Children and Young People’s Mental Health

Rosena Allin-Khan Excerpts

Wednesday 16th June 2021 Westminster Hall

[Dr Rosena Allin-Khan (Tooting) (Lab)]

It is such a pleasure to serve under your chairmanship, Sir Gary. I thank the hon. Member for Twickenham (Munira Wilson) for securing extremely important debate and all hon. Members for their thoughtful contributions.

My speech is full of stats. We have heard stats and real-life stories. We know what has been unfolding in our communities. Today, we have a choice to do something about it. The Government have a choice to do something about it. What are we going to do? We are going to make our interventions, state our cases, speak the numbers. The Government will respond and then we will go back to normal, with children attempting to throw themselves off bridges; a reality where parents have to take time off work or give up work because they are so worried about their children who are self-harming. We are going to go back to teachers who would walk over broken glass for their students, desperately telling me that they cannot get their children on to CAMHS waiting lists. Even if they are lucky enough to tick those boxes and get on a list, it is far too long until they are seen.

Today, we have the choice to do something about this. Demand for mental health support is at an all-time high, yet access to services is simply not keeping up. For over a year, Labour has warned that children’s mental health should not be forgotten in this crisis, but it is easy to blame the coronavirus pandemic for what we are seeing playing out in our communities—every single community. This issue cuts across the class and socio-economic divide. It can affect any child or young person. Prior to the pandemic, access thresholds in many places were so high that they created unacceptable waits and led to children having their referrals cancelled without treatment.

The former Children’s Commissioner outlined in her 2021 annual report that over half a million children and young children were referred to CAMHS in 2019 and 2020. Of those, approximately 3,500 either had their referral closed or were still on the waiting list by the end of the reporting period. This simply is not good enough.

The pandemic has pushed services that were once stretched to breaking point over the edge. The Minister does not need to take my word for that, but she should certainly heed the warning from the NHS mental health trust leaders surveyed in May this year. The survey, carried out by NHS Providers, found that two thirds of trust leaders said they were unable to meet demand for CAMHS. Every leader surveyed stated that demand for children’s and young people’s services is higher now compared with last year. Some 78% said they were extremely or moderately concerned about their local system’s ability to meet the level of demand over the next 12 to 18 months, and 84% of trust leaders said children were waiting longer for treatment than they were six months ago.

The Government know all these stats. The Minister knows all these stats. What is she going to do about it? Is she going to recycle yet more money in a new announcement? Is she going to spend £2.3 billion over and over again in every debate that we have, depending on exactly which mental health topic we are talking about? The NHS does an incredible job with limited resources. However, it needs the political will to close the gap, now more than ever, and workforce capacity is often cited as the biggest barrier to scaling up provision.

That has been known for some time, with not enough being done to rectify it. Failure to resolve the issue before the pandemic is now having disastrous consequences. Mental health trusts had to give money to local hospital trusts to plug gaps, leaving them with even less of the money that they needed. This, on top of 11 years of an austerity-driven agenda, means the money is simply not in the system, and anything put back into the system will simply not cut it.

Staff have been grappling with a health emergency for more than a year, under enormous pressure, resulting in the acceleration of burnout and exhaustion. They are in desperate need of a reprieve, but the mental health fallout from covid means that waiting lists continue to pile up. Without urgent action, that gap in access will only continue to grow, leaving thousands of children to fall through the cracks.

National and crisis provision are extremely important, but more must be done to ensure that support is proactive, holistic and community-led. The biggest driver of poor mental health in children is adverse childhood experiences —I can see colleagues nodding. That is a well-known fact. When I do a shift in accident and emergency, and a child comes in with mental health issues—a child I have seen multiple times in the previous year, living in mouldy housing, in multi-occupancy homes, with parents who cannot access jobs—it is no surprise to me that they are suffering with their mental health.

What will the Government do about that? In areas of deprivation, it is not uncommon for parents to resist answering calls from withheld numbers or opening letters labelled private and confidential, but that is the main way in which CAHMS appointments are communicated to parents. Many miss the appointments, despite them and local advocates having pushed for treatment for many months and even years. Those children, the poorest and the hardest hit by other Government measures, then get dropped, which unfairly creates the impression that parents simply do not care. Those same parents are often grappling with many children suffering with mental ill health as a result of their life experiences.

Advocates out there would give the shirts off their back and, as I said, walk across broken glass to get those children to appointments. A fully holistic approach would include in a child’s referral the GP and school, where necessary. In areas where mental health is less understood, or cultural or language barriers exist, many children will attend a CAMHS appointment with mum and dad after the school has referred them, but because of a lack of understanding, mum and dad cannot explain the issues that their child is facing, so no course of treatment is started and the child is taken off the list.

These are our most vulnerable children, and often the children who need our help the most. What will the Government do to make services accessible for such children and their families? The scars that children live with forever means that those with the best English and a better understanding get the treatment they need, while others fall through the cracks. Many of us serve communities where that is the case, and it is no surprise that, despite being four times more likely to have a mental health problem than their affluent peers, children from the poorest backgrounds are much less likely to access services. A more joined-up, proactive approach between education, health and local authorities is needed, with greater focus on prevention and early intervention.

Talent is everywhere, but sadly opportunity is not. That is why the Labour party announced a children’s recovery plan to ensure that children can continue to play, learn and develop in the post-covid period, no matter where they are from, or what school they go to. That programme is meant to support children and young people throughout their education, and to recognise that positive mental health and wellbeing can be pivotal for children to reach their fullest potential. By tackling food poverty in schools, guaranteeing quality mental health support for pupils and fully funding extracurricular clubs and tutoring, each child would have an equal chance to succeed.

The Government know we are facing a mental health crisis. That is not news. We have whole communities full of people who are desperate for support—parents, teachers, families, children, desperate for support. They are counting on us to use the debating time today to make real, effective change. They do not want just rhetoric—just empty words and gestures, the same old recycled announcements time and again—but an acknowledgement that the Minister has today listened: listened to the pleas from those with eating disorders; listened to those who are suicidal; listened to those unable to access CAMHS services; listened to those who have waited far too long for the help they need and deserve; and listened to people who are unable to reach their fullest potential because they have a Government that do not understand the scale of the issue.

The time for dither and delay is over. I look forward to the Government announcing some real, tangible change.