PARLIAMENTARY DEBATE
Children and Young People’s Mental Health - 16 June 2021 (Commons/Westminster Hall)

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I beg to move,

That this House has considered children and young people’s mental health.

It is a pleasure to serve under your chairmanship, Sir Gary. I am very grateful to be given the opportunity to lead a debate on this critical issue. Eighteen months ago in my maiden speech, I pledged that children and young people’s mental health would be an issue that I champion in this place. It is a cause for which I will fight relentlessly, because children and young people are our future. Their hopes and dreams depend upon us doing the right thing by them.

Those who are struggling with their mental health and wellbeing, whether those suffering mild anxiety to those young people attempting to take their own life, deserve the very best care and support. Yet children and young people do not have a voice in the political system and are too often overlooked. In fact, the former Children’s Commissioner, Anne Longfield, said in her final speech earlier this year that in Government there was an “institutional bias against children”—never more so than during the pandemic when, frankly, they have been an afterthought at every turn. From new born babies to schoolchildren to university students, the Government have let them down in planning and providing for their social and educational needs, and again in their announcements about children’s recovery.

Teenagers and young people in my constituency who are ambassadors for the fantastic local charity Off The Record tell me that uncertainty over exams, combined with the social isolation of being stuck at home away from their peers, worries about loved ones and now concerns about their future job prospects have all taken their toll. But this crisis in children and young people’s mental health started long before the pandemic. One reason why I made it my priority at the start of last year was because following my election, I was astounded week in, week out by the emails from parents or conversations at my surgeries, of stories of battles with child and adolescent mental health services to access treatment for children who are considering suicide, self-harming or withdrawing themselves from school. Yet they were having to wait six months or sometimes a year for treatment.

At a lower level, support in schools is patchy, with only some having access to a counsellor or mental health support team. Community-based support to intervene early can be dependent on voluntary sector provision in any given area. The pandemic has only served to highlight and exacerbate the existing lack of access and inequalities within children and young people’s mental health. In 2017, one in nine children had a diagnosable mental health condition. That rose to one in six at the height of the pandemic. The Government need to use this moment to renew their focus on mental health and overhaul the support available.

I want to focus on three elements within the system and what needs to be done: CAMHS, schools and community services. Turning first to CAMHS, referrals are at their highest ever level, with over 65,500 referrals for 0 to 18-year-olds received in March 2021. That is more than double the number in March 2020 and almost 70% higher than in March 2019. Behind the staggering numbers is a child or a younger person in turmoil, often left in limbo waiting for treatment, and a carer beside themselves with worry. From talking to NHS leaders in my area, I know that unplanned admissions for children suffering a mental health crisis are at extremely high levels with services struggling to cope.

While it must be acknowledged that the Government have increased spending in this area, resulting in the NHS slightly exceeding its 2019-20 target of community mental health support for 34% of children needing support, there is still a long way to go. Last week, a local GP said she is increasingly finding that children she refers to CAMHS are being knocked back, and she is routinely requesting schools make a supporting referral to secure therapy. When referrals succeed, the wait can seem interminable. I heard from the adoptive father of a seven-year-old who suffered significant trauma and abuse within her birth family. She was referred to treatment, the initial assessment took several months to secure, and then the family were told that there would be a year’s wait—yes, a year’s wait for a seven-year-old for an eight-session course of treatment, only if deemed necessary.

There is a postcode lottery of spending across the country. Eight local areas spend less than £40 per child on mental health services, while 21 areas spend more than £100 per child. That brings me to an important point about data and reporting, which is so important for accountability. Inconsistencies in financial reporting across clinical commission groups makes it difficult to interrogate the data to check they are meeting NHS England guidance to increase year-on-year the proportion of spending on children and young people’s mental health. This measure should be included in the mental health investment standard.

The other issue with data collection and publication is that it is impossible to judge whether different areas are meeting access targets, as the percentage of young people with a diagnosable mental health condition is only available nationally, not on a local basis. The Children’s Commissioner should not have to request this comprehensive data on waiting times and referrals every year. The Minister will know that I tabled an amendment during the passage of the NHS Funding Act 2020 to improve transparency in operational expenditure and performance at a local level. I discussed this with her ministerial colleague, the hon. Member for Charnwood (Edward Argar), a few months ago. He assured me that the Minister is taking this forward, and I hope she can update us on when this local data might be routinely available.

However much money is pumped into CAMHS, improving access to it is contingent on plugging big holes in the workforce. The Royal College of Psychiatrists’ 2019 workforce census found that the rate of unfilled NHS consultant psychiatrist posts in England has doubled in the last six years, with one in eight CAMHS psychiatrist posts vacant. We urgently need a proper long-term work- force strategy, adequately resourced and with an annual report to Parliament. The forthcoming heath and care Bill is the ideal opportunity to hardwire this provision.

Turning to the role of schools in tackling mental health concerns, they are key to early intervention, and step in where children do not meet the CAMHS threshold. Provision of counselling and other mental health support services in schools can be variable and dependent on already massively overstretched school budgets. Mental health support teams can fill the gap. However, the current roll-out rate is very slow. The Government are aiming to reach a fifth to a quarter of the country by 2022-23, and have recently provided more funding to accelerate the roll-out, but I urge the Minster to be more ambitious.

On children’s recovery from the pandemic, most of the education catch-up funding announced by the Government has been largely focused on academic catch-up, with little focus on emotional wellbeing and mental health support. All the research shows that it is difficult for children to learn if they are struggling with their mental wellbeing. Liberal Democrats supported YoungMinds’ call for a £178 million ring-fenced resilience fund to allow schools to provide bespoke mental health and wellbeing support packages, as appropriate to their pupils and context. So far the Government have committed just £17 million of dedicated mental health support for schools as part of the recovery. A recent Ipsos MORI poll showed that parents put increased wellbeing support at the top of their priority list as part of any education recovery plan.

Finally, I will touch on the importance of community support services. We know that half of all mental health conditions present themselves by the age of 14 and three quarters by the age of 24. That is why prevention and early intervention are so critical. We know that some children and young people do not want, or are unable, to access mental health support in schools, but community-based services can be a lifeline.

Waiting until children reach crisis point is far too late. For younger children, family-based interventions, such as those offered by Kids Matter, are an effective approach. The Purple Elephant Project in Twickenham, founded by the inspirational Jenny Haylock, who has built a team of art and play therapists, works with children and their families from a very young age. Coram is also doing some incredibly important work on boosting children’s self-esteem and resilience.

For teenagers and young adults, I warmly welcome the campaign launched by a range of children’s and young people’s mental health charities, called “Fund the Hubs”. It calls for early-support hubs, offering easy-access, drop-in support on a self-referral basis for young people up to the age of 25, who do not meet the threshold of CAMHS.

The hubs would offer a mix of clinical staff, counsellors, young workers and volunteers, providing a range of support services. Additional services could be co-located under one roof, such as sexual health services or employment advice. The hubs could be delivered in partnership with the NHS, through local authorities or working with the voluntary sector, depending on the local area. Such an approach has already been tried in Manchester, Ireland and Australia, and has been shown to relieve pressure on and deliver cost savings to the health service. I hope the Minister will look at that innovative model.

In conclusion, we owe it to our children and young people to offer them the very best start in life. As a Liberal, I am passionate that every child gets the maximum opportunity to reach their full potential. With spiralling figures of children suffering anxiety, who are self-harming or struggling with eating disorders, as well as many more who are grappling with low confidence and self-esteem, we need to use this moment as we emerge from the pandemic to hit the reset button.

I urge the Minister, who I know shares my passion on this issue, to develop a proper cross-departmental strategy to tackle this growing crisis. Let us re-envision what support looks like for children and young people. Let us break down the silos between schools, local authorities and the NHS. Let us make sure that we prevent and intervene early to stem the tide, while also investing in training the mental health workforce.

I have heard too many times, from too many parents sick with worry, that CAMHS is simply not fit for purpose. I have yet to see much evidence to disagree with them. I hope the Minister will make it her mission to fix it, and work cross-party, if she is willing. I stand ready to do so for the sake of our children and their future, and I hope my Labour counterpart will, too. Not only is it morally the right thing to do, but our country’s recovery depends on their success.

Colleagues, we have 45 minutes and nine Back-Bench speeches to fit in, so that is exactly five minutes each. Please try to keep to time, so that I will not need to impose any restrictions.

It is a great pleasure to serve under your chairmanship, Sir Gary. As we know, the Timpson review was commissioned by the Secretary of State for Education in March 2018 and published in May 2019. There is no need today to go into the detail of that excellent document, which is on public record, but I will highlight some key factors.

From 1998 to 2013, there was a downward trend of school exclusions. They dropped to a rate of 0.06% for the 2012-13 school year. However, that level has increased in recent years. For example, in 2017-18, there were almost 8,000 permanent exclusions in state-funded schools across all levels, a rate of 0.1%. The reasons are multifarious, including persistent disruptive behaviour and physical assaults against pupils and adults. Most intriguingly, the exclusion rates for children with special educational needs are much higher than average. With overall permanent exclusion set at 0.1% in 2016-17, it was 0.35% over the same period—three and half times the problem. So, indeed, Houston, we have a problem.

We are not here today to admire our challenges, but to solve them, so what do we need to do? The SEND review is expected imminently, but it is a matter for DFE and DHSC. First, we need to invest in our SEN children as never before. Yes, many are disruptive, hard to handle and come with a range of issues, but what about their energy, skills and strengths? If we can harness them to best effect, just think of the rewards.

Why might that work? By getting to the root cause of the issues, providing focused intervention and allowing children to fulfil their potential in the right environment, rather simply be excluded because it is all too difficult, we can get the best out of them. By providing the right care in the right settings, we can give them the focus they need to be productive, employable, law-abiding and responsible citizens, because we have addressed the root causes.

Our prisons are sadly full of people who have made the wrong decisions or acted impulsively, because they were not diagnosed at an early age, so let’s invest in all our kids to give them the best possible chance.

I want every single local authority in the UK to comprehensively review their SEN provision, so that it becomes available in every area. In other words, every authority should provide specialist in-house provision. Specialist and dedicated settings are the way forward, and I want more dedicated schools established for SEN. Why? It is because it is not fair on the 95% of children in a class if 5% are disruptive, nor is it fair on the 5% to be constantly out on a limb, feeling the odd one out or being excluded. Let us separate the children, where we need to, but also be free to adopt hybrid models where access to the mainstream will still be beneficial. It is about a needs-must basis—individually streamlined to each child.

Why is it necessary for local authorities to do that? It is because it is the right thing to do. Our children are closer to home and enjoy the normality that they crave. It would also save on the exorbitant cost of providing taxi fares to schools a long distance away and perhaps even save the huge school fees of private education, when this should be provided in the state sector.

We must also give our teachers better training in identifying special needs and processing the education, health and care plans. I know of many families who are simply swept under the carpet, waiting for years for someone to take them seriously and for the EHCP to be authorised. This cannot be a golden ticket for the lucky few, but a rightful passport for every child to get what they need. Please, let’s speed up the EHCP process and hold headteachers and councils to account. And please don’t get me started on local councils that fail to acknowledge hidden disabilities or autism in applications for blue badges—a whole different issue.

Lastly, our child and adolescent mental health services across the UK need 20,000 volts put straight through them. For families to be waiting up to two and a half years for a consultation, it is not only immoral, it is also, frankly, inept. The irony will not have escaped anybody that a GP cannot prescribe medication for autism spectrum disorders, attention deficit hyperactivity disorder, oppositional defiant disorder, Asperger’s or any other mental health condition without a diagnosis from CAMHS. Therein lies a vicious circle: children desperate to escape their symptoms, parents and teachers desperate for solace, GPs unable to prescribe without a diagnosis and CAMHS unable to see these children, in some cases, for up to two and a half years. It is a national disgrace, but we can now solve it.

To conclude, I commend the Timpson review. Let’s get diagnosing, treating and spending and give all our children the future that they deserve in specialist educational settings that give them the chance.

It is a pleasure to serve under your chairmanship, Sir Gary. A few weeks ago I had the pleasure of visiting Positive Youth Foundation in my constituency. I had the best time, as videos on my social media show. It is a fantastic organisation providing young people in Coventry with a huge range of activities and opportunities. Visiting the centre, I saw the bonds that had been formed between the staff, volunteers and young people and the confidence and support that gave them. I want to begin by paying tribute to everyone at Positive Youth Foundation from its founder and CEO Rashid Bhayat to all the staff and volunteers.

As staff and volunteers made clear to me, this is an incredibly challenging time for young people, with more than half of safeguarding reports at the centre being about children’s and young people’s emotional wellbeing and mental health. The pandemic, and the new stresses, strains and isolation it has brought, has added to what was already a mental health crisis for children and young people. Before coronavirus hit, one in five young people aged between 16 and 24 suffered mental ill-health, and for school-aged children the figure was one in six. That has only got worse in the last 12 months. University students have been trapped in accommodation, away from friends and family, and have missed out on what should be the most exciting time of their lives. Almost two thirds of the people who have lost jobs during the pandemic are under 25. Schoolchildren have been missing out on vital education and have often been stuck in overcrowded homes with overstretched parents.

Things have got even worse for oppressed groups. Nearly three in four children with autism have a mental health condition, but in Coventry waiting times for autism assessments have been growing, and were doing so even before the pandemic. Working-class and LGBT+ young people, and children from black, Asian and minority ethnic communities all have greater rates of mental ill- health. What makes this not just a crisis but a scandal is the totally inadequate support for children and young people’s mental health.

More than a decade of austerity has cut away the support that was once provided, while deepening the problems that give rise to mental ill-health. Since 2011, mental health trusts have faced a real-terms cut of more than 8%. Huge cuts to school funding have put even greater pressure on budgets, forcing schools to have bigger classes while cutting mental health services. Nearly half of young people with moderate to severe mental health needs have to wait more than 18 weeks to start treatment. That is a cruel failure for children and young people. Mental health support needs the funding across the board that it deserves—for services such as NHS services and school counsellors—to guarantee that every single young person who needs support can get it when they need it.

Although funding for support is vital, the mental health crisis cannot be tackled with funding alone. It is getting worse, and more and more young people face mental ill-health. It is estimated that depression has tripled for those aged between 16 and 39. We cannot look just at the consequences; we have to look at the causes, too. Asthma, for example, is a health condition, but people do not suffer from it totally at random. If someone lives in an area of high air pollution, they are more likely to suffer from asthma. It is an individual problem, but it has social and political causes. The same is true for many mental health issues. The more stress, anxiety and trauma there is in people’s lives, the more likely they are to experience mental ill-health. For children and young people who have grown up under austerity, life is getting more stressful and less secure. That is what is driving this mental health crisis, so although funding is vital, so is building a society that nurtures people, gives them security and safety, and truly values and cherishes them.

A report presented to the United Nations in 2019 argued that the best way to tackle the global mental health crisis is to build a supportive environment, including everything from the building of good homes to secure and well-paid work. If we are to solve the mental health crisis faced by children and young people, we must build a society where basic needs are met, where young people find decent and secure employment, where housing is both affordable and liveable, where education is understood to be a right and a good in itself, and where people do not have to work every hour of the day, but instead have time to live their lives to the fullest.

It is a great pleasure to serve under your chairmanship, Sir Gary. The issue of children and adolescent mental health is mission critical. It is the next tsunami—the challenge that will follow the covid pandemic. Now is the time not only to right historical wrongs—they are not as simple as underfunding; it is about truly looking at parity of esteem—but to look at the increasing needs that young people, and adolescents in particular, face and need to be satisfied.

We sometimes forget that mental ill-health is as much of a killer as physical ill-health. Life expectancy for those with mental health problems is usually reduced by some 10 years. Clearly, that can get worse in some areas and mildly improve in others. One of the real challenges is that it is those in deprived areas and lower-income families who suffer the most. Sir Gary, you will be aware of the huge deprivation in our rural areas, which is sadly hidden and therefore not properly addressed.

To get this right, we need properly to monitor it. We need to be clear what we mean by mental health. We need to be clear what illness means. We measure diagnosis, but there are many problems that come before it. We heard earlier from hon. Members that the time gap between someone putting themselves forward with a potential problem and diagnosis can be significant. We need to recognise that both have to be addressed.

The point that has been made about data is right. If we do not understand who is coming forward within the three systems—education, health and local government—what hope do we have of really understanding the scope of the problem? We need to collect, measure and keep consistent data across the country about diagnosis, waiting times, treatment and recovery. It is not just about what we put in to address mental health; what happens at the end of it—whether people get better—is equally important. Unless we do that, this promise of parity of esteem is never going to be delivered.

Some of the existing targets, which in my view are not adequate, are distinctly unambitious. The access target for children and young people is 35%. That seems the wrong way around—surely it should be the larger part, not the smaller part.

We must remember when we talk about youngsters that children are the most vulnerable to mental health problems, and an earlier contribution set out exactly what the statistics look like. I pay tribute to Devonshire Partnership NHS Trust in my area, which has done a fantastic job of providing support against all odds, but the numbers are growing. The eating disorder challenge is going exponentially upwards. Quarantined children are showing acute stress disorder and acute adjustment disorder.

Addressing the waiting time issue is just the start of solving the problem, but let us at least look at it and try to find a proper target to collect data for and monitor, with some sanctions if it is not met. In 2017, a four-week waiting time was piloted, but it was only a pilot and has not been rolled out across the country. We know from our own experience around the country that the actual waiting time can be significantly greater. My call today is for a national access and waiting time standard. It is much needed and would be the start of our journey towards true parity of esteem.

The pandemic has had a huge impact on youngsters. Many—up to 25%, it is estimated—are not getting the treatment that they have been given historically. We also know that the numbers have grown enormously. They will just add to the burden. Although the Government have provided support, it is not yet enough.

My ask is this. We need to look again at the health and care Bill, and at specific provision for mental health. We need to look at specific provision for how it is commissioned, and at proper measurement to deliver parity of esteem. We need national access and waiting time standards. The five year forward view for mental health has not been met; it must be. Mental health matters. Young people matter. What gets measured gets done.

It is a pleasure to serve under your chairmanship, Sir Gary. We have talked a lot about self-isolation over the past year but less about the impact of being isolated on our mental health. Many children and young people have faced the disruption, hardship and heartbreak of this pandemic largely away from their friends and school support networks.

Last week, I visited a breakfast club at a primary school in Camden, where I had some really uplifting conversations with young children. Most were absolutely delighted to be back in school, around their classmates and teachers once again. We know that the attainment gap has widened substantially during school closures, in part due to the Government’s failure to deliver laptops to disadvantaged children. Many of the children I have spoken to, however, found that their wellbeing and mental health took the biggest hit in lockdown. Most have been able to do classes on Zoom and to get on with their homework remotely, but they said that the wellbeing support which can only be delivered properly by teachers in person is what they have missed out on the most. The teachers I spoke to at the school expressed their frustration that they were not able to do more to help with mental health issues during school closures.

Children with special educational needs and disabilities have suffered particularly badly, with three quarters of parents saying that their disabled child is socially isolated and often unhappy, downhearted or tearful, and that there is a real risk that that could translate into serious long-term mental health issues without better support. That is also something I have picked up in my role as the governor of a primary school in my constituency. Remote learning also stifled the role that teachers often play in spotting problems that are emerging, intervening with assistance or, in serious cases, with referrals to other services.

The number of children and young people receiving support through the NHS for mental health difficulties halved in April and May last year, as did the number of referrals to CAMHS, compared with the previous year. Sadly, the number of current referrals does not make up that shortfall or address the worsening problems caused by the pandemic. That means that many children are still suffering in silence and without the support that they desperately need.

I heard that message loud and clear last summer when I met a group of inspiring children—the meeting was organised by Barnardo’s—who told me about the isolation and other difficulties they had faced as a result of the pandemic. They also spoke about how difficult it can be to access basic mental health assistance and how there is almost no joined-up thinking between different but related support services in some areas of the country. The reality is that young people are far too often unable to access mental health support until it is too late and they have, sadly, started to harm themselves.

It is a source of great sadness and shame that one in six young people in the UK could now have a mental health disorder, up from one in nine in 2017. We must turn that around, which requires a laser-like focus on improving access to mental health support, and giving schools and other bodies the resources to provide direct targeted help and to join up children’s services properly. The children and young people I have spoken to over the past year simply cannot afford to wait for the snail’s pace of change that this Government are overseeing in prioritising and investing in mental health support. We have to act, and we have to act now.

It is a pleasure to serve under you as Chair, Sir Gary, and I thank the hon. Member for Twickenham (Munira Wilson) for securing this important discussion. This debate on young people and mental health is important to my constituents, many of whom have contacted me about it. As many other hon. Members have said, people come to explain their experiences and their difficulties in accessing services.

To provide some context, according to NHS Digital, in 2017 one in nine children was estimated to have a diagnosable mental health condition. That number has increased to one in six because of the covid-19 pandemic, but it is important to emphasise that the crisis existed before the pandemic. Research by University College London shows that in 2018-19, almost a quarter of 17-year-olds had self-harmed in the previous year and 7% had attempted suicide at some point in their lives. According to the Office for National Statistics, in 2017 suicide was the most common cause of death for boys and girls aged between five and 19. The figure for boys was 16.2% of all deaths, and for girls 13.3%. That is a sobering thought.

I have the pleasure of chairing the all-party parliamentary group on suicide and self-harm prevention. We have been looking at this area over the past year, including hearing evidence from organisations such as YoungMinds and from young people themselves. We received evidence that many young people who self-harm still struggle to access the support that they need in an acceptable time- frame. In fact, the NHS dashboard shows that 37% of young people—just over a third—with a diagnosable mental health condition can access NHS specialist support.

Respondents to our inquiry made it clear that the single most impactful change to improve the support available to young people who self-harm would be a system shift away from the current reliance on crisis interventions and towards a preventive model of support. However, budgets for preventive interventions have markedly reduced in recent years. Demands for specialist NHS mental health services such as CAMHS and improving access to psychological therapies has therefore increased exponentially, outstripping investment and exacerbating workforce issues. This has led to longer waiting lists, higher thresholds, and refused referrals of young people who self-harm. Even before the pandemic, people who self-harmed could struggle to access the support they needed.

There are also clear inequalities when it comes to children and young people’s mental health, with higher rates of mental health problems among young women than young men, and among LGBTQ+ young people, young people with autism and young carers. There are also clear links between mental health and race, and between mental health and financial insecurity. Experiencing mental health difficulties in childhood or adolescence can have a significant impact across the life course, and can affect young people’s educational outcomes, earnings, employment and ability to maintain relationships, as well as increase their likelihood of engaging in risk- seeking behaviour.

I want to talk about early support hubs. We need a shift towards preventive community-based interventions to urgently address the wider drivers of self-harm. That is why I support the call by the Children and Young People’s Mental Health Coalition, including YoungMinds and the Children’s Society, for the national roll-out of the early support hubs model, which would ensure that young people in every area across England can access early support for their mental health. We know that the earlier young people get support, the more effective that support will be, and the better the outcomes. Early support hubs offer easy-to-access drop-in support, on a self-referral basis, for young people who need urgent help but do not meet the threshold for children and young people’s mental health services or who have emerging mental health needs up to the age of 25. These hubs can be delivered through the NHS, in partnership with local authorities and the voluntary sector, and would offer support across areas of need. Services would include psychological therapies, employment advice, youth services and sexual health services. Finally, I stress the need for security of funding for organisations providing these services.

It is a pleasure to serve under your chairmanship, Sir Gary, and I thank the hon. Member for Twickenham (Munira Wilson) for having secured this incredibly important debate. We know that half of mental health illnesses develop before the age of 14, and it is therefore essential that everyone has access to mental health services from an early age. I have spoken many times in this House about the inadequacies of CAMHS provision, including unacceptably long waiting times for referrals and the incredibly high threshold for treatment. However, today, I want to focus my remarks on infant mental health.

Worryingly, reports have demonstrated that there is a baby blind spot in our mental health service when it comes to the very youngest, and while children and young people’s mental health services are aimed at those aged 0 to 19, research has shown that there is inadequate provision for our youngest children. In 2019, 42% of clinical commissioning groups in England reported that their mental health services would not take a referral for a child aged two or under. The Parent-Infant Foundation recently surveyed professionals working in children’s mental health, and found that only 9% of those surveyed believed that sufficient provision was available for infants whose mental health was at risk.

Just like us, babies and toddlers can experience stress, anxiety and trauma. This impacts on their emotional wellbeing and development, but by failing to provide infants with access to mental health support, we enable mental health problems to build up. Given that thousands of babies have been born during lockdown with limited access to health visitors, peer support, playgroups and children’s centres, it is really urgent that we tackle these issues. Early intervention can have long-lasting benefits for mental wellbeing, benefiting not only the infant, but also reducing demands on mental health services in the future if it is tackled early on.

It is clear that we need action to address this blind spot. We need to invest in the provision of infant mental health services. We must also develop a strategy to ensure that there are enough qualified professionals to deliver it, so I urge the Government to address this baby blind spot and ensure that babies are not forgotten in mental health policies, strategies and services.

More widely, I am concerned by reports that find that one in six children now have a probable mental health condition. Demand for support is rising; there was a 35% increase in referrals to children’s mental health services in 2019-20. The Children’s Commissioner has warned that the pandemic will have a profound impact on children’s mental health going forward, putting already struggling mental health services under more pressure.

It is clear that urgent action is needed to support CAMHS. The postcode lottery in service provision has only worsened during the pandemic. There is huge disparity in the length of waiting lists, in the number of children accessing treatment and in the number of children being turned away. It is not acceptable that the availability of support can be based on where someone lives. The ability to access mental health services is so important, and this needs to be addressed.

I am concerned that the current expansion of mental health services is not fast enough to meet increased demand, and the Government must urgently address this. We need full and sustainable funding to support expansion, and we need a plan to address the shortage of specialist staff in the sector. Greater emphasis needs to be put on prevention and early intervention to ease demand, with properly funded mental health support in every single school across the country. After the extremely difficult year that our children, infants and young people have had, we owe it to them to put their mental health at the top of the agenda.

I thank my hon. Friend the Member for Twickenham (Munira Wilson) for securing this important debate. We have a long way to go to properly respond to our growing mental health crisis, especially for young people.

Eating disorders are a serious mental health issue, affecting many thousands of young people. They are complex and potentially life-threatening. They have no single cause, and they have the highest mortality rate of all mental health disorders. Recovery from an eating disorder takes, on average, three times as long as having the disorder itself. The fact that, all too often, an eating disorder goes undiagnosed and untreated for years adds to the problem.

Access to help continues to be a postcode lottery. NHS data on eating disorders show a fourfold increase in the number of children and young people waiting for urgent care. Behind these awful statistics hide thousands of real-life tragedies, not just for the sufferers themselves, but also for the friends and relatives who watch loved ones suffering from this awful illness virtually disappear before their eyes. With face-to-face appointments not going ahead, it has been much easier for sufferers to say that they are fine and not to ask for help until they reach crisis point. Like many forms of mental illness, eating disorders thrive in isolation. Some people have described their eating disorder as the only thing they have felt able to control during lockdown.

The demand for children and young people’s community services was already rising before the pandemic, but now these services are backlogged. The news that CCGs in England would increase their funding for eating disorders by an additional £11 million to help them cope with increased referrals was extremely welcome. However, this funding is not reaching the frontlines. Research commissioned by the all-party parliamentary group on eating disorders, which I chair, and carried out by the eating disorder charity Beat, shows that CCGs in England increased their spending on children and young people’s community eating disorder services by just £1.1 million in 2019-20. Only 15% of CCGs increased their spending in line with the increase in additional funding; 21% spent less. On behalf of the APPG and Beat, I ask the Minister and the Government to hold NHS leaders to account, because they must make sure that every penny that the Government have made available goes to frontline services.

The impact of the pandemic on the mental health of disabled children and young people has been considerable. Research from the Disabled Children’s Partnership consistently shows that disabled children have been more isolated than the rest of the population. Its latest survey shows that 90% of disabled children are socially isolated, and 72% of parents said their children are

“often unhappy, downhearted or tearful.”

Disabled children are at risk of being forgotten in the national recovery from the pandemic. It is deeply disappointing that the Government’s recently announced education recovery plan provides no tailored support for disabled children to meet their complex needs. I urge the Minister to back calls for immediate dedicated catch-up funding and services for disabled children and their families. In the autumn spending review the Government must go further. They should commit to proper funding to tackle the pre-pandemic gap in disabled children’s social care services.

Childhood trauma is at the bottom of a very large number of mental illnesses. Many children take their traumatic experiences into later life and it affects their life chances in every aspect, from educational achievement and professional qualifications, to health and wellbeing, to the risk of coming into contact with the criminal justice system. We still lack a proper understanding of the effects of childhood trauma and how to prevent it. 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. As the chair of the all-party parliamentary group for the prevention of adverse childhood experiences, I hope very much that we can engage with the Minister on the work we are doing in that field.

Our children’s mental health is deteriorating. We must do all we can to improve it.

I thank the hon. Member for Twickenham (Munira Wilson) for not just securing the debate but superbly setting the scene.

I want to reinforce the message that has just come so eloquently from the hon. Member for Bath (Wera Hobhouse) with regard to eating disorders. I saw the recent paper by Dame Til Wykes and other scientists and campaigners, supported by the Government’s national adviser, Chris Whitty. They discussed the end goals for mental health research. The first end goal was halving the number of children and young people experiencing persistent mental health problems.

Eating disorders are just one of the serious persistent problems that start early and often persist into adulthood. As the paper sets out, they are associated with extremely poor outcomes, so it is appropriate to try and stop these disorders persisting from an early age. It makes sense for the individuals and their families, but also for the NHS, in terms of reducing costs, and for the economy overall, because people can contribute so much more fully to society.

What came out of that paper is the decision that we need to implement what we know already, but also support more research to improve recovery. As the hon. Member for Bath said, we already know that eating disorders are a growing problem. Some of the statistics are startling. The NHS 2019 health survey for England found that 16% of adults aged 16 and over screened positive for a possible eating disorder. In recent years, we have seen a fourfold increase in eating disorder hospital admissions, and waiting lists are at an all-time high. Hon. Member after hon. Member is finding this in their constituency, particularly when they are approached by distressed parents.

It is estimated that one in three young people experiences an eating disorder. Because these disorders occur among so many young people, they are still sometimes viewed as almost a teenage girls’ illness—a diet, a lifestyle choice or something a person grows out of. Yet, the statistics on their severity are shocking. It is reported that eating disorders have the highest death rates among all mental health disorders, and the rate of suicide is 23 times higher in people with eating disorders, compared with the general population—one in five deaths in eating disorder patients is reported to take place because of suicide, and I pay tribute to the work my hon. Friend the Member for Blaydon (Liz Twist) and her all-party parliamentary group on suicide and self-harm prevention are doing. According to the reports that we receive as constituency MPs, these serious consequences result from eating disorders partly because of the lack of access to psychiatrists who are fully trained in eating disorders and who specialise in eating disorder treatments.

As the hon. Member for Bath said, evidence is emerging that there has been a significant rise in people with eating disorders during the covid pandemic. Those in recovery have been set back, and new eating disorders have developed among a wider range of the population. From what I hear from my constituents, there is a vicious cycle of a lack of awareness, a lack of training and a lack of research funding at the scale needed. Let me just quote the parents from one family, who said: “Tell them right now the support, the treatment and the understanding is just not out there for us.”

Concerns have also been expressed about what some people consider unhealthy messages being pushed by the Government’s obesity strategy, which is being developed at the moment. I hope that more consideration will be given to consulting organisations that represent people with eating disorders in the development of that strategy.

I want to pay tribute to Hope Virgo. Many will have heard of her campaign “Dump the Scales”, which has been calling so effectively through the media for proper investment in eating disorder treatments. Just this week, Hope told me she has received numerous letters from parents whose children have been naso-gastric-fed on general wards, with no psychological support in some health settings.

F.E.A.S.T., a global website campaign, is reporting thousands of people contacting it through Eating Disorders Support UK, and 5,000 have signed up for its 30-day support scheme. Hope Virgo is the founder of the Hearts, Minds and Genes eating disorder coalition, which is the first coalition to declare a state of emergency around eating disorder treatment, and I am pleased that it is now meeting the Department of Health and Social Care. This serious issue needs ministerial support to drive through the new programme, and I hope that pathways and support will be developed within a timescale that recognises its urgency and seriousness.

The winding-up speeches will begin at 3.28 pm. Jim Shannon has five minutes.

It is a pleasure to speak in this debate, Sir Gary. I thank the hon. Member for Twickenham (Munira Wilson) for setting the scene so well. She obviously has a passion for the subject. I love to engage with the debates that she is involved in, because I usually find I am on the same page, so I thank her for securing this debate.

I like quotations, and John F Kennedy had one that is appropriate for this debate. He once said:

“Children are the living messages we send to a time we will not see.”

I think that sentence captures this debate. The years march on, and for those of us of a certain vintage, they march terribly quickly—at least, they seem to. But that’s the way it is. I understand these things more than ever. My mum is 89 years old. In four weeks’ time, almost to the day, she will be 90, and she is very fit in mind and body. She reads the Minister’s novels, by the way—the Minister knows that—and she finds them very enjoyable. That is the sort of mind she has, but she is the first to tell me that she does not know how young people are coping at present. Long gone are the very simple times. Our children live in an age where the world is at their fingers, which sounds great. It also means that when they are at home, in a place that should be safe from the world, the cyber-bullies are still at play, information is still at hand, and the anxieties of the world are never too far away.

I am always amazed when I look at my two oldest grandchildren—Katie, who is 12, and Mia, who is seven. They are so active and so capable on their iPads and laptops. Their grandfather, unfortunately, has not caught up with them at all. I am thankful for the wonders of the internet and all the possibility it brings, yet it also brings a world of uncertainty and fear. Information is truly available, but so too is information that is false and that could really harm, corrupt and do a great deal to the health of our young people.

During home schooling, we told our children to access school online and do more on the iPad and the computer than ever before. At the same time, young children were scared and frightened by the seismic shift in their lives because of covid, watching informational programming that was not designed for them and that caused fear and upset. We were isolating them from their support systems at school, from their friends at church and even from their neighbours. Little wonder our young ones are struggling now, fearful of this bug and not sure what that normal is any more. I am not sure what the normal is any more either—it might be what we used to have.

YoungMinds, a charity that the hon. Member for Blaydon (Liz Twist) and others referred to, is doing tremendous work. In its recent survey, which I quote for the record and to focus our minds, 75% of respondents agreed that they found the current lockdown harder to cope with than the previous ones, with 44% saying it was much harder, while 14% said it was easier and 11% said it was the same. Some 67% believed that the pandemic will have a long-term negative effect on their mental health. That includes young people who have been bereaved or who have undergone traumatic experiences during the pandemic, who were concerned whether friendships would recover or who were worried about the loss of education or their prospects of finding work. Some 19% neither agreed nor disagreed, and 14% disagreed, but the figures we need to focus on are the 67%, the 75% and the 44%. Some 79% of respondents agreed that their mental health would start to improve when most of the restrictions were lifted, but some expressed caution about restrictions being lifted too quickly and about the prospect of future lockdowns.

The statistics speak volumes, yet the issue is the silent, solemn children who carry burdens that their wee shoulders were never designed to carry. How heartbreaking it is to imagine that one of my precious grandchildren could be feeling that; it is a feeling felt by too many children. I know that from speaking to parents, teachers and ministers back home in Northern Ireland. The question on our lips is, what can we do?

As a grandparent, I know that Katie and Mia are old enough to understand much of this. They have perhaps observed loss and watched their parents and grandparents grieve. As a Christian—I always say this if I get the opportunity, and I know it is something that resonates with you, Sir Gary—I will be seeking that the perfect peace that comes from God descends on our young people. But as a parliamentarian, I ask my Minister and my Government to put in place funding to enhance the counselling available, to encourage schools to carry out Mental Health Day events, and to work with churches to enable them to signpost children to help. We must act, lest the message that we send to the future be nothing other than an apology for our failings.

I begin by echoing the thanks to the hon. Member for Twickenham (Munira Wilson) for securing this debate and for her excellent exposition of the challenges that we face. Maintaining the good health of our children and young people is a challenge, and much more so in the wake of covid-19, with all the destruction and disruption it has wreaked on young lives, plaguing children with fear and uncertainty during their formative years. Tackling that has to be a public priority, and it is for the Scottish Government. I hope the Minister will agree that it will be a public priority in England as well.

Scotland was the first nation of the UK to create the post of a dedicated Minister for mental health. It is true that young people’s mental health was a challenge even before the covid pandemic, but we all need to try to more fully understand the mental health and wellbeing impact of lockdown and school closures for children and young people, in order to be better informed about how to support them and what support can be offered as lockdown eases.

It is perhaps obvious that feelings of anxiety have developed in many young people throughout lockdown, especially for those children whose parents are key workers. We often forget that the children of key workers will undoubtedly have been worried about their parents, and perhaps other family members, being on the frontline during the pandemic. While young people are off school, their worry is likely to be magnified and exacerbated, as their key worker parents could be working longer hours than usual on the frontline, to benefit wider society.

Those living in disadvantaged communities are more likely to have had negative impacts on their mental health during lockdown, but many young people across the board have been concerned about returning to school and missing out on school, and worrying about the future. We know that lockdown has been particularly difficult for young people who face challenges with digital access, physical space or insufficient support with their home learning, and lack of contact with peers, which is particularly important for children and young people.

There is no denying the link between poverty and poor mental health, as well as poor physical health. That is as true for young people as it is for adults. Tackling inequality must be part of any long-term strategy to improve mental health. The Scottish Government have established a range of measures to reduce inequality. The real levers to tackle the ingrained inequality, of which we are all aware, are reserved to the UK Government.

Local authorities have reported increased self-harming and suicidal feelings, with an increased number of suicide attempts among care leavers. Recent studies show that 6% to 7% of young people surveyed believe that the pandemic will have a long-term negative effect on their mental health. That is pretty shocking, but I do not think the long-term mental health adverse effects are inevitable—I sincerely hope that they are not. Hope, sadly, is not enough. There has to be a determined, decisive political will to tackle this problem.

The Scottish Government’s approach is to focus on further investment in and redesign of child and adult mental health services. The mental health transition and recovery plan is supported by an additional £120 million to transform services, with a renewed focus on prevention and early intervention. The additional demand for mental health support in the wake of covid poses challenges across the UK, but they are challenges that we have to meet. There is no dressing it up; there is no getting away from it.

We know that the waiting lists for mental health support in Scotland and across the UK are simply too long. That is why the Scottish Government are redoubling their efforts to ensure that waiting lists come down, and they are working closely with health boards to that end. The Scottish Government are also working hard to ensure that schools are as equipped as they can be to support children. That is why the £20 million additional investment in the pupil equity fund, bringing it to almost £147 million, is so important for supporting children and young people from the most disadvantaged backgrounds.

That fund resources educational psychologists, home school link workers and mental health counsellors. In addition, the investment in raising attainment and supporting the wellbeing of pupils is complemented by a £20 million summer programme, alongside a range of other investments in youth work, outdoor learning and education in Scotland, to support schools with the resources they need to strengthen mental health support. The Scottish Government’s £262.2 million budget for mental health and autism in 2021-22 is over and above the NHS spending, and more than double the previous year. Suicide prevention spending has also been doubled.

The hon. Member for Bath (Wera Hobhouse) is correct. Psychiatrists are warning of a “tsunami of eating disorders”, thought to be a direct consequence of the isolation and feeling out of control engendered during the pandemic. The mental health pandemic that has followed so hard on the heels of the health pandemic will require ongoing determined action across the UK. The explosion of mental health challenges created by the health pandemic will take time to treat, and it will take time for those suffering to recover. As long as we have the political will to do that and give it the priority it needs, that is what matters.

The reality is that we still do not yet know the full picture of the mental health impact of covid-19. We may not know that full picture for some time to come. However, a glimmer of hope can be found in the fact that now people are more willing and able to talk openly about their mental health, which is a real culture change, even from as recently as a decade ago. That means that young people today are more likely to ask for help or talk to someone they trust if they are struggling, and that has to be welcomed.

We know that talk is not enough; we need action. The focus we now have on the importance of mental health must not be lost. Young people and children who have mental health needs require and deserve our support and we have a duty to provide it. The Scottish Government are working hard to do this, and I hope to hear that the Minister will be doing the same in her role.

It is a pleasure to serve under your chairmanship, Sir Gary. I thank the hon. Member for Twickenham (Munira Wilson) for bringing forward this important debate. We have had a number of interactions and I know how genuinely important the issue is to her. I am aware of the meeting she had with the Minister for Health, my hon. Friend the Member for Charnwood (Edward Argar). I will give some information, but also reassure her that we are continually working on these issues. More has happened as a result of her meeting. I know she is genuinely very concerned about this issue and has been since the day she arrived in Parliament.

As the Minister, I speak to all stakeholders, trusts, organisations and just about everyone involved in the area of mental health, particularly among children and young people. It is incredibly important that we keep our language and our comments about children and young people both proportionate and responsible. There is not a mental health pandemic. I will go on to explain what I mean by that.

It is very important that we divide wellbeing from mental illness, not least because we do not want mental illness to fall by the wayside in people’s awareness and understanding of mental health, because the conversation is dominated by mental health and an overarching title that is not appropriate. Mental health is divided—it is not just a catch-all title. We have people who suffer with serious mental illness and childhood mental illnesses, such as schizophrenia, psychosis and eating disorders. I congratulate the hon. Member for Bath (Wera Hobhouse) on her speech; we have discussed eating disorders many times, and she is compassionate and is compelled to improve eating disorder services for children and young people in the UK. I thank her for her commitment to the issue.

It is incorrect to describe 140,000 children as having been turned away. The measurement of progress against the five-year forward target is based on two contacts with NHS services—this is an important point. Many children and young people have one session. After that, it is jointly decided to close their referral. To quote the 140,000 figure is misleading. One session is thought enough to provide them with the help they need or, more importantly, to provide pathways to their carers, parents and those who accompany them to the appointment. The expansion of Every Mind Matters, which was developed by Public Health England, to include children and young people under the age of 18 has been a huge boost. It is wrong to say—to misquote—that 140,000 children have been turned away. It is important to look at the reasons why.

I began by saying that I speak to stakeholders, trusts and others. I would like to quote from a letter a trust sent to MPs, following a debate on the issue only days ago. The trust said: “Partner organisations work incredibly closely to ensure children and young people receive the services they need.” It was referring to the narrative used by parliamentarians. It said that frontline staff had worked tirelessly throughout the pandemic and had taken the additional investment that the Government had provided to increase their workforce, and that to describe their services as failing had an impact on the morale and wellbeing of dedicated frontline staff and those who are delivering services to children and young people. It went on to say that the statements that were being made caused concern and alarm to children and young people and their families at an anxious time.

We have a responsibility in Parliament when we are talking about mental health, particularly of children and young people, to keep language proportionate. For me, talking in a debate about children throwing themselves off a bridge is completely beyond the mark and I am afraid that I think that that type of language is exactly what the trust was referring to—[Interruption.] The hon. Member for Tooting (Dr Allin-Khan) is commenting from a sedentary position. I reiterate my comments, Sir Gary. It is important that we consider the families and the people that we are representing and do not make inflammatory statements.

I have heard first hand from NHS staff that thousands of children and young people have had to adapt to the challenges of covid-19. It has been an incredibly tough year for everybody, and many children and young people have felt anxiety, apprehension and a gamut of emotions that adults also felt when faced with the unknown, sudden and rapid change to routines as well as a lack of understanding of what would happen and how life was to continue. However, many people are resilient, and many of those children and young people, who at stages reported they felt all those emotions and were included in that statistic of one in six, came through once there was a greater understanding of what was happening and how it was going to work. They were incredibly resilient, and we should be proud of those children and how they helped others too.

We take the pandemic and the mental health of children and young people extremely seriously. I work seven days a week on what this Government do, what we provide and how we assist. Although I have been criticised by the hon. Member for Tooting for talking about the investment we provide, we cannot provide services without the money for them. We cannot increase our mental health workforce if we do not provide the money to train people and to provide those services and that is exactly what we have done. I have no shame in quoting the figure of £2.3 billion a year that is going into mental health services—more than any Government has ever ploughed in, plus an additional £500 million to a mental health recovery plan for the pandemic this year, of which £79 million has gone into eating disorder services based in the community. We hope that that funding will allow around 22,500 more children and young people to access community health services.

The Minister has quoted the numbers for what the Government have made available. As I said, unfortunately a lot of that money has not reached the frontline. Will she make CCGs accountable and that money goes where it is meant to?

It is a constant pressure for me to ensure that. NHS England has worked incredibly hard to establish community-based services. It is important to say that the uptick in eating disorders came before the pandemic—it was spotted before it struck. We can have another debate on why we were beginning to see that rise in eating disorders, and the hon. Member for Twickenham and I have had that discussion. I am proud of how the NHS has rapidly looked at how we can deal with this exponential rise in eating disorders, because that is where our problem is.

We know exactly who has been affected by the pandemic, in terms of mental health services. We know from the referrals that have gone to our partners across the board and to local services. I am saddened to say that eating disorders are our toughest problem at the moment because of the exponential rise—over 22% over the past year.

NHS England is using that money. As I said a moment ago, having the workforce to provide services is really important, so we have accelerated the number of mental health support teams that we are putting in. The first question I asked when I took up my ministerial post was: “Can we have more mental health support teams in schools faster? Can we accelerate the long-term plan so that we get more areas covered quicker?” It took the pandemic to make that happen, but now—I have not even used my speaking notes; I have gone completely off piste—I think we have another 112 school areas covered. I will write to Members attending today to give them the figures on mental health support teams. We have managed to accelerate the programme by over a year as a result of the £500 million of funding that we put in.

Something that we can really shout about is that we have people coming forward. Mental health was never an area where people really wanted to work. I remember during my nurse training that we were given the option to take 12 weeks’ maternity or 12 weeks’ mental health, and my entire cohort took 12 weeks’ maternity. Nobody went to do the mental health training. Now—the pandemic has highlighted this—we have 100 applications for every place in university for people to train in mental health. That means mental health support teams to go into schools, deal with eating disorders and work with children and young people. When we put that kind of money in, run those kinds of courses and have the commitment to accelerate mental health workers, we do not see those results overnight, but that work is being done now to ensure we have the results. We want to ensure that people come out of universities and go into mental health support teams in schools. I have seen the work they do and how they work with children and young people.

Time has whizzed on, and I would just like to make a few points. The hon. Member for Lewisham West and Penge (Ellie Reeves) spoke about young mums and infant mental health. I am totally with her. That is why I worked so hard during the lockdowns to ensure that we kept support groups open for mums and young babies, and particularly those that give mental health support to mums. That included all sorts of groups, such as playgroups—Monkey Music is one that somebody used—where mums could meet together with their young babies. I argued for that and made the case for supporting their mental health. During the pandemic, those groups were kept open for young mums because I felt it was so important that they were supported.

May I remind the Minister to leave one minute at least for the hon. Member for Twickenham (Munira Wilson)?

I am going to sit down.

Will the Minister give way?

I do not think there is time.

You have one minute of your time left.

I have not got time, I am so sorry. There is only one minute left.

The hon. Member for Twickenham asked about data. That data is produced on the mental health dashboard every quarter. There is work ongoing, but I will come back to her on the details of it. I do not know whether she has access to the dashboard and the data, but I will make sure she does. If the hon. Member for Blaydon (Liz Twist) would like to speak to me when the debate is over, I will come back to her on the points she raised. I will sit down now to give her a chance to respond.

I thank all hon. Members who contributed in such a knowledgeable and passionate way to this debate. I hope the Minister has seen that there is cross-party support for greater support for and investment in mental health services. I recognise that the Government have put more money in, but one of the themes has been whether it is getting through to the local level and the frontline. That is why my hon. Friend the Member for Bath (Wera Hobhouse) and I keep picking up the point about data, and the hon. Member for Newton Abbot (Anne Marie Morris) did the same. I am grateful to hon. Members for picking up points that I was not able to cover, such as the baby blind spot, eating disorders and disabled children. There are so many issues; this is multifaceted.

The Minister talked about definitions and said that we are conflating mental health and wellbeing, but it is all part of a continuum. That is why it is so important, as part of the prevention agenda, to focus on wellbeing as much as the serious mental health concerns. That is why I was trying to cover that vast spectrum in my speech. I reiterate that I stand ready to work with the Minister.

The hon. Member for Strangford (Jim Shannon) quoted JFK. Well, I will quote Mandela back at him:

“There can be no keener revelation of a society’s soul than the way it treats its children.”

Motion lapsed (Standing Order No. 10(6)).