Mental Health: Young People

Lord O'Shaughnessy Excerpts

Thursday 9th February 2017 Grand Committee

[The Parliamentary Under-Secretary of State, Department of Health (Lord O’Shaughnessy) (Con)]

My Lords, I pay tribute to the noble Baroness, Lady Massey, both for bringing about this debate and for the work she has done over many years in promoting the issues of mental health and mental well-being. I am extremely grateful to all noble Lords for this well-informed and passionate debate, and will try to respond in my speech to as many questions as possible.

I also welcome the report from the Association for Young People’s Health, and thank the parents in the YoungMinds network for their courage and honesty in discussing the very difficult issues they face in raising children with mental health problems. Parents deal with so much, often under the radar, and they deserve our praise and admiration. As the noble Lord, Lord Hastings, said, the concept of being a parent, in the sense of parenting as an activity, goes much wider. As my noble friend Lady Redfern said, mental health problems are everyone’s problems.

We must be clear, as noble Lords have been very clear today, that there is a real and growing problem with mental illness among young people in this country. It is estimated that around one in 10 children and young people have a diagnosable mental health disorder. That is three children in every class, a fact worth reflecting on for a moment. A new report out today from the Varkey Foundation paints an alarming picture of young people’s mental well-being in this country as compared to other countries.

When I was growing up, self-harm was a problem, but on a very small scale. However, over the last 10 years the figure has increased by 68% and, as the right reverend Prelate the Bishop of St Albans, said, it now affects boys as well as girls. Around 8,000 children under the age of 10 have severe depression—another heart-rending statistic—and the number of 15 and 16 year-olds with depression nearly doubled between the 1980s and the 2000s.

As the noble Lord, Lord Giddens, said, eating disorders are some of the most dangerous mental illnesses, and their prevalence continues to rise. There are multiple, sometimes competing, explanations for why this might be so, which several noble Lords have discussed today, whether family breakdown, as my noble friend Lord Farmer mentioned, the increased use of drink and drugs, the appalling rate of mental illness among children in care, or the effects of consumerism, as the noble Lord, Lord Giddens, set out. This means that a broad-based approach is needed. There is, unfortunately, no silver bullet. But there is hope.

While the trends have largely been negative in terms of the prevalence of mental illness, a sea-change in attitudes is taking place. As the noble Lord, Lord Cashman, described so eloquently, this has particular impacts on certain groups, particularly on minorities, whether according to sexual preference or ethnic minorities. Through concerted efforts by medical professionals, parents, young people themselves, campaigners, politicians and even the Royal Family, we are at last confronting the stigma of mental illness. It is finally becoming acceptable to admit mental health problems without it connoting some kind of personal weakness, as my noble friend Lady Chisholm, pointed out.

Government policy has both led and evolved in response to this change. I am very proud to serve a Prime Minister who is deeply committed to ending “burning injustices”. What greater injustice could there be than to receive inferior healthcare because your needs are mental, not physical? The previous Conservative and Liberal Democrat Government legislated to create parity of esteem for mental and physical health in 2012, and since then the Government have introduced the first mental health waiting time targets and have begun to roll out a series of initiatives—supported by an additional £1.4 billion—to support those suffering from mental illness, including support for young people suffering from eating disorders and to support perinatal mental health, which the noble Baroness, Lady Tyler, highlighted as being so critical.

However, it is important to acknowledge that there is much more do to. There are concerns that funding is not getting through to the front line, as the noble Lord, Lord Patel, said—and as other Peers have said in other debates—and it must be admitted, as my noble friend Lady Fall pointed out, that the performance of child and adolescent mental health services is patchy. Care also needs to be delivered closer to home wherever possible, as my noble friend pointed out. The Government are aware of these criticisms and are working hard with NHS and local authority partners to address them.

The report we are discussing today revolves around the role of parents, and some of the quotes in it are, quite frankly, heart-breaking. They lay bare the helplessness and frustration that many parents feel. As some noble Lords may know, I have spent the last few years working in education and in schools we always talk about parents as being the “first educators”. That is relevant here because in health we can think of them as the “first carers”—the first line of both defence and action, as the noble Baroness, Lady Tyler, pointed out. Government policy must be geared to strengthening parents’ ability to provide the love and support that makes young people more resilient, and to arming them with the skills and knowledge needed to identify and respond to the signs of mental illness when it occurs. The noble Baroness, Lady Massey, asked for my personal support in making sure that there is increasing support for parents through government policy and I am happy to give it.

There are some good examples of government policies that are working in this area. The Department for Work and Pensions supports parenting classes aimed at reducing family conflict, which has been raised as an issue. The Department for Education supports the YoungMinds Parents’ Helpline and the MindEd website, which provide parents with guidance on a range of parenting issues related to mental health. There is also the Family Test, which was introduced by the previous Government and which my noble friend Lord Farmer was instrumental in bringing about.

The NHS England Five Year Forward View for mental health has put mental illness at the forefront of NHS reforms. The noble Lords, Lord Cashman and Lord Giddens, asked about waiting time targets for eating disorders; these will be in place from April 2017. There is more funding, but there are challenges, as we know, in getting it through to the front line. I will respond to the question of the noble Lord, Lord Patel, later.

I think we have also launched today the next stage of piloting the single point of contact, which will benefit children in 1,200 more schools. The voluntary sector is doing pioneering work in this area, whether through Place2Be’s counselling services or through the proposals for a new national parenting trust emerging from the Legatum Institute, where I used to be a senior fellow, and which will provide parent support groups to help parents in a very challenging time of life.

I am delighted that the Government have committed to creating a joint Department for Education and Department of Health Green Paper on children and young people’s mental health. The aim is to publish it this year. I am also clear that this will succeed only if it boosts parents’ ability to support their children to deal successfully with mental illness. It is essential to involve parents in that policy-making. Mental health is being transformed in this country through local transformation plans which have parents and young people themselves taking part in the design of policies.

I take the opportunity to respond to some of the specific questions noble Lords have raised. My noble friend Lady Chisholm asked about mental health training for GPs. That is something NHS England is working on actively with the Royal College of General Practitioners. She will also be aware, I hope, of the Prime Minister’s really important and signal announcement, which outlined that there would be mental health training for mental health first aid in secondary schools. However, I very much take the point of the noble Baroness, Lady Lane-Fox, who talked about that going into primary schools too.

The noble Baroness, Lady Lane-Fox, also talked about the impact of social media and social networks. My oldest child is nearly nine years old and I am frankly terrified by the prospect of her joining social media. There is a kind of fascination with devices and everything that goes beyond it. You try to explain to them that there may be more bad out there than good, but they are desperate to be part of it.

The Prime Minister announced initiatives on digital mental health services, but clearly there is much more that we can do through the Green Paper and she was quite right to point out that businesses need to take responsibility, too, whether that means the social media businesses themselves—I can imagine that she is a forceful advocate for that on the board of Twitter—or other businesses. The Prime Minister has asked the noble Lord, Lord Stevenson, and Paul Farmer from Mind to carry out a review on mental health in the workplace.

The right reverend Prelate the Bishop of St Albans asked about support for parents. Some 90% of the local transformation plans that I have mentioned have parenting and early years programmes. Clearly, for this to be an effective strategy, it must involve getting to parents and families early, before problems arise, so that parents and young people, as they get older, have the skills they need to spot and deal with mental illnesses as they arrive.

My noble friend Lord Farmer asked what else the Government are doing to support families. There is a troubled families programme and, since 2010, there has also been the healthy child programme, which provides health visitor support in the home. As well as that, there is the Family Nurse Partnership, which provides targeted support for young mothers who are vulnerable.

The noble Lord, Lord Cashman, highlighted the issue of LGBTI people suffering from worse mental health. I admit that is something I was not aware of prior to this debate. I am grateful to him for raising it. I understand that in general there is a problem in mental health, in both prevalence and treatment, when it comes to equalities issues, which fall under my brief. That is something I will certainly look into. It is critical that we reflect that in policy.

The noble Lord also raised mandatory sex and relationships education and PSHE. That is a debate I engaged with when I was on the Back Benches. I do not want to reprise the whole argument now, not least because I am in a rather different role, but the issue is one of quality, not necessarily making something compulsory if it is not very good. We need to focus on making it good, then the argument to make it compulsory may be easier to make.

I hope I have answered the questions asked by the noble Lord, Lord Giddens, on waiting times targets. I apologise: it was my noble friend Lady Fall who made the point about this applying to primary schools. She also asked about drop-in centres. I hope she will have noticed that in the Prime Minister’s announcement on mental health there was rather an interesting and innovative idea about supporting crisis cafés and drop-in centres, which are precisely the kind of informal setting that it might be easier for a young person to access to get the support they need.

There is so much more that could be said on this subject. I hope I have given noble Lords confidence that the Government are taking this seriously. We have this wonderful opportunity of a Green Paper. We have to develop it. I do not know what a pre Green Paper is called, but we are in that phase. It feels to me that there is a large and important bucket that can be filled with brilliant ideas. I have some more ideas for how we might do that, but I hope this is the first of many debates on this issue. I am absolutely open to all Peers to discuss ideas they may have to make that a real milestone in mental health services, mental health treatment and building resilience in this country. I look forward to working with noble Lords to make sure parents play a central role in that strategy.