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To ask Her Majesty’s Government when they intend to bring
forward proposals to reform Child and Adolescent Mental
Health Services as outlined in their 2017 manifesto.
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The Parliamentary Under-Secretary of State, Department of
Health (Lord O'Shaughnessy) (Con)
My Lords, the Government are committed to delivering their
manifesto pledge to reform child and adolescent mental
health services so that children and young people with
serious conditions are seen in a timely manner and no child
has to leave their local area and family to receive normal
treatment. We will set out proposals in the Green Paper for
children and young people’s mental health later this year.
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(Lab)
My Lords, I thank the Minister for his Answer. In a report
published on 5 November 2014, the Health Select Committee
came up with a series of deep-rooted complications in the
provision of child and adolescent mental health services.
With 75% of mental health problems starting before the age
of 18 but only 8% of mental health funding currently spent
on children and adolescents, questions must again be
raised. Will the Minister consider ring-fencing funding for
young people with mental health problems and ensure that it
reaches front-line services, so they do not have to wait
for another report to be published?
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I thank the noble Baroness for highlighting this very
important issue. She will know that ring-fencing funding
for mental health comes up a lot. There has been increased
funding for mental health, but there is more than one
reason why ring-fencing is not used for clinical
commissioning groups, including honouring the principle of
clinical autonomy, and we do not ring-fence around
particular disease areas. I should point out that CCGs are
being monitored now to ensure that they are increasing
spending on mental health, year on year, in line with the
increases in funding they are receiving, which is £1.4
billion over the coming years. The noble Baroness is of
course quite right in what she said about the specific
issue of children under the age of 18. That is why, among
other things, we have committed to introducing mental
health first aid in all secondary schools.
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(CB)
The Minister will be aware that the threshold for children
and adolescents who have severe mental health problems is
extraordinarily high and that they may have to wait months
before getting any treatment, whereas children with similar
levels of physical ill health will be treated within
perhaps a day or days. Does he accept that we are still an
incredibly long way from equality between mental and
physical healthcare, and what does he plan to do about it?
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I accept the point that the noble Baroness makes.
Unfortunately, we are starting from a low base, over many
years, in mental health provision, and that is what we are
trying to rectify. She will know that the Prime Minister is
deeply committed to this agenda. Let me point to a couple
of issues. First, there is the introduction of the first
waiting time standards—and indeed there are positive early
data on meeting those stretching standards—as well as an
increase in the number of beds available for those
suffering from the most severe episodes of mental illness.
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Lord Deben (Con)
My Lords, this is an area which has been not only
underfunded but not cared about for a long time, and we
have got to get it right. Someone has to stand up for these
people because in their own home circumstances they do not
have the kinds of opportunities and support that many
others do. Will the Minister commit himself personally to
make this worth fighting for? This issue is perhaps in the
front-line of human rights in Britain.
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I completely agree with my noble friend and I commit myself
personally to this issue. He may know that I have opened up
primary free schools which focus on improving mental health
and well-being, so I feel this personally. He mentioned
children coming from chaotic homes, which is true in some
instances. However, it is not always true. Mental illness
can strike anyone, and all families and schools need to be
prepared for it. Another commitment in the manifesto, about
which there will be more detail in the Green Paper, is the
introduction of a single point of contact in schools so
that there is a champion, if you like, for any child who
needs to access mental health services that go beyond the
school gate.
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The Lord
My Lords, I declare an interest as a member of the
Children’s Commissioner’s advisory board for Growing up
North. Recently, the Church in Newcastle and Durham brought
together delegates from more than 100 schools in the
north-east to share their serious concerns for the mental
health of children in our schools. Will the Minister say
what is being done to support schools in dealing with this
increasingly difficult problem and what plans there are for
in-school counselling?
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I thank the right reverend Prelate for raising this issue.
I have mentioned mental health training and single point of
contact. There are also curriculum changes. There will
certainly be a number of policies within the Green Paper
that will address the points she has raised.
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(LD)
The Government in Scotland are considering providing mental
health counsellors in every secondary school. Does the
Minister accept that all schools should have dedicated
members of staff able to do more than just provide mental
health first aid, and that there should be a trained mental
health and well-being lead in every school, college and
university?
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That is what we are moving towards with the mental health
first aid training for teachers in all schools. The noble
Lord will recognise that schools come in all different
shapes and sizes and that it is easier to do that initially
in secondary schools, which are bigger than, for example,
rural primary schools which might only have a staff of 10.
It is critical to make sure that there is at least one
member of staff who is highly trained in spotting and
dealing with the initial signs of mental health problems
and signposting them to the relevant authority—local health
authority or whatever it is—for further care.
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(Lab)
My Lords, the recent survey by the Children and Young
People’s Mental Health Coalition has shown that the
problems young people are now presenting with have become
even more severe. Can the Minister reassure the House that
funding earmarked for local CAMHS transformation plans will
reach local services this year? How are the Government
making sure that this happens and preventing funds from
being diverted to other desperately stretched services?
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The transition from CAMHS is now one of the mandatory
national indicators in what is called the Commissioning for
Quality and Innovation scheme which provides incentives for
performance, so I can reassure the noble Baroness on that.
She is also quite right to highlight the issue of severity.
That is why, under the plans that we have set out for
CAMHS, by 2021 the service will be able to see 70,000
additional children per year for evidence-based treatment.
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The (CB)
My Lords, I declare my interest as the chairman of
Forward-ME and a patron of the Young ME Sufferers Trust.
Many young people with ME are believed to have a mental
illness, and despite what the noble Lord said two weeks ago
and what other Ministers have said—that ME is not a mental
condition—how do we persuade professionals that these
children would probably be much better off if they were
left to allow their bodies to heal themselves rather than
having cognitive behaviour therapy and graded exercise
imposed upon them?
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I know that the noble Countess feels passionately about
this issue, but she will know that it is only right for me
to say that we need to be guided by evidence that is
collected in clinical reviews. A review is being carried
out by NICE at the moment and we shall wait to see the
results of that before deciding what needs to happen as a
consequence in terms of the kinds of treatments that are
appropriate for those suffering from ME.
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(Lab)
My Lords, the Minister has answered both this Question and
indeed the previous one in his usual effective manner.
However, I wonder if he could tell us on behalf of which
half of the Cabinet he is speaking.
