Children’s and Young People’s Mental Health Services

My Lords, we welcome the report of the Children’s Commissioner. It highlights pressures on children and young people’s mental health services, including rising demand, long waits and the need for better support for those with neurodevelopmental and SEND needs. The findings will feed into our new cross-government mental health strategy, which will focus on prevention, earlier intervention and joined-up support.

I thank the Minister for her Answer. The Children’s Commissioner report certainly made plain that children’s mental health services are facing record levels of referrals. The Minister referred to the forthcoming mental health strategy; what we need to see is concrete action in relation to children and young people. Will the Minister reassure me that children and young people’s services will be a priority in the strategy, and will the strategy commit to narrowing the treatment gap for mental health support so that more young people with diagnosable need will be seen by the end of this Parliament?

The mental health of children and young people is completely fundamental to the new strategy, which will cover all ages and be published later this year. But what really needs to be done, as I know the noble Baroness is aware, is to transform mental health care in this country, because the system currently responds too late, is not reducing waiting times and is allowing distress to escalate before intervention. The strategy will work to turn all that around, because we need that system-wide change.

My Lords, the Children’s Commissioner’s report is a timely reminder that we continue often to respond to crisis rather than preventing it. Twenty years ago, during the passage of the Mental Health Act, Parliament strengthened the safeguards around the admission of children into adult psychiatric wards. That should happen only in exceptional circumstances and only with specialist assessments. At that time, more than 350 children had been admitted, some as young as 11, into adult psychiatric wards. Ten years later, the figure was exactly the same. Can the Minister tell the House what the position is today? Also, what further action is being taken by education and community services to prevent that crisis in the first place?

I do not have the figures the noble Lord very fairly asks for, but I will certainly ensure that they are provided. He will be aware that Parliament recently passed the Mental Health Act, which updated the Mental Health Act to which he referred. The real issue here is about a move to prevention rather than waiting for crisis. That is our whole direction of change.

My Lords, I join my noble friend in welcoming the excellent report from the Children’s Commissioner this week. In her answer to the noble Baroness, Lady Tyler, my noble friend spoke of the need for early intervention and joined-up support. That is one of the issues mentioned in the Children’s Commissioner’s report. Part of that is highlighting the Young Futures hubs, and I know that the Government are committed to introducing 50 of them for 10 to 18 year-olds by 2029. They have a joined-up approach covering everything from education and mental health support to employment advice and crime prevention advice. Can my noble friend give us some idea about when the rollout of the Young Futures hubs will commence?

The first wave of eight, which my noble friend referred to, is under way. It is backed by £4.2 million of investment. The subsequent 42 Young Futures hubs will be rolled out by March 2029.

There was an initiative to have a mental health first aider in every school. What further work has been done to maintain that level in the Minister’s working collaboration with the DfE and local councils?

Important though they are, we are accelerating the rollout of mental health support teams, because we now want to meet a more ambitious target of achieving full national coverage by 2029. We have already made progress. As of March this year, some 60% of pupils in schools and learners in further education were covered by a mental health support team. That is up from 52% the year before. The principle of integration where young people and children are is absolutely right. That is why we are not just investing in but accelerating the coverage of mental health support teams.

Do the Government recognise that, as the report said, school staff often see the antecedents of mental health? Two areas where there is strong evidence are parental alcoholism, with a threefold increase in children considering suicide and a fivefold increase in eating disorders, and repeated physical punishment, particularly of children under the age of seven, resulting in emotional harm, so that simply intervening on the child may be too late, and intervention must be earlier to prevent problems.

I agree with the noble Baroness’s observations. Early intervention is key. That is what our entire focus is on, in the ways we have already discussed, and also on developing a children and young people’s modern service framework because we want to reduce variation and ensure that children get the right support at the right time.

My Lord, recent analysis from the charity Young Minds shows that, for the eighth month in a row, the average waiting time from referral to specialist support for young people was more than 300 days, and in the worst case it was two and a half years. Will the Government commit to using the forthcoming cross-government strategy to deliver open-access mental health support in every community for young people up to the age of 25?

The point about age is important and one that we will be considering as we go forward with the mental health strategy. Waiting times are way too long, but there is a particular challenge that we have to meet, which is that some 10% of young people are waiting for an inordinate amount of time, as the noble Baroness said. I was very glad that the report does recognise that increased prevalence is a driver. One in 10 17 to 19 year-olds was in need in 2017 and now it is 1.4. I think that gives some idea of the scale and of why we have to make such a systematic change.

My Lords, the report contains a wealth of information and new data on referral patterns, waiting times and outcomes. I welcome the Minister’s response that it will feed into the forthcoming mental health strategy. How is the Minister’s department using this information to target resources and to identify where children’s mental health services are under the greatest pressure, so that, at least in the shorter term, support can be directed to where it is most needed?

What the noble Lord says is absolutely right. That is why the Young Futures hubs, the early support hubs, focus on particular communities. We have taken a view that it is important to go to where need is greatest rather than to where it is easiest to deal with. I should add that we have expanded mental health services in terms of the workforce by delivering 8,500 additional mental health staff three years ahead of schedule. Around 18% of them are directly on children’s and young people’s services.

There is a proven, well-documented correlation between broken or highly conflicted families and poor mental health in children and young people. What are the Government doing to support keeping families united?

The noble Lord raises the legitimate point that children’s and young people’s mental health is not just a matter for the health service but requires cross-government thinking on housing, income and other pressures. That is why the mental health strategy is, for the first time, a cross-government strategy led by the Department of Health and Social Care.