Vulnerable Teenagers

Lord Davies of Brixton Excerpts

Thursday 26th January 2023 Lords Chamber

[Lord Davies of Brixton (Lab)]

My Lords, I join with previous speakers in expressing my gratitude to my noble friend Lady Armstrong of Hill Top for initiating this timely debate on an important subject, and also, serendipitously, securing time for us to develop our arguments adequately. Too often we have three-minute speeches; the 12-minute speeches that we have had so far have illustrated the importance of giving people time to talk and develop their ideas.

Now, there is no doubt, given the strength of the report, that the Government need to respond positively to its recommendations. I look forward to the response from the Minister, and I hope that we are not too disappointed. I support strongly the approach of the commission, and its specific recommendations. There is one point that I think could be developed, which I will come to in a moment, but I trust that that is not in any way taken to suggest a lack of support for the measures it proposes. Other speakers have highlighted particular issues; the background to many of the problems we face is poverty, and I am glad to see the report’s recommendation 4:

“Help young people and their families out of poverty”—


as was stressed by the right reverend Prelate.

To mention another, more specific issue, I very much agreed with the contribution of my noble friend Lady Blower on school exclusions. I support the recommendation in the report for the Government to promote a new era of inclusive education, ending the culture of exclusion and helping all children to succeed in their education. I hope therefore that we get a positive response from the Government to the call for a new era of inclusive education. It has to be acknowledged that it comes with a cost: it is not cost-free, it is not a change of attitudes, it is actually putting the resources in to enable schools to deal with all their children.

The main issue I want to address is the mental health of children, of young children in particular. The report is subtitled:

“A national plan of action to support vulnerable teenagers to succeed and to protect them from adversity, exploitation, and harm”,


so, reasonably, it focuses explicitly and implicitly on teenagers and what happens in secondary schools. But the simple point I wish to make is that it is so much better for the individual children concerned, the education system and society in general to help children who are at risk of problems with their mental health in primary schools. It is an unfortunate truth that too often it is too late or, at best, much harder to resolve problems by the time children have become teenagers. The report points out:

“The transition to secondary school can often escalate difficulties and be a trigger to greater risks”,


but this acknowledges that the problems are already there. They should be addressed at that age and not left to escalate.

The report’s findings demonstrate the need for a collaborative approach to children’s mental health services between schools, health services, local authorities and the police. In addition to this interorganisational approach for at-risk children, we need legislation to make access to early intervention for children and young people a statutory requirement. By providing early intervention and support when young children show signs of mental distress, or children are at risk, we can not only help break the cycles of exploitation and suffering for individuals but reduce the overall impact—indeed, the cost—to the economy.

I am sure I do not need to spend much time making the case for more action on improving mental health. More than £2 billion is spent annually on social care for people with mental health problems, with the wider cost being estimated at over £118 billion across the UK through lost productivity and informal care costs. As the report explains, mental health problems also add considerably to the workloads of our education, criminal and justice systems.

Therefore, it is crucial to understand that half of lifetime mental health problems start before the age of 14. It is therefore unfortunate that spending by local authorities on early intervention services for children and young people was cut by half between 2010 and 2020, when it is a growing problem. The Good Childhood Report 2022 shows that

“children’s happiness continues to decline. Young people are on average less happy with their life … than ten years ago.”

That is from the Children’s Society. NHS figures show that more than 700,000 children and young people were in contact with mental health services in the 2021-22 financial year, compared with a little over half of that only four years ago. The number of referrals to child and adolescent mental health services—CAMHS—has more than doubled since 2019, with resulting long waiting lists and, unfortunately, one in five referrals being turned away with no signposting to alternative sources of support.

The outcome of all this is that seven out of 10 children who experience mental health problems do not receive appropriate help early enough. Alarmingly, we are told that there is an average 10-year delay between young people first experiencing their symptoms and receiving the help they need.

It is unfortunate that the Government do not appear to understand the scale of the crisis. The Secretary of State for Health and Social Care was asked recently about plans to bring forward legislative proposals on early intervention measures to help safeguard the mental health and well-being of young people. The response was that there are no plans to do so.

There must be concern that currently there are no statutory measures in place to guarantee essential early intervention for children and young people who are developing mental health problems. The forthcoming mental health Bill will be an opportunity to change this, but so far the draft Bill focuses almost exclusively on crisis intervention.

Rather than developing strategies for early intervention, we have gone backwards over the past decade. Expenditure on late intervention increased over the 10 years from 2010 to 2020, from £5.7 billion to £8 billion. But how much of that increase was because expenditure on early intervention more than halved, from £3.8 billion to only £1.8 billion?

A 2014 report by the LSE and Rethink Mental Illness found that early intervention could equal a net saving of almost £8,000 per person over four years. Over a 10-year period, £15 in costs could be saved for every £1 invested in early intervention. There is therefore overwhelming evidence that early intervention is effective for society and for the individual and produces the greatest impact, leading to happier, more productive and more fulfilled lives. When we come to teenagers, the subject of this report, early intervention means when they are of primary school age.

It is so distressing how often we hear now of extremely dangerous and harmful behaviours exhibited by teenagers as young as 13 or 14, who mere months before were children and who had perhaps already been moved out of mainstream education and were already known to local police. The report describes excellently how the younger children in these communities are

“starting to follow the group around and mimic their behaviour.”

It is more important than ever that we have a workforce delivering professional psychological support to these groups earlier, when they are children. They should get the care they need when they first exhibit risky behaviour or first start mimicking older children in their communities who are behaving dangerously.

To conclude, I hope that we can continue to push for expert mental health support before the teenage years to be taken seriously as a preventive measure, instead of allowing issues to escalate and entrench, casting long shadows from childhood into young adulthood.