Young People’s Mental Health

Lord Beamish Excerpts

Thursday 27th October 2016 Commons Chamber

[Helen Hayes (Dulwich and West Norwood) (Lab)]

I beg to move,

That this House notes the recommendations of the Youth Select Committee report of November 2015 on Young People’s Mental Health; endorses the findings of that report on the need for more support from the Government for mental health services for young people; acknowledges steps taken by the Government, since its response of January 2016 to that report, with regard to some of its recommendations; and calls on the Government to set out what further progress has been made since its response and what its plans are further to improve mental health services for young people.

The motion concerns the report of the Youth Select Committee on young people’s mental health and the Government’s response to that report. I am grateful to the Backbench Business Committee for allocating time for the debate, the application for which was supported by more than 50 members from across the House, and to the hon. Member for South Cambridgeshire (Heidi Allen) for co-sponsoring the debate.

I start by paying tribute to the many health professionals and voluntary sector organisations working in mental health services for young people, the teachers and teaching assistants who support young people with mental health difficulties in classrooms every day of the week and the youth workers seeking to support our young people in many different ways. This debate is not about the commitment of those who work tirelessly to support our young people but about the resources and the framework within which they are working, which affect our collective ability to deliver the outcomes we need.

The Youth Select Committee report on young people’s mental health was published in 2015, as a consequence of more than 90,000 young people voting for the subject of mental health in the 2014 Make Your Mark ballot. It is an exceptionally important piece of work because it is a report on mental health by young people, about young people. Since I was elected last year, I have been struck by how often young people’s mental health issues have been raised with me; whether by individual constituents struggling to access the support that they or their children need, doctors in my local accident and emergency department or teachers in our local schools. The issue is raised very frequently, and no one thinks the current situation is even close to being acceptable.

I pay tribute to the Youth Select Committee for its excellent, rigorous report and clear recommendations, which fall into three areas: funding and the state of services; a role for education; and awareness, stigma and digital culture. The report concludes that mental health services are significantly underfunded, and young people’s mental health services even more so, and that the challenge posed today by young people’s mental health is unprecedented. It highlights significant problems in accessing services, particularly in relation to first contact through GPs, and raises the urgent need for every young person in the UK to leave school with a good understanding and awareness of mental health, empowered and equipped to look after their own mental health.

[Mr Kevan Jones (North Durham) (Lab)]

Does my hon. Friend agree that some of the issues on access that are raised by this very good report could apply equally to adult services, so there is clearly a read-across between the two?

[Helen Hayes]

My hon. Friend is absolutely right to say that, although today we are debating young people’s mental health, many of the same issues apply to mental health services across the board for all members of our communities.

The Government published a response to the Youth Select Committee report in January 2016. That response was, on the whole, disappointing. It referred mainly to work that the Government were already doing rather than the additional work that they and other agencies clearly need to do. Most disappointing of all, the response rejected the key recommendation that statutory levels of attainment in mental health education should be introduced for all young people. I welcome the fact that the Government have subsequently announced some additional funding for young people’s mental health, but I remain very concerned about the current state of mental health services for our young people and the resourcing of those services.

I will focus, therefore, on the current state of services, and what I believe to be evidence of a crisis that is growing, not diminishing, and demands a response far bolder and more comprehensive than that which the Government are currently offering. I will also return to the conclusions of the Youth Select Committee report.

One in four of us will experience mental ill health in any given year. That means that mental health is something that affects every one of us. All of us have a friend or family member who has mental ill health, and many of us will experience mental ill health ourselves. I have known close friends and family members who have suffered from severe anxiety that impacted on their daily lives, clinical depression and eating disorders. There are few worse feelings than the worry for a loved one who seems unreachable in the pit of depression, except perhaps the worry when that loved one is a child. All any of us wants for our own children and the young people we represent is that they grow up happy, healthy and resilient to the stresses and strains of our world. Watching a precious child struggle with clinical depression, severe anxiety or an eating disorder is absolutely devastating.

According to NHS statistics, around one in 10 children and young people has a diagnosable mental health condition; that is around three students in a typical classroom. Many more young people do not have a diagnosable condition but experience a period of mental ill health or emotional distress during their childhood or adolescence. The Government’s own measures of children’s wellbeing found that almost one in four children showed some evidence of mental ill health. Half of mental health problems are established by the age of 14 and three quarters by the age of 24.

Shockingly, suicide is the most common cause of death for boys aged between five and 19, and the second-most common for girls of that age, after traffic accidents. A recent survey by Girlguiding found that 69% of girls aged seven to 21 feel that they are not good enough. It is thought that around one in eight young people self-harm between the ages of 11 and 16.

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[Helen Hayes]

I agree with the hon. Lady completely. As we focus on prevention and early intervention, we need to think about early intervention in terms of age, as well as the stage of mental ill health.

As a consequence of the lack of early intervention support, the number of young people attending A&E because of a psychiatric condition has more than doubled since 2010. I have spoken to many doctors who tell me that when this happens and a seriously unwell young person presents at A&E needing a CAMHS in-patient bed, they frequently wait a very long time—sometimes days—for a bed to be identified. Often that bed is hundreds of miles away from home. One south London hospital has provided me with data that show a 37% year-on-year increase in the number of under-16s being seen in A&E with a mental health condition, and a 193% year-on-year increase in the number of those children being admitted to an in-patient bed.

[Mr Kevan Jones]

Does my hon. Friend agree that while there is a shortage of beds, another issue, particularly in cities such as London, is poor quality housing? In cases where individuals could perhaps have been treated at home and in the community, that treatment cannot be delivered because of the lack of proper housing.

[Helen Hayes]

My hon. Friend is right. There are multiple causes and contributory factors to mental ill health, and multiple contributory factors that present obstacles to addressing that and providing the treatment people need, where they need it. Housing is certainly one of them.

In London, 69 young people from Lambeth, Lewisham, Southwark and Croydon were unable to receive in-patient care in the South London and Maudsley Trust. Of those, 45 were sent out of London for their care. This issue, of seriously unwell young people being sent a long distance away from home to access in-patient care, needs to stop. It is distressing for families, it stops young people receiving the maximum possible support from family and friends to help them recover, and it makes them more vulnerable. When young people are admitted to a CAMHS in-patient unit, very often the service is not what it should be. The Care Quality Commission found that 62% of CAMHS in-patient wards and units were inadequate or required improvement.

The goal of parity of esteem for mental and physical health was introduced into the Health and Social Care Act 2012 via an amendment by Labour peers, and was a landmark in the way that mental health services are considered. However, we only need to think for a moment about what our response would be if some of the statistics on young people’s mental health related to a physical condition to realise just how far away we are from the stated objective of parity of esteem being realised. Just imagine if 75% of people with a bacterial infection struggled to get access to treatment; if almost a quarter of referrals for cataracts were turned away; if people with a chest infection were routinely forced to wait until they had pneumonia before any help was provided; or those with a broken leg were forced to wait for days in A&E only to be sent to a hospital hundreds of miles away to be treated. It would be a national scandal. The state of our mental health services, particularly those for young people, is a national scandal: it just is not being recognised as such. Words alone cannot achieve parity of esteem; the Government must start to act differently.

What action, then, is necessary to transform mental health services for our young people? I want to return now to the conclusions of the Youth Select Committee report. The Royal College of Psychiatrists highlights three recommendations in the report, which it believes are key. First, the Government must increase funding for young people’s mental health services and ensure that this funding is ring-fenced to guarantee that the money “reaches the ground” to CAMHS. There is particular concern at the moment about the introduction of sustainability and transformation plans across the NHS, and the resourcing implications of those plans. The Royal College of Psychiatrists recommends that the Government introduce ring-fenced funding for CAMHS and rejects any sustainability and transformation plans that do not clearly set out a plan to improve children’s mental health services in their area. I hope the Minister will commit to that today.

Secondly, health services must pursue co-production, in which young people themselves are involved in the process of formulating policy to improve CAMHS. Research shows that where young people have a clear voice in service design, the end result much better reflects the real needs of the patients.

Thirdly, the Government must focus on improving mental health education in schools, with the aim of ensuring that young people leave school with not only an understanding of mental health, but an understanding of how to help their own mental wellbeing. This recommendation was made by the Youth Select Committee and it is supported by the Education Committee, the National Association of Head Teachers and other teaching unions, the United Nations and many others. The Government have introduced new lesson plans for the personal, social, health and economic curriculum, but there is a broad consensus across the health and education sectors that the role of mental health education in developing resilience, preventing mental ill health and safeguarding young people is so important that it should not be left to chance, and that along with sex and relationships education it should be a compulsory part of the curriculum. I hope the Government will reflect on the urgency of the situation and the consensus around the need for compulsory education, and will make a commitment to introduce it.

The Youth Select Committee report made many other practical recommendations, including the introduction of regional commissioning, the development of an app to provide mental health advice and support, and the introduction of plans to support students through periods of exam stress. I would welcome an update from the Minister on the progress that is being made to deliver these excellent ideas.

Finally, we know that one of the greatest barriers to delivering the mental health support and services that our young people need has always been the stigma that surrounds mental health. I want to pay tribute to a brilliant piece of work that was recently published by the YMCA in partnership with the NHS. Called “I Am Whole”, the research sought to identify the extent and impact of mental health stigma and included the finding that three quarters of the young people spoken to believe that people experiencing difficulties with their mental health are treated negatively as a result of stigma. The project also sought to address stigma directly by publishing a series of stories from young people about their experiences of mental health difficulties. These make for very challenging and moving reading.

Before I close, I want to read a quotation from the foreword to “I Am Whole”, from Connie, aged 22:

“Having mental health difficulties is like being trapped inside a thousand invisible prisons. There are a thousand reasons that as a young person you are driven deeper into that colossal void. Not only isolated by the struggles you’re facing mentally, but further enveloped in a thick, suffocating darkness. The darkness descends, comprised of a tangled web of myths, harmful language, misconceptions and misunderstandings. This is stigma. It is time for these myths to be dispelled, the web broken and the isolation to end. It is time for us to be free to talk about our mental health difficulties openly, so that we can access the services we need. Once the conversation begins, you promote understanding for others and break down misconceptions people hold…It is like being stood in the dark, untangling parts of that web until the sun’s warmth breaks through…the light reaches your eyes, and you look around to see you are not alone.”

When we talk about young people’s mental health, we are talking about the wellbeing of our precious children, about their health and happiness, about the resilience of the next generation and about the ability of young people to fulfil their potential and be everything they can be. We are talking about the ways to stop more families living with the heartbreak of a young person with mental ill health and about ways to stop more families suffering the devastation of a loss to suicide. There are few things more important than this and it is time the Government got it right.

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[Tim Loughton (East Worthing and Shoreham) (Con)]

I declare my entry in the Register of Members’ Financial Interests. I apologise for missing the opening couple of minutes of the speech made by the hon. Member for Dulwich and West Norwood (Helen Hayes).

I am delighted that we are having this debate, and to be participating in it, for two main reasons, which I am sure you will share, Madam Deputy Speaker, because I know your interest in this matter. First, this is an important subject. It is something that we are failing on, so it is right, proper and beneficial that hon. Members talk about it openly, especially because, as we heard from my hon. Friend the Member for High Peak (Andrew Bingham), young people are much more prepared than ever to come forward with their own stories of their problems and issues, hopefully so that solutions can be found through them.

Secondly, I am delighted to participate in this debate because it is part of the UK Youth Parliament’s work. It is significant that we are giving up mainstream parliamentary time in the main Chamber of the House of Commons to discuss a report by the Youth Select Committee, an offshoot of the UK Youth Parliament. It is a shame that we have to do it in Backbench Business Committee time rather than Government time, but I pay tribute to the hon. Member for Dulwich and West Norwood for securing the debate and giving it such an excellent start—this will clearly be a high-quality debate. I take the view—I think that you share this view, Madam Deputy Speaker—that the Youth Select Committee has now taken on such status and stature, with its production of reports of such high quality involving such good research, that not only should the Government produce a formal response to the reports, as they have, but they should give up Government time in this Chamber on an annual basis—just once a year—so that we can formally debate the work of the Youth Select Committee. I have put that idea forward for some time, so I hope that the Whips and Government business managers are listening.

I am a big supporter of the UK Youth Parliament. It was founded during my time in Parliament, and I always try to attend its annual parliamentary sittings, which are a great spectacle. It is always exceedingly frustrating for Members when we return on the Monday and the Speaker inevitably says, “Why don’t you lot behave as well as the UK Youth Parliament members who were here on Friday; they are very smart, very concise, very well behaved, don’t heckle and set an example?” It is a shame that the media coverage of the Youth Parliament sitting is not more extensive because it is a great event for a great organisation, and it is great that we are discussing its work today.

When I was the Minister for children and young people, we produced the “Positive for Youth” document, which was all about promoting that sort of youth engagement. One of the things I most treasure having done is helping the transition of the UK Youth Parliament across to the British Youth Council to secure its future. I pay tribute to all its work over the past few years. It is a mainstream part of the youth voice in this country and in this Chamber.

I was the first witness ever to be called before the Youth Select Committee. It was an awesome and intimidating experience. I was called for its first inquiry back in 2012 along with the then Transport Minister, Norman Baker. We rather too nonchalantly rocked up before this group of young people in the Boothroyd Room. They were exceedingly well-rehearsed and well-researched, and were certainly not taking any BS from anybody. I have appeared in front of Select Committees—mostly the Education Committee—on many occasions, but I have to say that this was the most intimidating experience I ever had as a Minister in front of a Select Committee, and it was fantastic. That shows why the work of this Committee, and this, its fourth report, need to be taken seriously.

This Youth Select Committee report is difficult to distinguish, other than by its cover, from a House of Commons Select Committee report, and I congratulate Rhys Hart and his team on their work on it. They did all the things they should have done: they visited experts and sufferers of mental illness, and took no fewer than 148 submissions from expert witnesses and others—if only all the other Select Committees had as many well-informed and well-researched submissions as it did.

The Youth Parliament also has a substantial democratic endorsement. In 2014, when its priorities and the subject of the Youth Select Committee report were decided upon in the “Make Your Mark” ballot—which includes a debate in this House in the Youth Parliament’s annual sitting—no fewer than 875,000 young people from up and down the country bothered to turn out and vote. Of them, more than 90,000 voted specifically for the subject of mental health services, which is why we are debating this report in the Chamber today. That is a huge democratic mandate.

Every year I hold an event in the House of Commons to present democracy awards to schools in West Sussex, including my constituency, that have achieved a high turnout in the elections that are held every February. Each year the turnout gets higher, so more and more trophies have to be given out, and an ever bigger room has to be booked to accommodate everybody. Last year, one school had a 100% turnout—all its pupils turned out to vote for its UKYP members, which is absolutely fantastic.

This report is a chunky piece of evidence that needs to be appreciated, looked at and, importantly, acted upon. I am delighted that we are giving time to it today, and I am also pleased that the Government produced a formal response to it, whatever we may think about the shortcomings of what they said. That was produced jointly by the then Health Minister, my right hon. Friend the Member for North East Bedfordshire (Alistair Burt), and the then Education Minister, my hon. Friend the Member for East Surrey (Mr Gyimah). Neither of them are still in those ministerial posts, but I welcome the Under-Secretary of State for Health, my hon. Friend the Member for Oxford West and Abingdon (Nicola Blackwood), to her new position. I am sure she has learned the ropes quickly and that she will continue to do so. We need consistency in our approach to mental health, however, and a much more joined-up approach—and not just between education and health, because there are many other aspects as well.

This subject is clearly important to young people, as is this report, so it should be important to the House and the Government. There are many useful lessons that we can learn.

I am also very frustrated, however. I have been in the House for almost 20 years. I have been shadow Minister for mental health, and I was shadow Minister for children and young people for some nine years, as well as Minister for children and young people. I currently chair the all-party group on children and the 1001 group, which is all about perinatal mental health. I have seen mental health Bills come and go, too, and have been involved in them. I saw the 2011 mental health strategy “No health without mental health”, which was a very important statement about the parity of esteem we need to achieve, although we still have not. In 2014, I saw “Closing the gap: priorities for essential change in mental health”, with specific commitments to improve mental healthcare for children and young people. I saw the rolling out of talking therapies and the improving access to psychological therapies programme. In March 2015, as has been mentioned, we had the mental health taskforce, which produced “Future in mind”. I have seen lots of good work in the Department of Health, in particular, such as that done by my right hon. Friend the Member for North East Bedfordshire, and in February this year the mental health taskforce produced the “Five Year Forward View for Mental Health”. There has been a lot of talk about the importance of mental health and the necessity of achieving parity of esteem but, as the hon. Member for West Ham (Lyn Brown) rightly said, there is still a very big disparity. And here we are again: we are still here talking about this, and record numbers of children and young people still have mental health problems.

[Mr Kevan Jones]

Does the hon. Gentleman agree that we can have reports, taskforces and recommendations, but the real problem is that mental health is seen as a Department of Health issue, whereas what we actually need is a completely cross-Government approach so that mental health and wellbeing can be part of every single piece of policy development?

[Tim Loughton]

The hon. Gentleman is right; he pre-empts a couple of my comments. From my experience as a former Minister—and, I am sure, from his—the term “joined-up government” is a complete illusion. Joined-up government does not happen in practice. On becoming a Minister, one is cocooned in a Department, and instead of having a dialogue with colleagues in the Division Lobby or wherever, a huge wall suddenly comes between you. Trying to get interdepartmental action becomes really frustrating.

I remember setting up something called the youth action group, which consisted of Ministers from nine or 10 Departments and representatives of six major children’s charities. It was co-chaired by the Prince’s Trust and Barnardo’s. The charities came to us with problems—often complex ones—affecting young people. One example related to housing benefit and accommodation for children in care. I cannot remember what the specific problem was, but it involved housing, which was the remit of the Department for Communities and Local Government, and benefits, which were the remit of the Department for Work and Pensions, as well as children in care, who came under the remit of the Department for Education. Normally there was a vicious circle that involved people being pushed from pillar to post. Alas, that committee has not met for the past 15 months or so, but our meetings used to consist of at least six actual Ministers—not just civil servants—from the relevant Departments as well as their officials. We would get Ministers together and ask them to go away and solve the problem.

Mental illness falls into that category, in that it is not simply the remit of the Department of Health or the Department for Education. There are many other implications and knock-on effects that can relate to the underlying cause of somebody’s mental illness problems. The hon. Gentleman is absolutely right that the structure of government needs to be much better. We need taskforces that genuinely cut across Government Departments, but in my experience they will flourish only if they have the buy-in and direct engagement of Ministers at the top. One welcome initiative from the hon. Gentleman’s party was the appointment of a Cabinet-level Minister for mental health. I think that that appointment has slightly gone by the wayside now, but the principle behind it was absolutely right, in that it tried to join up all the relevant Departments at the top table.

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[Mr Kevan Jones (North Durham) (Lab)]

I congratulate my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes) on securing this debate and thank her for it. I also thank the Backbench Business Committee for allowing time for the House to discuss this issue. May I also put on record my thanks to the British Youth Council, the UK Youth Parliament and the Youth Select Committee for this excellent report? May I also give them another big thank you for allowing us again to talk about mental health on the Floor of the House? People perhaps get a bit sick of me saying this, but I say it again: the way to address some of the stigma is by talking about this more. Talking about this report as we have done today will mean that young people know we are taking this subject seriously.

As I said in an intervention, the report raises issues that cross over into those relating to adult mental health services. As the hon. Member for High Peak (Andrew Bingham) said, the unique thing about the report is that it gives those of us more advanced in years an insight into pressures on young people today that were not there when we were younger and into the challenges for parents and schools in dealing with them. The core of the report is very important, because it deals with a lot of issues that also affect adult mental health services.

I wish to concentrate on two aspects of the report: how young people get access to mental health services; and the vital issue of prevention and being able to address not just mental health, but mental health well-being. As has been said, how people access these services is important. The report talks about mental health services to young people being:

“The Cinderella of Cinderella services”.

Is this about money? Yes, it is, in some cases. My hon. Friend the Member for West Ham (Lyn Brown) eloquently mentioned that we can have all the aspirations in the world, but if the funding is not there locally to provide services, the services will not be there and people will not access them. I agree with the report that this is therefore about more cash, but it is also about how we structure our mental health services in this country.

Page 5 of the report sums it up well. It contains a diagram of a pyramid showing a list of organisations that commission mental health services—schools, local authorities, clinical commissioning groups and NHS England—and calls for a lead commissioner. I totally agree with that, but I would go one step further. When we talk about commissioning services, we need to talk about the treatment pathways and how people get into those systems. Adults trying to navigate the mental health system find that it is like a maze. Not only do they have to find their way through it, but when they get into it they on many occasions find that, as my hon. Friend said, they can wait weeks, months or years to get help—this help is available in some areas but it should be provided more quickly. Early intervention, especially for young people, can prevent problems further down the line.

I sympathise with parents today, because how do they know who to go to if their child has mental health problems? What do they need to ask for? We assume that, somehow, people are well versed not only in issues around mental health, but in how to access help—that is also true for families of adult sufferers. We do need that pathway.

The report quite rightly highlights the issue around GPs and GP training, but, as I have said many times, therein lies the problem. I am not criticising GPs, because there are some very good ones who do help, who are sympathetic and who can access services. I support the recommendation in the report for more training for GPs, but we need a more open system—a system of self-referral—which does not necessarily mean going through a GP.

That brings us to the issue around commissioning and how we provide mental health services in this country. Mental health services very much follow the medical model, but I am not sure whether that needs to be the case. What we need in this country is an open system, which involves the community and voluntary sector. I am suggesting this not because it is a cheap option, but because it is perhaps a better way of providing mental health services. However, those voluntary groups need to be funded, as my hon. Friend the Member for West Ham said. It is no good saying that we are going to pass this work over to some very good voluntary sector organisations and expect them to do it without the funding. Therein lies the problem. I give credit to the former Minister, the right hon. Member for North East Bedfordshire (Alistair Burt), who was a great champion of parity of esteem and of concentrating on how to make the system better. As I said in an intervention on the hon. Member for East Worthing and Shoreham (Tim Loughton), it is no good just looking at mental health in terms of the Department of Health, because the cuts that have taken place in local government are having a direct impact on the provision of mental health services—I am talking about the closure of youth services and voluntary sector organisations that provide mental health services locally. This is a false economy. If we are putting more money into health and taking it out from elsewhere in the system, we will create an ongoing problem.

We also need a fundamental review of CAMHS, as it is a complete failure. I am not for one minute criticising the dedicated individuals who work in that service, because I have met them and know that they work very hard. Given their workload and the way that they get their referrals, they are doing a fantastic job, but the system is broken. We cannot have this situation in which young people are waiting possibly six months for an assessment, and in which families and the individual young person are somehow expected to cope.

[Mark Tami (Alyn and Deeside) (Lab)]

Does my hon. Friend agree that, in some cases, children have to become badly ill before the problem is addressed? The problem should be addressed in the first place so that they do not get into that state.

[Mr Jones]

That is the case, yes. I can say from personal experience that the longer a person leaves the problem undiagnosed or untreated, the worse it gets.

I wish to touch on this idea that parents are, somehow, geniuses and know how to deal with children with mental illness. They do not. I work with Kinship Carers in Durham, which is run by Lyn Boyd, a friend of mine. It deals with grandparents, uncles, aunts and others who often find themselves, later on in life, looking after young people and children. Many of them have quite horrifying stories to tell. They often end up with the children, because of abuse, because the parents cannot cope, or because they want to save them from the care system.

I had a case earlier this year in which a six-year-old was self-harming. When I looked at his background and talked to his grandparents who were looking after him, I could understand why, but the issue is how does he access CAMHS. They were told that he had to wait six months. There we have a couple, who are not the biological parents, looking after a six-year-old. All they can say is, “What do we do?” The child is also disruptive at school. That leads to pressure on the school, which then seeks to exclude him. What happens to the child then? We are talking about not just the trauma, torment and heartache of a six-year-old self-harming, but the knock-on effect on the family and the school.

We do need a new system. It may be a community-based provision. I would certainly like to see open access services—they could be run by well-funded voluntary sector organisations or by the local authorities and councils—where people can go for help or even on occasion just information. Those grandparents, for example, did not have a clue what to do. What does a person do in that situation? The system is certainly failing those individuals. It should not be up to me as a Member of Parliament to contact a mental health trust to enable those people to gain access to services. That is where we are failing.

The problem is not just about ensuring that we have joined-up local services—I have already said that local authority budget cuts are having a direct impact on the working of such services—but the changes in the national health service and GP commissioning, which has made things worse for many voluntary organisations. Contracts are being let for a whole host of services, many of which are too large and too complex. The idea that local community groups can bid for such services does not work because those services are just too big, which means that those groups are being excluded from the money that is available. I am not for one minute saying that anyone who works in the voluntary community sector providing mental health services wants a free ride. Those groups are quite happy to be evaluated. My hon. Friend the Member for West Ham mentioned a project in her constituency that secured lottery funding. That project will certainly have had to ensure that the outcomes were there and that it was accountable. There is no way that many of those small organisations, which in many cases would provide a cheaper and better option for delivering the service, can manage those contracts that are currently being let by the NHS.

The way in which the Government should look at this matter—it is perhaps very difficult in this age of austerity—is that if they deal with it properly, they could save taxpayers’ money. It would save not just the heartache of the individuals who are going through the system, but, if done properly, money as well. On page 9 of the report, the chief medical officer said:

“Early intervention services that provide intensive support for young people experiencing a first psychotic episode can help avoid substantial health and social care costs over 10 years perhaps £15 in costs can be avoided for every £1 invested.”

If the Government really want value for money, this is a way to do it. However, there is a problem, which is that, in this country it is said that we know the cost of everything, but the value of nothing. The investment now in young people will possibly not pay for itself for another 10 or 20 years, but when it does, the payback to society will be quite large, and not just in terms of our having a healthier and happier society.

Another area I would like to touch on, which is covered in the report, is prevention—through the work done in schools and by making sure that we mainstream wellbeing. The hon. Member for East Worthing and Shoreham mentioned the difficulties of Whitehall Government and the silos people are in. We have enough reports on some of these areas now, and we do not need any more; what we need to do now is to hardwire mental wellbeing into all public policy across Whitehall. Can it be done? Yes, it can. I was involved when the last Labour Government mainstreamed veterans policy. Bob Ainsworth, who was the Minister at the time, commissioned a report on veterans. He made sure that the issue was taken forward and that each Department, when it was coming up with public policy, took veterans into account. We need a similar approach to mental health and mental wellbeing. The only way to do that is to have a Cabinet Sub-Committee so that this is dealt with at Cabinet level and the main Departments make sure, when they are coming up with a policy, that they take into account mental health and mental wellbeing.

As I said, early investment saves money, but it also makes for a better society. Another issue where I totally agree with the report is supporting school counsellors. Counsellors could be something of a pressure valve in the system. If they are properly trained, and there is a proper network of them across schools, they could intervene early on and prevent some of these issues. The hon. Gentleman said he was reluctant to make it mandatory for schools to carry out this work, but, as the report says, we have national standards and curricula for physical education, so we should have them for mental health as well.

Again, it is a patchy picture. There is some good work going on in schools across the country, with teachers taking the initiative. In my constituency, Simon Westrip, a lecturer at Northumbria University, has done some work around mindfulness with local community groups, and he is now taking that into secondary schools. If we look at some of the feedback on and evaluation of mindfulness in schools, it is clear that this is not just about the effect on individuals; it actually raises standards in many cases. However, the approach to these issues is patchy, and unless they have dedicated time in the curriculum, or they are something governing bodies need to take into account, people will not do that. Done properly, such work will not only address the pressures that a lot of our young people face now, so that they are happier going through school, but it will save lives and, in some cases, save money in the long term. Is this rocket science? I am not sure it is. We in this country have to change our attitude to mental wellbeing. If we get it right in children, as the report highlights, the payback for this country and its economy in the long term will be tremendous.

Let me finish where I started, by thanking the British Youth Council for its work. I also thank it for giving us another opportunity today to talk about mental health on the Floor of the House.

--- Later in debate ---

[Nicola Blackwood]

It is not fair to say that CCGs are ignoring the funding that is coming through. Moreover, it will not be possible for them to ignore what is going on when transparency and accountability is put in place with data sets that clearly show not only performance down to CCG level but the amount of funding that CCGs are given and the amount they are spending. These data will be much more detailed than before. In January, we introduced the first ever provider-level data set on children’s mental health services, and that will provide data on outcomes, length of treatment, source of referral, and location of appointment.

[Mr Kevan Jones]

The Health and Social Care Act 2012 contained one provision that I welcomed—allowing CCGs and others to commission services in the third sector, for example. A lot of the good work in this area is done in the third sector, but the problem lies in how the contracts are drawn up, because they are either too big or too complex for smaller organisations to bid for. Will the Minister look at that?

[Nicola Blackwood]

I am happy to look at it. We are very clear that there is a vital role for the voluntary sector to play in delivering some of these services. We hope that local transformation plans will be part of the way in which this is clarified. The programme to deliver transparency and accountability will be essential if local areas are not only to design effective services that match the needs of their local populations, but to be held to account for delivering them. I will not beat about the bush. We recognise that a complex and severe set of challenges faces children and young people’s mental health services. This area has been undervalued and underfunded for far too long.

While I am happy to investigate funding formulas such as those mentioned by the hon. Member for Ilford North in relation to Redbridge, I agree with him that leadership and accountability are also key to making the changes that we need. That is why we are committed to delivering real changes across the whole system, not just in funding, and to building on the ambitious vision set out in “Future in mind”. I pay tribute to my predecessors for the work they have done to bring those forward. As the hon. Member for Dulwich and West Norwood has said, we need to go further to drive through these changes, which young people have told us they want to see.

Children want to grow up to be confident and resilient, and they want to be supported to fulfil their goals and ambitions. We are placing an emphasis on building in that resilience, on promoting good mental health and wellbeing, on prevention—it is so important, as the shadow Minister has said—and on early intervention, as a number of the recommendations propose. We are looking, in particular, at how we can do more upstream to prevent mental health problems before they arise.