Catherine led a debate in Parliament yesterday on mental health education in schools as a member of the Petitions Committee, after this e-petition secured over 100,000 signatures. You can read a full transcript of Catherine’s speech below, and the full debate here. It is also possible to watch the debate here.
Catherine McKinnell: I beg to move,
That this House has considered e-petition 176555 relating to mental health education in schools.
It is a pleasure to serve under your chairmanship, Mr Brady, and to lead this debate on behalf of the Petitions Committee, given the importance of this issue for society as a whole and because of the frequency with which young people raise it with me whenever I visit local schools and youth organisations in Newcastle upon Tyne North.
The e-petition, entitled “Make mental health education compulsory in primary and secondary schools”, has been signed by more than 103,000 people. It reads:
‘Mental health education is still not part of the UK curriculum despite consistently high rates of child and adolescent mental health issues. By educating young people about mental health in schools, we can increase awareness and hope to encourage open and honest discussion among young people.’
I am pleased that many hon. Members are present today. That reflects the importance and timeliness of the debate. Many other hon. Members would like to be here but are unable to attend, and I am happy to put their concerns on the record. My hon. Friend the Member for Gedling (Vernon Coaker) asked me to convey his constituents’ concerns, even though he is unable to be here himself.
I congratulate the e-petition’s creators — Tom King, a student mental health nurse, and Adam Shaw, the chairman of the Shaw Mind Foundation — on securing more than 100,000 signatures in the three months before the e-petition was closed just before the unexpected general election. Adam Shaw launched the e-petition as part of his charity’s wider HeaducationUK campaign. He explained why he established it:
‘Currently mental health is only taught as an optional component of PSHE—but this is not good enough. It needs to be compulsory. Understanding mental health is an absolute life skill, and should be just as fundamental within the school curriculum as reading and writing. There needs to be a compulsory collaboration and integration between mental health education and physical education, so that children and young people can understand that maintaining good mental health is equally vital to their wellbeing.’
The HeaducationUK website states:
‘The UK national curriculum puts a lot of emphasis on teaching our children about how our bodies work, physical illnesses, and how exercise and nutrition can keep us healthy. These are taught in mandatory subjects such as PE (physical education) and biology…Currently, mental health education is taught inconsistently in the UK, and only in secondary schools — despite 1 in 5 children experiencing a mental health difficulty before the age of 11.’
Chris Ruane (Lab, Vale of Clwyd): Will my hon. Friend pay tribute to the mindfulness pioneers in the UK who developed the .b curriculum for secondary schools and Paws b for seven to 11-year-olds, which was developed at Bangor University? Bangor is already working on a curriculum for three to seven-year-olds. Most importantly, will she commend the work of Oxford University’s mindfulness centre and the Mindfulness and Resilience in Adolescence—MYRIAD—project, which hope to prove scientifically the benefits of mindfulness for young people aged 11 to 18?
Catherine McKinnell: I am more than happy to join my hon. Friend in congratulating those organisations. He has campaigned hard on that issue in this place for many years.
‘Mental health education is delivered via the non-compulsory subject PSHE (Personal, Social, Health and Economic), or sometimes during school assembly or drama lessons. As PSHE is a non-compulsory subject, this means that not all schools teach it, and that in turn means that mental health education isn’t always taught.’
Sir Nicholas Soames (Con, Mid Sussex): I completely support the thrust of the hon. Lady’s argument. Does she agree that, because of the lack of training for teachers in this particularly important subject, what is being applied now is really just emotional first-aid? If people are to do more, they have to have the ability to teach more. How does she see that working out?
Catherine McKinnell: The right hon. Gentleman makes a very important point. Teachers are not mental health professionals: they are teachers by profession. It is therefore vital that we improve not only our educational input but the training and support for teachers so they can deliver this support at an appropriate level and are able to signpost and refer issues if professional input is required. I will return to that key issue later.
Luciana Berger (Lab, Liverpool Wavertree): Following the point made by the right hon. Member for Mid Sussex (Sir Nicholas Soames), does my hon. Friend, like me, welcome the fact that one teacher in every secondary school is now going forward for mental health first-aid training? In itself, that will not deal with our young people’s mental health needs, so we need a full-scale plan to train teachers and equip every young person with the skills and expertise they need to deal with their mental health and that of others.
Catherine McKinnell: I absolutely agree with my hon. Friend, who is a passionate and successful campaigner on this issue.
Rachael Maskell (Lab, York Central): Does my hon. Friend agree that, in light of the fact that mental health challenges start when people are young, it is crucial that schools have mental health practitioners who can support young people? Teachers are not health professionals, and therefore do not have the necessary skills. They have numerous other pressures to focus on, so is it not crucial that we have mental health practitioners in schools?
Catherine McKinnell: Yes—I will come on to some of the big challenges in this area. It is one thing for us to agree on the principles and on the fact that we want a much better focus on mental health in the education system, but it is another matter to ensure we make the tools and resources available to make that a reality for every child in this country. I will expand on that later.
Sir Oliver Heald (Con, North East Hertfordshire): The Northherts Emotionalhealth in Schools Service trains teachers, parents and students, with peer mentoring, so all parts of the school team work together on mental health. It has been really quite successful, and has held conferences. Should the Government not look at examples such as that—it is funded by Hertfordshire County Council—for the future?
Catherine McKinnell: Indeed. I thank the right hon. and learned Gentleman for putting that on the record.
I pay tribute to UsActive, a Newcastle-based charity, whose representatives I met recently. It uses physical activity to promote better mental health for children and young people in my local area, and highlights the interrelated nature of physical and mental health in young people’s lives. I absolutely agree with the concerns that the petition raises. We must highlight the link between our physical and mental health if we are to get the best outcomes for our children holistically and educationally.
I agree that the earlier that children and young people are educated about these issues, the better. We must properly support them throughout their childhood, help them to develop resilience so they can deal with any issues they face, prepare them for adult life, help them to develop coping mechanisms for the many challenges that life will bring, and ensure that they become well-rounded individuals capable of empathy and understanding for others, whether friends, family members or work colleagues, who will inevitably be affected by mental health issues. They should recognise that such issues are as much a part of everyday life as physical health concerns.
I am delighted that I have a local link to the creator of the e-petition through my constituent Reverend Mark Edwards, who works closely with the Shaw Mind Foundation to raise awareness about mental health. Mark recently published a book via Trigger Press about his mental health journey entitled “Life After Care: From Lost Cause to MBE”. It details how he went from spending the majority of his childhood in foster care and being sectioned under the Mental Health Act 1983 to being a team vicar at St Matthew’s church in Dinnington in my constituency, a volunteer first responder with the North East Ambulance Service, police chaplain to the Northumbria police and a former volunteer lifeboat crew member—all of which led to his being awarded an MBE. Mark has shared his experience because, in his own words:
‘So many people’s stories end in tragedy either because they suffer in silence or because they feel there is no support for them and that they are the only one suffering mental health issues.’
Crucially, he wanted to share his story to illustrate that ‘there is always hope’. Mark’s story is a powerful one, and would be if it were included in any mental health education delivered in schools.
Lucy Allan (Con, Telford): The hon. Lady is making a powerful and important point about supporting children in care and meeting their mental health needs. She served with me on the Select Committee on Education when we did an important report more than a year ago about the mental health needs of young people in care. Does she agree that that is an important part of what we are debating?
Catherine McKinnell: Absolutely. The hon. Lady is right that the Select Committees on Health and on Education undertook a joint inquiry and report into these very issues because, crucially, health and education are intertwined when we look at mental health and physical wellbeing. The outcome of that inquiry was that I was very keen to lead in this debate, because I share her view that it is crucial to improve outcomes for children in care as well as for all our children and young people.
The statistics are startling.
HeaducationUK highlights some of them: 850,000 UK children and young people aged five to 16 have mental health problems, which equates to around three in every classroom; more than 75% of mental illnesses in adult life begin before the age of 18; the number of young people attending accident and emergency with a psychiatric condition has risen by 106% since 2009; reports of self-harming among girls aged 13 to 16 rose by 68% between 2011 and 2014; and suicide is the biggest killer of young people aged under 35, with an average of 126 suicides a week and more than 200 children of school age dying by suicide each year.
Chris Ruane: Is my hon. Friend aware that 32.3% of 15 to 25-year-olds have one or more psychiatric conditions? The wider point about all those terrible statistics is that even people who are not adversely affected by mental ill health can be taught in school through modern positive psychology and mindfulness to lead flourishing lives. The whole wellbeing curve of mental health could be shifted if we took that root-and-branch approach to putting mental education into our schools.
Catherine McKinnell: My hon. Friend makes a powerful point. It is about not just shifting the life experience of an individual, but the knock-on effect of shifting the life experience of everyone around the individual and the whole community. We know that the lack of support and mental health education affects not only individual young people, perhaps for the rest of their life, but those around them. The potential returns from investing in our young people in that way are significant.
Rachael Maskell: Is it not crucial that we also understand the triggers, the causation, of mental health conditions in young people and where the stress factors fall, for example in the pressures of the exam system? Those issues should be addressed.
Catherine McKinnell: I agree with my hon. Friend. I will talk about that because it is one of the issues that young people raise with me time and time again: the amount of stress and pressure that they feel under from a worryingly young age.
Luciana Berger: The figure my hon. Friend gave of three children in every classroom being affected comes from a study done more than 10 years ago. Does she, like me, look forward to the Government’s review of young people’s mental health in this country because, anecdotally and from what figures we have, more children are coming forward? The acuity of the conditions that they are affected by and of their feelings and whatnot are, in essence, elevated from previous levels.
Catherine McKinnell: I absolutely agree, and that is something I have seen even since I was elected in 2010. When I meet groups of young people, they used to be worried about their local parks—their availability or local vandalism—but now the No. 1 issue that young people raise is stress and anxiety. I will go on to talk about the range of factors involved, such as social media and its impact on young people, which is obviously positive but also has some clear negatives, with warning factors. The level of academic pressure that young people are under from a very young age is a big concern and one that I would like the Government to listen to seriously and address.
Kevan Jones (Lab, North Durham): I support the main thrust of the debate, but education is not the whole issue, although my hon. Friend is making some good points. The scandal that we are facing is about parity of esteem for support in schools—I totally support work on that—as well as the broken child and adolescent mental health services system. I have constituents who, even when they are not facing crisis, wait for months or in some cases years to get a diagnosis. This is about not only education in schools but, when young people get into crisis, the scandal of the CAMHS system which, I am sorry to say, is just broken.
Catherine McKinnell: My hon. Friend speaks from great knowledge, experience and passionate campaigning. I agree very much with what he has said. We would not tolerate a child with a broken leg being left untreated for months on end, yet that is the case for far too many of our children and young people who present with mental health issues that clearly need professional attention. Such is the concern about the situation in my local area that the newly established community-led campaigning organisation Tyne and Wear Citizens has decided to hold an inquiry into the issue in the new year, very much based on feedback from groups of young people who have raised it as their key concern. I look forward to taking part in that inquiry in the months to come.
Sir Oliver Heald: I agree very much with the general thrust of what has just been asked and said, but does the hon. Lady also agree that making counselling available in the school, increasing awareness among parents of issues such as self-harm and anxiety, and having peer mentors—to take an holistic approach—can nip in the bud some conditions that could otherwise get worse?
Catherine McKinnell: I absolutely agree, and we are not at odds in that viewpoint. What I hope comes out of the debate—what I hope the Minister listens to and takes on board—is the holistic approach. It is about taking a whole-person approach in the education system, while ensuring that our health system matches it equally. We talk about parity, but my hon. Friend the Member for North Durham (Mr Jones) is absolutely right that that is not a reality for those needing mental health support. We need proper training and resources in schools from as young an age as possible to give that support and educational input and to ensure that specifically trained health professionals can provide support and treatment where necessary for young people.
Louise Haigh (Lab, Sheffield Heeley): My hon. Friend is being very generous with her time. As has been mentioned, a survey by HeaducationUK found that 75% of school leaders said they lacked the resources to meet the mental health needs of their pupils, citing the lack of training as one of the main contributing factors. I of course agree with the right hon. and learned Member for North East Hertfordshire (Sir Oliver Heald) that counsellors and an holistic approach would be beneficial and would help to nip the problem in the bud, but I would like to put on the record the massive funding pressure on schools. I am sure that teachers and heads will be looking at this debate saying, “Of course we would like to put that on, but we are currently having to cut core subjects from our curriculum, let alone looking at additional extras that it would be wonderful to have in schools.”
Catherine McKinnell: I absolutely agree, and my hon. Friend makes the case clearly, as I intend to in this debate. It is not about talking the talk but about walking the walk, to ensure that we have the resources necessary, not only for the training that our teachers need to feel confident about providing educational input where appropriate, but for trained professionals to be in place where required.
Schools are under inordinate pressure. I had a very difficult meeting with a local headteacher who struggled to hold back tears as she explained that she would have to lay off the school councillor for this financial school year—the choice was that or cancelling all the school excursions for the entire year. That is a very difficult decision for any headteacher to make, but there are school leaders up and down the country making those difficult decisions that ultimately will ensure that our children do not have the support that they need, and that children and their families are not looked after when they are in trouble, which will have long-term impacts on the education outcomes not only of that child but all the other children in that school.
Luciana Berger: I thank my hon. Friend for kindly giving way—I will not make any further interventions although I am very passionate and want to do so, but unfortunately I cannot stay for the entire debate. To add to the point about the passion that exists across the country, I had the opportunity to join the Liverpool Association of Secondary Head Teachers on a termly basis. Those headteachers are all passionate about their students’ mental health, but in Liverpool we have just seen a cut to our young person’s advisory service, which is the key mental health service for our young people, of 74%. That is a staggering amount—three quarters of a million pounds. Our main service for primary school children, the seedlings service, has also been taken away. There is a big disconnect between what schools want to do for their students and what they are able to do, which is why this debate is so important.
Catherine McKinnell: I am delighted that hon. Members on all sides of this debate are making my case for me. I just hope that the Minister is genuinely listening and taking that on board, so that change and something positive can come from putting on record the cross-party agreement on the need to do something for our young people on this issue.
Chris Ruane: The figure that I mentioned of 32.2% of 15 to 25 year-olds will include trainee teachers. After they finish their training, 40% of teachers do not continue in education after the first year, largely because of stress, so does my hon. Friend agree that perhaps one way to square the circle would be to train those 18 to 21-year-old potential teachers in ways of getting their own equilibrium, which might be a gift that they can pass on to tens of thousands of children over the course of their career?
Catherine McKinnell: My hon. Friend makes a key point. It is not just children and young people who face mental health difficulties as a result of the stressed environment in our education system, but the teachers, too. One has a huge impact on the other. Taking a whole-school approach to the issue could transform the lives of everybody in that school environment, all the families who surround it and are connected with it, and the local community.
Lucy Allan: Last week, my right hon. Friend the Member for Harlow (Robert Halfon) and I, along with other members of the Select Committee on Education, met teachers to discuss that very point about the mental health implications for them of being overburdened and overstressed by the many demands made on them. They made the exact point that the hon. Lady just made: that the mental health difficulties that they encounter inhibit them from helping their pupils. Does she agree that it is very important that the Green Paper includes provision for assisting teachers in dealing with their own mental health?
Catherine McKinnell: The hon. Lady put that very well.
Comments from Adam Shaw, the creator of the e-petition, are highly pertinent. He says:
‘I would personally love to ask’
the Prime Minister
‘and Government ministers what the benefits are for not having compulsory mental health education. If you really study this question and ask yourself it seriously, the more ridiculous the concept of not having it becomes.’
As I mentioned, in the last Parliament, the Education Committee, of which I was a member, and the Health Committee published a joint report, “Children and young people’s mental health—the role of education”, which concluded that
‘Schools and colleges have a front line role in promoting and protecting children and young people’s mental health and well-being.’
We also welcomed the Government’s commitment in March to make personal, social, health and economic education and relationships and sex education a compulsory part of the curriculum from 2019. The Department for Education’s policy guidance accompanying the announcement confirmed that statutory PSHE is expected to cover:
‘healthy minds, including emotional wellbeing, resilience, mental health’,
and statutory RSE is likely to include:
‘how relationships may affect health and wellbeing, including mental health’.
However, in the context of this debate and the request of the e-petition, will the Minister say from what age he expects that to be covered in schools, and how much time he expects will be dedicated to it? It is important to highlight that we talking about a cross-party, joint Select Committee report, which expresses its support for:
‘a whole school approach that embeds the promotion of well-being throughout the culture of the school and curriculum as well as in staff training and continuing professional development.’
As such, we concluded:
‘The promotion of well-being cannot be confined to the provision of PSHE classes.’
Sir Nicholas Soames: I am very sorry to intrude on the hon. Lady’s good nature by intervening again. I share everything that she says and I will support it to the nth degree, but I am worried about a question that needs to be answered. Given the diversity of teacher training, how will we get the kind of consistency required to deliver the excellent improvements that she suggests?
Catherine McKinnell: The right hon. Gentleman raises a pertinent question and one that I would be keen for the Minister to answer when he responds. This is not just about the young people who we want to benefit from a whole-school, holistic approach to mental health education; it is about the ability of our teachers, support staff and the wider school to deliver that. It is partly a training issue but partly, and significantly, also a resource issue. I am pleased that the right hon. Gentleman raised that question and I would like to hear the Minister’s response.
The whole-school and universal approach to mental health is supported by the British Psychological Society and the Association of Educational Psychologists. The charity YoungMinds, which also campaigned on this issue, made the following recommendations to the Government in its recent report, “Wise Up: Prioritising Wellbeing in Schools”.
It recommended that existing legislation should be updated ‘to enshrine wellbeing as a fundamental priority of schools’, and that mental health and wellbeing should be established ‘as a central part of school improvement, by strengthening the focus on wellbeing provision within the Ofsted framework’.
It also recommended that a wellbeing measurement framework should be developed, trialled and established by 2020, that an ‘understanding of wellbeing, mental health and resilience’ is embedded in all teacher training, and that schools are provided with ‘designated funding to resource wellbeing provision.’
That leads me to a number of key issues that I believe must be addressed alongside the provision of compulsory mental health education if we are serious about genuinely supporting children and young people on this issue.
Rachael Maskell: On funding, does my hon. Friend not agree that it is economically expedient to put this training in place? I know from talking to a head of a primary school in York that she was spending all her time trying to support the mental health challenges of the children in her school, as opposed to being the head of the school, as it is so time-consuming. Therefore, putting the expenditure, funding and investment—if I can call it that—into ensuring that we have a proper mental health programme will actually save resources.
Catherine McKinnell: My hon. Friend is absolutely right. It feels uncomfortable to talk about this in monetary terms, but ultimately an invest-to-save policy approach would make huge differences, because if teachers and young people are better supported in their mental health and wellbeing, that will relieve pressures in that school and further down the system, and into adulthood and beyond.
The Government should take seriously the recommendations that I outlined from YoungMinds, which all address putting targets in place and the funding necessary to meet them. I want all children across the country to have the best possible education, filled with rigour and challenge—one that will provide them with the right knowledge and skills to set them up for their adult lives, where they will face many challenges, including in the workplace. However, I know from my time on the Education Committee and from regular conversations with school students, parents and teachers across my constituency just how much pressure young people feel under as a result of ever-increasing demands for schools to deliver the right academic results. Indeed, a constituent recently contacted me about her son, who was prevented from studying certain subjects at A-level despite having achieved good B grades at GCSE. She commented:
‘My son is resilient but this has knocked his confidence as he is effectively being told he is not good enough at the start of a really important two years of school.’
There are increasing concerns about the introduction of the English baccalaureate and its significant narrowing of the curriculum at many secondary schools, which reduces the opportunity for many pupils to excel, such is the pressure on schools to deliver results in a small number of Government-defined core subjects.
There is really disturbing pressure on primary age pupils as a result of significant recent changes to the curriculum, school performance measures and SATs. A recent Guardian survey found that some 82% of primary school leaders had seen an increase in mental health issues among primary age pupils around the time of exams, with effects including loss of eyelashes through stress, sobbing during tests, sleeplessness, anxiety, fear of academic failure, low self-esteem, panic attacks and depression. That is in primary schools. I find that a really disturbing picture. Although I am pleased that the Government have listened to some of the concerns across the sector and agreed to scrap key stage 1 tests by 2023, the impact of high-stakes assessments clearly remains for key stage 2 pupils.
It seems to me that there is little point in the Government mandating compulsory mental health education in our schools while they actively undermine pupils’ mental health in the way that I have outlined and that I have seen in the young people I have spoken to and heard from. Indeed, the joint report of the Education and Health Committees concluded:
‘Achieving a balance between promoting academic attainment and well-being should not be regarded as a zero-sum activity. Greater well-being can equip pupils to achieve academically. If the pressure to promote academic excellence is detrimentally affecting pupils, it becomes self-defeating. Government and schools must be conscious of the stress and anxiety that they are placing on pupils and ensure that sufficient time is allowed for activities which develop life-long skills for well-being.’
I look forward to hearing how the Minister intends to ensure that this situation is rectified, as it is clearly in the Government’s gift to do so. Of course, a plethora of other issues contribute to the poor mental health of far too many children and young people. The Select Committees’ joint report touched on some of those, which include social media pressures, cyber-bullying, internet safety, sleep deprivation and body confidence.
I also seriously urge the Government to recognise just how detrimental families’ economic situations can be for children and young people’s mental health. As part of its Breathing Space campaign, the Children’s Society powerfully highlighted that:
‘children in low-income families with multiple debts are more likely to suffer from mental health problems than equivalent families with fewer debts.’
It is estimated that in my constituency alone, some 3,348 children live in families with problem debt. Again, it is in the Government’s gift to do something about that.
Of course, one of the key ways to ensure that our schools deliver something is measurement of it by Ofsted. Reporting to the Education and Health Committees’ inquiry, the Association for Child and Adolescent Mental Health described Ofsted as the:
‘largest driving force in school practice‘
The Institute for Public Policy Research stated that the:
‘Ofsted framework has a very strong ability to influence school behaviour’.
And the Education Policy Institute commented that the:
‘benefit of having Ofsted look at wellbeing is that it is a signal to schools that it is part of their job, and it is not just about accountability measures and the academic side’.
However, IPPR research found that just one third of Ofsted reports made explicit reference to pupils’ mental health and wellbeing, even after personal development and wellbeing criteria were included in the Ofsted inspection framework. That is why the Select Committees’ joint report recommended:
‘More must be done to ensure that mental health and well-being are given appropriate prominence in inspections and in contributing to the overall grade given to the school or college. The recently appointed Chief Inspector should, as a matter of priority, consider ways in which the inspection regime gives sufficient prominence to well-being.’
Louise Haigh: I congratulate my hon. Friend, who is making a compelling case and a thoroughly excellent speech; she has stolen nearly all the points I wanted to raise. She makes an important point about Ofsted and why it is wholly inappropriate to roll mental health education into PSHE. Ofsted mentioned PSHE provision in just 14% of its secondary school reports and only 8% of its primary school reports under its most recent inspection framework. That shows how poor PSHE provision is in schools and why it is vital that mental health education provision is completely separate.
Catherine McKinnell: I thank my hon. Friend for both her kind comments and her intervention. We will go on repeating the same arguments and the same compelling case for change until the Government make the changes that we know are needed. I look forward to hearing the Minister’s responses to the specific concerns that I outlined in relation to the Select Committees’ joint report and to the concerns raised by my hon. Friend, from whom I hope we will hear more later.
It would be hugely remiss of me to lead a debate on this subject without touching on the increasing pressures on our education system. Although I firmly believe in the importance of mental health education in our schools, I am always reluctant to propose placing yet another requirement on teachers, who are hugely overworked and under-resourced, particularly given the ongoing financial crisis that many of our schools face.
Despite the Government’s recent announcement about additional funding, the reality is that 88% of our schools still face a real-terms budget cut by 2020. In my constituency, that means Walbottle Campus losing more than £460,000 in real terms between 2015-16 and 2019-20—the equivalent of 10 teachers or £321 per pupil. For Gosforth Academy, it equates to a total real-terms loss of almost £430,000 in the same period.
Those are staggering sums, and I know how agonising that is for headteachers who are trying to balance the books. I mentioned earlier that at least one of my local headteachers had to cut the school counsellor to make the necessary savings.
There is little point in seeking to introduce compulsory mental health education at the same time as budget cuts are resulting in existing mental health support for students and families being axed—a situation that is reflected around the country, as the evidence given to the Education and Health Committees showed. There is also little point in introducing compulsory mental health education or a whole-school approach to mental health if it is not done properly, which is why the Select Committees’ joint report highlighted that doing so:
‘will have implications for staffing and training and the balance of provision and delivery of subjects across the curriculum to allow more time to focus on well-being and building resilience.’
Our report also emphasised:
‘Teachers are not mental health professionals, but they are in many cases well placed to identify mental ill health and refer students to further assessment and support. Training school and college staff to recognise the warning signs of mental health ill health in their students is crucial. We encourage the Government to build on the inclusion of mental health training in initial teacher training and ensure current teachers also receive training as part of an entitlement to continuing professional development.’
I know that there is much support for that from hon. Members who have already contributed to this debate.
Rachael Maskell: I am grateful to my hon. Friend; she is being generous with her time. Is there not a risk that teachers may feel pressure that they may miss something if they have to refer people to the system, and therefore that they will be really concerned about over-referring or under-referring? That is why it is so important for mental health professionals to be available to support teachers and, more importantly, children.
Catherine McKinnell: My hon. Friend raises an important point. I wanted to come on to CAMHS, which my hon. Friend the Member for North Durham (Mr Jones) raised eloquently and powerfully. I support the introduction of mental health education in our schools, for that whole-school approach to be implemented, but I reiterate my concerns that teachers and schools must be adequately resourced and trained for that. School budget cuts, which are resulting in vital services being axed, must stop, and the Government must seriously look again at those issues that are causing young people’s mental health to be so adversely affected.
I also feel strongly that in promoting greater mental health awareness and encouraging children and young people to speak out and seek that help, we must ensure that treatment and support is available for them when they need it. We all know that simply is not the case for far, far too many young people affected by mental health conditions at present.
In the Care Quality Commission’s recently published review of mental health services for children and young people commissioned by the Prime Minister, it found that:
‘whilst most specialist services provide good quality care, too many young people find it difficult to access services and so do not receive the care that they need when they need it. One young person told CQC that they waited 18 months to receive help. Using estimates from the London School of Economics, Public Health England reported that only 25% of children and young people with a diagnosable mental health condition accessed support. The Royal College of Psychiatrists has noted difficulties in finding specialist inpatient beds close to a young person’s home.
CQC has rated 39%—26 services—of specialist community child and adolescent mental health services…as requires improvement and 2%—1 service—as inadequate against CQC’s ‘responsive’ key question, which looks at whether people access care and treatment in a timely way.’
It went on to comment:
‘The problem of gaining access to specialist help is contributed to and compounded by the fact that those who work with children and young people—in schools, GP practices and A&E…do not always have the skills or capacity to identify or support the mental health needs of children and young people. When concerns are identified, children and young people, and their families, often struggle to navigate the complicated and fractured system of services created by a lack of joined-up working. Many organisations are involved in planning, funding, commissioning, providing and overseeing support and care for young people with mental health problems. Poor collaboration and communication between these agencies can lead to fragmented care, create inefficiencies in the system, and impede efforts to improve the quality of care.’
That paints a deeply concerning picture, particularly in the light of the statistics I cited at the beginning of the debate. Indeed, the Children’s Commissioner, Anne Longfield, has stated that the CQC’s report makes for ‘sad reading.’ She went on to comment:
‘Like the CQC, I acknowledge there are efforts being made to change things and that the staff working in children’s mental health are doing a good job in difficult circumstances. That was never my concern. It is those not getting the care they need…that worries me most…fewer than a quarter of children needing mental health support received it last year. There are severe shortages throughout the system, with the majority of local NHS areas failing to meet NHS standards on improving services.
Yet the numbers we cite on delays, expenditures and percentages can only tell you so much. The reason my office has focused so hard on…mental health this year is that we also hear—day in, day out—from children themselves, their carers, teachers and health system professionals about just how desperate the need is out there.’
I reiterate my concerns about the risks of introducing compulsory mental health education and a whole-school approach to this issue if we do not ensure at the same time a dramatic improvement in the support and treatment available to children and young people when they encounter a mental health condition. We must not have situations in which children wait 18 months to receive support, so that we are not simply ensuring that that those children and young people will continue to be affected by those mental health issues throughout their lives, with all the long-term social, economic and personal costs associated with that.
I reiterate my absolute support for the issues the e-petition raises and the need to ensure that all children and young people receive good quality, age-appropriate mental health education throughout their schooling. I acknowledge that some progress has been made in this area: for example, the Education and Health Select Committees heard about the 2015-16 £3 million pilot between the Department for Education and NHS England to provide joint training to schools and CAMHS staff and to test how having single points of contact in both schools and CAMHS can improve referrals to specialist services.
I also know from the Government’s response to the e-petition that they are developing a new Green Paper on children and young people’s mental health to be published later this year, with
‘new proposals for both improving services and increasing focus on preventative activity.’
May I take this opportunity to press the Minister to ensure that the various concerns I and hon. Members have raised today—I am sure they will continue to be raised as the debate continues—are tackled as part of the Green Paper, if we are genuinely to address the wider issues for children and young people: the pressures they face as a result of issues in their school and home life; the severe financial pressures schools are now facing and the implications of that in their ability to provide mental health support; and of course the monumental pressure on CAMHS services, which has resulted in a system that is at breaking point?
I also suggest to him that, instead of more pilots, promises or warm words about mental health, we take those urgent, necessary steps. We need Government action if we are to prevent the terrible statistics I have outlined throughout this speech, which are just getting worse.
Indeed, only yesterday it was reported that 12 mental health organisations, including the UK Council for Psychotherapy, the Mental Health Foundation and YoungMinds, have written to the Chancellor ahead of his Budget this month, saying:
‘We cannot go on with such unambitious targets, or simply accept a situation where promises of extra funding don’t actually materialise at the front line. If the Government is actually to deliver parity of esteem, the Chancellor needs to invest in and ring-fence the mental health budget to ensure any money promised genuinely reaches those it is intended to help. The crisis is here, the crisis is now.’
I agree, and compulsory mental health education, if introduced, would be an important part of the jigsaw in tackling those issues, but only if it has the support it needs both financially and in Government action to make it a reality.