Green Paper on Child Mental Health is unambitious and leaves hundreds of thousands without proper care, say Committees
The Government's proposed Green Paper on Transforming Children and Young People's Mental Health lacks ambition and will provide no help to the majority of those children who desperately need it.
So says the combined Education and Health and Social Care Committees in their joint report examining the Government’s Green Paper on Children and Young People's Mental Health Provision.
Trailblazer Pilot schemes
The Committees are worried that the long timeframes involved in the Government's strategy will leave hundreds of thousands of children and young people unable to benefit from the proposals. The Government is rolling out new “Trailblazer” pilot projects where mental health teams provide extra support alongside waiting time targets. But these schemes are set to roll out in only a fifth to a quarter of the country by 2022/23.
Chair of the Health and Social Care Committee, Dr Sarah Wollaston MP, says:
“The Green Paper is just not ambitious enough and will leave so many children without the care they need. It needs to go much further in considering how to prevent mental health difficulties in the first place.
"We want to see more evidence that Government will join up services in a way which places children and young people at their heart and that improves services to all children rather than a minority.”
Chair of the Education Committee, Rob Halfon MP, says:
“The Government must back up its warm words by taking urgent action to address the mental health issues which children and young people face today.
"This strategy does not go far enough, which raises the very real prospect of hundreds of thousands of children missing out on the getting the help they so desperately need. We heard of the strong links between social disadvantage and mental health issues.
"If the Government is serious about tackling injustices in our society, it must ensure proper targeted funding of support for those most in need. Ministers should also recognise the separate support needs of apprentices and FE students.
"Social media is an increasing part of young people’s lives. Given both the negative and positive impacts it can have on young people’s mental health, social media education should be made a compulsory part of PHSE in all schools.”
Strain on schools and colleges
Both health and education services are under great strain with significantly stretched resources, and workforce recruitment and retention concerns. Half of school leaders appear to have cut back on their mental health support services.
The Green Paper wants schools and colleges to deliver the ‘Designated Senior Lead for Mental Health’ role from within their own ranks. But this will only make worse the pressures of the existing high-accountability system, combined with a stretched teaching workforce.
Staff need support within their school or college to ensure that their role is balanced with their normal duties. The Government must ensure that the existing CAMHS workforce is not overburdened by the demands of the Green Paper.
In a discussion forum held with young people, participants told the Committees that high-stakes exams have adverse effects on their mental health and well-being. The Government needs to gather independent evidence concerning the impact of exam pressure on young people.
In addition, the Committee heard, in formal evidence, that young people excluded from school seem much more likely to have social, emotional and mental health needs, yet the Green Paper does not address this issue. The Government must focus on the increase in pupils being excluded with mental health needs and how the mental health needs of excluded pupils are being met.
Transferring to adult care
Young people are also falling through the gaps and not receiving the services they need as they enter adulthood. At age 18, young people
transition to adult mental health services. But a far more appropriate age appears to be 25. Indeed it seems that a third of 18 year olds drop out of mental health support rather than transfer to adult services.
The Government must commit to a full assessment of the current transition arrangements between child and adult mental health services. In addition there needs to be a distinct and separate set of proposals for looked after children accessing mental health services.
Dr Mary Bousted, Joint General Secretary of the National Education Union, said:
“The Education and Health and Social Care Committees have highlighted the Government’s consistent failings to tackle the crisis in child mental health provision in their joint report. The NEU supports their call for independent evidence on the impact of exam pressure and a narrowed school curriculum on young people’s mental health. We agree with the Committees that PSHE should be compulsory in all schools.
“We share the analysis that the crisis in child mental health provision will not be ‘transformed’ by the unambitious proposals in the Government’s Green Paper. A Government that’s complacent about child poverty and relaxed about excessive testing in schools can’t claim to care about young people’s mental health. The NEU shares the concerns about the slow timeframes for action which will leave many children without care that is urgent. Funding cuts to schools, colleges and local authorities which have decimated mental health support services must be reversed, otherwise we leave vulnerable students at a higher risk of experiencing mental health conditions.
“We face great barriers to getting the right support to children and their families because of inadequate funding, cuts to services, competing pressures on schools and education policies that undermine inclusion. If the Government wants to ensure schools, colleges and specialist mental health services can deal with the increasing numbers of referrals, they must be fully funded and fully staffed.”
David Hughes, Chief Executive of the Association of Colleges, said:
“AoC welcomes the way in which the findings highlight the importance of education in supporting young people with mental health difficulties. Many of the findings are also in line with experiences in many of our colleges, particularly since it is clear that 75% of mental health conditions are established before the age of 24. AoC welcomes the opportunity to get involved with the group looking at the needs of those aged 16-25.
“As the report outlines, it is very difficult for colleges currently to find adequate resources to support young people and help build their resilience. Post-16 education is funded significantly less per student than 11-16 schools or universities, and colleges have a higher proportion of students from disadvantaged backgrounds who, as the report indicates, are more likely to develop mental health challenges. We would welcome a review of 16-19 funding which recognises the additional costs of supporting large numbers of those with mental health needs.
“Colleges across the country do excellent work in helping students to stay well and to support those with mental ill health, keeping people out of A&E and hospital beds. A number have strong relationships with local NHS and mental health teams. We would like to see every NHS Trust match the best in terms of partnership working with colleges. We will continue to work with Government and other partners to provide consistent support to students of all ages across England and to do our bit to prevent a growing crisis in mental health in young people and the next generation of adults.”
Anna Feuchtwang, Chief Executive of the National Children’s Bureau said:
“With 1 in 4 teenage girls and 1 in 10 boys experiencing symptoms of depression, we need a Green Paper that backs up good ideas with ambition and urgency to make good mental health care for children a reality.
“Decisive action now can turn the tide on the number of teenage girls who are self-harming; relieve the relentless academic and social pressures our children are facing; and meet the unmet needs leading to children with autism being excluded from school.
“Three children in every classroom have a diagnosable mental health problem, and this number is on the rise. These children need help now, not in five years’ time, and not in only a quarter of the country.
“This Green Paper should be an opportunity to ensure children get the support they urgently need and to address the underlying issues causing these problems. Instead what we’ve got is a shuffle in the right direction when we need a stride.
“The Government must listen to demands from the Education and Health and Social Care Select Committees and the children’s sector, and bring forward funding to support schools to prevent poor mental health, with a clear and properly resourced action plan to implement improvements in specialist mental health services.
“While the Government’s vision recognises that prevention is better than cure, the focus on early years in this Green Paper is not nearly strong enough. Like teachers, staff in nurseries and other early years settings need mental health training so they can work with parents to promote young children’s social and emotional development. This is a vital part of the jigsaw if a child is to have the confidence and social skills that will get them ready for school and stand their emotional wellbeing in good stead throughout their childhood.”