Children and Young People’s Mental Health

Wera Hobhouse Excerpts

Wednesday 16th June 2021 Westminster Hall

[Wera Hobhouse (Bath) (LD)]

I thank my hon. Friend the Member for Twickenham (Munira Wilson) for securing this important debate. We have a long way to go to properly respond to our growing mental health crisis, especially for young people.

Eating disorders are a serious mental health issue, affecting many thousands of young people. They are complex and potentially life-threatening. They have no single cause, and they have the highest mortality rate of all mental health disorders. Recovery from an eating disorder takes, on average, three times as long as having the disorder itself. The fact that, all too often, an eating disorder goes undiagnosed and untreated for years adds to the problem.

Access to help continues to be a postcode lottery. NHS data on eating disorders show a fourfold increase in the number of children and young people waiting for urgent care. Behind these awful statistics hide thousands of real-life tragedies, not just for the sufferers themselves, but also for the friends and relatives who watch loved ones suffering from this awful illness virtually disappear before their eyes. With face-to-face appointments not going ahead, it has been much easier for sufferers to say that they are fine and not to ask for help until they reach crisis point. Like many forms of mental illness, eating disorders thrive in isolation. Some people have described their eating disorder as the only thing they have felt able to control during lockdown.

The demand for children and young people’s community services was already rising before the pandemic, but now these services are backlogged. The news that CCGs in England would increase their funding for eating disorders by an additional £11 million to help them cope with increased referrals was extremely welcome. However, this funding is not reaching the frontlines. Research commissioned by the all-party parliamentary group on eating disorders, which I chair, and carried out by the eating disorder charity Beat, shows that CCGs in England increased their spending on children and young people’s community eating disorder services by just £1.1 million in 2019-20. Only 15% of CCGs increased their spending in line with the increase in additional funding; 21% spent less. On behalf of the APPG and Beat, I ask the Minister and the Government to hold NHS leaders to account, because they must make sure that every penny that the Government have made available goes to frontline services.

The impact of the pandemic on the mental health of disabled children and young people has been considerable. Research from the Disabled Children’s Partnership consistently shows that disabled children have been more isolated than the rest of the population. Its latest survey shows that 90% of disabled children are socially isolated, and 72% of parents said their children are

“often unhappy, downhearted or tearful.”

Disabled children are at risk of being forgotten in the national recovery from the pandemic. It is deeply disappointing that the Government’s recently announced education recovery plan provides no tailored support for disabled children to meet their complex needs. I urge the Minister to back calls for immediate dedicated catch-up funding and services for disabled children and their families. In the autumn spending review the Government must go further. They should commit to proper funding to tackle the pre-pandemic gap in disabled children’s social care services.

Childhood trauma is at the bottom of a very large number of mental illnesses. Many children take their traumatic experiences into later life and it affects their life chances in every aspect, from educational achievement and professional qualifications, to health and wellbeing, to the risk of coming into contact with the criminal justice system. We still lack a proper understanding of the effects of childhood trauma and how to prevent it. Trauma-informed services across the board, in schools, the NHS, the police and our prisons, would have a transformative impact on the whole of our society. As the chair of the all-party parliamentary group for the prevention of adverse childhood experiences, I hope very much that we can engage with the Minister on the work we are doing in that field.

Our children’s mental health is deteriorating. We must do all we can to improve it.

--- Later in debate ---

[The Minister for Patient Safety, Suicide Prevention and Mental Health (Ms Nadine Dorries)]

It is a pleasure to serve under your chairmanship, Sir Gary. I thank the hon. Member for Twickenham (Munira Wilson) for bringing forward this important debate. We have had a number of interactions and I know how genuinely important the issue is to her. I am aware of the meeting she had with the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar). I will give some information, but also reassure her that we are continually working on these issues. More has happened as a result of her meeting. I know she is genuinely very concerned about this issue and has been since the day she arrived in Parliament.

As the Minister, I speak to all stakeholders, trusts, organisations and just about everyone involved in the area of mental health, particularly among children and young people. It is incredibly important that we keep our language and our comments about children and young people both proportionate and responsible. There is not a mental health pandemic. I will go on to explain what I mean by that.

It is very important that we divide wellbeing from mental illness, not least because we do not want mental illness to fall by the wayside in people’s awareness and understanding of mental health, because the conversation is dominated by mental health and an overarching title that is not appropriate. Mental health is divided—it is not just a catch-all title. We have people who suffer with serious mental illness and childhood mental illnesses, such as schizophrenia, psychosis and eating disorders. I congratulate the hon. Member for Bath (Wera Hobhouse) on her speech; we have discussed eating disorders many times, and she is compassionate and is compelled to improve eating disorder services for children and young people in the UK. I thank her for her commitment to the issue.

It is incorrect to describe 140,000 children as having been turned away. The measurement of progress against the five-year forward target is based on two contacts with NHS services—this is an important point. Many children and young people have one session. After that, it is jointly decided to close their referral. To quote the 140,000 figure is misleading. One session is thought enough to provide them with the help they need or, more importantly, to provide pathways to their carers, parents and those who accompany them to the appointment. The expansion of Every Mind Matters, which was developed by Public Health England, to include children and young people under the age of 18 has been a huge boost. It is wrong to say—to misquote—that 140,000 children have been turned away. It is important to look at the reasons why.

I began by saying that I speak to stakeholders, trusts and others. I would like to quote from a letter a trust sent to MPs, following a debate on the issue only days ago. The trust said: “Partner organisations work incredibly closely to ensure children and young people receive the services they need.” It was referring to the narrative used by parliamentarians. It said that frontline staff had worked tirelessly throughout the pandemic and had taken the additional investment that the Government had provided to increase their workforce, and that to describe their services as failing had an impact on the morale and wellbeing of dedicated frontline staff and those who are delivering services to children and young people. It went on to say that the statements that were being made caused concern and alarm to children and young people and their families at an anxious time.

We have a responsibility in Parliament when we are talking about mental health, particularly of children and young people, to keep language proportionate. For me, talking in a debate about children throwing themselves off a bridge is completely beyond the mark and I am afraid that I think that that type of language is exactly what the trust was referring to—[Interruption.] The hon. Member for Tooting (Dr Allin-Khan) is commenting from a sedentary position. I reiterate my comments, Sir Gary. It is important that we consider the families and the people that we are representing and do not make inflammatory statements.

I have heard first hand from NHS staff that thousands of children and young people have had to adapt to the challenges of covid-19. It has been an incredibly tough year for everybody, and many children and young people have felt anxiety, apprehension and a gamut of emotions that adults also felt when faced with the unknown, sudden and rapid change to routines as well as a lack of understanding of what would happen and how life was to continue. However, many people are resilient, and many of those children and young people, who at stages reported they felt all those emotions and were included in that statistic of one in six, came through once there was a greater understanding of what was happening and how it was going to work. They were incredibly resilient, and we should be proud of those children and how they helped others too.

We take the pandemic and the mental health of children and young people extremely seriously. I work seven days a week on what this Government do, what we provide and how we assist. Although I have been criticised by the hon. Member for Tooting for talking about the investment we provide, we cannot provide services without the money for them. We cannot increase our mental health workforce if we do not provide the money to train people and to provide those services and that is exactly what we have done. I have no shame in quoting the figure of £2.3 billion a year that is going into mental health services—more than any Government has ever ploughed in, plus an additional £500 million to a mental health recovery plan for the pandemic this year, of which £79 million has gone into eating disorder services based in the community. We hope that that funding will allow around 22,500 more children and young people to access community health services.

[Wera Hobhouse]

The Minister has quoted the numbers for what the Government have made available. As I said, unfortunately a lot of that money has not reached the frontline. Will she make CCGs accountable and that money goes where it is meant to?

[Ms Dorries]

It is a constant pressure for me to ensure that. NHS England has worked incredibly hard to establish community-based services. It is important to say that the uptick in eating disorders came before the pandemic—it was spotted before it struck. We can have another debate on why we were beginning to see that rise in eating disorders, and the hon. Member for Twickenham and I have had that discussion. I am proud of how the NHS has rapidly looked at how we can deal with this exponential rise in eating disorders, because that is where our problem is.

We know exactly who has been affected by the pandemic, in terms of mental health services. We know from the referrals that have gone to our partners across the board and to local services. I am saddened to say that eating disorders are our toughest problem at the moment because of the exponential rise—over 22% over the past year.

NHS England is using that money. As I said a moment ago, having the workforce to provide services is really important, so we have accelerated the number of mental health support teams that we are putting in. The first question I asked when I took up my ministerial post was: “Can we have more mental health support teams in schools faster? Can we accelerate the long-term plan so that we get more areas covered quicker?” It took the pandemic to make that happen, but now—I have not even used my speaking notes; I have gone completely off piste—I think we have another 112 school areas covered. I will write to Members attending today to give them the figures on mental health support teams. We have managed to accelerate the programme by over a year as a result of the £500 million of funding that we put in.

Something that we can really shout about is that we have people coming forward. Mental health was never an area where people really wanted to work. I remember during my nurse training that we were given the option to take 12 weeks’ maternity or 12 weeks’ mental health, and my entire cohort took 12 weeks’ maternity. Nobody went to do the mental health training. Now—the pandemic has highlighted this—we have 100 applications for every place in university for people to train in mental health. That means mental health support teams to go into schools, deal with eating disorders and work with children and young people. When we put that kind of money in, run those kinds of courses and have the commitment to accelerate mental health workers, we do not see those results overnight, but that work is being done now to ensure we have the results. We want to ensure that people come out of universities and go into mental health support teams in schools. I have seen the work they do and how they work with children and young people.

Time has whizzed on, and I would just like to make a few points. The hon. Member for Lewisham West and Penge (Ellie Reeves) spoke about young mums and infant mental health. I am totally with her. That is why I worked so hard during the lockdowns to ensure that we kept support groups open for mums and young babies, and particularly those that give mental health support to mums. That included all sorts of groups, such as playgroups—Monkey Music is one that somebody used—where mums could meet together with their young babies. I argued for that and made the case for supporting their mental health. During the pandemic, those groups were kept open for young mums because I felt it was so important that they were supported.