Children’s Wellbeing and Mental Health: Schools

Debate between Norman Lamb and Madeleine Moon

Tuesday 10th January 2017 Westminster Hall

[Norman Lamb]

I thank the hon. Lady for that intervention and pay tribute to the tremendous campaigning work that she does on mental health. Her point highlights the gap between the rhetoric, which is often well intentioned, and the reality. There is now a much greater focus on prevention in the Government’s argument, but what too often happens with a system under impossible strain is that the preventive services are cut first because there is a desperate need to prop up acute services within the system. She makes an important point.

Let me address the issue of stigma in schools. Stigma can exacerbate mental health conditions and prevent people from speaking out and seeking help. In October 2016 the YMCA launched a nationwide campaign aimed at tackling the stigma associated with mental health difficulties and to help to encourage young people to speak out. It found that more than one in three young people with mental health difficulties had felt the negative impact of stigma. School is where most young people experience stigma, and more than half of those who have experienced stigma said it came from their own friends. There is often a lack of understanding among young people—teenagers—about what mental health really is. That is why it is so important that we get this on the curriculum so that every teenager learns about their mental, as well as physical, health and wellbeing, and about how they can become more robust in coping with the challenges they face.

The impact of stigma is profound and pervasive, affecting many areas of a young person’s life. Young people reported that the stigma affected their confidence and made them less likely to talk about their experiences or to seek professional help. I can remember the moment when our eldest son said to me, “Why I am the only person who is going mad?” I just thought that here is a teenager feeling that and having stored it up inside himself, having not been able to talk about it for a long time. We can just imagine the strain of trying to cope with that on top of all the normal pressures of being a teenager. We have to do far more to combat stigma if we are to improve young people’s experiences.

I want to mention “Future in mind”, which is the blueprint we published in March 2015 just before the coalition Government came to an end. It was widely welcomed across the sector. We involved educationalists, academics, practitioners and young people, in particular, in the work we did. Central to the recommendations was the role of schools, and among the recommendations was the proposal that there should be a specific individual responsible for mental health in every school to provide a link to the expertise and support available, to discuss concerns with an individual child or young person and to identify issues and make effective referrals.

There should be someone taking responsibility but also a named contact point in specialist mental health services—too often we find that schools do not have the faintest idea who to contact when a child needs support—and also joint training. The hon. Member for Upper Bann (David Simpson) made the point about the training of teachers. If we can get teachers working alongside specialist mental health workers in schools, everybody will benefit.

[Mrs Madeleine Moon (Bridgend) (Lab)]

Will the right hon. Gentleman also pay tribute to the work of the Samaritans? It has a scheme called DEAL—developing emotional awareness and listening—which it is rolling out across Wales in particular. There is a resource pack available for teachers if they want to take it into schools, or the Samaritans will send volunteers into schools to undertake, separate from the school system, talks and raise awareness for young people. That is the sort of low-cost—not expecting lots of money to be involved—involvement of people and organisations such as the Samaritans, with their specialist knowledge and awareness, that is extremely helpful in reaching young people.

[Norman Lamb]

I pay tribute to the hon. Lady for the incredibly valuable work that she has done, particularly on suicide. I join her in paying tribute to the work of the Samaritans and the army of volunteers who give up their own time to save people’s lives. The sort of initiative that she described is incredibly important. Do the Government remain committed to implementing “Future in mind”? There is a danger in Government that we just replace one initiative with another. There is a very good plan there, which has all the right principles, and the important thing is just to do it and make sure that the money—I will come to that in a moment—actually gets through to where it is required.

Local Suicide Prevention Plans

Debate between Norman Lamb and Madeleine Moon

Wednesday 4th March 2015 Westminster Hall

[The Minister of State, Department of Health (Norman Lamb)]

It is a pleasure to serve under your chairmanship, Mr Gray, I think for the first time. I congratulate the hon. Member for Bridgend (Mrs Moon) on securing the debate and, more importantly, on her leadership on the subject of suicide prevention. Nothing could be more important, and any conversation with those going through bereavement following the death of a loved one through suicide makes us realise just how important it is for us to do better. The impact on those people’s lives is massive—the reverberations that she talked about are enormous. We can talk about the cold economic facts and the cost of £1 million per suicide, but the reverberations and economic impact on the whole family and beyond are incalculable.

The hon. Lady also made a point about the suicide rate varying so much around the country, and said that in some areas it appears to be remarkably low. One of the issues that she and I have talked about is whether suicides are being accurately recorded in inquests. We have a completely shared view on the need, once and for all, to confront the issue of the burden of proof, which is an example of the continuing stigma on suicide. To secure a suicide verdict, it remains necessary to prove the suicide “beyond reasonable doubt”; the only other type of death in which that level of proof applies is unlawful killing. That harks back to when suicide was a criminal offence. It is high time that was changed. I have argued the case in government and will continue to do so—whether in or out of government—in the next Parliament, because the change has to happen.

I congratulate the all-party group on suicide and self-harm prevention on its work, and from the start I want to pick up on the role of the police. In my work on mental health, I have been impressed by some inspiring leadership in police forces across the country. In London, the Metropolitan police have worked brilliantly with mental health trusts. In many areas, police are taking the lead in ending the scandal of people being put into police cells in the middle of a mental health crisis. I applaud them.

[Mrs Moon]

The British Transport police have undertaken some particularly successful work in conjunction with the Samaritans on preventing deaths on the railway. That, too, should be recognised.

Child and Adolescent Mental Health Services

Debate between Norman Lamb and Madeleine Moon

Monday 2nd February 2015 Commons Chamber

[Norman Lamb]

We want to try to ensure that when there is a crisis, a bed is available locally. With regard to the philosophy of seeking to reduce the tendency to have long periods of in-patient care—institutionalising people—it is absolutely right that we move away from that and focus far more on early intervention, community support and recovery. That is the general trend in progressive views within mental health. However, there must be a bed available when a crisis occurs.

[Mrs Madeleine Moon (Bridgend) (Lab)]

The Minister generously attended the launch of the report by the all-party group on suicide and self-harm prevention, which showed that one third of local authorities have no suicide prevention plan. Has he found any correlation between the lack of such a plan, poor CAMHS provision and a high incidence of suicide, particularly among young men?

[Norman Lamb]

May I first pay tribute to the hon. Lady for her inspiring work on suicide? Not many people in the House focus on issues that are talked about so seldom, so I pay tribute to her for the brilliant leadership she has shown. The all-party group’s report provides some really interesting and important questions of the sort that she has put to me today. These are questions that we need to ask. We have not yet established that link, but I think that it enables us to start asking local areas those questions. The Deputy Prime Minister has talked about the ambition of avoiding every suicide. We can improve services across the board by focusing much more on preventing conditions deteriorating to the point where someone becomes so desperate that they choose to take their own life.

Oral Answers to Questions

Debate between Norman Lamb and Madeleine Moon

Tuesday 15th July 2014 Commons Chamber

[Norman Lamb]

We had a very good round table discussion about this with leaders from around the country last week. What emerged is that fantastic progress is being made in many places, but it is not uniform. There needs to be a concerted effort to ensure that mothers get access to the same specialist treatment wherever they live across the country, and we are determined to achieve that.

[Mrs Madeleine Moon (Bridgend) (Lab)]

21. The all-party group on suicide prevention has been looking at the money going into suicide prevention as a result of the Government’s suicide prevention plan. It is acknowledged by most local authorities that there is more money for mental health, but suicide has been rolled into mental health and there is a distinct lack of support for those who are suicidal but do not have a diagnosable mental health problem. What does the Minister intend to do about that?

[Norman Lamb]

The hon. Lady raises an important point, which she and I have discussed before: the fact that very many people who end up taking up their own lives have had no contact at all with statutory services. I would be happy to discuss further with her what additional steps we can take to ensure that those people get the support they need.

Care Homes

Debate between Norman Lamb and Madeleine Moon

Thursday 1st May 2014 Commons Chamber

[Norman Lamb]

I am certainly happy to have another look at the White Paper and to discuss it with my right hon. Friend, but let me just address his key point. It is absolutely right to say that when we have closed doors, awful things can happen beyond the sight of the public. Professor Martin Green, who is a very good leader of providers of care, has argued the case for care homes to become a sort of hub in their local community, opening their doors to ensure that they become a centre of excellence for that community and providing services and support for people who may live independently at home, but who would benefit from the skills in such an organisation. Openness, transparency and ensuring that the public gaze is cast upon what goes in such places is the right way forward.

[Mrs Madeleine Moon (Bridgend) (Lab)]

Before I came into the House, I worked for the Care Standards Inspectorate for Wales, and when I had concerns about a care home with which I was working, I made unannounced inspections. Will the Minister tell us how many unannounced inspections were made at Oban House, and can he guarantee that the CQC has enough inspectors and enough capacity to carry out frequent unannounced inspections for homes about which it has any concerns?

[Norman Lamb]

We are making absolutely sure that the Care Quality Commission has the capacity and the funding to do its job properly. That question was also asked by the shadow Minister, and I apologise for not responding on that point. We absolutely want to make sure that the CQC has the capacity to do unannounced inspections, but, critically, to do much more robust inspections as well.

This is a process—we cannot introduce a different system overnight—but the new system of robust inspections is already being used in about 1% of care homes, with a view to the process being rolled out fully in October this year. The first ratings of care homes will emerge in October this year. Members of the public, when they are making crucial decisions about where a loved one will receive care, will therefore have much more information about which care providers are good and which are not up to standard. I will make sure that the hon. Lady receives the same timeline of what the Care Quality Commission did that I offered to the shadow Minister.

Mental Health

Debate between Norman Lamb and Madeleine Moon

Thursday 16th May 2013 Commons Chamber

[Mrs Moon]

The hon. Gentleman is right that a number of universities are doing excellent work in this area. The centre at Oxford has done wonderful research, as have Bristol and Manchester. I have referred several times to King’s college London because of its expertise in defence medicine. I am not denigrating the work that is taking place elsewhere; I am merely highlighting the importance of the work at King’s college London.

The King’s college London research has looked at the importance of decompression, whereby serving members of the armed forces have the opportunity to spend time together and take part in physical activity before they reach home. That has made a huge difference in the mental health outcomes of serving personnel.

Interestingly, the research has identified the groups that are most at risk of problems. They are not those who have served for the longest or most frequently in the armed forces. They are the early service leavers—those who leave the service shortly after their initial training. The risk is higher among those who fulfil combat roles. We forget how small a percentage of our armed forces is made up of people who go out through the gate and pursue combat roles. That work is of great benefit to the military, but it is also important that it is sustained and utilised in our wider understanding of mental health.

I want to talk briefly about TRiM, which is about trauma resilience. It was developed and utilised by the Royal Marines. It trains individuals to identify signs of distress within their own units and within themselves. It means that problems can be identified early on, and help provided quickly. Interestingly, the trauma and resilience handbook that is given to serving personnel and their families provides advice on looking after themselves, talking about their experiences, and how to deal with returning home—coping skills such as dealing with anger and alcohol, combating stress, and sleeping better. It provides tips for spouses, partners, families, friends and parents of returning serving personnel, as well as for the returning reservist. It is a prime example of how we help prepare people for what they are going to experience. We do too little in this country to prepare people for the risks of mental health problems. We do not tell people; we are not educating our young people in how they can identify within themselves, or within their families and friendship groups, some of the risks they will inevitably face in times of difficulty throughout their lives.

I am pleased that the work of TRiM has gained traction elsewhere and been adopted by many other organisations and employers. Even a cursory internet search demonstrated that a number of organisations are using TRiM to help their employers, in particular the blue-light brigades. The police force and Departments including the Foreign and Commonwealth Office frequently train their officers in TRiM.

US research into factors predicting psychological distress among rape victims has shown that initial distress was a better predictor of subsequent psychological functioning than other variables, as well as in the treatment of rape and other types of post-traumatic stress disorder. The use of TRiM and post-traumatic stress disorder management is extending into areas that we had not previously recognised would impact on the general mental health of people in the wider community.

Another area in which the military has taken time to expend its capabilities is the Big White Wall—an online 24/7 early intervention service for people suffering from mental distress. It is free for serving personnel veterans and their families, and as of December last year, 2,500 members of the armed forces community were registered. Seventy-five per cent. of members talked about an issue for the first time on the Big White Wall, 80% managed their psychological distress, and 95% reported an improvement in their well-being as a result of using that service.

There is consensus that reservists are more likely than other serving personnel to experience mental health problems as a result of their service, which is thought to be because when they return from tour they return to civilian life, away from the support network that a regiment offers. Academics at the King’s Centre for Military Health Research, in conjunction with others, conducted a five-year study of 500 reservists who worked in Iraq, which showed that they were twice as likely as regular soldiers to suffer from post-traumatic stress disorder.

Current drives to recruit 30,000 reservists as part of the Future Reserves 2020 programme mean that we will need further research in that area. A number of Members will have an interest in this issue, because reservists come from across the country and live and work in all our constituencies. The most recent figures Combat Stress could give me showed that it had received 1,558 approaches from veterans from Iraq, 123 of whom were reservists. From Afghanistan it had received 752 approaches, including 55 from reservists. With the discharge of large numbers of serving personnel as a result of cuts, I am concerned that high levels of alcohol misuse within the services may be transferred into their civilian life. Service personnel are not a group that readily seek help, and much remains to do in relation to mental health. Our wider society and its services must be ready for the discharge of large numbers of serving personnel into our communities.

Every hon. Member who speaks today will no doubt be aware of the difficulty of working with general practitioners and of making them aware of the mental health services that are available. One problem is that GPs see few veterans. There is a heavy reliance on individuals to make their GP aware of their military service. In 2011, the Royal College of General Practitioners issued guidance to GPs on how to meet the health care needs of veterans, but the onus is on the GP to be aware of it. According to the last figures I have, only 320 GPs had accessed an e-learning package on help to identify veterans with mental health problems. We need to work to increase that number.

Our police forces need to be helped and supported in understanding how often they will come across veterans. Figures show that they are coming across veterans who are dealing with alcohol problems and having episodes of self-harm, which in military terms means looking for fights in which they will receive physical injuries. Alarmingly, a recent independent commission on mental health and policing showed that the Met police have a particularly poor record of dealing with people in mental distress. A quarter of calls to the Met police each year—600,000 calls—were linked to mental health. We need to tidy up the link between mental health and the police.

[Norman Lamb]

The hon. Lady makes important points on people in the armed forces and veterans. Is she aware of Lord Adebowale’s valuable work and report on the link between police and mental health, which was published last week? It was commissioned by the police and dealt with how to improve the way in which they operate. It is good news that the police were prepared to commission Lord Adebowale’s report and are prepared to listen to his advice.

[Mrs Moon]

I am very aware of that research; the point I was about to make comes from it. The problem is that we often use the police as our first line in dealing with people with mental health problems, but they are not trained and equipped to carry out that role and function. We must do something about that. Otherwise, the person with the mental health problems is often dealt with as a disruptive element, and treated as if they are someone violent and aggressive, rather than someone who has a mental health problem. We must deal with that problem.

Words and anecdotes can be dangerous, particularly in the military. Research was published this week by the Defence Analytical Services and Advice agency on Falkland veterans. It found that 95 veterans had taken their own lives since the end of the conflict. That figure is lower than previously assumed, although each death is a tragedy for the individual and family involved. The research showed that, of the 26,000 mobilised, 255 died in conflict and 95 took their own lives, but 455 died of cancer. We sometimes forget that our armed forces community has problems we need to address that are not necessarily mental health problems.

Suicide Prevention

Debate between Norman Lamb and Madeleine Moon

Wednesday 6th February 2013 Commons Chamber

[Norman Lamb]

I thank my hon. Friend for that intervention. I would not want to indulge in cheap speculation about that. The statistics are clear on the prevalence of suicide among young men and clear that it is significantly higher than among young women. It is important that we carry out the research, which is why the Government have also committed to that as well; it is so that we gain a better understanding.

[Mrs Moon]

The Minister will be aware that research suggests that women and young girls are less vulnerable to suicide because they are help seekers, whereas young men are not and they will not articulate the problems they are facing. That is the major difference. Women and girls will go to their friends and talk about their problems, whereas men bottle things up so that they grow and grow and they can no longer manage them.

[Norman Lamb]

I thank the hon. Lady for that helpful intervention. What she says makes sense and I am most grateful to her for coming to my rescue on that—

Oral Answers to Questions

Debate between Norman Lamb and Madeleine Moon

Tuesday 15th January 2013 Commons Chamber

[Norman Lamb]

I thank my hon. Friend for that question. The Government take the development of talking therapies extremely seriously and I can confirm that I met Lord Layard yesterday, together with representatives of the NHS Commissioning Board. There will be a central team and we are absolutely determined to keep driving this approach forward, as there is real evidence of results.

[Mrs Madeleine Moon (Bridgend) (Lab)]

Today’s edition of The Daily Telegraph carries an article on dementia, including a quote from a GP who says that it is not useful to give an early diagnosis when there are no drug or care needs. Does the Minister agree that that GP, like many others, fails to realise that for pre-senile dementias in particular, early diagnosis allows planning and allows families to understand the confusion created by altered personalities, behaviour, emotional responses and language skills?