was the case. He also made the important point that although lots of areas of the country have seen really ridiculous disinvestment in mental health and children’s mental health, other enlightened areas have not done that. There is no necessity for it to happen; it depends on what the local priorities are. In his area they have done the right thing and made the necessary investment.

The hon. Member for Easington (Grahame M. Morris) talked about the horror of suicide. The husband of my hon. Friend the Member for Totnes is a psychiatrist in Devon. He has been a brilliant advocate of the case for a zero-suicide ambition. Every organisation within the NHS ought to be setting the same ambition that has been set in Devon.

The Government have prioritised improving mental health as part of our commitment to achieving parity of esteem, or, as I would prefer to call it, equality. I have been frank that the current system for supporting children and young people’s mental health is simply not good enough, but let us be clear that this is not a new problem. Previous reviews into CAMHS have identified similar issues to those that the Committee highlights, such as a lack of beds, complex commissioning and referral arrangements, poor practice around transition from children to adult services, and instances of children being treated far from home or on adult wards. These issues are deep-seated and hard to resolve. Lord Crisp was recently quoted in the Health Service Journal, when asked about parity of esteem:

“If something has developed over 40 or 50 years you don’t solve it in five minutes.”

I know a youngster who in the past decade was horribly let down by mental health services at that time. This is not something that has just emerged over the course of this Parliament. I fully recognise that too many areas of the country have disinvested in young people’s mental health. I firmly believe that the situation can and must improve. The Government have taken steps to do this.

It is worth saying that, as I have done this job, I have seen some really impressive services. There is a brilliant NHS team in Accrington providing the best possible service to young people. I visited South London and Maudsley, where there is a fantastic eating disorder service based on the quickest intervention, with specialist support for youngsters very quickly reducing massively in-patient admissions. That is the sort of service we need to see across the country. There is a brilliant in-patient facility in Colchester, where there is a great school in the mental health service so that youngsters do not lose out on their education while they are receiving support. There are some brilliant third sector organisations. MAC-UK is a wonderful organisation that takes therapy out on to the streets to support youngsters who get involved in gangs, rather than expecting youngsters in those circumstances to visit traditional services. MAP—the Mancroft Advice Project—in Norwich is a brilliant service supporting youngsters in a non-stigmatising way.

Since 2010, we have raised the profile of children and young people’s mental health to unprecedented levels. We have produced the mental health and suicide prevention strategies, set out the top 25 priorities to help to achieve parity of esteem in the “Closing the gap” document last year, and we have worked, through Time to Change, to reduce the stigma attached to mental health issues. The 2014-15 mandate to NHS England sets it a clear objective to deliver equality and parity of esteem, and in 2014 we published our five-year vision for mental health. At its heart was a radical change: an ambition to set access and waiting time standards for mental health—just as they exist for physical health—including children and young people’s mental health, for all services by 2020. That is a landmark step in rebalancing our health and care system and achieving equality.