Mental Health Education in Schools

Wera Hobhouse Excerpts

Monday 6th November 2017 Westminster Hall

[Wera Hobhouse (Bath) (LD)]

I was a secondary school teacher and I delivered some PSHE classes. I remember that they were often not very satisfactory, because there were no exams, so young people did not take it particularly seriously. Also, they were often lumped into the last lesson of a particular school day. Would it not be a lot better if each school had a dedicated mental health lead? That would obviously be a teacher-led position, and each school could then deliver a strategy for dealing with mental health.

[Lucy Allan]

That is an excellent idea, although I would still like to see some form of training built into the basic PGCE training that all teachers receive. However, a dedicated individual with a strategy for the school, which the governors would be aware of and everybody would buy into through a whole-school approach, would be extremely helpful.

As I am sure anybody who has ever heard me talk about anything knows, I am instinctively wary of the state telling those at the coalface how to best deliver for the young people in their care. Education should never be about delivering as many qualifications as possible but always about preparing young people for life and the challenges that they will face. Building resilience is a key part of that.

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[James Morris (Halesowen and Rowley Regis) (Con)]

It is a great pleasure to serve under your chairmanship, Mr Brady. I congratulate the hon. Member for Newcastle upon Tyne North (Catherine McKinnell) on putting the case so cogently for the importance of education about mental health in schools.

In preparation for the debate, I reflected on the distance we have come and the sense that we still have a long way to go on what I would call mental health literacy. I remember being at school in the late 1970s and early 1980s and having, as a 13 or 14-year-old, a sense of anxiety and some sense of uncertainty about the future. I could not label the condition I was suffering from at that time, but subsequently I learned that it was called depression. I think I had a depressive episode of quite a severe nature when I was about 13 or 14 at school. At that time, it was not a condition that was being labelled, so I did not have a way of talking about it that made sense. In the school environment of the 1970s and 1980s, teaching staff did not have the capability and my peers did not have the awareness of what mental health really meant.

The truth is, as other Members have said, that we have come a huge distance over the last 30 years. It would be churlish to characterise what we face today as a unique set of contemporary circumstances. The debate about mental health and our understanding of young people’s mental health has come a huge distance, as has the way in which it is represented in our media and the way we have talked about it in Parliament over the last few years. As you may know, Mr Brady, I was chair of the all-party parliamentary group on mental health in the last Parliament, when we had a series of very important debates about mental health that galvanised and were a lightning rod for further discussion in the public realm about young people’s mental health.

The representation of mental health in drama and soap operas has undergone quite a revolution. There was a time when young people’s mental health was often talked about only in terms of negative, stigmatised associations with suicide and so on. The public’s and schools’ awareness of mental health has undergone some degree of transformation.

[Wera Hobhouse]

The broad consensus in the Chamber on this subject is really welcome. Like the hon. Gentleman, I very much welcome the fact that the stigma about mental health is starting to go away and people can talk more openly about their issue, but helping young people requires resources. Norman Lamb, who was the initiator of an initiative called Future in Mind, secured funding, during the coalition Government, of £1.25 billion, to be spent over the next five years. That should amount to £250 million each year, but only £143 million was released in the first year of the programme, 2015-16. Should not we all in this Chamber urge the Minister to continue that commitment and the budget that was secured under the coalition Government?

[Mr Graham Brady (in the Chair)]

Let me just remind the hon. Lady that her colleague should be referred to in the Chamber as the right hon. Member for North Norfolk, rather than by name.

[Wera Hobhouse]

I apologise, Mr Brady.

[James Morris]

I thank the hon. Lady for her intervention. The simple answer to her question is yes.

[Phil Wilson in the Chair]

The Government are, as I understand it, fully committed to that additional investment over the five years of this Parliament. The truth is that a lot of progress has been made under the current Government in terms of further investment in child and adolescent mental health services. Obviously, there is more to do, and Future in Mind, to which the hon. Lady refers, was a very good initiative, led by the right hon. Member for North Norfolk (Norman Lamb) when he was the Minister with responsibility for mental health. I am not arguing that somehow that money will magically transform the CAMHS system, but the truth is that some progress has been made in understanding the extent and prevalence of children and young people’s mental health problems. The Department of Health is beginning to gather, for the first time, meaningful data about what is happening in the system. That was never in place before; child and adolescent mental health was a data-free zone until very recently.

Also, in terms of the extra money, we have only started to understand and have the data on where the money is actually being spent. The NHS dashboard that has been created for mental health is, for the first time, acting as a tool to put pressure on local commissioners to spend the money that they have been allocated. Clearly, there has been a discussion about this. The money is not ring-fenced currently, but with the dashboard created by the Department of Health, we can see what local clinical commissioning groups are spending on child and adolescent mental health. That should be used as a tool to continue to put pressure on commissioners to make the right sorts of choices.

I mentioned what the vision and set of principles should be for this area. In the school environment, we should be trying to move towards what I call mental health literacy, which means giving young people the facility to talk about the mind and their mental health in a way that is intelligible for them and their peers. That is what we should seek to achieve in this context. We have had a very rich debate talking about this issue. I do not think that it is just a question of what is in the curriculum. Young people and children as they are growing up will listen to teachers in a particular way. They might not really want to listen to the message that the teacher is giving, because the teacher may represent a position of authority that they feel uncomfortable with. I am not saying that it is not important that teachers are trained and aware and that there is provision in the school environment, but that is not the whole picture.

We need to consider two further aspects. Peer pressure or peer conversation is almost as important as what is in the curriculum. I am talking about a structure in the school environment that allows young people to talk with one another about mental health, equipping them with the knowledge, skills and literacy to be able to have that conversation. I remember that back when I was at school, I felt very isolated—a sense of isolation—that somehow what I was thinking about was not legitimate; it was something dark and horrible and I was the only person who could possibly be having that issue at the age of 13 or 14. It is extremely liberating for young people when they realise that a vast range of their peers have the same sorts of questions about the future. It is relatively normal for adolescents to have periods when they are very uncertain about the future and how they fit in with their peers. They may have particular issues, but that ability for the school community, for children and young people together, to be able to talk about that is vital. It is a kind of therapeutic valve in the school environment, which I think is critical. In fact, much of the evidence base that I have seen shows that peer-to-peer communication on mental health in schools is extremely effective as a mechanism for helping young people, so that is the vision of what we should seek to achieve.

Also crucial, as other hon. Members have mentioned, is the involvement of families in the conversation. Families should not be excluded from the conversation, but brought into it as part of the process that we are describing, because obviously the family is the crucible in which a young person is brought up. For many young people, that is, as my right hon. Friend the Member for Mid Sussex (Sir Nicholas Soames) said, a golden experience, but for many other young people it is characterised by dysfunction and relationships breaking down; it is often characterised by confusion.

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[Chris Ruane]

Absolutely. Ghandi said, “Be the change you want to see.” We are change-makers in this room, and we need to make our personal, political and parliamentary decisions from a position of personal equanimity and balance. If we do that, we will be doing tribute to ourselves and our society. Some 150 MPs and Lords have had the training, and we instituted a parliamentary inquiry on mindfulness in health, education, criminal justice and the workplace. We have put forward recommendations.

[Wera Hobhouse]

I appreciate the benefits of a healthy mind, a strong child and preparing children and young people for the challenges in life, but does the hon. Gentleman see that even though someone might have been brought up in a happy, healthy family, mental health issues can hit them at any point? There is not prevention for mental health in the same way as for other things, because we never know what will happen or come round the corner. We need to monitor mental health throughout the years, again and again and again.

[Chris Ruane]

I absolutely agree with the hon. Lady. That is what is happening in mindfulness research. Bangor University is looking at mindfulness for the baby in the womb. The biggest cause of low birth weight babies is maternal stress—either directly or through legal and illegal drugs, tobacco or alcohol—and it is working on a curriculum for babies in the womb. Bangor University is looking at a mindfulness curriculum for three to seven-year-olds; it already has one for seven to 11-year-olds. The .b course has been devised for 11 to 18-year-olds by top mindfulness experts who actually teach in the Palace of Westminster. There is another £7 million study into the effects of mindfulness on 11 to 18-year-olds at Oxford University called the MYRIAD project. Hopefully, the interim report will be published around 2020. If that scientific evidence is proven, as decision makers and policy makers we should look carefully at it. If we can get on top and provide that resilience to children and young people from the age of three, we should be implementing that.

I want to draw hon. Members’ attention to what we are doing in mindfulness to help us in our initiative to ensure that the proven science of mindfulness is taken up in the national health service, the education service and the criminal justice service. Some 85% of prisoners have one or more mental health issues, and some people are incarcerated from a very young age. Again, we owe it to them to look after them and to give them the best provision available.

I mentioned this in an earlier intervention, but the bell curve of wellbeing includes people who are well below that curve, the majority who are somewhere above that position of mental ill health, and a few who are flourishing. If we can shift the whole of that wellbeing curve along, the biggest beneficiaries will be those with the poorest mental health, but it will also help everybody on the curve. Mindfulness can be used not just to give people back their equanimity, but for human flourishing. This question has been posed for thousands of years, but something seems to have gone wrong in society over the past 30 years. We have had a tsunami of mental ill health washing over the whole of the world, and especially the western world. We give more credence to the pursuit of money and wealth than to individual, family, societal and community wellbeing. It is time that we took stock and asked ourselves what is important in life. The most important thing for me is to think from a position of balance. There are curricula and courses that can be taught to young people, and we are failing if we do not put those provisions in place.

Again, as I said in an earlier intervention, there is a way that we can help those students who go to university at 18 to become teachers in three or four years’ time, or who go at 18 to be medics or doctors and come out at 25 to be GPs. Many of those young people are in stress themselves—“Physician, heal thyself”. If those young students can be given the skills to get their own personal balance, when they go through their career as a GP, nurse, midwife, teacher or lecturer, they will remember the benefits that they have had—the equanimity and the ability to concentrate, to focus, to improve their grades and to improve their way of living—and they will be able to touch thousands of minds over the course of their medical or educational career. It is a huge problem that is out there, and some of the answers could be quite simple.