Mental Health: Young People

Lord Prior of Brampton Excerpts

Tuesday 11th October 2016 Lords Chamber

[Lord Farmer]

To ask Her Majesty’s Government how they intend to amend the 2012 national suicide prevention strategy to take account of the mental health challenges faced by young people.

[The Parliamentary Under-Secretary of State, Department of Health (Lord Prior of Brampton) (Con)]

My Lords, we will publish later this month the next annual progress report of the national suicide prevention strategy, which will set out details of how we are strengthening the strategy in key areas, including to target specific groups such as children and young people. The national strategy recognises children and young people as a group with specific mental health challenges that require a tailored approach to meet those needs.

[Lord Farmer (Con)]

I thank the Minister for that informative Answer. Front-line clinicians and local authorities are very aware of the role that family dysfunction and relationship breakdown frequently play in the onset of pronounced mental illness in adolescents. What steps are the Government taking to prevent mental health problems from developing, particularly where family breakdown is a root cause?

[Lord Prior of Brampton]

My Lords, in his recent national confidential inquiry, Louis Appleby reported that in 36% of all suicides of people aged under 20, family breakdown or family circumstances were part of the cause. My noble friend is absolutely right that families are critically important. That is very much part of the strategy in our Future in Mind paper. I was horrified by the figure that 43% of all people who took their own lives under the age of 20 had had no prior contact with any agency—no contact with GPs, no contact with CAMH units, no contact with schools—about their condition. Nearly half the people who took their own lives were completely below the radar. That is a shocking figure.

[Baroness Walmsley (LD)]

My Lords, I ask the Minister about young people with mental health problems in the criminal justice system, where they are particularly vulnerable to self-harm and suicide attempts. Recent draft NICE guidelines recommend that all staff working in the criminal justice receive training to recognise and respond to mental health problems. Although the NHS is not responsible for the physical or mental health of those in custody, the guidelines recommend co-operation between healthcare and the criminal justice system on mental health, so how will his department respond to them, and who will fund the training?

[Lord Prior of Brampton]

My Lords, I do not think I can answer the question about who will fund the training; I will write to the noble Baroness to answer it. She is absolutely right that a huge proportion of people who are in the criminal justice system, in prison, also suffer from mental health problems. Tackling the mental health problems of people in prison is just as important as tackling them outside. If I may, I shall write to the noble Baroness on this matter.

[Lord Watts (Lab)]

I must tell the Minister that there is very little sign of any investment in mental health services taking place in Merseyside. Will he investigate what is happening to that investment strategy and why Merseyside is failing our children and failing to invest in this vital service?

[Lord Prior of Brampton]

My Lords, I am obviously disappointed to hear what the noble Lord says about Merseyside; I cannot answer specifically on Merseyside today. We have the Future in Mind strategy, which pledged £1.4 billion of extra spending over the lifetime of this Parliament for children and young people. If it is not reaching the front line in Merseyside, we should look at that.

[Baroness Finlay of Llandaff (CB)]

Can the Government provide assurance that the phenomenon of suicide contagion is now being recognised? That is contagion both from personal contact with somebody who has attempted or committed suicide and through media reporting, where the higher the profile in the media, the more likely there is to be suicide contagion. That appears to be a linear relationship. Do the Government recognise that the best way to deal with the complex problem of suicide contagion among children and adolescents at school is to provide suicide screening within schools—for the precise reason that the Minister outlined, which is that many of these people are below what you might call the healthcare radar?

[Lord Prior of Brampton]

My Lords, the issue of suicide clusters and contagion is serious and real. By 2017, as recommended by the Five-Year Forward View on Mental Health prepared by Paul Farmer, every authority will have a multiagency plan addressing that issue. I agree with the noble Baroness that we need to do a lot more in schools. Interestingly, 255 schools are now part of a pilot scheme where there is a single point of contact within the school, so that when a child is feeling suicidal or has mental health problems, it is at least clear who they should go to to seek advice.

[Lord Hunt of Kings Heath (Lab)]

My Lords, it is clearly not just an issue of funding, but you cannot escape the issue of funding. Yesterday, police chiefs said that they were being forced to act as emergency mental health services because of the inadequacy of provision up and down the country. Recently, an FoI request showed that two-thirds of CCGs which responded are spending less as a proportion of their budget on mental health this year, rather than more, as Ministers required them to do. The Minister mentioned the review to come out later this month, which will reflect on this distressing issue. The question is how one can have confidence in what the Government are saying, because they clearly are having such little impact on what the NHS does locally.

[Lord Prior of Brampton]

My Lords, this is a difficult issue. As the noble Lord will know, a key part of the five-year forward view is to take resources out of acute physical care, out of acute hospitals, so that there is more available for mental health care, community care and primary care. It is very difficult to do that. As the noble Lord will know, we have been trying to do this since 2000 but all that has happened is that more and more of the available resource has been sucked into the big acute hospitals. Getting that resource out and into the community and into mental health is extremely difficult. The STP process is going on at the moment. We are committed to seeing more money going into mental health, but I acknowledge the difficulties.

[Lord Alton of Liverpool (CB)]

My Lords, will the noble Lord confirm that last year we saw the highest level of teenage suicides in 17 years? Welcome though the review of the 2012 strategy is, will the noble Lord say that, as well as looking at issues such as family breakdown, he will look at issues such as cyberbullying? Did he see the case only last week of an 11 year-old boy who committed suicide? His mother said that he had been subjected to cruel and overwhelming social-media and cyber bullying. Will the review examine these links with breakdowns in mental health and teenage suicide, and the very poor state of mental health provision inside the National Health Service for young people?

[Lord Prior of Brampton]

My Lords, on the noble Lord’s last point, the very poor state of mental health provision in the NHS has been with us since 1948, if not earlier. We are trying to address this problem but there is a huge way to go. I acknowledge absolutely the difficulties to which the noble Lord, Lord Hunt, also alluded. Professor Appleby, in his report which came out in May of this year, cites cyberbullying as one of a number of factors. They tend to be multifactorial. When someone takes their own life it is normally the end result of often years of misery and a whole range of things. It could have to do with sexuality, bullying, family breakdown or bereavement. This is not an easy situation to solve. Last year, 145 people under the age of 20 took their own lives. This is a tragedy for them and, of course, for their families as well.

[The Lord Bishop of Peterborough]

My Lords, may I draw to the Minister’s attention the specific needs of children and young people from refugee and recent immigrant families? In many cases, they have been through dreadful trauma in other countries and find themselves dislocated and here, sometimes, without their families. There is a need for proactive mental health care as well as for reactive and responsive care, both of which seem to be in short supply.

[Lord Prior of Brampton]

My Lords, the right reverend Prelate makes a very important point. The life history of some of these children and young people in refugee camps who have fled from desperate parts of the world is truly shocking. I can only completely agree with the sentiments to which he has drawn our attention.