Schools (Mental Health Professionals) Bill [HL]

Lord Watson of Invergowrie Excerpts

2nd reading
Friday 1st March 2024 Lords Chamber

[Lord Watson of Invergowrie (Lab)]

My Lords, we are indebted to the noble Baroness, Lady Tyler, for introducing this important Bill. It is certainly welcome because the extent to which young people are exhibiting mental health disorders in school has increased dramatically and the measures introduced thus far by the Government are proving inadequate to the task in hand.

In her powerful opening speech, the noble Baroness demonstrated an existential crisis in the mental health of far too many school students. Why should that be? To paraphrase The Who, one of the seminal bands of my childhood, the kids are not all right—at least, not according to the Programme for International Student Assessment, PISA. Its 2022 survey, whose results were published recently, showed that 25% of UK students reported that they are not satisfied with their lives, compared with the OECD average of 18%. The question is why, but I am afraid it is not one that we can begin to answer today.

As the noble Baroness said, around one in five children and young people aged eight to 16 years in England had a mental health disorder. That in itself is most worrying, but even more so is the fact that, as reported by the Local Government Association, evidence suggests that NHS specialist mental health services are turning away one in three children and young people referred to them for treatment. The NHS, the Government, the system—point the finger wherever you want—but the reality is that young people who need support with their mental health are being failed.

It is hardly necessary to add that experiencing mental health problems can impact educational outcomes, including attainment and attendance, in only a negative way. On the other hand, there is evidence to show that, when effective, mental health interventions are likely to improve educational attainment, particularly in high-risk groups. One example, a study of school-based interventions delivered by the children’s mental health charity Place2Be, found that school-based counselling positively influences educational engagement.

Clearly, although the extent of mental health cases among children and young people had been increasing before the Covid pandemic, they exploded following the weeks and months of school closures. Those latest figures that I mentioned earlier showed an increase from one in eight in 2017, with three-quarters of a million children and young people accessing NHS-funded mental health services in England during 2023. The extent of the crisis is greater than those figures suggest, because the Royal College of Paediatrics and Child Health reported a year ago that more than 400,000 children and young people were waiting for treatment. We can only imagine the compounding effect that being denied the treatment they require will have on their conditions.

The most recent parent survey by Parentkind, the membership association for PTAs, showed that the most common causes of school stress and mental health problems were exam stress, homework-related stress, anxiety, depression and bullying. In each of those categories, the figures were considerably higher for pupils in academies—part of a MAT or stand-alone—compared with maintained or community schools. I am not sure what that tells us, but the disparity requires closer scrutiny.

It is clear that too many children are going into school not ready to learn. This places additional burdens on teachers, many of whom are taking on responsibilities that go way beyond their teaching and learning responsibilities. Last year a survey undertaken by Education Support, a charity dedicated to supporting the mental health and well-being of teachers and education staff in schools, found that three-quarters of education staff often helped pupils with matters beyond their academic work, while almost 70% helped pupils to process their emotions and talked to them about their mental health. A third had even helped pupils to resolve a family conflict. A significant number of education staff feel that there is insufficient support for their pupils from other public services such as CAMHS, social services and the NHS; 11% said there was no such support at all.

These additional demands naturally increase staff working hours and have a negative impact on their own mental health and well-being. This matters, because schools cannot properly support children and young people if their workforce is mentally exhausted or unwell. Healthy teachers are more engaged and effective in the classroom. Proper mental health support in schools is needed to support children and the staff responsible for their learning. Mental health support should be embedded in every school, accessible to every pupil through a school-based counsellor or mental health practitioner. School-based mental health services need to deliver both targeted and universal provision through a whole-school approach.

The Children and Young People’s Mental Health Coalition has called for the Government to embed whole-education approaches to mental health and well-being in all their policies and across all education settings to promote positive mental health and well-being for both learners and staff. This would have a universal impact on the health of every child and young person. The coalition estimates that a whole-school approach programme in England would cost approximately £530 million a year. In the longer term, the cost of not adopting such an approach would be much more.

In fairness, the Government recognised the mental health issues associated with children and young people’s support as long ago as 2017, when they published the Green Paper that led to the introduction of mental health support teams, based on the principle of early intervention. However, by the end of last year, the Government reported that although nearly 400 mental health support teams were operational in England, these covered a mere 35% of school pupils. Understandably perhaps, the Government did not look beyond 2025, by which time they have projected that the figure will have increased to 50% of pupils, which of course means that 50% will not be covered—an entirely unsatisfactory position for the parents and families of children waiting for help, support or treatment.

The other strand of the Government’s approach has been the establishment of mental health leads in schools. That is well intentioned, but cannot be seen as a replacement for adequate capacity in children’s mental health services. Making teachers social workers or therapists by stealth cannot be the answer to this complex challenge. It requires greater funding than the £1,200 grant that schools and colleges can apply for to train a mental health lead. Last month, the DfE reported that more than 15,000 schools had applied for the grant, which equates to around 60% of all schools, again leaving many thousands of children and young people without access to even that limited level of mental health support.

It is to be hoped that the Bill will ramp up the level of support provided. Noble Lords may be aware that the Labour Party has promised to legislate for the provision of quality mental health support in every school, giving every child the support they need to transition back to school and manage personal challenges, with access to qualified in-school counselling staff. It remains to be seen what that means for the level of staff provided. The Bill of the noble Baroness, Lady Tyler, spells out that a qualified mental health professional or school counsellor is an individual with

“a graduate-level or postgraduate-level qualification … earned through a course commissioned by NHS England”.

That is a reasonably high bar, and it suggests that funding will be required to attract people qualified at that level. I certainly hope that will be the level to which a Labour Administration will aspire in their aim to place mental health within their children’s recovery plan.

For now, we can only wish the noble Baroness, Lady Tyler, well with her excellent Bill and hope that it receives the support and fair wind from the Government that it certainly deserves. I hope that the Minister will not tell us that she believes it is unnecessary because the Government are already doing all they can to support the mental health needs of children and young people. What they have done is good, but, as the young people’s organisations that have provided briefings for today’s debate have made clear, it is not nearly good enough.

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[The Parliamentary Under-Secretary of State, Department for Education (Baroness Barran) (Con)]

My Lords, I also offer my congratulations to the noble Baroness, Lady Tyler of Enfield, on securing a Second Reading for her Bill. I thank all those noble Lords who shared their personal experiences of how the mental health issues of their children and wider families have had an impact on them. I join noble Lords in recognising the extraordinary job that our schools do in supporting pupils every single day and, of course, I thank those charities that work in our schools and outside them to support young people.

I am grateful to my noble friend Lady Wyld for stressing the importance of good attendance as a protective factor for children’s mental health. As she rightly said, the Government approach this with a very caring intention. There must be boundaries around it as well as consequences in certain cases where children do not attend and parents facilitate that without good reason. The intention is clear. Of course, enabling children and young people to thrive is a priority for this Government, which is why we actively explore approaches that could improve young people’s mental health and well-being.

Of course, I welcome the noble Baroness’s tireless commitment to ensuring that mental health support is available for all children, but I must express reservations about this Bill. As the noble Baroness acknowledged, most schools already have in place mental well-being provision, including counsellors, educational psychologists and pastoral support staff. All of those can play a valuable role, but maintaining a school’s flexibility to choose what works best for its pupils is paramount. For instance, depending on their needs, not all children will benefit from specific mental health interventions such as psychotherapeutic counselling. Schools are well placed to decide which approach will be most effective, drawing on specialists where necessary.

Beyond this, it is important to reiterate that schools are not health services and should not be expected to act like one in terms of managing specialist staff. They may choose to do so where they have appropriate expertise, but we believe that our current approach, which encourages collaboration with specialist services where appropriate, avoids putting the extra role and burden on schools that the Bill would involve.

On the co-ordination between the health service and schools, my noble friend Lord Jackson of Peterborough asked, specifically in relation to Tourette’s syndrome, whether there is co-ordination between the two departments. We are more broadly taking a joint approach to workforce planning and reforms to the special educational needs and AP systems. There is an implementation board, chaired jointly by Education Ministers and Health Ministers.

Returning to our schools, our aim is for schools to be a place where positive well-being is promoted and mental health difficulties are picked up on early, with referral to specialist services as needed—an aim that is being pushed forward through our programme of grants for senior mental health leads in schools and colleges and the continuing rollout of mental health support teams. My noble friend Lady Berridge asked about the take-up of grants for senior leaders in different areas, including whether schools with particularly high levels of disadvantage had lower take-up. I do not have that specific data for her, but we know that lower take-up has been seen in London, the east Midlands and the east of England, so we are working hard there to encourage higher take-up.

The Government’s focus, as many noble Lords have advocated, is to support schools to develop a whole-school approach. That wider approach to well-being works alongside more specialist support, which is why we agree with the spirit of the Bill, if not its specificity. That is why we have a comprehensive plan to roll out mental health support teams, including access to education and mental health practitioners, who deliver interventions and support schools to develop their whole-school approach.

The noble Lord, Lord Storey, asked whether there was more focus on mental health in the initial teacher training and early career framework. The very recently updated framework, published in the past few weeks, has a much greater integration of special educational needs and disabilities, including mental health within that. We expect these teams to cover at least 50% of pupils by April 2025.

We come to the issue of funding, which a number of noble Lords, including the noble Lord, Lord Hunt of Kings Heath, mentioned. He will understand very well that it takes time to train mental health professionals. Although I absolutely acknowledge and share the urgency that noble Lords have expressed this afternoon, it is important that we learn from early intervention to make sure that the support team model is as effective as possible—but we are also trying to co-ordinate and take a responsible approach to rollout, working with NHS England to make sure that we do not draw professionals away from the wider mental health workforce, which clearly would not be desirable.

We are also building on the learning from the independent evaluation of the Green Paper programme and data and intelligence from the ground, which will help to shape future delivery. One of the strengths of the mental health support teams is that they are an NHS service focused on supporting schools and pupils in a responsive way. That need for it to feel human, as I think my noble friend Lady Wyld phrased it—the noble Lord, Lord Hunt of Kings Heath, also referred to the difficulty that people sometimes have in navigating these systems—is absolutely critical. They are specifically trained to do that, and to build those links between sectors.

It is also true that even a significant number of additional staff in mental health support teams cannot provide all the help that pupils need, which is why the range of pastoral support and early interventions that schools already provide, including drawing on counsellors and educational psychologists, is so important. We have been working with the mental health support teams to make sure that they support that provision and do not displace it. But we are concerned that, by specifying just two types of professional support, the Bill is likely to constrain the range of support options that pupils can benefit from, which I know is not the noble Baroness’s intention.

We have also committed to offering all state schools and colleges a grant to train a senior mental health lead by 2025, enabling them to introduce effective whole-school approaches. More than 15,000 settings and the great majority of secondary schools have claimed a grant so far. This training and associated support equip schools to offer the right support from the full range of sources, making the best use of their funding.

[Lord Watson of Invergowrie (Lab)]

I do not know whether I picked this up correctly, but I think the Minister said that all schools would have access to mental health support teams by 2025. I thought the figure the Government were aiming for was 50%. Have I got that wrong?

[Baroness Barran (Con)]

There are two different elements, and I apologise to the noble Lord if I was not absolutely clear. He is quite right that with the mental health support teams we aim to cover 50% of schools by April 2025. What I was referring to just now was the senior mental health lead training, so that there will be a senior mental health lead in every school, supporting staff in their response and giving them confidence to respond to children, which we know is so vital.

My noble friend Lady Berridge referred to children in secure mental health institutions. I will write to her. We are reviewing and redesigning provision to support the move to more community-based provision closer to home—a concern that my noble friend rightly raised. I am not aware of whether there is updated data on this but if there is, I will share it with my noble friend and put a copy in the House Library.

In conclusion, we believe that, to continue to support children and young people, rather than having a new set of requirements in schools, we should continue with the rigorous implementation of the evidence-based approach exemplified by the mental health support teams and the senior mental health leads. For that reason, we cannot support the noble Baroness’s Bill.