Norman Lamb MP has challenged the Prime Minister to respond to the mounting crisis in children’s mental health by improving support for emotional wellbeing in schools.
Leading a debate in Parliament, Norman highlighted the national strategy for improving children and young people’s mental health services – Future in Mind (2015) – which was published when he was Care Minister in the Coalition Government.
Central to the Future in Mind vision is mental health support in schools, which aims to build children’s emotional resilience, prevent mental ill health, and provide early support when problems arise.
However, an independent commission set up by the Education Policy Institute, chaired by Norman Lamb, recently found that this strategy is not being properly implemented in many parts of the country. Norman secured the debate in Parliament to demand that the Government makes good on its promise to implement this strategy in full, and to ensure that the extra funding secured by the coalition government is used for this purpose.
In the debate, Norman raised the following key points:
- One in 10 children are estimated to have a diagnosable mental illness, and 75% of mental health problems in adulthood started before the age of 18, so there is both a moral and an economic case for dealing with mental ill health among children and teenagers.
- However, three in four children with mental illness are not in touch with appropriate mental health services, and it can sometimes take up to 10 years before the first symptoms are diagnosed and addressed. By neglecting children’s mental health problems, society stores up enormous problems for people later in life, at enormous cost to the public purse.
- School-based counselling is an accessible and highly effective form of early intervention for children experiencing emotional difficulties. However, counselling services are still not a statutory requirement for schools in England.
- Stigma can exacerbate mental health conditions and prevent people from speaking out and seeking help. More than one in three young people with mental health difficulties have felt the negative impact of stigma, which is most commonly experienced in schools.
- Among the recommendations of the Future in Mind strategy was that there should be a specific individual responsible for mental health in every school – to discuss concerns with an individual child, provide a link to support services, and make effective referrals where necessary. It also recommends a named contact point in specialist mental health services for every school.
- A commission for the Education Policy Institute, chaired by Norman Lamb, looked at what has happened since Future in Mind, and published its final report in November. It found that although there has been good progress in some parts of the country, very little has changed in others, with the bulk of money for mental health services still going to the acute end of the spectrum rather than being invested in preventive care.
- Despite securing £1.25bn additional investment for children’s mental health in the coalition government’s last budget, a survey by the charity Young Minds found that 50% of all CCGs are not spending the full allocation on children’s mental health. Instead, it is being diverted to prop up local acute hospitals. This is “scandalous [and] amounts to theft of money solemnly pledged by the Government for children’s mental health”.
- In Future in Mind, local areas are only entitled to additional funding if they produce a Local Transformation Plan to show how that money will be spent on changing the system to focus more on prevention. Echoing a recommendation of the EPI Commission, Norman Lamb challenged the Government to ensure that additional funding is in future tied to a commitment from CCGs that every penny of it is spent on children’s mental health.
- Theresa May should launch her own Prime Minister’s Challenge on Children’s Mental Health, as former prime ministers did for dementia to establish "a prime ministerial stamp of importance for the subject".
- Mental health must be built into the school curriculum so that every teenager learns about their mental health, and about how they can become more robust in coping with the challenges they face.
- Because there are no maximum waiting time standards, many children experiencing mental ill health are left waiting, sometimes for months, to get any treatment at all. The Government has a duty to ensure that when a child needs specialist evidence-based treatment, they get it on time.
Norman Lamb’s full speech can be read here.
Responding for the Government, the Health Minister Nicola Blackwood paid tribute to Norman Lamb’s “continuing personal commitment to improving mental health services, not only as my predecessor but also through chairing the commission on children and young people’s mental health for the Education Policy Institute”. She put on record that his work has been “extremely valuable” to the Government.
The Minister reinforced the Prime Minister’s commitment to improving children and young people’s mental wellbeing, and to press ahead with the implementation of Future in Mind. In order to achieve this, she confirmed the following measures to improve the mental health support available to children and young people:
- A large-scale school survey on the activities and approaches used in schools to support children and young people’s mental health, conducted by the Department for Education;
- An in-depth review of children’s mental health services by the Care Quality Commission;
- A prevalence survey on children and young people’s mental health, which will look at issues such as cyber-bullying and the impact of social media, to report in 2018;
- Improved collection of data on children and young people’s mental health services to strengthen accountability;
- A 10-year research strategy will be published, and a new policy research unit for mental health will be established in 2017 to make sure that the research continues to become a reality;
- The Government will publish a Green Paper on children’s mental health services, with a focus on preventive activity;
- Funded provision of mental health first aid training for teachers in secondary schools;
- A pilot programme by NHS England has been trialling a single point of contact in 255 schools across the country. The programme has tested improvements in joint working between school settings and specialist mental health services, aiming to develop effective referral routes and ensure that children have timely access to specialist support where required. The Government is reviewing whether that system is more effective than having an individual counsellor in every school;
- The Department for Education is looking again at the case for further action on PSHE and sex education provision, with particular regard to improving quality and accessibility;
- The Department for Education has produced guidance on good school-based counselling as part of a whole-school approach to wellbeing. It has also published advice on behaviour and mental health, which provides teachers with information, and with tools to help them identify pupils who need help and to give effective early support in understanding when a referral to a specialist mental health service may be necessary.
Commenting after the debate, Norman Lamb said:
“I was pleased to lead today’s debate on such a crucial topic. I welcome the fact that the Government is addressing the issue of children’s mental health, and the focus on schools is right. Failing to ensure access to high-quality services stores up problems in later life, with an enormous cost both in terms of human life and the cost to the public purse.
“However, measures to improve mental health care in schools were already agreed during the coalition, and the current government has failed to ensure the investment needed to implement them has got through.
“Much of the additional £1.4 billion of funding secured for child mental health care is being diverted to prop up other services. When a CCG is under financial stress, it is too easy to shave a bit off children’s mental health to spend it where the public are clamouring for action, because ambulances are stacked up outside the A&E department. This amounts to theft of money intended to improve the lives of vulnerable young people.
“Sadly, mental health is often the first area which loses out when budgets are tight. Unless the government addresses the funding crisis facing the NHS and ensures extra investment gets through to where it’s needed, we will not see the improvements in mental health care that are so badly needed.”