Children’s Mental Health Week 2024

Rosena Allin-Khan Excerpts

Tuesday 30th January 2024 Westminster Hall

[Mark Pritchard (in the Chair)]

May I apologise to colleagues for being a minute late? I was informed about two minutes ago, so that was the best workout I have had in a while.

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

I beg to move,

That this House has considered Children’s Mental Health Week 2024.

It is a pleasure to serve under you as Chair, Mr Pritchard—a breathless Mr Pritchard.

The challenges facing the mental health of our young people have never been greater. One in five children have a mental illness, and half of all mental illnesses develop by the age of 14. In the coming years, as many as 1.5 million children will need support for their mental health needs. Amid this escalating crisis, we need bold action to support our young people, but the Government too often lack the ambition, funding and attention that are needed. Meanwhile, the human cost of their inaction only grows.

In A&E, I see children coming in younger and younger. I will never forget their emaciated faces when attending having self-harmed, living with eating disorders or having attempted to take their own lives. I will never forget the faces of parents agonised by their children’s suffering, exhausted from being on suicide watch and fighting tooth and nail for their child, or pushing to access vital services that their child needs, and frequently finding their children being turned away and left to languish for months or even years on waiting lists while their condition deteriorates exponentially.

Pretty much every year we have a debate like this in Westminster Hall and we have many debates in the main Chamber. Every year, we all agree that this has to end, that we must do better and that our children deserve better, but year on year there is simply inaction. Parents are having to give up work to stay at home to be on suicide watch, because they fear what their child will do if they go to work. This affects families in a way that no one can ever possibly understand. A lack of investment in that one young person goes on to affect their parents, their siblings and their future, as well as their and their family’s ability to contribute to the economy and, most importantly, their ability to have a quality, healthy and happy life.

In calling for this debate I am labouring under the hope that we can actually move forward and do something. It is simple: poor mental health is carried through childhood into adulthood. The failures to address the mental health crisis in our young people will leave them ill-equipped as they grow older. We know all too well that prevention is better than cure, yet we ignore that wisdom when it comes to children’s mental health. That is something I simply do not understand. We have the ability collectively within the House positively to impact the lives of millions of children yet, somehow, remarkably, we fail to do so. The Government should invest in early intervention, working to improve child and adolescent mental health services and ensuring prompt access to vital support. Instead, children are being let down and left behind.

Despite young people making up a quarter of all contacts with mental health services, only 8% of funding goes towards children’s mental health services. There are almost half a million children on CAMHS waiting lists. That is a record figure that should be a badge of shame for this Government. Let me remind everybody that, when we talk about half a million children, we are talking about wider families who are affected, people who will never see their children again because those children felt they had no choice but to take their own lives. There are families begging their children to eat that one extra morsel of food because they have not been able to get the services they need for eating disorders.

We are talking about pain and anguish of epic proportions, and on a scale that we have to take seriously. Forgive my passion, but I care deeply about this. We must all care deeply, because this crosses the socioeconomic divide. Regardless of the size of house someone lives in or the amount of money their parents earn, if this pain is known to a family, it does not matter who they are or where they live—it is crippling. A parent loves their child just as much if they live in a £5-million house or a one-bedroom flat.

[Dr Neil Hudson (Penrith and The Border) (Con)]

The hon. Member is making a powerful and passionate speech. As an expert specialist clinician, she has touched on the concept of prevention, and the fact that the key is preventive medicine and signposting. I have had applied suicide intervention skills training and mental health first aid training. I have been privileged to work with 3 Dads Walking, who tragically lost their daughters to suicide. A key part of their campaign is to get suicide prevention on to the school curriculum. Does the hon. Member agree that prevention is a key part of this that we should invest in, and that we should support efforts to get suicide prevention and mechanisms for helping young people into schools and education colleges?

[Dr Allin-Khan]

I thank the hon. Member for his passionate intervention. He is right that prevention is better than cure. Anybody who knows anyone who has lost someone through suicide will know that it is not a pain someone ever gets over. They simply hope to God that they can learn to live with it in some way, so that they may get through their own lives with a semblance of existence. If there is any way in which we could prevent even one needless loss of life, that would go a long way.

The 3 Dads Walking are incredible—I have had the honour of following their marvellous work—but there are many people who are not in the public light, and many who are too embarrassed to admit how they lost their loved ones, for fear of blame and shame and what that means. We know that many people who have lost people in that way feel they want to take their own lives, and often do.

[George Freeman (Mid Norfolk) (Con)]

I, too, congratulate the hon. Member on securing the debate and her passionate advocacy. Many of us across the House share a deep understanding of the need for it. Does she agree that, if we are to tackle the causes, we need better data? We need to understand what is driving this epidemic. I particularly want to draw attention to the children of alcoholics and the great work done by the National Association for Children of Alcoholics; the children of divorce and conflict; and those children badly affected during the pandemic. Does the hon. Member agree that we need better data to understand the causes, then we can start to prevent it, as well as, importantly, treating it when it occurs. We could prevent a lot more of this.

[Dr Allin-Khan]

I thank the hon. Member for that intervention. Yes, I wholeheartedly agree that there is definitely space for more research. Adverse childhood experiences are the single biggest driver of mental ill health in children and, later on, in adults. I will touch on that later.

I want to know today when the Government will finally get their act together to end the wait for children’s mental health services. We are sick and tired of the same old meaningless platitudes from the Government. I know the Minister: I had the pleasure of working with her in my role as a shadow Minister. I know she is decent, good and kind, and she absolutely wants the best for children. I believe that. I also understand that her hands, regardless of what she might want to do, will be tied. However, in my role as shadow Cabinet Minister for mental health over three and a half years, the number of times the Minister and her predecessors have harped on, quite frankly, about the £2.3 billion they have put into mental health services! They have used that figure no fewer than 90 times in five years for many different things, depending on the focus of the debate. Whenever we have a debate about eating disorders, the £2.3 billion comes out. Whenever we have a debate about access to IAPT—improving access to psychological therapies—the £2.3 billion comes out. Whenever we have a children’s mental health debate, it is again rolled out. I understand that, but we really need tangible answers because the waiting lists grow, children are let down and families suffer.

[Dr Dan Poulter (Central Suffolk and North Ipswich) (Con)]

I commend the hon. Lady for securing a debate on this important issue. She is absolutely right to highlight the fact that we have known there are challenges in CAMHS for many years: we know there are problems with commissioning CAMHS and we know there are workforce challenges. We know there has been a failure to properly recruit mental health doctors and nurses to posts across CAMHS. Does she agree that we need to hear proper answers from the Minister today? We have known about these challenges for a long time. It is time we got on and did something about it.

May I apologise, Mr Pritchard? I should, at the beginning, have drawn the attention of the House to my entry in the Register of Members’ Financial Interests as a practising NHS psychiatrist.

[Dr Allin-Khan]

I thank the hon. Member, whom I would like to call my hon. Friend, because we have worked very closely on this issue for a number of years. He speaks not just as a politician, but as a practising NHS psychiatrist and I take my hat off to him. He speaks from a position of authority. We also sat together on a pre-legislative scrutiny Committee for a number of months, where we heard how black people and those with autism and learning disabilities are affected by current policy. We made cross-party, cross-House recommendations, but all of that has been scrapped. The Bill has not been introduced to the House and we are wondering how, with such cross-party agreement, that can be.

[Kim Johnson (Liverpool, Riverside) (Lab)]

I thank my hon. Friend for bringing this very important issue to Westminster Hall. She just spoke about black children. Does she think that this crisis is impacting disproportionately on black children and young people? Does the profession need to look at racism as a trauma, and does more work need to be done to consider those issues and deal with this crisis?

[Dr Allin-Khan]

I thank my hon. Friend for her intervention. Absolutely yes, black people are significantly more adversely affected. The work has been done. We sat together and saw the evidence, and the Government have chosen to ignore the recommendations. Experts have been working for years on understanding the drivers and coming up with solutions. Young black men are four times more likely than white men to be diagnosed with mental ill health when they have entered the judicial system, when their life is over and they have already had their cards marked, as it were. What beggars belief is the fact that we had consensus. We had the experts who did the research. They came and presented, yet we have got nowhere. I am fed up, as are many people here, with the same old soundbites and no meaningful action.

Tonight, many children will be going to bed cold and hungry. More than 120,000 children will be without a home. Let us think about that for a moment: 120,000 children without a home. Millions more are living in poverty in damp and mouldy houses. Parents simply wanting the best for their families are suffering under the sharp pinch of the cost of living crisis. That is the damning reality of 14 long years of Tory rule.

[Richard Burgon (Leeds East) (Lab)]

My hon. Friend is making a powerful speech, in keeping with the expertise that she has in this area. I agree that one of the great driving causes of the epidemic of mental ill health among young people is the unnecessary poverty and lack of opportunity in this country, following the political choice that was made to pursue 14 years of austerity. That means that, in one of the richest countries on earth, we need not only a solution to the root causes of unnecessary child poverty, but extra Government investment in children who are already on a waiting list for mental health support. People may be shocked to discover that, in West Yorkshire, 24,560 children were on a waiting list for mental health support as of November last year—a nearly 30% increase from the same time the year before. Does that not go to show that urgent action and urgent extra funding are needed from this Government?

[Dr Allin-Khan]

I thank my hon. Friend for his intervention, and he is absolutely right. This is about understanding. As I alluded to earlier, adverse childhood experiences are the single biggest driver of poor mental health in children and then later on in adults. Of course, there are other causes—most definitely—but adverse childhood experiences are huge. That is why, as my hon. Friend articulated so well, it is important to understand that, yes, there has to be money going directly into the mental health pot, but there must also be a wider ambition for our children. There must be an understanding of how we tackle these root drivers that are causing so many children to have poor mental health.

Inequality and poverty drive mental illness. We know that children from the very poorest households are four times more likely to develop a mental illness. Some 43% of children who are receiving mental health support from Place2Be, a fantastic organisation, are on free school meals. Addressing the mental health crisis in children must go hand in hand with addressing the cost of living crisis and child poverty. Yet, as many families continue to struggle to afford food and bills, the Government have offered little to tackle childhood poverty.

It will come as no surprise to Members here that I believe we need a set of policies that bring essential change to young people’s mental health. That means having specialists in schools; fixing the chronic staffing shortages and recruiting more staff; ensuring that patients are getting timely access to treatment and not languishing on long waiting lists, desperately waiting for that letter to come through the door telling them that they have an appointment; and enabling young people to access support in the community. As a country, we have a duty to be bold in our offer and uncompromising in our aims, with mental health interwoven into every decision the Government take.

[Tim Loughton (East Worthing and Shoreham) (Con)]

The hon. Lady is being very generous with allowing interventions. I agree with much of what she has said, particularly in regard to early intervention. I was the Children’s Minister when we set up the early intervention fund, which recognised that having money invested early and attention on children as young as possible would bear dividends later on. The hon. Lady has made a number of criticisms of the Government, saying that they have done nothing, but she has not mentioned the Best Start for Life project set up by the Under-Secretary of State for Health and Social Care, my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), which is all about that early intervention, from conception to age two. Does she acknowledge the good that that is beginning to do, because in addition to adverse childhood experiences, the other biggest impact on a child’s mental health is the lack of attachment, or attachment dysfunction? There is a 99% correlation between a mother suffering from depression or low-level mental illness during pregnancy and the likelihood of her children going through similar mental health and depression episodes as teenagers. Therefore, working with parents, and particularly the mother, before conception is absolutely where we can have the biggest impact in making sure that children are well-balanced, ready to join society, join school and join nursery, and able to avoid many of the problems that happen later on.

[Dr Allin-Khan]

I thank the hon. Member for his intervention and for highlighting something that we so often forget. When we talk about mental illness and children’s mental health, we often do not talk about the early years—the early attachment-forming part of life that is so important for positive mental health. He is right that healthy mental health in a mother is essential for positive mental health in a child. I would pick him up slightly on some of his points, because if we look at health inequalities, the groups that I have been talking about, who are most adversely affected with their mental health, are the ones who struggle to access any of the support available. The numbers speak for themselves.

Of course, all projects, interventions and ambitions for our children and their parents are important, but right now we have a children’s mental health epidemic. That is why it is important that we talk about these things during Children’s Mental Health Week next week, and beforehand in this debate. As a country, we have to be bold in our offer and have mental health interwoven in every decision the Government make. That goes to the point made by the hon. Member for East Worthing and Shoreham (Tim Loughton), having been early years Minister, about the importance of having mental health not in a health silo but across Departments, from local planning applications to Bills taken through this House. However, our children are being failed by a lack of prevention and early intervention, by long waiting lists, by a lack of funding, by an overstretched system and by a Government who are simply not concerned with children’s mental wellbeing.

We simply cannot allow our children’s future to continue to be squandered as a result of more inaction. The Minister may challenge me on this point, but the proof of the pudding is in the eating. It is no longer time for warm words; they have to be backed up with resources and ambition for our children. I hope we will hear something new from the Minister today, and I thank everybody for attending the debate.

--- Later in debate ---

[Maria Caulfield]

Let me point out what we are doing with our funding. We have introduced two waiting time standards for children and young people. The first is for 95% of children up to 19 with an eating disorder to receive treatment within one week for urgent cases and four weeks for more routine cases. I can showcase for the hon. Member for Tooting figures from her local integrated care board for eating disorders: 82% of children and young people under 19 are seen within four weeks. That is not 95%, so we are not where we want to be, but a significant proportion are being seen according to our new target. Our extra funding to children and young people’s services for eating disorders will rise to £54 million in the coming financial year, creating more capacity, but we absolutely acknowledge that there is more to do.

The second waiting time standard we have introduced is for 50% of patients of all ages, including children and young people, experiencing a first episode of psychosis to receive treatment within two weeks of being referred. That target is being met across the country.

Our plan for children and young people is cross-Government, because this is not just a health and social care problem. Mental health is everyone’s business. That is why we are working with the Department for Education to implement proposals from the children and young people’s mental health Green Paper.

[Dr Allin-Khan]

If the Government are interested in implementing cross-party proposals, why on earth have they scrapped the Mental Health Bill?

[Maria Caulfield]

I will touch on what we are doing and come back to the hon. Lady on that point.

Last week we met the Education Secretary and the chief executive of the NHS to discuss how we can better support school attendance, because we know that children with mental health problems are the most likely not to attend school. I do not think there was a single proposal from any of the Labour MPs, apart from on mental health support teams in schools, which we are already rolling out. We have rolled out 400 mental health support teams, covering 3.4 million pupils in England—something that Labour has not started to do in Wales, where it runs the health service. Our original ambition was to cover 25% of pupils, but we have done that a year earlier than expected; we are now on track in March this year to cover just under 50% of pupils with a mental health support team. We will also have 13,800 schools and colleges with a trained senior mental health lead, including seven in 10 state-funded schools in England.

We are already doing what Labour says it plans to do if it ever gets into government, and our evidence shows that that is making a difference across the country. In addition, in October we announced £4.92 million of new funding to develop new mental health and wellbeing support hubs for young people across all of England. We will be announcing in the next few weeks the successful hubs and where they will be based. That clearly shows that the work we are doing is on track and amounts to far more than just the warm words we have been accused of.

[Dr Allin-Khan]

Let me point out two things. First, 12,140 children are on waiting lists at my ICB, an increase of 18.15% on last year. Secondly, the Minister spoke about 1.63 million people accessing mental health services and said that 38% of them were children, but that is actually up on the 25% that I cited. She used that figure in her argument about the amount of money that has been spent on children’s mental health services. She was incorrect, and all she did was highlight that the situation is getting worse, rather than arguing against my point that only 8% is being spent on children. She did not address that point.

[Maria Caulfield]

The hon. Lady is making my argument for me. We are seeing a significant increase in demand, and that is why we are spending more on rolling out these services. She did not welcome the progress we are making on mental health support teams across our schools, or the fact that we are set to announce new mental health support hubs across England.

Last year we published our new suicide prevention strategy; my hon. Friend the Member for Penrith and The Border (Dr Hudson) talked about 3 Dads Walking, who I was pleased to meet. We are also rolling out mental health and wellbeing support in our school curriculum, teaching young people what good mental health looks like and about support mechanisms. Our strategy sets out over 100 actions to help reduce suicide and to ensure that young people in particular, who are identified as a high-risk group in the strategy, are getting the support they need. That includes making mental health and wellbeing part of the school curriculum.

--- Later in debate ---

[Dr Allin-Khan]

I thank all Members, including the Minister and my hon. Friend the shadow Minister, for their contributions. Disappointingly, I have not heard anything about the scrapping of the Mental Health Bill, which the Minister conveniently avoided.

[Maria Caulfield]

Will the hon. Lady give way?

[Dr Allin-Khan]

No, I will continue. The Minister had ample opportunity to respond to a direct intervention, and she chose not to. That Bill was a great piece of cross-party work that would have improved the lives and outcomes of so many people in our country, particularly minority groups. The Minister did not address the fact that only 8% of funding is spent on children’s mental health services, but she highlighted that the need is greater than ever.

The £2.3 billion was promised before covid. We have heard multiple arguments today that the situation has got worse post covid. There has been no money to make up for the increased need related to covid, and no assessment of how we are going to deal with the fact that adverse childhood experiences and poverty are contributing so greatly to our nation’s mental ill health.

The Minister talked about the fact that there are many new referrals. There are many new referrals, but she did not mention that in so many parts of this country, and even in parts of this city, it is a postcode lottery. In some places, up to 50% of referrals are closed before the person has even been seen. While I welcome the fact that efforts are being made—it would be churlish of me to suggest that they are not—the fact remains that they are not good enough, they do not reach far enough and they are not ambitious enough. Even on the £2.3 billion, I know for a fact that the head of mental health services in the NHS asked for more, and that was before covid.

I thank everyone for being here and for their contributions. Although we are all on the same page in the sense that this is an issue we all care about, regardless of how we vote, where we live or what our socioeconomic background is, this Government still lack ambition for children in this country and for their mental health. Let me again, on the record, thank all the organisations that work so tirelessly in this space.

Question put and agreed to.

Resolved,

That this House has considered Children’s Mental Health Week 2024.

Oral Answers to Questions

Rosena Allin-Khan Excerpts

Tuesday 7th March 2023 Commons Chamber

[Mr Speaker]

I call the shadow Minister.

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

There is a mental health staffing crisis of the Government’s own making. Figures out last week show that there are more than 28,000 mental health vacancies in our NHS, which is up on the year before and the year before that. Are we seeing a pattern here? The number of mental health nurses is down 5% since 2010, but do not worry, Mr Speaker: just so the Secretary of State is aware, Labour has a plan to recruit and retain more mental health staff and to get waiting times down. Can he put a word in with the Chancellor in case he wants to nick that too?

[Steve Barclay]

It is always good to find a plan that the hon. Lady actually agrees with the shadow Health Secretary on. As we know from her questions, that is not always the case, not least on the use of the independent sector. What we do know is that she has a habit of writing her questions before she hears the previous answer. I just reminded the House of the 7,400 more staff in mental health in September 2022 compared with September 2021. Obviously she had written her question before that point.

Eating Disorders Awareness Week

Rosena Allin-Khan Excerpts

Tuesday 28th February 2023 Westminster Hall

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

What a pleasure it is to close for the Opposition with you in the Chair, Ms Harris. I thank the hon. Member for Bath (Wera Hobhouse) for bringing forward this debate; I am honoured to be part of it again. It is a shame that we have to be here every year talking about this issue, but it is a testament to how seriously we take it. We will be here until we see the issue resolved.

This is normally the point at which I mention a few comments from Labour Members and say, “Didn’t they do well?”, but every single contribution and intervention was valuable. I learned new things on a topic that I thought I already knew very well. I hope that this debate will not just be filled with words about what needs to change, but that there will be something tangible—some action—at the end.

Across the UK, as many as 1.25 million people are living with an eating disorder. That is a staggering number, if we actually think about what that means. We have heard about the considerably high mortality rates; anorexia claims the most lives of any mental illness. With timely and appropriate treatment, people can go on to live healthy and fulfilling lives, so how many of those deaths are avoidable? That is the truth that we have to face.

I welcome the fact that we have opportunities in this place to mark Eating Disorders Awareness Week, but we have to do so much more all year long to challenge the stereotypes and assumptions that so many people still hold about eating disorders. It is so important to remember that eating disorders can manifest themselves in a variety of ways—through people eating too much or too little, or even restricting what they eat. To echo what has been said, we must never forget that eating disorders can affect people of any age, gender, ethnicity and socioeconomic background.

We have heard that one in four people with eating disorders is a man. It is staggering that it is still so difficult for boys and men to come forward and talk about their issues with eating. In my work in A&E, I see younger and younger people—especially boys—talking about their struggles with food and body image. They often cite social media and peer pressure as the source of those struggles.

I always like to thank the charity Beat for its incredible work. It works so hard to combat the negative stereotypes and misleading perceptions of eating disorders, which are sadly all too common. As was said eloquently today, people experiencing an eating disorder can often find themselves in mental health hospitals. To pick up on the point made by my hon. Friend the Member for Sheffield, Hallam (Olivia Blake), about the use of restraint, I have written to the Minister on that topic. I look forward to having a meeting about it, and to seeing the end of the inappropriate use of restraint. Mental health in-patient settings must be a place of safety, where patients and their loved ones can expect to be treated with dignity and professionalism. However, that is clearly not always the case.

For the families of those with eating disorders, the situation is crippling. They have an all-encompassing fear of the unknown when it comes to what their loved one will eat that day. They are concerned that they may have to give up their job, or even not care as much for their other children because they are obsessed with what one child is eating. They know that the child could lose their life at any moment.

It has been agonising to listen to the recent reports of the death of 19 eating disorder patients in in-patient settings; serious concerns were raised about their care. Lives should not be needlessly lost because of poor care and a lack of understanding of eating disorders. My heart goes out to their friends and families. Far too many families—not just the families of those with eating disorders—have lost loved ones in mental health hospitals. How many more people will lose their life before the Government get a grip on safety in in-patient settings? We need a Government who will get serious about mental health and eating disorders. As we have said time and again, access to proper treatment can be life-changing. Prevention is important, and early intervention provides the best chance for recovery. Think of those families who have lost loved ones, knowing that it could have been prevented, and that we in this place have not yet done enough to save these lives.

Targets on accessing treatment are being routinely missed. In 2016, a clear standard was set that 95% of children and young people experiencing the most urgent eating disorder cases should receive treatment within one week. Since then, however—I accept that the Minister has not been in post that entire time—the Government have missed the target; I hope the situation will improve. Disappointingly, only 60% of urgent cases were seen within one week last year. That means that four in 10 children and young people were not seen at the point of desperation. Children and young people are being left on lengthy waiting lists, unable to access support. Meanwhile, their families are helpless, and are trying their best to support their children without vital help from mental health professionals.

[Wera Hobhouse]

Does the hon. Lady realise the mental health impact on those who see a sufferer suffering and not getting the intervention they need? Families see what is happening to their loved one. They are waiting with them, and their mental health is deteriorating at the same time.

[Dr Allin-Khan]

Without a shadow of a doubt, not investing in a person with a mental health need often has a knock-on impact on four, five or six members of the family. Ultimately, we then need to use more mental health resources to serve their needs as well. It makes no economic sense, and no moral sense either, so I thank the hon. Member for her intervention.

The strain that an eating disorder places on an entire family is immense. As I say, parents often have to stop working to care for their child around the clock. How can the Government continue to fail young people with mental health needs? This cannot go on. For how long do the Government think it is acceptable for young people to be stuck on waiting lists for mental health treatment? Eating disorder psychiatry and child and adolescent psychiatry are two of the three psychiatric sub-specialties with the highest consultant vacancy rates. Where is the Government’s workforce plan? Patients are suffering.

After more than a decade of Tory mismanagement, patients are being failed, waiting lists are soaring and services are struggling to cope. I do not like to make eating disorders a political football—they are not—but the truth has to be told: the Government have failed thus far on their commitment. If they cannot get a grip and improve services, Labour will. We stand ready with a bold plan to recruit 8,500 additional staff in order to provide mental health treatment within a month for all who need it. Labour will put prevention and early intervention at the forefront of our approach to mental health. We will place a mental health specialist in every school, and we will place an open-access mental health hub for young people in every single community. The Government can no longer continue to neglect mental health services.