Mental Health Education in Schools Debate

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Department: Department for Education

Mental Health Education in Schools

Nicholas Soames Excerpts
Monday 6th November 2017

(3 years, 11 months ago)

Westminster Hall

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Department for Education
Catherine McKinnell Portrait Catherine McKinnell
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6 Nov 2017, 4:34 p.m.

I am more than happy to join my hon. Friend in congratulating those organisations. He has campaigned hard on that issue in this place for many years.

HeaducationUK continues:

“Mental health education is delivered via the non-compulsory subject PSHE (Personal, Social, Health and Economic), or sometimes during school assembly or drama lessons. As PSHE is a non-compulsory subject, this means that not all schools teach it, and that in turn means that mental health education isn’t always taught.”

Nicholas Soames Portrait Sir Nicholas Soames (Mid Sussex) (Con)
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6 Nov 2017, 4:34 p.m.

I completely support the thrust of the hon. Lady’s argument. Does she agree that, because of the lack of training for teachers in this particularly important subject, what is being applied now is really just emotional first-aid? If people are to do more, they have to have the ability to teach more. How does she see that working out?

Catherine McKinnell Portrait Catherine McKinnell
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The right hon. Gentleman makes a very important point. Teachers are not mental health professionals: they are teachers by profession. It is therefore vital that we improve not only our educational input but the training and support for teachers so they can deliver this support at an appropriate level and are able to signpost and refer issues if professional input is required. I will return to that key issue later.

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Catherine McKinnell Portrait Catherine McKinnell
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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.”

Nicholas Soames Portrait Sir Nicholas Soames
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6 Nov 2017, 4:56 p.m.

I am very sorry to intrude on the hon. Lady’s good nature by intervening again. I share everything that she says and I will support it to the nth degree, but I am worried about a question that needs to be answered. Given the diversity of teacher training, how will we get the kind of consistency required to deliver the excellent improvements that she suggests?

Catherine McKinnell Portrait Catherine McKinnell
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6 Nov 2017, 4:58 p.m.

The right hon. Gentleman raises a pertinent question and one that I would be keen for the Minister to answer when he responds. This is not just about the young people who we want to benefit from a whole-school, holistic approach to mental health education; it is about the ability of our teachers, support staff and the wider school to deliver that. It is partly a training issue but partly, and significantly, also a resource issue. I am pleased that the right hon. Gentleman raised that question and I would like to hear the Minister’s response.

The whole-school and universal approach to mental health is supported by the British Psychological Society and the Association of Educational Psychologists. The charity YoungMinds, which also campaigned on this issue, made the following recommendations to the Government in its recent report, “Wise Up: Prioritising Wellbeing in Schools”. It recommended that existing legislation should be updated

“to enshrine wellbeing as a fundamental priority of schools”

and that mental health and wellbeing should be established

“as a central part of school improvement, by strengthening the focus on wellbeing provision within the Ofsted framework”.

It also recommended that a wellbeing measurement framework should be developed, trialled and established by 2020, that an

“understanding of wellbeing, mental health and resilience”

is embedded in all teacher training, and that schools are provided with

“designated funding to resource wellbeing provision.”

That leads me to a number of key issues that I believe must be addressed alongside the provision of compulsory mental health education if we are serious about genuinely supporting children and young people on this issue.

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Lucy Allan Portrait Lucy Allan (Telford) (Con)
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6 Nov 2017, 5:31 p.m.

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.

Nicholas Soames Portrait Sir Nicholas Soames
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6 Nov 2017, 5:39 p.m.

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 Portrait Lucy Allan
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6 Nov 2017, 5:39 p.m.

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.

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Lucy Allan Portrait Lucy Allan
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6 Nov 2017, 5:46 p.m.

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.

Nicholas Soames Portrait Sir Nicholas Soames (Mid Sussex) (Con)
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6 Nov 2017, 5:48 p.m.

It is a great pleasure to serve under your chairmanship, Mr Brady. I congratulate the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) on her formidable introduction. It was completely dispassionate yet very powerful about this terribly serious issue. I also congratulate my hon. Friends who have spoken. I will, unusually, speak very briefly, just to make a couple of points.

My hon. Friend the Member for Telford (Lucy Allan) made an important point about the ability of children and young people to confront this issue for themselves, and also to have the immense guts required to tell someone that they really do have a problem. It takes a brave person to do that, who will quite often be in a very ugly place, which, if anyone knew what they were dealing with, would have been identified sometime beforehand. This is where the Government have an immensely important part to play in the very difficult area of children’s centres and children’s hubs and all the works that go towards trying to help people through these very difficult periods.

However, those children all end up back at school somehow, and it is the teachers who have to pick up the pieces if the parents cannot; often, the parents will not be able to, or will be so worried that they will not know how. As so often, the teachers have to rescue the day. It is not easy to do that in such a specialist area for someone who has not been properly trained to do so.

The hon. Member for Bath (Wera Hobhouse) made mention of PHSE teaching. I had not thought of that, and it is true—if it is lumped at the end of the day, with no exam on it, who will take it seriously? I agree.

This issue is a fundamental part of growing up. Looking back on it, I know how lucky I was to have a happy, golden childhood. Parents come to see me in my surgery who are desperately worried about their children and anxious about what they will get at school. When we talk to the schools, the teachers say that they know they cannot do the job properly, and headteachers know they do not have the resources to do it.

My right hon. Friend the Minister and I live in West Sussex. He is a senior West Sussex Member, and he knows the difficulty that our local county council has with finance for this kind of thing. I was in a school the other day where I asked about mental health teaching and was told that an excellent lady had done it, but she had moved on in a general sort-out and had not been properly replaced. We are back into what my hon. Friend the Member for Telford and my right hon. Friend the Member for Harlow (Robert Halfon) were talking about.

I think this is a national crisis. I wish, if I may, to stray a little beyond what I normally do in public and to congratulate the Duke of Cambridge and Prince Harry on what they have done to bring national attention to this issue in a very powerful, acceptable and touching way. We can see the connection they have with these young people and the way the young people look to them for help, which is what they are providing. I commend them and the Duchess of Cambridge very strongly for what they are doing. It is very important work, and I hope they will go on doing it.

I do not want to overdo it. There are a number of areas in our national life where we constantly face great difficulties, but this is a real national crisis, and the scale of it is only just beginning to be realised. I know the Minister will take very seriously what the hon. Member for Newcastle upon Tyne North said, but the whole question of training teachers is cardinal. I repeat that if there is not consistent teaching across a diversity of providers, there is no way these children will be able to access the kind of services we want to see. Headteachers and teachers do not have the time; they have so many things to deal with, and they need to be confident they have the skills and ability to see these children right in referring them to other services.

Mr Brady, thank you very much for calling me to speak. I apologise for speaking so briefly, as I know it will disappoint you, but there are others here who know much more about this than I do.

Oliver Heald Portrait Sir Oliver Heald (North East Hertfordshire) (Con)
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6 Nov 2017, 6 p.m.

I do not intend to speak at great length. I would just like to reiterate the vital nature of this issue.

I support what my right hon. Friend the Member for Mid Sussex (Sir Nicholas Soames) said a moment ago: this has got to the point where it is of great national importance. Some years ago, I was my party’s mental health spokesman, and at that time we were learning about children’s mental health. We now have a real understanding of how early mental health problems can arise—something that was not fully understood back then —and how important it is to intervene as speedily as we can to tackle these issues, which can become much worse over time if that does not happen.

Hertfordshire County Council has supported the Northherts Emotionalhealth in Schools Service, led by a co-ordinator who is a very experienced school mental health counsellor. She is offering teacher training and support, and numerous teachers have now been taught about how counselling works and mental health issues that arise. Teachers have found that knowledge very useful for not only the students but themselves, because they also face pressures. The service offers training to parents, and forums are held on subjects such as self-harm and promoting resilience against anxiety, for which there is now quite a waiting list. It offers peer mentor training on positive mental health called “How to help a friend” and provides schools with registered counsellors, who are helping. There is close liaison with NHS services, so everybody knows what is going on. As my right hon. Friend the Member for Mid Sussex said, it is necessary to understand the problem but then also perhaps to pass it on, in cases of serious mental conditions.

That approach seems to be working quite well. The service has had support from the Anna Freud Centre and recently held a conference with early years and primary school staff. There was a really good response from everybody involved, including the Anna Freud Centre and Steve Mallen, who heads up the MindEd Trust. His son Ed took his life two years ago. Steve set up that charity and is very supportive of this approach. He believes it is helping parents, students and teachers. Comments that came out of the conference included,

“The workshops were particularly useful and I can see how they can be implemented in my school and be beneficial to the children and their families”

and,

“All of it was useful. A good balance between knowledge and practical stuff.”

This petition is about education in schools, but the Minister might like to look at the sort of service we have in north Hertfordshire, with his Green Paper in mind. Finally, it is worth mentioning that young people, of course, are marvellous with digital and social media. I understand that some apps are available that can help with anxiety and reinforce messages. He might want to look at that too.

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James Morris Portrait James Morris
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6 Nov 2017, 6:02 p.m.

I thank the hon. Lady for her intervention. The simple answer to her question is yes.

[Phil Wilson in the Chair]

The Government are, as I understand it, fully committed to that additional investment over the five years of this Parliament. The truth is that a lot of progress has been made under the current Government in terms of further investment in child and adolescent mental health services. Obviously, there is more to do, and Future in Mind, to which the hon. Lady refers, was a very good initiative, led by the right hon. Member for North Norfolk (Norman Lamb) when he was the Minister with responsibility for mental health. I am not arguing that somehow that money will magically transform the CAMHS system, but the truth is that some progress has been made in understanding the extent and prevalence of children and young people’s mental health problems. The Department of Health is beginning to gather, for the first time, meaningful data about what is happening in the system. That was never in place before; child and adolescent mental health was a data-free zone until very recently.

Also, in terms of the extra money, we have only started to understand and have the data on where the money is actually being spent. The NHS dashboard that has been created for mental health is, for the first time, acting as a tool to put pressure on local commissioners to spend the money that they have been allocated. Clearly, there has been a discussion about this. The money is not ring-fenced currently, but with the dashboard created by the Department of Health, we can see what local clinical commissioning groups are spending on child and adolescent mental health. That should be used as a tool to continue to put pressure on commissioners to make the right sorts of choices.

I mentioned what the vision and set of principles should be for this area. In the school environment, we should be trying to move towards what I call mental health literacy, which means giving young people the facility to talk about the mind and their mental health in a way that is intelligible for them and their peers. That is what we should seek to achieve in this context. We have had a very rich debate talking about this issue. I do not think that it is just a question of what is in the curriculum. Young people and children as they are growing up will listen to teachers in a particular way. They might not really want to listen to the message that the teacher is giving, because the teacher may represent a position of authority that they feel uncomfortable with. I am not saying that it is not important that teachers are trained and aware and that there is provision in the school environment, but that is not the whole picture.

We need to consider two further aspects. Peer pressure or peer conversation is almost as important as what is in the curriculum. I am talking about a structure in the school environment that allows young people to talk with one another about mental health, equipping them with the knowledge, skills and literacy to be able to have that conversation. I remember that back when I was at school, I felt very isolated—a sense of isolation—that somehow what I was thinking about was not legitimate; it was something dark and horrible and I was the only person who could possibly be having that issue at the age of 13 or 14. It is extremely liberating for young people when they realise that a vast range of their peers have the same sorts of questions about the future. It is relatively normal for adolescents to have periods when they are very uncertain about the future and how they fit in with their peers. They may have particular issues, but that ability for the school community, for children and young people together, to be able to talk about that is vital. It is a kind of therapeutic valve in the school environment, which I think is critical. In fact, much of the evidence base that I have seen shows that peer-to-peer communication on mental health in schools is extremely effective as a mechanism for helping young people, so that is the vision of what we should seek to achieve.

Also crucial, as other hon. Members have mentioned, is the involvement of families in the conversation. Families should not be excluded from the conversation, but brought into it as part of the process that we are describing, because obviously the family is the crucible in which a young person is brought up. For many young people, that is, as my right hon. Friend the Member for Mid Sussex (Sir Nicholas Soames) said, a golden experience, but for many other young people it is characterised by dysfunction and relationships breaking down; it is often characterised by confusion.

Nicholas Soames Portrait Sir Nicholas Soames
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6 Nov 2017, 6:07 p.m.

I agree with that point and ask my hon. Friend to consider the excellent work being done by our hon. Friend the Member for Congleton (Fiona Bruce) on family hubs and centres, which I think is remarkable. If people are in the very unhappy position described, the trouble is that there is no one single signpost for them other than, as I said, the poor teachers, so the family hubs or centres are immensely important and must be encouraged and developed.

James Morris Portrait James Morris
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6 Nov 2017, 6:08 p.m.

I definitely agree with my right hon. Friend on that. As I said, the family is the crucible. The issue is often very complex, and the relationship between the family and the school is a critical part of what we are discussing because, again, families can be a place where therapy is very effective, and can be a very effective way of helping the child and making them resilient, so I very much agree with my right hon. Friend’s point.

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Mike Kane Portrait Mike Kane (Wythenshawe and Sale East) (Lab)
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6 Nov 2017, 6:38 p.m.

It is a pleasure to serve under your chairmanship, Mr Wilson. I acknowledge the good work done by the Shaw Mind Foundation in securing the debate. For Adam Shaw, the foundation’s chairman and founder, after struggling for 30 years with his own mental health, which led him to the brink of suicide, this is a personal issue. It is vital that we listen to the voices of those such as Adam who have experienced mental ill health in their childhood. They are telling us that understanding our own mental health is a life skill, which should be part of our childhood education as much as reading and writing. The response from the public to Adam’s petition shows that that view is shared by many people in the UK. This debate has left us in no doubt that action needs to be taken now to safeguard our children’s mental health.

My hon. Friend the Member for Newcastle upon Tyne North (Catherine McKinnell) made an exceptional speech. It was a real tour de force, highlighting national and local policy and bringing in individual cases from her constituency. The 103,000 people who signed the petition so that it could be debated in Parliament today can be extraordinarily proud of her contribution.

Other contributors to this debate include the Chair of the Select Committee on Education, the right hon. Member for Harlow (Robert Halfon). I could not agree more that mental health requires a whole-school approach rather than just being pushed into PSHE lessons. As a former PSHE co-ordinator for a primary school in the borough of Trafford, which I represent, I know that mental health cannot be taught in the time given to that subject. More must be done.

The hon. Member for Telford (Lucy Allan), who is also a member of the Select Committee, spoke extraordinarily powerfully about the stigma that needs to be shattered; this debate is part of doing so. I join the right hon. Member for Mid Sussex (Sir Nicholas Soames) in congratulating the Duke of Cambridge and Prince Harry, who have raised the issue. He also spoke powerfully about the need for teacher training to incorporate mental health education in colleges and universities up and down the land.

The hon. Member for Halesowen and Rowley Regis (James Morris) gave an extraordinarily powerful personal testimony about his own mental health during his childhood. MPs being brave in that way in public life are beginning to shatter the stigma. The right hon. and learned Member for North East Hertfordshire (Sir Oliver Heald) also spoke eloquently about the good practice that he has seen between NHS councils and schools in his constituency. We need exemplars of good practice across the land.

My hon. Friend the Member for Vale of Clwyd (Chris Ruane), citing the World Health Organisation, said that mental health would be the defining issue of the 21st century and that there is a tsunami coming. He is a passionate advocate for mindfulness day in, day out in this place. We have had an extraordinarily good debate. As a former teacher, I know that schools are struggling to deal with an upsurge in mental health needs among pupils.

The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron), in an excellent speech, brought her clinical prowess and expertise to this Chamber. As she pointed out, statistics show that one in 10 children have mental health issues. That is three children in every classroom of 30. One in five adolescents experience a mental health problem in any given year. A recent survey by the union NASUWT involving more than 2,000 teachers and school leaders further underlined the scale of the problem: 98% said that they had come into contact with pupils whom they believed were experiencing mental health problems, and 46% said that they had never received any training on children’s mental health or on recognising the signs of possible mental health problems in children.

We know that half of people with mental health problems as adults present symptoms by age 14, and 75% do so by age 18. Shockingly, suicide is the most common cause of death for boys between the ages of five and 19. Data from a recently published Government study showed that one in four girls are clinically depressed by the time they turn 14, and hospital admissions for self-harm are up by two-thirds; the number of girls hospitalised for cutting themselves has quadrupled over the past decade.

I also want to point to research on the LGBT community. Stonewall found that more than four in five young people who identify as trans have self-harmed; that is an incredible statistic. Three in five lesbian, gay and bi young people who are not trans have self-harmed. Shockingly, more than two in five trans young people have attempted to take their own life. For that community, mental illness rates are huge.

The number of young people aged under 18 attending accident and emergency for a psychiatric condition more than doubled between 2010 and 2015, yet just 8% of the mental health budget is spent on children, although children represent 20% of the population. Referrals to CAMHS, as has been mentioned, increased by 64% between 2012-13 and 2014-15, but more than a quarter of children and young people referred were not allocated a service. Perhaps most damningly, Public Health England estimates that only 25% of children and young people who need treatment for a mental health problem can access it.

Following the groundswell of evidence of mental ill health in our children and young people and the system’s abject failure to deal with it, the Prime Minister announced in January, to a fanfare, a package of measures aimed at transforming mental health support in schools, workplaces and communities. As my hon. Friend the Member for Worsley and Eccles South (Barbara Keeley) pointed out following the Prime Minister’s announcement, that will not deal properly with the burning injustice faced by children and young people with mental ill health.

I am afraid that this Government talk a good game on mental health, but in reality, they have continued to underfund services. The Government’s proposals do nothing to improve waiting times for treatment for children and young people, and they put pressure on schools to take on extra work on mental health, at a time when they are having to cut budgets. The Minister and I have been no strangers to discussing budget cuts in this Chamber over the past six months.

The evaluation of the mental health services and schools link pilots published in February underlined the lack of available resources to deliver the Government’s offer universally across all schools. Headteachers are telling us that real-terms cuts of £2.8 billion to school budgets threaten existing in-school care. On top of that, funding for child and adolescent mental health services fell by almost £50 million between 2009-10 and 2012-13. The Government also cut £600 million from mental health budgets between 2010 and 2015, and the number of mental health nurses in our country has decreased by 6,000 since 2010. Our Government continually expect our teachers, schools and health services to do more for less.

Nicholas Soames Portrait Sir Nicholas Soames
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6 Nov 2017, 6:47 p.m.

Will the hon. Gentleman give way?

Mike Kane Portrait Mike Kane
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6 Nov 2017, 6:47 p.m.

I would love to give way to the right hon. Gentleman, so I can regroup and have a glass of water.

Nicholas Soames Portrait Sir Nicholas Soames
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6 Nov 2017, 6:48 p.m.

I do not want to spoil the harmonious general cross-party agreement on this point, but the hon. Gentleman’s litany of despair occurs against the background of a substantial investment in mental health in this country. The problem—I see it in my constituency, and I am sure that everyone in this room sees the same thing—is the time from what, in the Army, they call flash to bang. Once the money is voted and put into the service, it takes a very long time to bring through properly qualified people to deal with the problems.

Mike Kane Portrait Mike Kane
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The right hon. Gentleman spoke eloquently about the need for better mental health provision for teachers throughout our country, but I point out to him, as part of the litany of despair, that a third of teachers who have trained since 2011, on this Government’s watch, have already left the profession. We must deal with these issues if we are to have a future cadre of teachers who are adequately trained in mental health education.

On the upside, there are things that we can do. We could invest in CAMHS early interventions by increasing the proportion of mental health budgets spent on support for children and young people. In order to protect service, we could also ring-fence mental health budgets and ensure that funding reaches the frontlines. We know that school counselling is an effective early intervention; Labour have committed to ensuring that access to counselling services is available for all pupils in secondary schools.

Early intervention is much cheaper to deliver, as has been pointed out. The Department of Health estimates that a targeted therapeutic intervention delivered in school costs about £229, but derives an average lifetime benefit of £72,525. That is a cost-benefit ratio of 32:1. Of children and young people who had school counselling in Wales in 2014, 85% did not need any onward referral to children and adolescent mental health services.

The sad fact is that the Government’s plans for school budgets will result in further cuts to school counselling and wellbeing services. Labour has said that it will fund and ensure that every secondary school in England and Wales offers counselling. This Government’s sticking-plaster approach to our children’s mental health has not been, is not and will not be good enough. I urge the Minister to look closely at the recommendations of the first joint report of the Education and Health Committees, “Children and young people’s mental health—the role of education”.

Teachers are not mental health professionals, but they are the frontline professionals in daily contact with our children and young people, and are often the first to spot the signs of mental ill health. They are also overworked, underpaid and under-resourced, so adding an additional responsibility to their workload without the necessary training and investment will only deepen our teacher recruitment and retention crisis. Our schools need an honest approach from the Government that acknowledges the £2.8billion real-terms cuts in school budgets since 2015.

We must act now and give our children the knowledge and confidence to take charge of their own mental health. If we do not, we will never be able to relieve the huge strain on our NHS, CAMHS, social services and teachers. The Prime Minister must make good her pledge and act on children and young people’s mental health. If the Government believe in parity of mental and physical health, they will ensure not only that age- appropriate mental health education is available for children in our schools from primary school upwards, but that our schools are properly funded with the resources to deliver that.

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Nick Gibb Portrait Nick Gibb
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6 Nov 2017, 7:03 p.m.

The hon. Lady raises an important point that will be considered in the Green Paper that we will publish shortly.

My right hon. and learned Friend the Member for North East Hertfordshire (Sir Oliver Heald) raised peer-to-peer counselling. One of the pilots that we have just launched relates to peer-to-peer support for children and young people with mental health. We are working with the Anna Freud Centre on it, and have just invited interested schools and colleges to apply. The programme is being independently evaluated so that we can share its findings with other schools and colleges when the pilot ends in 2019.

We want to provide all young people with a curriculum that ensures that they are prepared for adult life in modern Britain. Most schools already use their curriculum and school day to support pupil wellbeing, for example through the personal, social and health and economic education curriculum and a range of extracurricular activities. Good schools establish an ethos, curriculum and behaviour policy that teaches children about the importance of healthy, respectful and caring relationships. The Government want to ensure that all children receive a high-quality education in that respect. The Children and Social Work Act 2017 requires the Secretary of State for Education to impose a statutory duty on all primary schools to teach relationships education and on all secondary schools to teach relationships and sex education. The Act also gives the Government the power, which we will consider carefully, to make PSHE a compulsory subject in all schools.

A thorough engagement process will be undertaken to determine what schools should teach with respect to these subjects. We will say more about that process shortly; we announced today that Ian Bauckham, an experienced headteacher, will lead that work. We are also carefully considering what support schools may need to adapt to changes and improve provision. I can confirm that relationships education will focus on teaching pupils about different types of relationships and the difference between healthy and unhealthy relationships, both online and offline, which will help pupils to understand their own and others’ relationships and their impact on mental health and wellbeing. That knowledge will support pupils to make good decisions and keep themselves safe and happy.

When considering how to teach these issues in schools, we need to look at what the evidence says. To help with this, the Department is undertaking a programme of randomised controlled trials to assess the effectiveness of school-based interventions to support children and young people’s mental health and wellbeing. We are also exploring, through pilots, how pupils can support each other with their mental wellbeing. The aim of these trials is to determine whether approaches such as mindfulness are effective and to make information available to any school that might be considering offering such interventions. Of course, it is equally important that we identify approaches that are not effective.

My right hon. Friend the Member for Mid Sussex (Sir Nicholas Soames) asked about teacher training. Our randomised controlled trials include two international mental health programmes—Youth Aware of Mental Health, and the mental health and high school curriculum guide—and programmes that link physical and mental health through exercise, activities and routines. Those evidence-based approaches will ensure that schools can provide the right support to children and young people.

The Prime Minister has committed to a range of other activities with regard to children and young people’s mental health. The “Supporting Mental Health in Schools and Colleges” survey showed that 90% of institutions offered at least some training to staff in supporting pupils’ mental health and wellbeing, and that in most cases that training was compulsory. To support school staff further, the Department of Health is funding a mental health first-aid training offer for every primary and secondary school in England. That training, which 1,000 schools should receive by the end of the year, will help teachers to identify and support pupils with mental health issues as early as possible.

The Government have also committed to tackling the effect that bullying can have on mental health. The Department for Education and the Government Equalities Office are providing £4.6 million of funding over two years to support 10 projects to help schools prevent and tackle bullying. These include projects that target the bullying of particular groups, such as those who have special educational needs and disabilities and those who are victims of hate-related bullying; a project to report bullying online; and projects specifically to prevent and respond to homophobic, biphobic and transphobic bullying in schools.

We are committed to supporting the positive mental health of teachers, in particular by alleviating the workload pressures that teachers tell us have an impact on their mental health and wellbeing. We have worked extensively with unions, teachers, headteachers and Ofsted to challenge practices, such as triple or dialogic marking, that create unnecessary workload. As a consequence of this work, we established three independent review groups to address the priorities emerging from our 2014 workload challenge: ineffective marking, use of planning and resources, and data management. Work is progressing to meet all the commitments set out in the action plan published alongside the 2016 teacher workload survey, and we remain open to other ways in which the mental health of wellbeing of teachers can be supported.

As I said, my right hon. Friend the Member for Mid Sussex raised the issue of teacher training. We have strengthened initial teacher training, ensuring that teacher standards include the requirement for trainees to understand mental health and wellbeing. The Department’s 2017 provision survey found that 90% of schools and colleges offered staff training on mental health.

I hope hon. Members are reassured that improving and protecting the mental health of young people remains a key priority for the Government. In 2015 we allocated £1.4 billion over five years for children and young people’s mental health.

Nicholas Soames Portrait Sir Nicholas Soames
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I am sorry to intervene on the Minister so late in his winding-up speech, but may I ask him to give the House an assurance that the very complex roll-out of all these new schemes will be properly co-ordinated, so that delivery throughout the system is even? It is often difficult to see that happening when new schemes are introduced, so I will be grateful if the Minister ensures it does this time.

Nick Gibb Portrait Nick Gibb
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6 Nov 2017, 7:10 p.m.

My right hon. Friend raises a very important issue, details of which will be set out in the Green Paper that will be published shortly. The purpose of the various pilots is to ensure that we have an evidence base, so that interventions that we make in the future are effective and deliver what we all want, which is a generation of young people who are secure in their mental health and able to identify and deal with mental health issues as they arise.

I was talking about mental health spending, which has been increased to record levels by this Government, with 2016-17 seeing a record £11.4 billion being spent, with a further £1 billion planned by 2020-21. That clearly highlights the importance that the Government place on mental health and wellbeing in this country.

Crucially, we can see that mental health is already a key priority for schools themselves. The commitment that we have made to making relationships education and RSE compulsory in all schools, and to considering the case for doing the same for PSHE, will further ensure that pupil wellbeing is supported in our schools. That sits alongside the wide range of other activity to support schools that I have set out today, and I hope that reassures right hon. and hon. Members of the Government’s absolute commitment to this vital agenda for children and young people.