Children’s Mental Health Week 2024

Tim Loughton Excerpts

Tuesday 30th January 2024 Westminster Hall

[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 ---

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

I had not intended to speak, but there appears to be an opportunity to do so, and I am not one to pass it up, so I will make just a few comments. I declare my interests as per the Register of Members’ Financial Interests. Until recently, I was also for six years the chair of the trustees of the Parent-Infant Foundation, which did and continues to do very important work on infant mental health awareness, attachment and the provision of services.

I again congratulate the hon. Member for Tooting (Dr Allin-Khan) on securing this debate. It is a subject about which she knows much, and her passion shows through. I disagree with little of what she said, although her speech became a little partisan at some stages. This issue has besieged Governments over many years, but if one looks at the figures, most alarmingly, the incidence of mental illness among children has got particularly bad since the beginning of covid, and there are reasons for that that we should continue to be worried about. This is not a gradual progression; there has been a very serious downturn in recent years, which I will come back to.

I agree with all the comments that have been made about the disproportionate impact on children in the care system, children from black and minority ethnic backgrounds and those in poverty. However, as my hon. Friend the Member for Mid Norfolk (George Freeman) said, the issue is not exclusive to people from deprived backgrounds. In some projects run by the Parent-Infant Foundation around the country, we see parents from well-to-do city backgrounds who have serious attachment problems with their children. At times, we forget that mental illness spreads across the whole of society in different ways, and we need to be open to all of them.

[Wera Hobhouse]

Does the hon. Member not recognise that those from a less deprived background have better access to help than those from a poorer background?

[Tim Loughton]

There is something in that, and people from better-off backgrounds may have recourse to the private sector as well, but the point is that the illness impacts on everybody, although I certainly agree that the capacity to get early help for that illness is differentiated across families.

The impact of covid should not be underestimated. During covid, we saw the impact on new parents, particularly new single parents. One of the biggest impacts was the absence of health visitors able to go across the threshold of new parents’ homes, particularly on single parents having a child for the first time. There were the other horrors of covid going on, and people were detached from the normal family networks they might have, such as grandparents coming along to share their experience and give support. On top of that, they did not have a health visitor coming to visit them physically, because about three quarters of health visitors were diverted to the frontline of dealing with covid. It was only in the most deprived cases, where there were concerns, that health visitors physically got to go and visit.

On top of that, we had a decline in the numbers of health visitors, which reversed the position that the coalition Government produced, where we had an additional 4,200; quite rightly, that was a pledge by the Government, and it was actually delivered in the lifetime of one Government. Since then, numbers have declined again. I think there is absolutely a false economy.

[Dr Poulter]

I agree entirely with what my hon. Friend said about health visitors. I think I was actually the Minister who oversaw that increase in the number of health visitors. The change to commissioning by local authorities has been a very big mistake in the provision of health visitor services. I wonder more generally—after reflecting on the link between poverty and poor mental health—whether he would also reflect on family nurses, who provide significant support to deprived families and families with challenges. That workforce also struggled to do its good work during the pandemic, which has had a consequential effect on those families and indeed the mental health of young people.

[Tim Loughton]

My hon. Friend is absolutely right. Family nurse partnerships were another great success story, for which he can take part of the credit. There are various ways of providing that support, in particular to new families, but a lot of it was not available during covid.

I have a real concern about babies born during covid. We are only starting to see the consequences. I remember well one of our own colleagues in a debate in this Chamber during covid saying that she gave birth during that time and it was five months before her own baby got to meet another baby, and the baby did not react well—“What on earth is this? Another baby?” There were no mum and toddler classes available then, and there were no support networks of grandparents and others coming in. If there were no health visitors or other professionals there as well, it was difficult to spot signs of attachment disorder or safeguarding issues within a household—and we are only starting to see the consequences now. It has compounded the issues for these children. Now at last, they are at least being diagnosed with a mental illness, but it might have been prevented earlier if all that support was there. That really needs to be on the radar of the Department of Health and Social Care and the Department for Education.

Then there is the impact of school lockdowns, which should also not be underestimated. There is a strong correlation when it comes to children, particularly younger children, not being able to go to school and socialise with their friends, or go through all the normal disciplines of what school brings. There are also safeguarding concerns that teachers and early warning exercises can pick up. We are seeing the impact of children being cooped up at home and not able to get on with the ordinary day-to-day business of growing up and being a child, and there were many safeguarding problems as a result of the schools lockdowns.

I will not apportion blame here, but it was a big mistake that the schools were closed down, and the unions forced those closures in the early days. We are seeing the consequences now. I agree with many of the solutions. Of course we need more investment. The Government have been investing, but they need to invest more, and we need more professionals to come into the system, because they do not grow on trees. It is absolutely right that awareness is needed of mental health first aiders and the mental health support available in schools—and we need more of that.

The trouble is that when somebody’s mental health problem is spotted in school, the thresholds for getting the treatment, therapy or whatever they require are so high that it takes too long, and in too many cases the condition worsens over that time. It really is a false economy. We need far quicker referrals, and without having to go through so many hoops. As the hon. Member for Tooting said, parents are waiting weeks or months on end to get a referral—in many cases, just to get the diagnosis before they can actually get the appropriate treatment.

I also have big concerns about eating disorders. The Government have put a lot of investment into increasing eating disorder specialist placements, but they are full up. I had a particularly tragic case in my constituency. The father rang every hospital in the country, including all the private hospitals because he could afford to fund treatment for his daughter, but everywhere was full. Eventually he secured a bed on, I think, Christmas eve. This was a teenage girl who was suicidal and had been through various episodes before. Eventually she got good treatment in hospital.

But there is a problem when people come out of hospital; often it is a case of falling off a precipice because the support services are no longer there. We need a much better system where people who need residential intensive support can be supported when they come out of that residential environment, which is a particularly tricky time because too often they end up having to go back into that intensive residential environment.

[Dr Poulter]

rose—

[Tim Loughton]

I will give way one more time. I have one more point to make and then I will finish.

[Dr Poulter]

I thank my hon. Friend for giving way. He is making an excellent contribution to this debate. His points about eating disorders are absolutely right. On the arrangements that are in place for discharge from in-patient units and also on preventive care such as community services for eating disorders, does he agree with me that one of the challenges is that there has been a failure to develop the workforce in that area? There are many unfilled posts in community eating disorder services. Unless we get that right, we will not address the challenges of eating disorders that he has outlined.

[Tim Loughton]

Again, my hon. Friend reinforces my point. I think we have done better on the provision of beds for that intensive care, although there are still not enough of them, but we have not done nearly enough on picking up afterwards and on preventing people from getting to that stage in the first place. The issue disproportionately affects young girls, who have all the pressures of social media. The Media Bill is being discussed in the main Chamber at the moment, and we are clamping down on sites that pretend to be there to offer support but that actually encourage vulnerable teenagers into obscene eating disorders as though they are a badge of honour. So much more needs to be done. It is so expensive—financially, as well as socially—when we do not act at the appropriate time.

My final point comes back to early intervention and prevention. The Best Start for Life project, pioneered by my right hon. Friend the Member for South Northamptonshire (Dame Andrea Leadsom), really is a game changer. It has had the buy-in of all the political parties. I was a part of the various advisory research groups that we had in this place working with Members across the Floor, and we now have the roll-out of family hubs. This is all about supporting families, particularly mums, but not exclusively mums because fathers have a role; too often they are neglected and yet they are a part of the support mechanism. There are mental illness problems affecting new fathers, which are quite severe, as well as the perinatal mental illness around women. We need to do much more to make sure we have happy mothers and that we attack domestic violence problems, a third of which happen during pregnancy. If we have a happy mum, we have a happy baby, who is likely to grow up well attached, happier, well balanced, and more resilient against all the pressures and problems of mental illness in society that are manifested in schools and beyond.

It is not true to say that the Government have done nothing and have not invested in this issue. We need them to do more and invest more. The Best Start for Life project is one of the most exciting and fundamentally important projects for attacking a problem right at the beginning, before it becomes a much bigger problem for children, families and society as a whole.

[Several hon. Members rose—]

--- Later in debate ---

[Amy Callaghan (East Dunbartonshire) (SNP)]

I congratulate the hon. Member for Tooting (Dr Allin-Khan) on securing this debate and the passion and professional experience she brought to her contribution.

The contributions we have heard so far highlight how important it is to take action to improve children’s mental health and address the root causes and aggravating factors leading to poor mental health in children. As the MP for East Dunbartonshire and the SNP health spokesperson, I am fully committed to tackling the underlying causes of mental health issues. The key themes I want to reiterate are improving support for children who are struggling with their mental health, and poverty as a key driver of poor mental health. Addressing that is key, to ensure children are not taking on the burden of this Tory Government’s financial mismanagement.

I will start with support. The theme of this year’s children’s mental health week is “My Voice Matters”. It is important that we acknowledge in this place that we are here to represent our constituents and give a voice to those not feeling heard. It is our responsibility to advocate for those families and ensure that, when children are struggling with their mental health, they are met with support and a listening ear.

It is also important to note that LGBT young people are more likely to struggle with their mental health. It is no wonder, really, when the rhetoric in this place and from the Government constantly undermines and questions young people who may already be struggling with their identity. Instead of questioning and doubting these young people, we all have a duty to understand and support our young LGBT constituents. That is why the Scottish Government recently announced additional funding for a new project to support LGBT children and young people’s mental health. LGBT Youth Scotland will receive £50,000 to establish a new mental health LGBT youth commission. The commission will explore barriers and the challenges young LGBT people face when accessing mental health support and services. That will involve listening to young people and their lived experience to help inform future work, designing targeted and tangible solutions formulated by the LGBT Youth Scotland mental health ambassadors.

The SNP believes that supporting children’s wellbeing should be rights-based, strength-based, holistic and adaptable. That is why, in 2021, the Scottish Government published the whole school approach framework to assist schools in supporting children and young people’s mental health. The Scottish Government’s mental health transition and recovery plan also emphasises a health-promoting and preventative approach to mental health and wellbeing. The preventative approach is something we have heard about from across the Chamber today, so I am delighted to represent the SNP in that regard.

Education and the time children spend in schools have a large part to play in that approach, through raising awareness and understanding, and supporting the positive mental health of children and young people. Included in the framework are considerations for local authorities and guidance for schools to develop and embed policy in practice within schools and the wider community, and to support them in evaluating their mental health practices and identify areas for improvement. It is essential that schools, where children spend so much of their time, are equipped with the proper tools and knowledge to support children and ensure their mental health is prioritised and understood. That is why the Scottish Government also continue to support local authority partners with £60 million of funding to ensure that every secondary school has access to counselling services. The Scottish Government have also published a mental health and wellbeing strategy built around the three pillars of promote, prevent, provide: promoting positive mental health and wellbeing; preventing mental health issues occurring or escalating, while tackling underlying causes; and, of course, providing mental health and wellbeing support and care.

That leads me to the other major theme I want to highlight, which is tackling the underlying and aggravating causes of poor mental health, the most prominent being financial pressures and the impact of the Tory Government’s cost of living crisis. Childhood should be a time of happiness and freedom. Children should not need to worry about their family’s finances or whether they will be warm and well fed, a point explored by the hon. Member for East Worthing and Shoreham (Tim Loughton), who is no longer in his place.

[Tim Loughton]

Yes, I am!

[Amy Callaghan]

Oh, sorry, you’ve just moved.

Low-income families with children continue to be disproportionately hit during the crisis. It is no surprise that that has had an horrendous impact on mental health. When families are in fuel and food poverty, struggling to keep warm and fed, the stress is certainly not limited to parents, as mentioned by the hon. Member for Tooting. It can aggravate specific mental health conditions, including, but not limited to, eating disorders.

The cost of living payments from the British Government have been one-off flat-rate payments. That means that a single person receives the same as a family of five. Research has shown that single-person households saw their income rise by 6% thanks to those payments, which is of course welcome, whereas for families with two or three children, the increase was only 3.3%. The Work and Pensions Committee’s cost of living payment report states that the failure to provide extra support for families is notable and should be examined further by the UK Government. Unfortunately, the response from the British Government rejects the idea that cost of living support payments should take account of family size, despite that being a common sense recommendation based on data and fairness.

We in the SNP are deeply concerned about the UK Government’s welfare policies. Instead of heaping additional pressure on low-income families, the British Government need urgently to address the fundamental issues with universal credit. One particular example is ending the two-child limit and the rape clause, a policy that I am afraid would be kept by any future Labour Government. The End Child Poverty Coalition analysis estimates that almost 90,000 children in Scotland are impacted by the two-child limit, and ending it could lift 250,000 children—15,000 of whom are in Scotland—out of poverty. This British Government’s political choice to keep and force kids into poverty is simply to the detriment of children’s mental health across these isles.

Meanwhile, the Scottish Government have lifted 90,000 children out of poverty with ground-breaking, game-changing policies such as the Scottish child payment. We in the SNP are not the only ones who are concerned and calling on the British Government to end the two-child limit. The chief executive of the UK Committee for UNICEF, Jon Sparkes, said:

“We urge the UK government to take steps to protect all children from poverty, starting by making child poverty reduction a government priority, scrapping the two-child limit policy and benefits cap, and improving services and support, especially for the youngest children”.

I ask the Minister this: why is reducing child poverty not an ambition of this Government? We in the SNP call on the British Government to scrap the benefit cap and to introduce an essentials guarantee to ensure that universal credit is set at a level that allows households to cover essential costs such as food and utilities. As much as the Scottish Government progressively mitigates the policies of this place, 85% of welfare expenditure and income replacement benefits remain reserved to Westminster. That is why social security policy should be fully devolved to the Scottish Parliament.

Adverse childhood experiences are of course a significant factor in a child experiencing poor mental health, as outlined by the hon. Member for Bath (Wera Hobhouse), who chairs the childhood trauma all-party parliamentary group. ACEs and the trauma associated with them are, by and large, linked to poverty. I sat on and chaired children’s panels in the central belt of Scotland before being elected to this place. I saw at first hand the trauma that ACEs and poverty can cause to children and families. The SNP Scottish Government’s strategy of investing in people, investing in children, would work much more significantly if our hands were not tied by this place.

It is clear that the Scottish Government have the willingness and the ideas to help children’s mental health. We just need the powers. It is abundantly clear that, no matter which party forms a British Government after the next election, ending child poverty will not be a priority. Only with the full powers of independence will we be able to tackle the root causes of child poverty and improve the mental health of children in Scotland, continuing the Scottish Government’s current ambitions as an independent nation.