Children’s Mental Health Week 2024 — [Mark Pritchard in the Chair]

– in Westminster Hall am 11:24 am ar 30 Ionawr 2024.

Danfonwch hysbysiad imi am ddadleuon fel hyn

[Mark Pritchard in the Chair]

Photo of Mark Pritchard Mark Pritchard Ceidwadwyr, The Wrekin 2:31, 30 Ionawr 2024

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.

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting

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.

Photo of Neil Hudson Neil Hudson Ceidwadwyr, Penrith and The Border

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?

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting

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.

Photo of George Freeman George Freeman Ceidwadwyr, Mid Norfolk

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.

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting

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.

Photo of Daniel Poulter Daniel Poulter Ceidwadwyr, Central Suffolk and North Ipswich

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.

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting

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.

Photo of Kim Johnson Kim Johnson Llafur, Liverpool, Riverside

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?

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting

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.

Photo of Richard Burgon Richard Burgon Llafur, Leeds East

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?

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting

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.

Photo of Tim Loughton Tim Loughton Ceidwadwyr, East Worthing and Shoreham

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 Dame Andrea Leadsom, 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.

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting

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 Tim Loughton, 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.

Photo of Wera Hobhouse Wera Hobhouse Liberal Democrat Spokesperson (Transport), Liberal Democrat Shadow Leader of the House of Commons, Liberal Democrat Spokesperson (Energy and Climate Change) 2:51, 30 Ionawr 2024

It is an honour to serve while you are in the Chair, Mr Pritchard. I congratulate 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.

Photo of Jeremy Quin Jeremy Quin Chair, Defence Committee, Chair, Defence Committee

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 Dr Hudson and others have referred to. That is proving extremely effective in my constituency.

Photo of Wera Hobhouse Wera Hobhouse Liberal Democrat Spokesperson (Transport), Liberal Democrat Shadow Leader of the House of Commons, Liberal Democrat Spokesperson (Energy and Climate Change)

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.

Photo of George Freeman George Freeman Ceidwadwyr, Mid Norfolk

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.

Photo of Wera Hobhouse Wera Hobhouse Liberal Democrat Spokesperson (Transport), Liberal Democrat Shadow Leader of the House of Commons, Liberal Democrat Spokesperson (Energy and Climate Change)

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.

Photo of Tim Loughton Tim Loughton Ceidwadwyr, East Worthing and Shoreham 3:01, 30 Ionawr 2024

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 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 George Freeman 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.

Photo of Wera Hobhouse Wera Hobhouse Liberal Democrat Spokesperson (Transport), Liberal Democrat Shadow Leader of the House of Commons, Liberal Democrat Spokesperson (Energy and Climate Change)

Does the hon. Member not recognise that those from a less deprived background have better access to help than those from a poorer background?

Photo of Tim Loughton Tim Loughton Ceidwadwyr, East Worthing and Shoreham

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.

Photo of Daniel Poulter Daniel Poulter Ceidwadwyr, Central Suffolk and North Ipswich

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.

Photo of Tim Loughton Tim Loughton Ceidwadwyr, East Worthing and Shoreham

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.

Photo of Tim Loughton Tim Loughton Ceidwadwyr, East Worthing and Shoreham

I will give way one more time. I have one more point to make and then I will finish.

Photo of Daniel Poulter Daniel Poulter Ceidwadwyr, Central Suffolk and North Ipswich

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.

Photo of Tim Loughton Tim Loughton Ceidwadwyr, East Worthing and Shoreham

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 Dame Andrea Leadsom, 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:


Photo of Mark Pritchard Mark Pritchard Ceidwadwyr, The Wrekin

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 Yasmin Qureshi.

Photo of Yasmin Qureshi Yasmin Qureshi Llafur, Bolton South East 3:13, 30 Ionawr 2024

It is a pleasure to serve under your chairmanship, Mr Pritchard. It is also a pleasure to follow Tim Loughton. I congratulate my hon. Friend 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.

Photo of Rachael Maskell Rachael Maskell Labour/Co-operative, York Central 3:18, 30 Ionawr 2024

It is a pleasure to serve with you in the Chair, Mr Pritchard. I congratulate my hon. Friend 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.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 3:23, 30 Ionawr 2024

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 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, Maria Caulfield—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 Wera Hobhouse 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.

Photo of Amy Callaghan Amy Callaghan Shadow SNP Spokesperson (Health and Social Care) 3:28, 30 Ionawr 2024

I congratulate 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 Tim Loughton, who is no longer in his place.

Photo of Amy Callaghan Amy Callaghan Shadow SNP Spokesperson (Health and Social Care)

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 Wera Hobhouse, 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.

Photo of Abena Oppong-Asare Abena Oppong-Asare Shadow Minister (Women's Health and Mental Health) 3:37, 30 Ionawr 2024

It is a pleasure to serve with you in the Chair, Mr Pritchard.

Let me start my remarks by praising my hon. Friend 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 Yasmin Qureshi 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 Rachael Maskell 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.

Photo of Maria Caulfield Maria Caulfield The Parliamentary Under-Secretary for Health and Social Care, Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women) 3:44, 30 Ionawr 2024

It is a pleasure to serve under your chairmanship, Mr Pritchard. I am grateful to 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, Amy Callaghan, 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.

Photo of Amy Callaghan Amy Callaghan Shadow SNP Spokesperson (Health and Social Care)

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.

Photo of Maria Caulfield Maria Caulfield The Parliamentary Under-Secretary for Health and Social Care, Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)

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.

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting

If the Government are interested in implementing cross-party proposals, why on earth have they scrapped the Mental Health Bill?

Photo of Maria Caulfield Maria Caulfield The Parliamentary Under-Secretary for Health and Social Care, Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)

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.

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting

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.

Photo of Maria Caulfield Maria Caulfield The Parliamentary Under-Secretary for Health and Social Care, Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)

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 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.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health)

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?

Photo of Maria Caulfield Maria Caulfield The Parliamentary Under-Secretary for Health and Social Care, Parliamentary Under Secretary of State (Department for Business and Trade) (Minister for Women)

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.

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting 3:57, 30 Ionawr 2024

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.

Photo of Rosena Allin-Khan Rosena Allin-Khan Llafur, Tooting

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.


That this House
has considered Children’s Mental Health Week 2024.