Mental Health and Wellbeing in Schools

Nick Gibb Excerpts

Tuesday 4th December 2018 Westminster Hall

[Marion Fellows (Motherwell and Wishaw) (SNP)]

It is a pleasure to serve under your chairmanship, Mr Stringer. I congratulate the hon. Member for Oxford West and Abingdon (Layla Moran) on securing this very important debate. I will not run through all hon. Members’ contributions because we are running very short of time, but I have a few words to say. The hon. Lady’s knowledge and breadth of experience shone through her contribution, and her clinical dissection of the high stakes in the school system was informative and chilling.

As a member of the Education Committee, I am aware that the UK Government are not responsible for education matters in Scotland, Wales or Northern Ireland, but that does not mean that I or anybody else in the House have no desire to improve the mental health and wellbeing of children right across the UK. Schools are on the frontline of supporting children and young people’s mental wellbeing. We can shift the focus on to preventing mental health problems and building resilience through simple methods. In one of my granddaughter’s schools, children are being taught to think not, “I can’t do this,” but, “I cannot do this yet.” That is a huge step forward. It was never done in schools in my and my children’s time.

Increasing the availability of learning tools and experiences in health and wellbeing ensures that children and young develop knowledge about mental health and understand the skills, capabilities and attributes that they need for mental, emotional, social and physical wellbeing now and in the future. The Scottish Government’s mental health strategy focuses on early intervention and prevention, which feeds into this issue.

Over the course of their education, children spend more than 7,800 hours in school. Emotional wellbeing is a clear indicator of academic achievement, success and satisfaction in later life. Combining mental health awareness and coping mechanisms is critical for prolonged resilience. The Scottish Government have spent quite a bit of money recently. I spoke to Clare Haughey MSP, the Minister for Mental Health, who had recently taken on the recommendations of the “Children and young people’s mental health audit” report, which was produced by the Auditor General and given to the Public Audit Committee on 22 September.

It is important that we do not just throw money at these problems. There has to be a change in attitude. Money helps by making counselling available. In Scotland, our hope is that £20 million will provide 250 additional school nurses, and that £60 million will provide 350 counsellors. There will be other counsellors in further and higher education.

In Scotland, we are also doing mental health first aid programmes for teachers so that the early signs of mental health problems are spotted and children can be moved forward into services. In the package of money given by the Scottish Government, there is also provision for community support. The Scottish Government have set up a Mental Health Youth Commission, which is working with the Scottish Association for Mental Health and Young Scot to put young people’s issues front and centre. The Scottish National party Government are committed to meeting their commitments to ensure all children are given the tools they need to achieve a happy and prosperous life.

The UK has signed up to the UN convention on the rights of the child, but has stopped short of making it part of its legislation. That has been done in Wales, and the First Minister of Scotland is committed to making it part of domestic law in Scotland. Article 19 of the UNCRC says:

“State Parties shall take all appropriate legislative, administrative, social and educational measures to protect the child from all forms of physical or mental violence”.

The First Minister’s commitment will better enable positive mental health and wellbeing practice in Scottish schools.

Will the updated guidance, which is intended to come into force in September 2020, apply in academies and free schools, as well as local authority-maintained schools? It is my understanding that those types of school do not have to follow national school curriculums.

[The Minister for School Standards (Nick Gibb)]

We have changed the basic curriculum, rather than the national curriculum, to ensure that it applies to academies as well as local authority-maintained schools.

[Marion Fellows]

I am very grateful to the Minister for that response.

It is necessary that children across the UK are able to access timely and helpful support when they need it.

--- Later in debate ---

[The Minister for School Standards (Nick Gibb)]

Certainly, and thank you, Mr Stringer; it is a pleasure to serve under your chairmanship. I congratulate the hon. Member for Oxford West and Abingdon (Layla Moran) on securing the debate and introducing it so well.

Mental health can have a profound impact on the whole of a child’s life; it is not just about the effect that poor mental health can have on their attainment at school. We worry about the whole life ahead of them. Improving mental health starts with promoting good mental wellbeing and ensuring that children and young people have the help and support that they need. Schools can play an important role with the right support from specialist services, which is why the Government have made mental health a priority, with a shared approach between the Department for Education and the Department of Health and Social Care.

The hon. Members for Oxford West and Abingdon and for South Shields (Mrs Lewell-Buck) mentioned exam stress in schools. Tests and exams have always been times of heightened emotions for pupils and teachers, but they are not meant to cause stress and anxiety. As the hon. Member for South Shields acknowledged, I have said on many occasions that schools should encourage all pupils to work hard and achieve well, but that should not come at the expense of their wellbeing. Schools should provide continuous and appropriate support as part of a whole school approach to supporting the wellbeing and resilience of pupils.

The hon. Member for Oxford West and Abingdon also mentioned GCSEs. We have reformed GCSEs to match the expected standards in countries with high-performing education systems, so that young people have the knowledge that they need to prepare them for future success and the skills that Britain needs to be fit for the future. We are determined to ensure that no child has an inadequate education that reduces their life chances; we want to ensure that every child has an education that helps them to fulfil their potential. That is the key driver of all of our education reforms since 2010. Better education means better prospects of quality employment and better health outcomes for those young people in the long run.

As a psychiatrist, my hon. Friend the Member for Central Suffolk and North Ipswich (Dr Poulter) brings serious expertise to the debate. He said that it was important that Departments did not work in siloes. I can assure him that I worked very closely with the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price), in whose portfolio mental health resides. We worked particularly closely on producing the Green Paper on children and young people’s mental health.

We know that mental health is also a priority for teachers, because of the challenges that many children face in the modern world; a fact that has been referred to by other hon. Members. To get an up-to-date picture of children’s mental health, this Government commissioned the first national survey of children and young people’s mental health since 2004, which was cited by the hon. Member for Westmorland and Lonsdale (Tim Farron). The results published last month show that in 2017, 11.2% of children and young people aged five to 15 in England had a diagnosable mental health disorder. That figure stood at 10.1% in 2004, so the latest results show that there has been a slight increase since then. They reinforce what we have heard from schools and colleges about how many children face issues and about the need to act. We have listened to what schools have told us and are already taking steps to help schools to support children and young people with mental health problems. The findings of the survey will help us to ensure that the action that we take is informed by the most up-to-date evidence.

I understand the important points made by my hon. Friend the Member for Central Suffolk and North Ipswich about the number of staff in children and young people’s mental health services. The Government are already taking significant steps to improve specialist children and young people’s mental health services with £1.4 billion of funding to ensure that an extra 70,000 children a year receive the support that they need by 2020-21.

We recognise, however, that we need to do more, which is why the NHS will invest at least £2 billion a year more in mental health, including children’s services, under the recently announced Budget proposals, increasing NHS funding by an astonishing £20.5 billion a year in real terms by 2023-24. As I said, from that the NHS will allocate £2 billion a year to mental health services. The Budget also included a commitment to set up specialist NHS crisis teams for children and younger people in every part of the country.

[Dr Poulter]

The extra money is of course welcome, but the focus on crisis intervention is perhaps wrong. We should try to stop children getting to that point in the first place, and invest more in early intervention and community teams. In order to do that, we need to reverse the decline in the mental health workforce. I wonder whether that is an issue the Minister will raise in particular, challenging his counterpart in the Department of Health and Social Care on how to improve recruitment and retention of CAMHS professionals.

[Nick Gibb]

My hon. Friend makes a crucial point, which I will come to when I talk about the mental health Green Paper. It is absolutely crucial that we are able to devote resources and expertise to intervening early, before a child’s mental health problem escalates into something requiring medical intervention.

[Luciana Berger]

Will the Minister give way?

[Nick Gibb]

I will, but this will be the last intervention, I am afraid.

[Luciana Berger]

What percentage of that £2 billion extra for mental health services will go to young people’s mental health services? To what extent will it replace—I asked this question before—services that have already been lost, not just from the NHS but from right across education in schools throughout the country?

[Nick Gibb]

I have already mentioned that £1.4 billion will be put into young people’s mental health services. I do not have the precise figure that the hon. Lady asks for, but I am happy to write to her with it. I suspect that it will not have been determined precisely at this point, but our plan is to increase that spending, and we can only get to that through careful marshalling of our economy, because our economy of course produces the wealth that enables us to provide such a level of funding.

In the debate, there was a reference to eating disorders. The Government are on track to meet, or are exceeding, waiting-time standards for eating disorder services and early intervention in psychosis.

[Dr Drew]

Will the Minister give way?

[Nick Gibb]

I will not give way now, because we only have a few minutes left. I have already given way a number of times.

Schools have an important role to play in supporting the mental health and wellbeing of their pupils by putting in place whole-school approaches tailored to the particular needs of those pupils. Our 2017 survey, “Supporting Mental Health in Schools and Colleges”, was commissioned to derive robust national estimates on activities to promote and support mental health and wellbeing. It found that about half of schools and colleges already had a dedicated lead for mental health in place, that 61% of schools offered counselling and that 90% of schools and colleges offered staff training on supporting pupils’ mental health and wellbeing.

The Government are committed to supporting schools and colleges to do more to promote good mental wellbeing in children, to provide a supportive environment for those experiencing problems and to secure access to more specialist help for those who need it. To support schools to build the capability to identify and promote awareness of mental health needs, we have committed to introduce mental health first aid and awareness training for teachers in every primary and secondary school by the end of the Parliament. To date, we have trained more than 1,300 staff in more than 1,000 schools.

[Mrs Lewell-Buck]

Will the Minister give way?

[Nick Gibb]

I will not give way. I am sorry, but I want to leave time for the hon. Member for Oxford West and Abingdon to respond to the debate.

We have recently published updated guidance to help schools to identify pupils whose mental health problems manifest themselves in their behaviour, and to understand when and how to put in place support.

The hon. Member for South Shields raised the issue of PSHE. As part of an integrated, whole-school approach to the teaching and promotion of health and wellbeing, we are making health education compulsory for pupils receiving primary and secondary education, alongside relationship and sex education in all secondary schools—

[Mrs Lewell-Buck]

When?

[Nick Gibb]

All pupils will be taught about mental health, covering content such as understanding emotions, identifying when someone is experiencing signs of poor mental health, simple self-care, and how and when to seek support.

The hon. Lady asked when health education would be made compulsory. We have already published draft guidance and consulted on it—the consultation closed on 7 November. It was well received, and 11,000 pieces of evidence were supplied to it. We will respond in due course. Our plan is to roll out the subject as compulsory in the academic year beginning in 2020. We hope for and expect early adopters from September 2019, but it will be compulsory a year later. We want to ensure that all schools have a proper lead team so that they can implement the policy as well as they can.

On the mental health Green Paper, while schools have an important role to play, teachers are not mental health professionals and they should not be expected to act as such. When more serious problems occur, schools should expect pupils and their family to be able to access support from specialist children and young people’s mental health services, voluntary organisations and local GPs. The £1.4 billion that we have already made available will play a significant role, but we want to do more and to provide a new service to link schools to mental health services more effectively, with swiftly available and clinically supervised support.

To enable that, our Green Paper set out proposals to support local areas to adopt an ambitious new collaborative approach. The cornerstone will be new mental health support teams to improve collaboration between schools and specialist services. We expect a workforce numbering in the thousands to be recruited over the next five years to form such teams. They will be trained to offer evidence-based interventions for those with mild to moderate mental health needs. The teams will be linked to groups of schools and colleges, and the staff will be supervised by clinicians. They will work closely with other professionals such as educational psychologists, school nurses, counsellors and social workers to assess and refer children for other specialist treatments, if necessary.

[Mrs Lewell-Buck]

Will the Minister give way?

[Nick Gibb]

I will not give way because, literally, there are only three minutes to go.

The roll-out of the teams will start with about 25 trailblazer sites, each with at least two teams, to be operational by the end of 2019. The first trailblazer areas will be announced imminently. They will test and evaluate a range of ways to set up and run the new mental health support teams to see what works. The overall ambition is for national roll-out of the teams, to be informed by evaluation of the trailblazers. The detail will be considered further as the long-term plan for the NHS is developed.

We also want to ensure that we have a designated senior lead for mental health in every school to oversee the delivery of whole-school approaches to promoting better mental health and wellbeing. The Department will provide up to £95 million to cover the cost of significant training for senior mental health leads. It is an ambitious programme, and I am optimistic that it will help to deal with a number of mental health problems that are emerging among young people in today’s society.

Good mental health remains a priority for the Government. It can have a profound impact on the whole of a child’s life, not just on attainment. We want all our children to fulfil their potential, and we want to tackle the injustice of mental health problems so that future generations can develop into confident adults equipped to go as far as their talents will take them.