Young People’s Mental Health

Ruth Cadbury Excerpts

Thursday 27th October 2016 Commons Chamber

[Tim Loughton]

The hon. Lady and I have the same objective, but I am always sceptical about a solution that means making something another compulsory part of the curriculum. Sex and relationship education is an interesting case in point. Some of the best SRE that I have seen has been from outside youth workers and others who can empathise with young people and talk to them in a way that they will appreciate, respect and learn from. Making it another subject taught by Mrs Miggins the geography teacher, who happens to have a free period on a Thursday afternoon and so can be in charge that term, can cause problems. More schools should automatically want to have well-informed mental health education in whatever form is appropriate to engage their children. It is in their children’s best interests. I do not think that my objective differs from the hon. Lady’s, but we can have a debate about how we can most effectively achieve it.

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

The hon. Gentleman makes a good point about the importance of having appropriate, properly trained, empathetic people—specialists—delivering mental health education to young people. He suggests that youth services could provide such education. The problem is that local authorities are cutting those services because they are non-statutory. Many schools that have been providing support and bringing in specialist experts to help young people and teachers in this curriculum area are also facing cuts. Headteachers are having to pare back services as they deal with reduced budgets.

[Tim Loughton]

I hear what the hon. Lady is saying and that is a subject for another debate. It is an issue on which I have campaigned for many years, and indeed I chaired a commission looking into the role of youth workers in schools. Some really good examples of best practice are available, often in academies, which have appreciated the value of youth workers, because they can empathise with young people better, and brought them into schools. That is missing in so many other places. I have been advocating giving other roles to youth workers, who, sadly, are no longer being employed, particularly in local authorities, because this is not a statutory requirement and therefore has fallen by the wayside. So I have a deal of sympathy with that view, but it is for another day and debate.

I wish briefly to deal with a couple more points, the first of which relates to the last one: the importance of resilience and character education in the well being agenda in schools. Recent Education Secretaries have begun to take that on board, and a lot of this subject lies within that area. Another issue to consider is how this is monitored, and another good recommendation in the report is that Ofsted should have a role in that. Ofsted now has a role in assessing behaviour in schools, but that should extend to how it copes with mental health problems among pupils—that should be on the checklist. We are really bad in this country at disseminating good practice, but I have seen many examples of it. I recall visiting a school in Stafford and sitting in on some of the sessions held by their full-time counsellor. The teachers had confidence in her, would refer to her children about whom they had some doubts, and the children would speak frankly to her. Such people can prevent a lot of problems from occurring later on in the schools that have them, but not enough schools do—again, there is a debate to be had about why that is.

We also have to address the issue of cyber-bullying and the role of social media. The report gives examples about websites that promote self-harm, which are a huge scourge. We need to be much more aggressive in tackling these sites, particularly where they relate to anorexia and self-harm. People are going to them to seek advice and find a solution because they have feelings about self-harm or problems with anorexia, but these bizarre websites are promoting those things. As the report suggests, we need some form of verification scheme and, as has been mentioned, a much more responsible and bigger role for our social media companies. They are huge companies employing many thousands of people, yet the numbers in their scrutiny and enforcement departments are woefully low. As Members of Parliament with Twitter accounts, most of us have blue ticks to show we are who we say we are. Can there not be some form of verification scheme, described in the report as a “kitemarking scheme”, so that young people, particularly those who are vulnerable and impressionable, have confidence that the sites they are accessing are there to give them support, not to encourage them to do harmful things to themselves? This applies to so many different areas, including in respect of radicalisation sites.

Body image has been mentioned, and Girlguiding, which regularly revisits the issue of body image and young girls’ perceptions, has recently produced a report on the subject. It is always so alarming and petrifying to see the number of young girls as young as 13 whose aspiration is to have plastic surgery. Despite the fact that their bodies are not even fully formed and that they are still growing up mentally, they are being conditioned to think that this is the ideal to which they must aspire. That is wrong, and these influences on our young people are at the root of so many of the weaknesses and vulnerabilities leading to mental illness and, in the most tragic cases, to suicide. In the old days, a note passed across a classroom with the words “Sealed with a loving kiss” might, at worst, end up on a playground floor. At the worst extremes, in the case of a form of sexting, the equivalent these days goes viral and ends up on social media in perpetuity, where it is open for millions of people to see. That is the difference between the note in our playground days and the casual, ill-advised text on social media these days.

Finally, the report makes recommendations about young people wanting to relate to people their own age, rather than old men in suits, which I guess takes in quite a few of the hon. Members here today. [Interruption.] Okay, I was talking about myself and my hon. Friend the Member for High Peak. They say that taking such an approach makes it easier to receive the right message, hence the recommendation that

“a consultation group of young people, both with and without a mental health history, be set up to work on and contribute to the anti-stigma campaign, and that someone is identified to ensure this happens.”

I completely agree with that.

My final point is that when I was a children’s Minister, I had four reference groups within the Department for Education, each of which came to me on a three-monthly basis: one comprised children who had been adopted; one comprised children in foster care; one comprised children in residential care homes; and one comprised children who had recently left care. They came to me in the Department without adults, we sat around the table and they told me exactly what was going on. They challenged some received wisdoms, and I got some of the best information that I ever got from any experts by speaking to those young people. This report has been produced by young people and by reference to many thousands of young people, many of whom have suffered and are suffering the sorts of problems that I and many other hon. Members have mentioned today. We need to listen to the voice of these young people, to act on their recommendations, and to include and involve them in the solutions. That is why this report is so important to them, but it needs to be equally as important to us, to this House and to this Government.

--- Later in debate ---

[Ruth Cadbury (Brentford and Isleworth) (Lab)]

I apologise to the House for missing the start of the debate—it started a little earlier than I anticipated and I was sitting on a bus in Millbank—and thank you, Madam Deputy Speaker, for calling me. I also thank my hon. Friend the Member for Dulwich and West Norwood (Helen Hayes), and I congratulate her on leading this debate and the Backbench Business Committee on delivering it.

I am speaking towards the end of the debate, so I will try not to repeat the many excellent contributions that hon. Members have already made. Like so many other Members, I have had parents contacting me in great distress at the lack of adequate acute services when their children are in crisis. I had one parent who was worried about her daughter having to spend yet another weekend—this was not the first period of crisis she had had—in the children’s ward of the local hospital, as no specialist beds were available. The children’s ward is not a safe place for a young person in a mental health crisis, nor is it fair on the staff or children in the ward to have to support her either. She needed to be in a specialist bed, but in London there are too few tier 4 beds for young people.

I had another distressing experience, where a young man needed to go to hospital urgently, but because of a disconnect between the police, the ambulance services and the other services, it took two attempts on the same day to draw him from his house and get him to the safe place he needed to be in, leading to added trauma and distress and worsening his already critical health situation. To be fair, we are seeing some improvements locally, and we are promised additional tier 4 beds and better joined-up thinking between services, but I have to say that this is a small increase from a very low bar.

An additional problem is the break in consistent service when a child in crisis suffers further as they hit their 18th birthday. They lose one set of services and the adult services may or may not pick up at the same place, which does not make it easy for the child, the family and those trying to support her.

I pay credit to those working in the public and voluntary sector who support and heal these young people, but whose job is being made difficult because of the funding situation and lack of adequate joined-up thinking. In common with all Members here today, I want to thank the Youth Select Committee, the British Youth Council and the many Members of the Youth Parliament across the country for their work.

Earlier this year, I met Hounslow’s MYP, Tafumi Omisore, who told me about the history of this debate and how young people across the country had voted mental health as the top agenda issue for discussion among MYPs and the top issue that they wanted to bring to our attention. Tafumi told me:

“The future of tomorrow cannot possibly get to a stage where young people can rise to their full potential when they are being failed by this current generation”,

by which I think she means us. She continued by saying that they

“lack the support they need for Mental Health. Every time we say we need more support, Mental Health services simply get cut.”

National campaigns for the Youth Parliament come along only once a year, so we have to treat young people’s demands seriously. Tafumi will be holding sessions in her school to promote more education on this subject—and all credit to her.

Earlier in July this year, I met a group of primary and secondary school heads, and I expected them to raise with me the issues of funding, recruitment and retention and testing, which they did. What I had not expected was that they raised their concerns about children’s mental health and the state of the services available to them as being equally important. They were concerned about the increasing incidence of mental health problems, self-harming, disruptive behaviour and so forth. These headteachers had feelings of inadequacy when it came to supporting those children. They felt that they could not get them through a good-quality education and make them ready for the world of work or higher education unless they could give those young people better mental health support.

These headteachers said that the capacity of CAMHS was overstretched and that there were long waiting lists. They had real concerns about inadequate early intervention. They pointed out that more children were vulnerable for many and varied reasons, including mistreatment and abuse at home, and that more families were living in chaotic circumstances. They noted that more families were living in uncertain, insecure and poor-quality housing, which was exacerbated by austerity, particularly in respect of benefits and tax credits. Most parents and families were working, but they had suffered as a result of the changes to the benefit and tax credit system. Increasing numbers of families could not find enough money to pay the rent and put food on the table. This stress impacts on children—it could not fail to impact on them. The head of Kingsley Academy, who has been at the school only a year, told me that during her tenure, three of her children have been sectioned. Some of her children were self-harming and not enough support was available. The social work team could not cope either.

Some solutions were identified. Most of our schools either commission the Hounslow youth counselling service to deliver counselling or employ in-house counsellors. Strand on the Green runs a programme called “theraplay”, which combines therapy and art for children. It is very successful, but there is no funding left to allow it to continue indefinitely. The school heads concluded that not enough support was being provided.

An excellent youth counselling service serves the borough of Hounslow, and has done so for many years. Its counsellors strongly believe that Government cuts have led to the increased need for counselling. Less money means higher criteria for early entry to tier 1 services, and—as other Members have pointed out today—when tier 1 services pull out, young people enter the system when they are in crisis and need tier 3 and 4 services, which are extremely expensive. The Hounslow youth counselling service, like many others, is a tier 1 service, and is there to provide initial counselling and support. It is not a therapeutic service; it cannot be, and it is not funded to be. It does not have the necessary professional advisers. However, it is often the only option for young people, because higher-level services such as CAMHS will not see them for many weeks, and often for many months.

The Hounslow counselling service says that skilled and experienced staff are being replaced by others who are less skilled and experienced, which has made it difficult to maintain important standards in certain departments. It also says that there is no sign that the increase in the number of young people requiring counselling is slowing down, and that further cuts could worsen the situation. It is a voluntary service organisation, funded mainly by local government and the NHS, which are cutting support for the voluntary sector as their own funding is cut. It says that it is likely to see at least 3,000 young people per year and that the number is growing, but it is highly unlikely that it will be able to grow as well in order to meet that pressure. Its waiting lists will lengthen, and young people who are referred by schools or parents, or who refer themselves, will have to wait even longer for counselling.

Our experience in our borough reflects the experiences that other Members have described today. Children and young people are under ever greater pressures from social media, family poverty, housing crises and identity questions. Services are already stretched, and some face an uncertain future: as school and voluntary sector cuts are made, many are closing or have already closed. There is a lack of early intervention. Different services have different priorities, and there are reports of the decommissioning of early intervention services as a result of reductions in spending on social services.

We could do things differently. It is not just a question of funding, although we cannot fail to discuss that issue. My hon. Friend the Member for North Durham (Mr Jones) made an excellent suggestion, based on experience of the armed forces covenant. The establishment of the covenant under the Labour Government was led at Cabinet level, but it filtered through a range of services into local government. I was a councillor in Hounslow at the time, and we adopted the covenant, which filtered into several of our services and priorities. Could we not do the same for children’s mental health?

As many Members have said, we need to do more as a country, and the Government must lead. We must do better. We must listen to young people. We must deliver joined-up services, and we must deliver them early. By doing that, we will save money, but, more important, we will save our young people’s future.