Children’s Mental Health Week 2024 [Mark Pritchard in the Chair]
2.31pm 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...Request free trial
Children’s Mental Health Week 2024
[Mark Pritchard in the Chair]
2.31pm
(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.
(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.
(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.
(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.
(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.
(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.
(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.
(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
), 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 (), 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.
2.51pm
(Bath) (LD)
It is an honour to serve while you are in the Chair, Mr
Pritchard. I congratulate the hon. Member for Tooting (Dr
Allin-Khan) on introducing the subject in such a wide-ranging and
compassionate way. I prepared only a few notes because I thought
the debate would be over-subscribed, but I hope we will still
fill the time. I might add a few things that I have not
prepared.
I want to focus particularly on adverse childhood experiences. I
have been the chair of the all-party parliamentary group for the
prevention of adverse childhood experiences, which we now call
the APPG for childhood trauma, for some years. Listening to and
understanding the science of adverse childhood experiences has
given me a real insight. I commend the WAVE Trust, which has also
done a lot of work on attachment disorder and the importance of a
child’s early attachment to their mother. The trust has been a
fabulous supporter of the APPG for childhood trauma.
Our children are falling through the cracks. It is clear that our
approach to childhood mental health is not working—I agree with
the hon. Member for Tooting on that. As the chair of the APPG for
childhood trauma, I will focus my attention on trauma in mental
health.
Adverse childhood experiences, also known as ACEs, are the
biggest drivers of poor mental health in children. They can be
anything that threatens to overwhelm the child, including abuse
and neglect. Being unable to process prolonged stress can alter a
child’s normal brain function, which often stays with that person
all their life. That is what we call trauma. A child’s brain
helps them to survive in the moment, but it assumes that
persistent stress or danger is normal and it therefore adapts to
constant adrenalin. Because of that, those who experience
childhood trauma are twice as likely to develop depression and
three times as likely to develop anxiety disorders.
Very often, children’s behaviour at school is also affected. I
asked a question in Education questions earlier this week about
the Government’s behaviour policy, because ACEs are not even
mentioned in it. If we do not talk about ACEs more—I use every
opportunity to talk about them—gaps appear in the behaviour
policy or guidelines to schools. The Department for Education
does not even mention ACEs and childhood trauma; that needs to be
corrected.
Many children carry their traumatic experience into later life.
Someone’s chances of dropping out of school, being obese or even
developing diseases such as strokes are higher the more ACEs they
have experienced. The life expectancy of those with six or more
ACEs is 20 years lower than that of peers with none. There is no
limit for the reach of ACEs. That does not mean that people who
suffer adverse childhood experiences are invariably condemned to
a life of disadvantage, but it is so much more likely. We
therefore have to focus on it.
Poverty is also an adverse childhood experience. That is why the
connection between mental ill health and poverty is so important.
We need to focus and see it for what it is.
Sir (Horsham) (Con)
The hon. Lady is making a fascinating speech, and I look forward
to hearing more from her on a future occasion. She draws
attention to how young people can get support and be recognised.
In my constituency, we had a series of tragic events. Out of
that, the NHS has provided i-Rock Horsham District, which is an
opportunity for young people without a referral—without being
told by a teacher, parent or doctor that this is the appropriate
path—to present themselves for professional support. It will not
be fully-fledged psychiatric support but it will have that
triaging process, sometimes helping them with more basic issues
or reassuring them, but often helping to pick up where they
really need the kind of support my hon. Friend the Member for
Penrith and The Border (Dr Hudson) and others have referred to.
That is proving extremely effective in my constituency.
I could not agree more. I hope my speech will make everybody here
realise that we need much more understanding about ACEs. Some
countries have that understanding and roll out trauma-informed
services across the board, including police, education, welfare
and health. A better understanding of ACEs will lead to more
specialism and more people understanding this area.
Trauma-informed schools, for instance, would also mean that
teachers pick things up and go deeper into the issues of
childhood trauma. I was a secondary school teacher before I
became a Member of Parliament, and I sometimes wish I had known
about ACEs, given some of the behavioural challenges I faced,
which would make someone think, “That is just a very difficult
child.” If I had known more, I would probably have picked up the
behaviour as that of a traumatised child, rather than that of
somebody who was consistently causing trouble. We would therefore
deal with children differently.
The hon. Lady is making a powerful case, and I am keen to hear as
much of it as I can. To the point I was trying to make earlier,
extreme poverty is one cause of childhood trauma, but there are
many others. Like many people in this House—I put my own hand
up—I experienced childhood trauma, but I was in a materially
privileged family. Poverty can provide a lot of those drivers
that the hon. Lady has talked about, but I was taken out of the
arms of my father by the police at 11 months, and I was a child
carer of an alcoholic parent. Poverty has a part to play, but
does the hon. Lady agree that we need to make sure we frame this
in the context of the real causes, some of which are not related
to poverty but to other chronic problems, such as alcohol,
addiction or domestic violence? If we view the matter simply
through the prism of a poverty attack, we are in danger of
missing out some of the causes that are really embedded in
repeated patterns of trauma within families.
First of all, it is brave that the hon. Gentleman is sharing his
experiences of trauma. I think we need more people to do that. He
is also absolutely right that not all of this is directly linked
to poverty. Poverty or extreme poverty is one ACE among many
others, and these things can happen in any family. Those who are
doing research into ACEs would always recognise that trauma is
not just suffered in a particular type of household but across
socioeconomic backgrounds. The hon. Gentleman will know how
difficult it is to overcome the traumas of early childhood and
deal with them.
I want to make some progress. I am sorry that I cannot expand on
ACEs now, but I encourage everybody who is here to inform
themselves about them and the research that the WAVE Trust has
done into the subject, which is fascinating and ongoing. That
research suggests that the adverse childhood experiences of abuse
and neglect alone, which can happen in any family, cost the UK
more than £15 billion a year. Clearly, the cost of preventing
adverse childhood experiences is less than that of inaction.
Unnoticed and unaddressed, adverse childhood experiences can be a
lifelong sentence. Childhood trauma does not end with the child
and it gets transferred to the next generation—that is also
something that the APPG for childhood trauma has researched
further. Then, there is a spiral or a vicious circle of repeat
trauma. If childhood trauma is not addressed, those who become
parents will carry their adverse childhood experiences into the
next generation, and their children may suffer trauma, too. We
must end this cycle, and that starts with early intervention. One
factor that can help to prevent childhood trauma is whether the
child feels capable and deserving. A supportive and reliable
adult presence is key, and we often hear about how teachers, for
example, have helped a great deal because they, as an adult, have
been in the room when home life has been very difficult.
As I have said, 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. Social workers
must be supported to recognise the effect of ACEs early in
children’s lives. Early years practitioners can spot signs of
trauma at the age at which it is most likely to be resolved. I
hope to hear commitments from the Minister on implementing
trauma-informed services. Examining how trauma affects minds
allows us to gain an enriched understanding of behaviour, and I
have mentioned how that would support teachers. Rounded insights
and changes in approach lead to better care for children, and
better care for children now will be felt for generations to
come.3.01pm
(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 () 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.
Does the hon. Member not recognise that those from a less
deprived background have better access to help than those from a
poorer background?
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.
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—
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.
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 ), 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—
(in the Chair)
Order. I am afraid I will have to impose a time limit of five
minutes for each speech—we have about three left. We will move on
to the Front-Bench speakers just before half-past, so that will
be 10 minutes each. I call .
3.13pm
(Bolton South East)
(Lab)
It is a pleasure to serve under your chairmanship, Mr Pritchard.
It is also a pleasure to follow the hon. Member for East Worthing
and Shoreham (). I congratulate my hon. Friend the Member for
Tooting (Dr Allin-Khan) on securing this really important debate.
I thank her for all the work that she has done over the years on
mental health issues. She works as a doctor while still working
as a Member of Parliament, so I thank her so much for everything
that she has done.
I will speak for about two minutes, so hopefully colleagues will
have a chance to get in. The problem is that mental health has
always been a bit of a Cinderella service; there has never been
proper investment in, for example, the training of professionals,
or in sufficient spaces—for example, in schools—to help children
with mental health issues. As a constituency MP, parents come to
see me when they are trying to get their children into a special
school, and I am sure other colleagues will have heard about the
same issues: there are not enough spaces available and, if there
are spaces, they are often far away. It is heartbreaking to see
parents crying about how much their children are suffering. In
Bolton, the wait just to get a first appointment with CAMHS is at
least 12 weeks, and the NHS Greater Manchester integrated care
board recently reported that, as of November 2023, there were
29,690 children on the waiting list for mental health support—a
25% increase on the figures in November 2022.
Mental health issues have affected almost 1.6 million young
people—double the number 10 years ago—who are effectively being
reported as “disabled”, and 650,000 children receive disability
living allowance. There are many reasons why children experience
mental health issues. We have discussed the cost of living
crisis; being unable to access proper food, a warm home and
clothes will have an impact. I agree with the hon. Member for
East Worthing and Shoreham that the covid lockdown, school
closures and other reasons have also contributed to the
situation. There are also existing recognisable mental health
issues, like attention deficit hyperactivity disorder, eating
disorders and self-harm—and we often forget about factors such as
the sexual and physical abuse of children in the home. These are
real crises that we are facing.
The country cannot afford to have 1.6 million children who will
become adults with mental health issues. There is a moral
argument for the situation to be resolved. I heard what my hon.
Friend the Member for Tooting said about the Government; whether
people like it or not, this Government have been in charge for
the last 14 years, so if there are still problems now, they have
to take responsibility and tackle the issue properly. I will say
it again: while there is a moral case to address the situation
immediately, there is an economic case as well, because we will
have adults with a lot of emotional health issues, and that is
not good for our society. The time for discussion is over.
3.18pm
(York Central)
(Lab/Co-op)
It is a pleasure to serve with you in the Chair, Mr Pritchard. I
congratulate my hon. Friend the Member for Tooting (Dr
Allin-Khan) on securing the debate and on all the work that she
has contributed in looking at mental health and, in particular
today, children’s mental health.
I believe that no one has the monopoly of wisdom in this
area—every day we are learning how to move forward—but key
components need to be put in place. We know, and have heard in
the debate, the role that trauma plays and its impact on
children’s mental health. We also know that the environment to
which a child is exposed can trigger and escalate the challenges
they face.
We have heard about the shortfalls in the number of professionals
required in the services. We need greater investment, not just
through ringfenced and protected finance and funding, but to
ensure that the NHS long-term workforce plan focuses on the
mental health workforce that is needed now and into the future.
As we have heard, whether workforce issues are due to the impact
of covid or other factors, they will have a significant impact;
and unless we make the right interventions early, there will
clearly be consequences.
I particularly want to focus the Minister on the issue of
leadership, because in an ever more complex health system—we have
heard again today about the challenges of trying to navigate
local authority and health systems—we need to have very clear
leadership in this area. I urge the Minister to go back to the
major conditions strategy and to pull out mental health,
specifically looking at children and young people’s mental
health, and to develop a 10-year strategy, not just for mental
health in general as was originally planned, but for children and
young people’s mental health, so that there can be not only a
laser focus on the interventions that are needed but so the
strategy can be held up to scrutiny, which is what this place
needs to do.
I also urge the Minister to co-ordinate cross-departmental work
to ensure that that strategy is robust and that the
inter-relationships between different Departments work, because
we recognise that the issues we are discussing today have impacts
in so many different areas, whether we are talking about the
environment, housing, poverty—as we have today—or indeed
education. We need to ensure that we pull all that work together.
I urge her to take that work forward and to respond to the
debate.
In particular, I also want to focus on the intersections with
children from the care sector—care-experienced young people—and
the additional traumas that they have. Just last Thursday, we
heard powerful evidence in this place when Adoption UK put
forward its latest report, which discusses how the education
system itself needs to change. I would be really interested to
know what discussions the Minister is having with Education
Ministers about creating a trauma-informed approach to schooling,
particularly addressing some of the behaviour codes that are in
place, and the processes of isolation and exclusions, which are
bearing down on young people who, as we have already heard, have
faced significant challenges since covid and before. It is
incredibly important to ensure that such an approach is put in
place, in particular for children with autism and children with
attention deficit hyperactivity disorder, or ADHD.
Those children are having an adverse experience in the education
system, which will be costly in the long term. There are too many
children in that situation. I met an Education Minister this
morning and highlighted the number of children who are not in
school. We cannot just say that children are refusing to attend
school with no reason and we also need to ensure that the school
environment is safe for children.
I welcome the presence of health professionals in schools. I have
to say that relying on teachers to lead on mental health in
schools is the wrong approach, because teachers have so much to
do already that they need back-up. Teachers are scared that they
will miss something because they have not had the training that
mental health professionals have. However, the roll-out of those
teams of health professionals in schools is far, far too slow. I
appreciate that there is a workforce challenge, but we need to
expedite that work.
I will close by drawing attention to the work of Healthwatch
York, which has really dug deep into children’s mental health
issues in our city, and to the work that I have been doing and a
recent meeting that I have had with parents from across our city.
Systems seem to be impossible to navigate, there are long waits
and ultimately services are overstretched and under-resourced. It
is not just the young people themselves but their parents who
need support, so I trust that the Minister will ensure that there
is a parents strategy in all the work she does.
3.23pm
(Strangford) (DUP)
It is a real pleasure to speak in this debate, Mr Pritchard,
which is on an issue that I have a very big interest in.
I start by thanking the hon. Member for Tooting (Dr Allin-Khan)
for securing this debate on such an important subject and on
setting the scene really well with her massive knowledge of this
subject, which helps us all to develop a better understanding of
it. This issue is experienced in all of our constituencies; it is
not just a nationwide issue but a universal one. So, I am very
pleased to be able to make a contribution to this debate
today.
I know first-hand stories about this issue from my own
constituency. I will not mention any names, but I know that a
large number of children are genuinely struggling, so it is great
to be here to represent them and discuss ways to combat mental
health issues. It is the parents who I deal with; they speak on
behalf of the children who have the problems.
I will give a Northern Ireland perspective. I am very pleased to
see the Minister—the Under-Secretary of State for Health and
Social Care, the hon. Member for Lewes ()—here in Westminster Hall
today. She is a Minister who understands these issues and I have
no doubt that she will reply very positively to our requests. In
Northern Ireland, the system is operated by child and adolescent
mental health services, or CAMHS, which goes above and beyond to
support young children who are suffering from conditions such as
depression, problems with food or eating, self-harm and abuse,
violent tendencies, bi-polar disorders, schizophrenia or anxiety.
More than 2,000 young children are waiting for an assessment by
CAMHS and some of those children have to wait for up to nine
weeks.
There is no greater worry than the worry that one has about a
child or grandchild. I have six grandchildren and I really do
worry about the six of them and the society that we live in now.
It is different from when I was a teen growing up, which, by the
way, was not yesterday. Support and openness is the main source
of encouragement and I will go on briefly to that in terms of
school and education. In my constituency of Strangford, I have
heard of and taken many phone calls concerning eating disorders.
I commend the hon. Member for Bath () because she has been at the
forefront and done a grand job. She has highlighted the matter,
not just here but in the main Chamber, and I congratulate her on
that.
I have spoken about having good and efficient eating disorder
services available. For example, in my constituency there is no
access to a clinic to allow people to weigh in with their GP or
to receive specialised treatment. Each year in Northern Ireland,
50 to 120 people develop anorexia, while 170 develop bulimia. Way
back when I first came here, the Minister in Northern Ireland at
that time helped one of my constituents, who was a young girl of
15. She went to St Thomas’ hospital across the road here. My
Minister, along with the then Minister of Health here, saved that
girl’s life.
That is a story of how our NHS works. We do not always hear the
good stories. I know as a fact that that young girl is now
married with two children. I remember meeting her with her
parents in the Lobby here, who were worried sick about her. Yet
our health service, our Minister back home and the Minister here
saved her life at St Thomas’, just across the water.
There are 100 admissions to acute hospitals for eating disorders
every year. It is important to remember with these figures that
that they record only people who have been admitted to hospital,
so there will be more. What is this about? Young boys and girls
who suffer with eating disorders struggle with their looks and
self-confidence. Children and teens spend so much time in school,
that often their parents will be completely unaware of what is
taking place. We must also make discreet pastoral care accessible
for young children. It is really important to have that, and I
hope the Minister will provide a response on pastoral care and
where we are here.
I can speak for the schools of Strangford, as I am in frequent
contact with them regarding multiple issues. The care our
teachers have for young people is unwavering. It is a fact of
life that so many young people are struggling. I have never seen
anything like the struggles of the past two years. The hon.
Member for Tooting mentioned that in her introduction, and I see
that replicated, unfortunately, in my constituency.
Other features are struggling at school, personal appearance,
heartbreak and grief. We must always remind them of the
importance of speaking up and sharing feelings, so that we can
help them. In conclusion, I urge the Minister, the Department and
the Government to engage with devolved institutions. I always say
that because it is important that we work better together, to
ensure we have the necessary means to support our young people
with their mental health.
This issue is incredibly important, as I have witnessed in my own
constituency, from what parents and children have brought to me.
To reiterate the point I made at the beginning, this is an issue
we must all understand and must resolve as a nation. I have said
often that we can do these things better together, and I think
the Minister grasps that.
3.28pm
(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 (), who is no longer in his place.
Yes, I am!
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 (), 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.
3.37pm
(Erith and Thamesmead)
(Lab)
It is a pleasure to serve with you in the Chair, Mr
Pritchard.
Let me start my remarks by praising my hon. Friend the Member for
Tooting (Dr Allin-Khan). She is a true champion for the nation’s
health. She works tirelessly to highlight mental health issues,
especially those among children. In my unbiased way, I have seen
how she has operated as an MP and as an NHS emergency doctor, as
echoed by some of my colleagues, and she commands huge respect on
these issues, so I wish to congratulate her, as others have, both
on securing the debate and on her excellent speech.
I also wish to thank hon. Members who have contributed to this
debate. My hon. Friend the Member for Bolton South East () said that this was not just
a moral case, but an economic case, especially as children grow
into adults and continue to be negatively affected. My hon.
Friend the Member for York Central () talked about the impact
on the mental health workforce and the fact that there needs to
be clear leadership in this area. She called for a 10-year mental
health strategy along with a parent strategy.
I am delighted to be marking Children’s Mental Health Week, which
starts on 5 February. This is its 10th year. It is organised by
Place2Be, which deserves great thanks for all the work that it
does to support children’s mental health. I also congratulate its
chief executive, Catherine Roche, and its president and founder,
Dame Benny Refson. These are strong women leading the way. This
year’s theme, “My Voice Matters”, goes to the heart of the issue.
Every child matters. Each child counts no matter who they are,
what their parents do, what their race or religion are, or where
they live. Every child must know that their voice matters. We
need a system that listens to every child. We know that our child
and adolescent mental health services are in a severe state of
crisis—they are at breaking point.
Last May, we read reports in The Guardian that the number of
children in mental health crisis in England was at a record high.
NHS data collected by the excellent YoungMinds charity revealed
more than 3,500 urgent referrals for under-18s in May, three
times higher than the same month in 2019. The number of children
and young people undergoing treatment or waiting to start care
also reached new highs, with record open referrals to children
and young people’s mental health services. This month, The
Independent newspaper revealed that NHS figures show that a
record 496,897 under-18s—nearly half a million—were referred by
GPs to child and adolescent mental health services at the end of
November last year, up from 493,434 the month before.
More children than ever with anxiety, depression and other
serious mental illnesses are waiting, for longer than ever, in
anguish. We know that the causes are complex: social
disintegration, harmful social media, bullying, worries about the
climate and anxiety about the future. As has been mentioned,
covid was a real game changer. Secondary school pupils across the
UK experienced significantly higher rates of depression and
social, emotional and behavioural difficulties—overall, the worst
mental wellbeing—during the pandemic. An Oxford University
department reported that cases of depression among secondary
school pupils aged 11 to 13 rose by 8.5% during the pandemic
compared with a 0.3% increase among the same cohort before covid,
that girls’ mental health deteriorated more than that of boys
during the pandemic and that girls were also more likely to find
the return to full-time schooling difficult. This is a generation
in pain, so when we use the word “crisis”, we mean it.
The Oxford University research highlighted something else that is
really important: the students who were most resilient during the
pandemic were those with plenty of social interaction and
support, including a supportive school environment, along with
good relationships at home and a friend to turn to for support
during lockdown. That is why the centrepiece of Labour’s plan for
children’s mental health is the introduction of specialist mental
health support for children and young people in every school.
That will mean that every child in the school will have someone
to talk to, someone to listen to, someone to offer support and
someone to prove that “My Voice Matters”. It will go alongside
recruiting thousands more mental health staff to cut waiting
lists and ensure that more people can access treatment. Labour
will create an open-access mental health hub for children and
young people in every community. We will focus on prevention,
early diagnosis, early intervention and timely treatment near
where people live. It simply cannot be right that young people
travel miles and wait for months to see a specialist. We know
that mental illness is best tackled early and that it seldom gets
better as the wait goes on longer. Prevention is not just
socially just but, as has been mentioned, economically efficient.
It saves young lives and it saves money. The next Labour
Government will pay for this move by abolishing tax loopholes for
private equity fund managers and tax breaks for private schools.
That is social justice.
That promise sits alongside the many other measures in Labour’s
child health action plan—a plan that adds up to a comprehensive
mission to create the healthiest generation of children ever.
That is why, when we meet again for Children’s Mental Health Week
in early 2025, after the ballot papers have been filled in at the
general election, we hope that we will have a new Government and
a fresh start for children’s mental health.
I once again thank my hon. Friend the Member for Tooting for
securing this important debate.
3.44pm
The Parliamentary Under-Secretary of State for Health and Social
Care ()
It is a pleasure to serve under your chairmanship, Mr Pritchard.
I am grateful to the hon. Member for Tooting (Dr Allin-Khan) for
securing this debate ahead of Children’s Mental Health Week. I
thank all hon. and right hon. Members for their thoughtful
contributions, and I will try to answer as many points as I can
in the time that I have.
It is absolutely clear that we face a challenge in ensuring
timely support is available for children and young people’s
mental health. Two factors are proving the greatest challenges.
The first, as was pointed out by a number of speakers today, is
the historic underinvestment in mental health services in this
country. No other Government before us had tackled this, trying
to introduce a parity in esteem between mental and physical
health. The Government are investing £2.3 billion extra a year—I
know the hon. Member for Tooting is tired of this figure —in
mental health services. That is making a difference.
I just want to correct one figure that the hon. Member raised,
about only 8% of funding going to children and young people’s
mental health services. Actually, 1.63 million people were in
contact with mental health services in November last year, and
31% of those were children aged between nought and 18. That shows
that children are making up a large proportion of those
benefiting from the funding. The extra £2.3 billion a year is
going into projects such as our capital investment programme to
eradicate mental health dormitories, and is being invested in our
crisis centres, our crisis cafés, and 27,000 additional staff. We
are seeing evidence that that is making a difference already. Our
crisis cafés are associated with an 8% lower admission rate and
our crisis telephone services with a 12% lower admission rate,
and detentions under the Mental Health Act 1983 are 15%
lower.
Our second challenge is the sheer scale of demand for services in
the past few years. Even though we are investing more than ever
before in children and young people’s mental health services, as
the hon. Member for Tooting pointed out, one in five children now
suffers with a mental health problem, compared with one in nine
in 2017. There were 743,000 new referrals to children and young
people’s mental health services in 2022, up 41% from just the
year before. We recognise that we have to put in more funding. We
are doing that, but it is difficult to meet the sheer demand for
the support that children and young people need.
This is true across all four nations of the United Kingdom and
not just here in England, where the Government are responsible
for health. In Cardiff, for example, where Labour runs the health
service, 83% of CAMHS are not on target for seeing children and
young people. The Welsh Labour Government target of 80% of
children and young people being assessed within 28 days had not
been met for the five years up to 2021, the dates covered by the
latest figures. I was quite surprised by the contribution from
the SNP spokesperson, the hon. Member for East Dunbartonshire
(), as Scotland have been
missing their national targets. Under some health boards,
children and young people have been waiting for more than 1,000
days for services. In Northern Ireland, 60% of those targets have
not been met, either. All four nations of the United Kingdom are
facing exactly the same pressures.
In England, however, we have a plan, and I can assure hon.
Members that it is far from just warm words. While our spending
on children and young people’s mental health services has
increased from £841 million in 2020 to just over £1 billion in
2022-23, it is not just about how much we spend, but about how we
spend it. An additional 345,000 children and young people are
getting the mental health support they need. As of August last
year, 703,000 children and young people aged under 18 were being
supported through NHS-funded mental health services. That is a
13.1% increase on the year before.
I recognise what the Minister is saying. Things are not perfect,
but we in Scotland are investing more in the NHS and mental
health services than they are in England. We recognise the
problem, but we are doing something about it. That is more than
can be said for down here.
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?
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.
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.
Has the Minister had the opportunity to look at how to ensure
that young people have some church activity and pastoral care,
which is very important?
The hon. Gentleman is absolutely right. Part of that can be done
in our schools. With the increase in mental health support teams,
which will now cover 4.2 million pupils, there will be different
levels of support, from pastoral support right through to acute
help for those with more acute mental health needs. It is really
important that we ensure that those teams are rolled out as we
are planning. Our hubs in local areas will also be able to
provide more bespoke services for the communities they represent,
which is crucial. I would like to thank Dr Alex George, the
Government’s youth mental health ambassador, who has been leading
much of this work, particularly on the suicide prevention
strategy and making children and young people a priority
group.
I reiterate my thanks to everyone who has contributed to the
debate. The Government have a plan to improve mental health
services for children and young people by investing in services,
with capital projects to improve infrastructure in order to
provide the care that is needed, from crisis centres right
through to the 27,000 extra mental health workers; rolling out
mental health support teams in schools and our new children and
young people’s mental health hubs, which will be announced
shortly; and dealing with the sheer tsunami of demand, whether it
is due to the fallout of covid or the fact that people are coming
forward because we are encouraging them to talk about their
mental health and ask for support.
Our plan is making a difference. I am hopeful that, with the
investment we are putting in to tackle the lack of investment for
decades under many Governments, we are providing the building
blocks to improve the mental health of our young people in this
country.
3.57pm
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.
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.
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