Mental Health Education in Schools

Lucy Allan Excerpts

Monday 6th November 2017 Westminster Hall

[Catherine McKinnell]

Indeed. I thank the right hon. and learned Gentleman for putting that on the record.

I pay tribute to UsActive, a Newcastle-based charity, whose representatives I met recently. It uses physical activity to promote better mental health for children and young people in my local area, and highlights the interrelated nature of physical and mental health in young people’s lives. I absolutely agree with the concerns that the petition raises. We must highlight the link between our physical and mental health if we are to get the best outcomes for our children holistically and educationally.

I agree that the earlier that children and young people are educated about these issues, the better. We must properly support them throughout their childhood, help them to develop resilience so they can deal with any issues they face, prepare them for adult life, help them to develop coping mechanisms for the many challenges that life will bring, and ensure that they become well-rounded individuals capable of empathy and understanding for others, whether friends, family members or work colleagues, who will inevitably be affected by mental health issues. They should recognise that such issues are as much a part of everyday life as physical health concerns.

I am delighted that I have a local link to the creator of the e-petition through my constituent Reverend Mark Edwards, who works closely with the Shaw Mind Foundation to raise awareness about mental health. Mark recently published a book via Trigger Press about his mental health journey entitled “Life After Care: From Lost Cause to MBE”. It details how he went from spending the majority of his childhood in foster care and being sectioned under the Mental Health Act 1983 to being a team vicar at St Matthew’s church in Dinnington in my constituency, a volunteer first responder with the North East Ambulance Service, police chaplain to the Northumbria police and a former volunteer lifeboat crew member—all of which led to his being awarded an MBE. Mark has shared his experience because, in his own words:

“So many people’s stories end in tragedy either because they suffer in silence or because they feel there is no support for them and that they are the only one suffering mental health issues.”

Crucially, he wanted to share his story to illustrate that “there is always hope”. Mark’s story is a powerful one, and would be if it were included in any mental health education delivered in schools.

[Lucy Allan (Telford) (Con)]

The hon. Lady is making a powerful and important point about supporting children in care and meeting their mental health needs. She served with me on the Select Committee on Education when we did an important report more than a year ago about the mental health needs of young people in care. Does she agree that that is an important part of what we are debating?

[Catherine McKinnell]

Absolutely. The hon. Lady is right that the Select Committees on Health and on Education undertook a joint inquiry and report into these very issues because, crucially, health and education are intertwined when we look at mental health and physical wellbeing. The outcome of that inquiry was that I was very keen to lead in this debate, because I share her view that it is crucial to improve outcomes for children in care as well as for all our children and young people.

The statistics are startling. HeaducationUK highlights some of them: 850,000 UK children and young people aged five to 16 have mental health problems, which equates to around three in every classroom; more than 75% of mental illnesses in adult life begin before the age of 18; the number of young people attending accident and emergency with a psychiatric condition has risen by 106% since 2009; reports of self-harming among girls aged 13 to 16 rose by 68% between 2011 and 2014; and suicide is the biggest killer of young people aged under 35, with an average of 126 suicides a week and more than 200 children of school age dying by suicide each year.

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[Catherine McKinnell]

My hon. Friend makes a key point. It is not just children and young people who face mental health difficulties as a result of the stressed environment in our education system, but the teachers, too. One has a huge impact on the other. Taking a whole-school approach to the issue could transform the lives of everybody in that school environment, all the families who surround it and are connected with it, and the local community.

[Lucy Allan]

Last week, my right hon. Friend the Member for Harlow (Robert Halfon) and I, along with other members of the Select Committee on Education, met teachers to discuss that very point about the mental health implications for them of being overburdened and overstressed by the many demands made on them. They made the exact point that the hon. Lady just made: that the mental health difficulties that they encounter inhibit them from helping their pupils. Does she agree that it is very important that the Green Paper includes provision for assisting teachers in dealing with their own mental health?

[Catherine McKinnell]

The hon. Lady put that very well.

Comments from Adam Shaw, the creator of the e-petition, are highly pertinent. He says:

“I would personally love to ask”

the Prime Minister

“and Government ministers what the benefits are for not having compulsory mental health education. If you really study this question and ask yourself it seriously, the more ridiculous the concept of not having it becomes.”

As I mentioned, in the last Parliament, the Education Committee, of which I was a member, and the Health Committee published a joint report, “Children and young people’s mental health—the role of education”, which concluded that

“Schools and colleges have a front line role in promoting and protecting children and young people's mental health and well-being.”

We also welcomed the Government’s commitment in March to make personal, social, health and economic education and relationships and sex education a compulsory part of the curriculum from 2019. The Department for Education’s policy guidance accompanying the announcement confirmed that statutory PSHE is expected to cover

“healthy minds, including emotional wellbeing, resilience, mental health”,

and statutory RSE is likely to include

“how relationships may affect health and wellbeing, including mental health”.

However, in the context of this debate and the request of the e-petition, will the Minister say from what age he expects that to be covered in schools, and how much time he expects will be dedicated to it? It is important to highlight that we talking about a cross-party, joint Select Committee report, which expresses its support for

“a whole school approach that embeds the promotion of well-being throughout the culture of the school and curriculum as well as in staff training and continuing professional development.”

As such, we concluded:

“The promotion of well-being cannot be confined to the provision of PSHE classes.”

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[Lucy Allan (Telford) (Con)]

Thank you for calling me to speak in this important debate, Mr Brady. It is a pleasure to follow my right hon. Friend the Member for Harlow (Robert Halfon), and I pay tribute to the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) for her inspiring opening to the debate.

We all agree that education is about preparing our young people for the future. Key to both success and survival in life is being able to build resilience and learning how to take care of our own wellbeing and mental health. Without doubt, that is the most vital tool in the armoury of any young person, as they will inevitably take on many challenges as they go through life. Schools have a critical role to play in promoting an understanding of self-care as it relates to exercise, diet, sleep, mindfulness and building strong social networks for support, as well as the negative role of alcohol and drugs in mental health and how to avoid the pernicious influence of social media and its effect on wellbeing. However, family, friends and healthcare workers also have a significant role to play.

I am pleased that today young people are far more likely to talk openly about mental health issues, whether in school, at home or with friends. There are real signs that the silence and stigma are being shattered, but there is much more work to do, and schools can play a vital part in that. I welcome the Prime Minister’s commitment to mental health training—I think it was referred to mental health first aid training. I was not entirely sure what that meant, but mental health awareness training is a goal we should seek to achieve. I would like every school to seek to promote mental health awareness and to give students pointers on where to go, and all teachers to have an understanding of how to spot signs of mental ill health.

I welcome the forthcoming Green Paper on children’s mental health, and I ask the Minister to consider an earlier Education Committee report, prior to the joint report between the Health and Education Committees that we have talked about. The earlier report was in the 2015-16 Session, when the Education Committee looked into the mental health of children in care. One of the points that emerged in that report was about navigating the system and getting access to support when a child might experience multiple placements in any one year. One of the blockages to accessing support was that without a stable placement, the child was not eligible to qualify for child and adolescent mental health services. I urge the Minister to commit to reading that report, because we took evidence from a large number of influential and knowledgeable people, and their recommendations and some of the proposals in the report were somehow put to one side at the end of the last Session. Please, please can the Minister read the report and confirm that the upcoming Green Paper will specifically include provision for children in care and the need for school-based counselling for looked-after children?

To re-emphasise that point, during the inquiry into the mental health care of children in care, one child told us:

“The state took us away from our parents, the Government are now our parents. Parents will do anything for you”—

parents will help their children to navigate the system—

“but the state doesn’t provide that.”

We have a special duty to those children in care, who do not have parents to fight the system for them and help them to get access.

About a year ago, we had a debate on that report in this Chamber. I urge the Minister to look back at what was said, because the excellent and much missed former Member for Crewe and Nantwich, then the Minister for Children and Families, had a great deal to say. He committed to a number of measures that I feel may also have slipped to the back of the shelf. I would love to see that work not going to waste but brought forward during the drafting of the Green Paper, so that the Committee’s work, the Minister’s commitment and the evidence of all the experts are not wasted. The then Children’s Minister said that there would be an expert working group to consider access to mental health care for children in care via school systems. That may have fallen by the wayside, or the expert working group may be well under way, and I would be grateful to know which it is. If the Minister cannot answer that today, I would be most grateful if he did so in due course.

I hesitate to sound any discordant note in this collaborative and helpful debate, where we all want to achieve the same thing, namely improving the mental health of children in school, but I have concerns, and will sound a note of caution, about the compulsory element for all schools. I recognise that there is patchy provision across the country, but to my mind it is the CAMHS provision that is so patchy. I am wary of imposing on teachers yet another burden that becomes a tick-box exercise, so they can say, “We’ve done this—end of. We’ve dealt with mental health care of children. We gave that half-hour lesson in the personal, social and health and economic education class and that’s finished. We don’t have to deal with it anymore.” Schools may want to signpost students, discuss wellbeing through informal drop-ins or school counselling sessions, or they may want to make it a formal part of PSHE, but that may not always deliver the results we all seek for our young people.

I also question whether a school should be responsible for identifying our young people’s mental health needs. As we have heard from many speakers today, teachers are not mental health professionals. They cannot replace the services of CAMHS and we should not ask them to do so. What role should we encourage families to take in helping young people to understand self-care and the pointers to where mental health support is required? We should all encourage young people to take care of their own mental health and wellbeing and, as they grow older, to accept some responsibility and accept that they can make a difference to their own mental health and seek out assistance and support where required.

[Sir Nicholas Soames]

I entirely agree with the line that my hon. Friend is taking, but as I said to the hon. Member for Newcastle upon Tyne North (Catherine McKinnell), who so brilliantly introduced the debate, there are not enough teachers qualified to do that, and to get them all up to speed and consistently trained will be a very long-term project. What we need to aim for is a tiered service that works, where the teacher is able to help with more than just emotional first aid, but is then guaranteed to be able to pass the child through to the next stage, which will then deal with them. It is the next stage that simply fails in my constituency. It fails. That is the stage where, if a child can cope with their own mental difficulties—God knows that is hard enough—there is someone they can go and talk to, who can refer them on to someone who will do something about it.

[Lucy Allan]

My right hon. Friend makes a vital point. I would like to see mental health awareness built into the fundamental training of all teachers. To be a good teacher, someone has to have an understanding of the mental health issues and challenges that young people in their care will face.

Far more important than training one teacher to be a first aid counsellor is to give all teachers that awareness, so that they can identify the signs and be able to point people in the right direction and encourage young people to seek help. They could also then advise them on how to navigate the system and access that help, because one of the most difficult things in providing support to young people—to anybody with a mental health condition, in fact—is their accessing the support that they need. Somebody may go along to their GP and say they think they are having a mental health crisis, but how many people can actually navigate the appointments system and persuade their GP that that is the issue that they face? That is where young people need the most help possible, because navigating the available mental health system, which is of a high quality in some areas, is a complex process.

To give an example in support of my earlier point about a formal mechanism for educating young people about mental health within a PSHE framework, a young constituent told me in a recent surgery that she had learned all about child exploitation in school in a PSHE class. As she sat there listening and taking notes, she knew that she was a victim of child sexual exploitation at that time, yet she still felt unable—despite the fact it was being discussed within a classroom environment—to get the help she needed. She went through the motions of attending the class and nodding away, but she felt completely disconnected from what was going on; it did not bear any relation to her personal experience.

I therefore do not think that compulsory mental health education is enough; we should look for an entire shift in attitude. It is about creating an environment that gives the confidence to ask for help and to know where to go, and that says it is okay to ask for help. Perhaps that is the sticking point at the moment: young people can sit in a class, but do they know how to access the help they need, or even have the confidence to overcome some of the shame and stigma that still exists in going up to the teacher and saying, “Okay, I have a problem—what do I do?”? That young person felt unable to do that, in the context of the child sexual exploitation problem that she faced.

[Wera Hobhouse (Bath) (LD)]

I was a secondary school teacher and I delivered some PSHE classes. I remember that they were often not very satisfactory, because there were no exams, so young people did not take it particularly seriously. Also, they were often lumped into the last lesson of a particular school day. Would it not be a lot better if each school had a dedicated mental health lead? That would obviously be a teacher-led position, and each school could then deliver a strategy for dealing with mental health.

[Lucy Allan]

That is an excellent idea, although I would still like to see some form of training built into the basic PGCE training that all teachers receive. However, a dedicated individual with a strategy for the school, which the governors would be aware of and everybody would buy into through a whole-school approach, would be extremely helpful.

As I am sure anybody who has ever heard me talk about anything knows, I am instinctively wary of the state telling those at the coalface how to best deliver for the young people in their care. Education should never be about delivering as many qualifications as possible but always about preparing young people for life and the challenges that they will face. Building resilience is a key part of that.

[Catherine McKinnell]

The hon. Lady is making a compelling speech, and I understand her reservations about the state telling teachers how to do their jobs. However, a key issue, which I hope the Government will respond to, is the role of Ofsted and its power and influence over what schools can and cannot manage to do within their limited resources and the time in the school day. Will she take that into consideration?

[Lucy Allan]

The hon. Lady makes an important point about Ofsted’s role in all of this. Many teachers, who I am sure she speaks to, live in fear of Ofsted. I do not know if she has ever been a school governor, but Ofsted visits are quite a scary process, as is the whole concept of having one more box to tick—“Have I satisfied the safeguarding requirement? Have I satisfied the mental health requirement?” Instead of, “Have I met the needs of the children?”, it is, “Have I met the needs of Ofsted?” While I understand that that focuses the attention of the school, the governors and the teachers as a body, sometimes it becomes, “As long as I keep Ofsted happy, perhaps what I’m delivering to the young people in my care is a secondary priority.” I would be very concerned if that were the case.

[Catherine McKinnell]

I understand the hon. Lady’s point, and it is certainly one to consider, but the flipside to her argument is that schools are therefore so focused on delivering what Ofsted requires of them, in terms of ticking the boxes, that the holistic wellbeing of the young people and children in their care is perhaps not prioritised as much as it could and should be.

[Lucy Allan]

The hon. Lady is absolutely right. What we must press for, and what we must ask the Minister to respond to, is that this becomes a priority for all schools. They should help their children to identify the signs of mental ill health and equip them with the skills to deal with those, as well as helping them to access the support that they need. All teachers must be trained to understand the signs and the steps they can take, but we should be wary of forcing more burdens on to already overburdened schools and teachers, as we heard on the Education Committee last week.

The Green Paper is to be welcomed, and I urge the Minister to consider the recommendations of the Education Committee’s report on the mental health of children in care. They are so often forgotten, and their mental health needs are often way above those of children in a family environment that helps them to overcome some of the challenges they experience, so it merits specific provision in the Green Paper. I will continue to press for that, so that those children are not forgotten. I thank the hon. Member for Newcastle upon Tyne North and everybody else who has come together today to make an important contribution on what is a huge issue for the future of our young people and their success in building a future in which they are able to cope with what life will throw at them.

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[Chris Ruane (Vale of Clwyd) (Lab)]

I apologise, Mr Wilson, for dipping out for an hour. I had to meet Carwyn Jones, First Minister of Wales, at a Welsh group meeting, but I was here for the first 30 minutes and I did intervene on many occasions on my hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell).

The World Health Organisation says that by 2030 the biggest health burden on the whole of the planet will not be heart disease or cancer; it will be depression. The term “burden” is not a pejorative but a descriptive term for the burden on the individual, their family, society and the economy. This tsunami of mental ill health is coming our way, and I believe that we are ill-prepared for it—ill-prepared for how we treat our adults and especially our children and young people.

In the 19th century, Frederick Douglass said:

“It is easier to build strong children than to repair broken men”—

he definitely should have said, “and women.” That is the situation today. If we can build strong children and give them that resilience, it benefits the individual child and their family, and the knock-on effects of building in that resilience from an early age will benefit our economy and health service down the decades.

I am speaking today about mindfulness. I am co-chair of the all-party parliamentary group on mindfulness— I draw hon. Members’ attention to my declaration of interest. I gave the statistic in an intervention earlier that 32.3% of 15 to 25-year-olds experience one or more psychiatric conditions. That is while they are studying for their GCSEs, A-levels, degrees or post-graduate degrees. They are studying and living sub-optimally, and their suffering is magnified because we have not put the strategies in place to help those young people to cope with the modern stresses of society. Our Ministers and health service say that oral hygiene is very important, and we must brush our teeth three times a day; that nutritional health is very important, and we must have our five fruit and veg a day; and that physical activity is very important to keep our bodies healthy. But how much time is allocated to looking after our own minds, our own brains and how we actually view the world?

There are many stresses out there affecting young people. There are the stresses of advertising. Young people have Maccy D’s telling them to “Go large,” and the fashion industry saying “No, no—size zero.” The average child will see 120,000 adverts a year and the messages are well researched and well honed, especially in a digital age, when every time a young person goes on a computer an algorithm calculates what is going on inside their head and sends micro-messages to them. The point of adverting is to make people unhappy with what they have, so that they will purchase something else.

The impact of social media has already been mentioned by many speakers. When I went to school in the 1960s, if I had a fall-out, it was with five or six people. Now it could be 5,000 or 6,000 people. Being tested at school— at the ages of five, seven, 11, 14, 15, 16, 17, 18 and 21—produces massive stresses on young people. We are not equipping them with the capability to deal with those stresses; in fact we are adding to those stresses. There are many other factors that are bringing stress to our children and young people today.

We as politicians should be doing something about that, and I am pleased that this is an area we can agree on. I pay tribute to the former Prime Minister David Cameron for measuring wellbeing and saying—he was quoting Robert Kennedy—that GDP and wealth are not enough; we must look at the wider benefits to society and what makes us click as a society and as individuals within that society. I pay tribute to the Prime Minister for declaring in January that mental health, and children’s mental health, will be right at the top of her priorities. Our own shadow Chancellor, my right hon. Friend the Member for Hayes and Harlington (John McDonnell), quoted Robert Kennedy at the Labour conference in saying that the wellbeing of society is important. This is an area where we can, and should, come together.

I want to stress the impact that I believe mindfulness can have. Mindfulness has been freely available on the national health service since 2004. Some people might think that it is a bit woolly, but the copper-bottomed science has been proven to the National Institute for Health and Care Excellence by Professor Mark Williams, John Teasdale and Zindel Segal from Canada. Mindfulness has been available, but the take-up is minimal. The science has been proven for this intervention, which puts the individual in control and is cheaper in the long term than antidepressants or talking therapies, yet the take-up has been minimal. Again, I pay tribute to the Government, because they have promised to train an extra 200 or 300 mindfulness-based teachers over the next two years, and that is progress. We have been teaching mindfulness to MPs, peers, their staff and civil servants in Westminster.

[Lucy Allan]

The hon. Gentleman is making a very interesting point about the benefits of mindfulness. I have had the great pleasure of participating in the MPs’ mindfulness training, and have to say that it is quite a challenge to get MPs to turn off their phones and concentrate. Does he agree that we need to encourage more people to understand the benefits of mindfulness and to participate in it?

[Chris Ruane]

Absolutely. Ghandi said, “Be the change you want to see.” We are change-makers in this room, and we need to make our personal, political and parliamentary decisions from a position of personal equanimity and balance. If we do that, we will be doing tribute to ourselves and our society. Some 150 MPs and Lords have had the training, and we instituted a parliamentary inquiry on mindfulness in health, education, criminal justice and the workplace. We have put forward recommendations.