Children's Mental Health Services: Lincolnshire

Maria Caulfield Excerpts

Tuesday 7th February 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Sir Christopher. I thank my hon. Friend the Member for Grantham and Stamford (Gareth Davies) for securing this debate and for the way he continues to champion children’s mental health services. I recently discussed many of the issues with him and some of his constituents. The experience that they brought to me has helped to influence the work we are doing. I reassure my hon. Friend that there is a huge focus on improving children’s mental health services, both nationally in terms of funding and, as he indicated, in terms of staffing. In his local area, much of the work will be in the major conditions strategy, which includes mental health, and also in our suicide prevention strategy—[Interruption.]

[Sir Christopher Chope (in the Chair)]

Order. There is a Division in the House, so the sitting is suspended. If there is one vote, it will be for 15 minutes; if there are two votes, it will be for 25; and if there are three votes, as expected, it will be for 35 minutes. I look forward to seeing Members back here then.

--- Later in debate ---

[Maria Caulfield]

Thank you, Sir Christopher, for allowing me to continue what I was setting out to my hon. Friend the Member for Grantham and Stamford, who has been campaigning so eloquently on the issue of children’s mental health, particularly from a constituency point of view. He is quite correct that we are investing record levels of funding into children’s mental health services. We are trying to recruit as many staff as possible to expand those services, which are being extended to support children’s mental health. I will touch on how that is happening, both at a local level in Lincolnshire and nationally across England.

Lincolnshire’s children and young people’s mental health services have always been rated as outstanding by the Care Quality Commission. Pre-pandemic, the average wait for child and adolescent mental health services assessments was 4.4 weeks, and the Healthy Minds Lincolnshire early-intervention service helped to reduce referrals to child and adolescent mental health services by 5%. Lincolnshire has always had an excellent track record in delivering services and supporting young people in particular with their mental health, compared with the figures nationally. I know that is not necessarily much consolation for those parents and children waiting for services, but Lincolnshire mental health services have traditionally been very good.

However, the pandemic has had an impact, as it has across the country. In Lincolnshire, referrals to CAMHS have increased by 15.7%; nationally, the increase was 35%. Although Lincolnshire has not had the same increase in the number of referrals as other parts of the country, it has still had a significant increase. Lincolnshire has had 15% more clinical contacts than the national average, and 92% of children who sought an emergency telephone response received one within four hours as a result. We can see, then, the scale of the pressures that services are facing. Lincolnshire has performed relatively well compared with most other parts of the country but is experiencing challenges. That was very much the point that my hon. Friend made: his constituents are now struggling with waiting times, the sheer scale of the number of referrals is putting pressure on the service, and although a lot of work is going on to improve things, his constituents are feeling the pressures on the service.

The loss of workers in this field is particularly high in my hon. Friend’s area, as it is in other parts of the country. I assure him that we are recruiting more staff, but it takes time to train them up and get them providing services at a local level. Lincolnshire does not have a children’s and young persons’ in-patient unit, and I have heard from his constituents about the impact of that and the difficulty of a child being placed out of area. We fully recognise that and want to work with his local team on it. His local integrated care board is standing up to the challenge—it has increased funding to CAMHS by £1.2 million in this financial year to help to reduce waiting times, which has had a positive impact—but the workforce is probably the single biggest issue in terms of trying to improve services further.

By September of last year, 67% of children and young people who were assessed for CAMHS were assessed within six weeks. If early-intervention and emotional services are included, 72.5% of young people who were assessed were assessed within four weeks, with the national average being 68%. The big concern for Lincolnshire is the length of time that children are waiting for support and the workforce capacity to change that, so I am committed to working with my hon. Friend’s ICB to see how we can address that concern.

My hon. Friend touched on the out-of-hours service. Such services are available throughout the country—there are 24/7 helplines available—but he is quite right that many people do not know how to access those services, and that applies in respect of emergency services as well. We hear from ambulance trusts throughout the country that very often ambulances have to attend to someone with a mental health crisis, and they are not always able to access a 24/7 service. It is not because it is not there but because sometimes it just not clear how it can be accessed. There is, then, a lot of work to do.

Let me reassure my hon. Friend about what we are doing from a national perspective; this will be replicated in Lincolnshire. We are on course to deliver 399 mental health support teams in schools and colleges, and we already have 287 of them in place. They are making a significant difference to children and teachers. They are able to support children who have mental health concerns, mental illnesses or conditions at an earlier stage and get young children into the system much more quickly, before they reach a crisis point, to get them the help and support they need. They also take the pressure off teachers, who until now have done a significant amount of the heavy lifting when it comes to children’s mental health.

We are providing £79 million to boost capacity in children’s mental health services and to help 22,500 more children and young people to access those services. Also, we are specifically expanding access to services that address eating disorders. The funding has increased significantly to try to match our level of ambition, with £53 million of support in 2021-22, which will rise to £54 million in the forthcoming financial year. All that work sits on top of record levels of investment in NHS mental health services in England and the unlocking of support for an extra 345,000 children and young people.

I recognise from the points that my hon. Friend made that where we are making a difference that is great, but for the children and parents who are waiting it is still very difficult. Although Lincolnshire is probably performing better than most parts of England, it is facing some significant pressures with workforce capacity and the lack of an in-patient facility, which also puts pressure on community services.

The Government hope to reform the Mental Health Act 1983 fairly soon. That will support mental health services and make them much more community and crisis team-led, rather than letting people get into crisis and their needing much more extensive services. We have recently announced our major conditions strategy, which includes mental health, and we will also publish our national suicide prevention strategy, in which we will focus on children and young people in particular, because we recognise that significant work needs to be done for them.

It is also about ensuring that we have the workforce capacity in place. The Chancellor and his team will specifically include mental health in the workforce strategy, which is being worked on. We know that when we expand community services to get people seen much more quickly and avoid crisis situations, we will absolutely need the workforce at a community level to meet the demand.

I hope I have been able to reassure my hon. Friend. The Government recognise that there are challenges, particularly with things such as out-of-hours support and rapid access into services. I thank my hon. Friend for the work he is doing by constantly raising the situations his constituents face, because it does make a difference. It means that we are able to assess whether we are making progress in supporting not only children and young people in particular but everyone who wants to improve their mental health or has a mental illness and is in need of support.

Our ambition is that children and young people, wherever they are from in England, whatever their background and whatever their mental health condition, will be able to get the support that they need in a timely manner. I know that my hon. Friend will be holding our feet to the fire to make sure that that happens, particularly in Lincolnshire.

Question put and agreed to.

[Sir Christopher Chope (in the Chair)]

Because the Minister responding to the next debate is not present, I have to suspend the sitting until 5.7 pm. We will then have one hour in which to debate the next motion.