Child and Adolescent Mental Health Services

Jim Cunningham Excerpts

Tuesday 3rd March 2015 Commons Chamber

[Paul Blomfield (Sheffield Central) (Lab)]

It is a pleasure to follow the hon. Member for Totnes (Dr Wollaston), whose very thoughtful and incisive speech drew on both her own rich experience and the Select Committee’s excellent report.

In the September recess each year, I organise a series of consultation meetings across my constituency. The one I enjoy most is that with young people. It is organised with a range of youth groups, such as Members of the Youth Parliament, and brings together a good number of young people aged from 18 to their early 20s. It is really sparky and lively, and they pull no punches in raising issues. When I ask them what are the top priorities that I, as their Member of Parliament, ought to take up on their behalf, it has been very striking just how high mental provision has come in the past couple of years. That would not have been the case when I was young.

The fact that young people themselves put such a high priority on mental health as an issue should send us a very clear warning signal. That does not only apply in Sheffield. Following ballots of tens of thousands of young people across the country, the Youth Parliament has made mental health one of its two priority campaigns this year. If it is so important for young people and they are pressing us on the issue, we should be deeply concerned.

In advance of today’s debate, I have been in contact with three of the groups I work with in Sheffield: CHILYPEP —the Children and Young People’s Empowerment Project; Young Healthwatch; and STAMP—Support, Think, Act, Motivate, Participate—which is a group of 14 to 25-year-olds who have come together with the specific objective of improving mental health support for other young people. They are concerned about the current state of provision, or what they would describe as the lack of provision, and they fear for the future and the impact of cuts on an already desperately inadequate service.

The groups have identified three key problems. The first is that reductions in funding are taking place at a time of increasing need. The second, which very much echoes the points made by the hon. Lady and the report, is about the lack of early intervention. The STAMP young people’s manifesto states:

“Act now, tomorrow could be too late!”

That indicates the severity of what we are talking about. The third is that young people are abandoned at 16.

[Mr Jim Cunningham (Coventry South) (Lab)]

On the issue of resources, budget cuts have been inflicted on local authorities, such as Coventry. Some of them have had to find about £3 million or £4 million, which is an extra burden. The Government hope that local authorities can somehow resolve that situation, and then they wonder why they have problems with young people.

[Paul Blomfield]

My hon. Friend makes a very important point. Such a matter is close to my heart in Sheffield, where funding from central Government will halve over the lifetime of this Parliament. That is putting an enormous strain on all the related services and support for young people that can play a broader role in alleviating some of the difficulties. In Sheffield, we are very conscious that our position is in sharp contrast to that in wealthier parts of the country.

The first point is about cuts at a time of increasing need. We know that budget cuts to front-line services are difficult and can be devastating at any time, but cuts to child and adolescent mental health services are being made at a time of increasing need. From 2011-12 to 2013-14, Sheffield CAMHS saw a 36% increase in referrals, and a 57% increase in initial appointments. If we are serious about reducing stigma, talking openly about mental health problems—we have made enormous advances in doing that—and having parity of esteem, we should welcome those referrals. However, that demand comes against the background of what has effectively been a 4% budget cut, disguised as a requirement to drive efficiency savings. That has had severe consequences for the level of support that young people are receiving. There has been a stark increase in waiting times.

--- Later in debate ---

[Mr Geoffrey Robinson (Coventry North West) (Lab)]

I am grateful to be called to speak in this debate after the hon. and learned Member for North East Hertfordshire (Sir Oliver Heald), who has ministerial experience in this sphere. I do not, but I have some experience in other spheres of finding money for it and I know how difficult that can be. I therefore congratulate the hon. Member for Totnes (Dr Wollaston), Chair of the Select Committee, on her report. We in Coventry find it very timely, and we look forward in due course to the Minister’s taskforce and its report, leading, we hope, to what the hon. Lady very precisely referred to in terms of improvements to services—better services for children and adults on the ground, which is where it matters. She also said she found having to grapple with out-of-date figures—it is rather surprising that we should have them—frustrating. I therefore thought I would take part in the debate in order to bring up one or two up-to-date figures on a particular aspect of young persons’ and adolescents’ mental health that is becoming more and more prevalent, and disconcertingly and alarmingly so in Coventry: self-harm.

We have seen a terrible and frightening increase in self-harm over the past five years. The first figures we had were back in 2010 and the figures for 2014 have just come out. They show an alarming increase from 50 referrals in 2010 to over 300 in 2014. That is a terrifying rate of increase. It has been going pretty steadily at over 20% year in, year out, and, as my hon. Friend the Member for Stoke-on-Trent South (Robert Flello) pointed out so tellingly, it points to the impact deprivation and poverty can have on children, as there is a fairly well-established causal link between pockets and areas of deprivation and poverty and the tendency among adolescents to self-harm and referrals.

Those referrals come on top of what we already know is a crisis in A and E. They are only exacerbating that, and leading to youngsters with terrible mental health problems being turned away—doors closed in their face. It is a situation that in Coventry has led to a clear and recognisable crisis, and to an emergency meeting of the scrutiny board to examine exactly what the situation is, to report on it, and to see what measures can be taken to deal with it.

It is often all too easy to blame lack of resources and the Government, but, as the Chair of the Select Committee said, there clearly is a lack of resources. Towards the end of my brief remarks, I will discuss the fact that mental health services have always been the Cinderella services of the health service. I think that is fairly well accepted both outside and within the NHS. If we are to embark on yet another reorganisation and integration of health services as a whole, I hope that the underfunding and the lack of past attention that has affected and led to the present situation in mental health services will not be overlooked. It is not as though all the services can be integrated equally or proportionately, but if certain services are not to be further damaged, they will need to receive particular recognition and get preferential priority in the integration—I do not like the word “reorganisation”—which all the parties agree needs to be done carefully. This should not be rushed. We do not want another reorganisation forced on the health service. It should be done sensibly and gradually, and with sensitivity to the individual needs of the services that are being integrated.

[Mr Jim Cunningham]

Does my hon. Friend agree that the Caludon health centre at the University hospital Coventry does a very good job in very difficult circumstances? Yesterday, I met some young people from Coventry college who told me about the pressures that they were under. They are worried about exams and about whether they will be able to get a job after their exams, because the number of young people out of work in the west midlands is extremely high. Does my hon. Friend agree that we need to consider all the pressures that young people face these days?

[Mr Robinson]

Yes, I do indeed. The pressure in the education system to achieve results at any cost simply adds to the problem, as do the deprivation and poverty to which other Members have referred. All those factors have resulted in a situation in which incidents of self-harm are increasing at the rate of 20% a year. Referrals in Coventry are going up, and that constitutes a crisis, given that our accident and emergency services are already overcrowded and hard pressed.

Let me explain what that crisis means in regard to the number of weeks involved. Normally, effective substantive intervention would be expected within 18 weeks, but in Coventry the average wait for a substantive intervention has been 44 weeks. That is in a sector in which early intervention is clearly the most effective route to the successful management and eventual elimination of a mental health condition. That simply is not good enough, and I put that to the Minister for consideration by his taskforce.

We have asked the local council what can be done. As my hon. Friend the Member for Coventry South (Mr Cunningham) has said, budgets have been heavily cut. According to current Government plans to reduce public expenditure to 1930s levels—from which I know the Minister of State, Department of Health, the right hon. Member for North Norfolk (Norman Lamb) has dissociated himself—Coventry would experience a further 50% cut over the next five years. There would be nothing left. Fortunately, however, that is unlikely to happen, as I am sure that there will be changes of one kind or another to those plans, or to those making the plans, in the very near future.

It is impossible for the councils to find more funds, because they are under tremendous pressure, but there has already been a £50 million cut in the budget for CAMHS. It has been cut from £766 million. I think that that relates to the £800 million figure quoted by my hon. Friend for Eastleigh—