There have been some additions to the speaking list, so I will introduce a time limit for Back-Bench speeches, which is likely to be seven minutes, following the opening speech from the right hon. Member for Newcastle upon Tyne East (Mr Brown).
That this House has considered the provision of school-based counselling services.
Let me start by saying how grateful I am to the Backbench Business Committee for affording me almost half a day for this topic. I thank my friends throughout the House for making the case to the Committee, and I particularly thank my friend the right hon. Member for Harlow (Robert Halfon), who has joined me in sponsoring the neutral proposition on which the debate is based.
It is estimated that in England, one in eight young people—13% of those aged between five and 19—are living with diagnosable mental health disorders. They include depression, anxiety, and conduct disorder, which is a type of behavioural problem. While the announcement earlier this year of extra funding for young people’s mental health services is welcome, it is targeted specifically at the extra dimensions of the problem caused by covid within schools. The problem was there before. It has grown, and it needs to be addressed. The services were under pressure before the pandemic, and they remain so now.
The Children’s Society tells us that 75% of young people are not receiving the help that they need, and 34% of those who manage to be referred to NHS services are not accepted for treatment. Public Health England says that in the north-east the number of pupils with social, emotional and mental health needs is higher than the national average, and the same is true in respect of hospital admissions resulting from 10 to 24-year-olds self-harming. This is an issue for the country, but it is a particular issue for our region.
I apologise for interrupting an excellent and very timely speech, and congratulate my right hon. Friend on securing the debate. I do not know whether he has seen the data, but does he share my concern that there seems to have been a much steeper increase in the mental health challenges faced by girls throughout their secondary school years than has been the case among boys? By the time they leave secondary school, girls have had almost twice as many contacts with mental health services as boys. Many of those challenges could potentially have been avoided if there were proper counselling in schools, for which I am sure my right hon. Friend will be making the case. Moreover, if boys are more reluctant to come forward for that help, is that not also a problem demonstrated by the data?
Whatever the cause, the problem is clear enough, and it needs to be addressed. My hon. Friend is right to make the point, and she is also right to suggest that the roots of this, particularly in our region and the city that we both represent, are to be found in deprivation and in poverty. That is a particular feature of our region, and my hon. Friend spoke about it very movingly in the earlier debate. We know that mental health issues have a disproportionate impact on the most vulnerable children, and the roots of that are in social deprivation. It is a particular problem in my own constituency. In 2014, 27% of children in east Newcastle lived in poverty; the latest figure, for 2019-20, is 38%, and it is increasing year on year.
The north-east of England is bearing the brunt of the increase in child poverty, with all 12 local authorities within the north-east region in the top 20 authorities that have seen the highest increase across England as a whole. The last Labour Government boosted the life chances and welfare of children, and I am proud of being a part of that. Policies such as Sure Start, working tax credits and well-funded family-friendly public services ensured that every child had a positive start in life. How far we have slid from that, and how misguided and mistaken we were to get ourselves into that position.
I particularly want to make the case for services for the disabled, whether they have a physical disability or mental health problems. I recently met representatives of the National Deaf Children’s Society who told me about the disproportionate impact that the coronavirus lockdowns have had on the mental health of deaf children. Measures taken to fight covid, such as the widespread wearing of face masks, particularly in the classroom, have led to communication difficulties for deaf children. As a result, 60% of deaf children have indicated that their mental health has worsened, and 58% have reported feeling isolated and lonely. Many felt that services relied too much on the telephone for booking appointments, and others did not like the fact that some appointments were now available only on the telephone.
There are many charities, particularly children’s charities, across the United Kingdom that I can think of, such as the National Society for the Prevention of Cruelty to Children, Barnardo’s and Mind, that have a great grasp and knowledge of where the real priorities need to be. Does the right hon. Gentleman feel that when the Government reply, they should listen to the organisations that know, and then deliver a strategy that can help with these situations?
I have a relatively open mind on the particular route that should be taken to meet these issues head-on, and I have no ideological objection to a role for the voluntary sector or for those who want to contribute, but—at least in England—the state must take a lead. Things cannot be left as they are. I believe that school-based counselling, regardless of which organisation provides it, could fill the gap between those mental health support teams in schools and the national health service’s child and adolescent mental health services. There are limits to voluntarism, of course, and we would need the people delivering the service in the schools to have some form of qualification and understanding of what they are doing.
The British Association for Counselling and Psychotherapy makes that point and is campaigning on these issues. Schools-based counselling is a proven intervention for children and young people experiencing psychological distress. Some 50% of mental health disorders are present by the age of 14, increasing to 75% by the age of 18, so early intervention is key, as it is with many of these issues.
My right hon. Friend has just mentioned the statistics about early intervention. In the previous debate we were talking about investment in children at a young age. Does he agree that targeted investment in these young people is not just good for those individuals but makes economic common sense, in that the payback will be that we have productive and stable members of society?
My right hon. Friend is absolutely right. It also relieves pressure on the national health service in the longer term, because the NHS tends to end up as the service of last resort—a role it shares with the police, equally unfairly in my view.
I commend the efforts of the Tyne & Wear Citizens group, which has been working to raise the profile of schools-based counselling and with which I have had regular meetings. The group has set out three core principles that a successful schools-based counselling programme ought to follow: first, that services should be co-operative and inclusive, including the use of digital wellbeing tools, telephone counselling and face-to-face sessions at school or external venues; secondly, that services should be collaborative and liaise with external agencies such as social services and the police where it is appropriate to do so; and, thirdly, that services should be consistent, provided by those trained on a nationally recognised course, registered with a professional body and experienced in working with school-age children.
In concluding my contribution to this debate, I want to say something about the schools-based counselling programme in place in the Newcastle East NEAT Academy Trust in my constituency. I have nothing but praise for the project itself and the enthusiastic support that it is receiving from the broader schools community; my right hon. Friend will remember it well, because he used to be a councillor for the local government ward that it serves.
The project has found clear signs of improvement in educational attainment for around one in three of the pupils who received counselling. There was a significant improvement in pupils’ achieving their personal goals, with an 85% improvement in reported progress towards achieving these goals. No child reported a sharp deterioration in progress.
The counsellor—not a local government-type councillor but a schools-based counsellor—in the trial that is taking place has told me that embedding the counselling service as part of the whole-school approach is vital to removing the stigma around mental health and promoting a culture shift in the community. She has reported high levels of engagement in the programme and has stressed that demand is increasing. In order to reach more children and young people in crisis and to prevent future mental health issues from developing, I am convinced that the project has made a strong case for more school-based counsellors delivering interventions.
It is an honour to be able to speak in this debate, and I congratulate the right hon. Member for Newcastle upon Tyne East (Mr Brown) on securing it and the Backbench Business Committee on granting the House time to discuss such an important matter.
I want to start with an admission. When I first became an MP, I did not think that schools should be involved in matters that were beyond the core curriculum, such as mental health. My mind was changed pretty swiftly in two ways. First, my own brush with anxiety and depression in 2012 enlightened me about mental health and cast aside any unconscious prejudice I may have had about who is affected by poor mental wellbeing. The second came through the privilege that we, as Members, have of visiting schools in our constituency and seeing that education is holistic, child-centred and rarely textbook—I ask the House to forgive the pun.
Having had my lightbulb moment, I now feel a responsibility to stand up in this Chamber to advocate for better mental health services for our children. Our child and adolescent mental health services are, I am afraid, overwhelmed, and we could, and perhaps should, have another three-hour debate about that. However, while that remains the case, the system of support for our children needs to be widened, and that is where our schools come in.
Reading the briefings for this debate, I was struck by the statistics of deteriorating mental wellbeing among our children, especially following covid, but the stat that made me feel sick was in the brief provided by YoungMinds, which noted:
“In 2017, suicide was the most common cause of death for both boys and girls aged between 5 and 19”.
That made me want to cry. There are so many heartbreaking stories of children whose lives have been robbed by a disease over which they had no control, but suicide should be preventable, if we have the right awareness, training and essential support services in place. No one, but especially no child, should lose their life to suicide.
The hon. Lady is making an excellent speech and I agree with pretty much everything she is saying. On hubs, does she agree that some children and young people will not feel comfortable and will not want to access services through their school, for a variety of reasons? Community-based mental health support hubs that are a one-stop shop for a variety of services are an essential complement to school-based counselling services.
I am grateful for the hon. Lady’s intervention. We need to reduce the stigma around mental health and give people the confidence to access support services wherever they are, whether that is in a school or a community hub.
It is clear that we stand on the edge of a young people’s mental health crisis, and more so because of covid, but it could also be that because of covid we have the chance to make fundamental change rather than minor tweaks here or there. I have a great deal of respect for the Minister and know that he will hear what colleagues say this afternoon. I hope he will go back to the Department, gather together all the relevant stakeholders to urgently review provision in the light of the increasing need, and then propose radical reform to support better in-house provision, because it takes less than a few minutes of listening to teachers in our constituencies to understand how urgently that is needed.
I am happy to speak on school-based counselling services and thank my right hon. Friend the Member for Newcastle upon Tyne East (Mr Brown) for securing this important debate.
A silent epidemic is sweeping through our schools and through some of our young people. It is a wide-reaching and indiscriminate epidemic, yet we are so often unwilling to discuss it. I am, of course, talking about the mental health crisis in young people. A recent NHS report published in 2021 found that the number of young people with probable mental health disorders had been rising steadily since 2017. Currently, an estimated one in six young people between the ages of six and 19 have a probable mental health disorder. The pandemic was hard for us all, but it could be said that it was felt hardest by our young people, who were cut off from school, part-time jobs and their friends. Worse still, the pandemic and chronic underfunding of our NHS caused one of the largest backlogs of mental health patients that this country has ever seen. The situation is dire and changes are long overdue.
As children return to school, we must use this opportunity to build a more welcoming and available system for young people with mental health problems. While mental health problems can afflict anyone from all walks of life, for those children whose homes have unstable economic or familial dynamics, and when those disorders are also compounded by fear and stigma, schools are often the only outlet, the only safe place. Schools must be part of the solution.
I am sure that all of us here know someone who has suffered from mental health issues. Tragically, some may also end up taking their own lives as a result. It is in times such as these that we are often forced to ask ourselves: what if we had known sooner; what if they had got the support they needed? That is the essence of what I am putting forward today. What if we tackle mental health complications early? No child should be left to begin their life with baggage—a weight to bear for the rest of their lives. Schools provide us with unparalleled access into the minds of still developing young people and it is here that we can really make a difference.
It was an honour to present the proposal for the debate to the Backbench Business Committee with my friend, the right hon. Member for Newcastle upon Tyne East (Mr Brown).
The repercussions of the pandemic will have a significant impact on children and young people. As the mental health charity Mind has pointed out, covid-19 will leave a “deep and lasting scar” on the mental health of millions. The statistics are grim; some have already been cited. In March, my Committee heard from the Royal College of Psychiatrists that there had been a “massive” rise in children self-harming, with a 7% rise among girls aged 11 to 16 since 2017. In 2019-20, the number of children being referred for mental health treatment soared by 60%. We all see these awful statistics in our constituencies. A mother in Harlow came to me and told me that her otherwise healthy child had started compulsively washing her hands until they were raw and bleeding since lockdown and not being at school.
Are our children getting the help that they need? The Children’s Commissioner suggested that the number of children accessing the treatment that they need has increased by just 4%. I believe that there are ways in which we can turn the tide. Let us rocket-boost the Government’s proposals to put mental health professionals in every school, quicker than the current plans. The What Works Centre for Wellbeing has identified that good mental health and wellbeing at age 14 to 15 has a significant impact on educational attainment at age 18. The Department for Education shows that pupils with better emotional wellbeing at age seven were more than one term ahead of pupils with poorer emotional wellbeing. I have seen the impact of organisations such as Place2Be in schools in Harlow, including Stewards Academy, which benefits from its services.
This is not just about the provision of mental health; it is also about prevention and resilience. Last week, I visited a remarkable school—Newham Collegiate Sixth Form Centre—where I met students and the headteacher, who described the resilience and preventive work that the school does. It employs a coach to work with students to develop techniques to conquer their anxieties. School assemblies are used to teach the tools needed to manage highly pressured environments, using examples presented by sporting personalities. In private study periods, the desks are set up to resemble an exam hall to help pupils to become familiar with the setting. That is the kind of arsenal that should be replicated in schools around the country.
20 of 32 shown
I also want to say something about the special needs and significant mental health problems that child refugees face when they enter the United Kingdom and, eventually, the school system. I have received a substantial amount of casework regarding the situation in Afghanistan, including many requests for help to leave that country. I do my best to help my constituents, and I know that other MPs are in the same position. On the point about ring-fenced funding for mental health support in schools, I have written to the Home Secretary on behalf of my constituents and I look forward to receiving a response. It is a specific problem and it requires a specific response.
Existing provision of schools-based counselling is patchy. There is currently no legal requirement on schools in England to provide counselling services. There is, however, a specific requirement for such provision in Scotland, Wales and Northern Ireland. I understand that the Department for Education does not routinely collect school workforce data that would allow us to identify how many schools directly employed their own counsellors. Some employ their own, and some link up with other schools and share a counsellor. We know that provision is varied. Some have more casual arrangements with the voluntary sector or local authority partners. Some simply do not offer any school-based provision, and instead refer children to an external service.
There is a demand to make schools-based counselling services more consistent. More than two thirds of young people would prefer to be able to access mental health support without going through their GP. The Government’s roll-out of mental health support teams goes some way towards meeting the lower-level mental health support needs of children by offering group work and cognitive behavioural therapy for emerging issues. However, by 2023, the new teams will reach only about 30% of schools and colleges, leaving a worrying 70% with no additional early help or support other than funds that may be accessed directly via the education recovery plan.
Were the Government to continue to take an interest in this way, it should be possible to achieve something more. I give them credit for tentatively seeing the need to intervene in this area and I hope that today’s debate, across the Floor of the House, reinforces their appetite for further action.
Prior to this debate, I sought some thoughts from a handful of schools in my constituency, both primary and secondary, just as a snapshot reflection of need and provision. Anything I say from here onwards is not a criticism of the services that they, as schools, provide—quite the opposite. They are doing their absolute best, despite all the challenges that they face, which I hope to outline in what is left of my speech. It is clear that schools can play a vital role in supporting pupils’ mental health, given that they provide routine and structure to those in their daily care. However, as the need increases, it is clear that the existing provision, which in itself varies, is inadequate in meeting the need from not just a quantitative perspective, but a quality one.
Access to school counsellors may well be an integral part of ensuring that young people have access to support, but only if a school can afford to purchase the school counsellor. Most of my local secondary schools are in some form of academy trust and therefore they are able to pool resources and provide a school counselling service. One trust told me that, despite having a counsellor who works at one secondary each morning and one primary in the afternoon, and another secondary that buys in external support for three days a week, that is nowhere near enough. Another trust told me that it is lucky to have built up a specialist team of experienced professionals to plug the gap when other agencies are not on board. It has a qualified counsellor and a full-time safeguarding lead, but still it young people are crying out for help and, with the greatest respect to those working their socks off in schools, what they absolutely does not need is to be told there is a two-year wait to see CAMHS when a pupil is self-harming or has suicidal thoughts.
It is useful to be able to provide that support where the resources can be pooled to do it, but for a small school with a published admission number of 180, like one of the primary schools I reached out to, the funding is simply not available. If anyone thinks that there is not an acute need in primary schools for wellbeing support services, they are a fool. I have heard as many stories of self-harm, suicidal thoughts and depression in our younger age groups as I have in secondary. But if schools cannot afford a counsellor or a family liaison officer, they are left to rely on a mental health lead, which is basically a teacher still doing their job and all the things required on a curriculum, but having completed an online learning course. That course qualifies them to deal with mental health conditions as much as my FA level 1 coaching badge qualifies me to manage England.
I applaud the Government focus on this issue in guidance and, of course, the increase in funding for mental health services, but the sad truth is that more is needed. First, we need ring-fenced funding. One head said to me that
“if you put additional funding into our budgets it would get lost so whilst I hate this process, look at a ring fenced amount for the next 5 years to allow us to specifically fund mental health provision in schools”.
Secondly, as suggested by one of my local schools, the training of mental health first aid should be mandatory in schools. They legally have to provide physical first aiders; why is it not the same with mental health? The training needs to be funded and not just the preserve of schools that can pay £300 per person and release staff for two days of training.
Thirdly, the Government need to fund the provision of curriculum resources to adequately teach mental health and wellbeing skills. As a strong advocate of the benefit of mindfulness in schools, I believe that the welcome but patchy initiatives that help to support wellbeing while building resilience should become standard, funded practice. It does not have to be mindfulness—one of my schools has a pat-a-dog, which has had a remarkable impact on student wellbeing—but aligning mental health and wellbeing to the curriculum, as we do with physical education, would be enormously positive.
We need to reflect on the role of designated mental health lead. I am afraid my local schools think that although it was designed with good intentions, it will end up like the role of designated safeguarding lead, which is taken by a teacher, usually someone on the senior leadership team who, by the nature of their position, already has significant responsibility.
Finally, it is clear that schools are really good places to host hubs for wellbeing, so why not capitalise on that view and ensure that each cluster of schools has access to a mental health worker, a social worker, a school nurse and even a police community support officer, to deliver resource right into the heart of the community, for the most vulnerable within it?
The current system to tackle young mental health concerns is outdated. A 2014 report by the Health Committee found that CAMHS has a complex funding arrangement and a tier-based model that fails to truly integrate the range of organisations tasked with safeguarding young people. We must show that we have listened to those families who have struggled to access mental health support during the pandemic, when pressures on children and families were at an all-time high.
While I welcome the Government’s plan to expand mental health provision in schools, progress is painfully slow. I also fear that their current solution of increasing mental health support teams creates a “missing middle” of children who would not qualify for CAMHS, but whose needs are too complex for MHSTs. Yet again, the Government have put forward a plan that is unambitious and riddled with holes. We need a system that is more straightforward and co-operative and supports all needs.
Employing counsellors in every school could be a viable solution to this, and it is an extremely popular measure among the public, especially those with children under the age of 18. Only around 61% of schools and colleges in England offer counselling services, more often than not run by under-qualified counsellors. That is not good enough. Concerns about the number of trained counsellors in schools and whether they are mandatory should be addressed by the Government.
Citizens UK has estimated that hiring the required 13,394 fully trained, school-based British Association for Counselling and Psychotherapy accredited counsellors would cost only £554 million a year. That compares with the £1.4 billion per year currently spent on CAMHS. School counsellors in every school would centralise services, reaching the “missing middle” as well as helping the 65% of pupils not currently supported under the MHST model.
I am by no means suggesting that we should spend less on mental health services, but the current unsubstantiated spending does nothing to improve services. We need focused care that identifies the problem, communicates with students in the most appropriate way and co-operates with all local institutions.
For far too long, mental health services have been shunted to the back of the queue and not taken seriously. I was shocked to discover that, when questioned in July, the former Health Minister, the right hon. Member for Mid Bedfordshire (Ms Dorries), revealed that counselling services for schools were not yet mandatory and she did not indicate any plan to make mental health services mandatory. Instead, she indicated that schools should be given the “freedom to decide”. The mental health of our children is not a subject for party dogma over freedom. Would any responsible parent send their child to school without someone who is, at the very least, first aid trained with a first aid kit to hand? If their child then fell over in the playground or had an allergic reaction, they would hope that someone would be there to help them, so why should mental health be any different?
What my right hon. Friend the Member for Newcastle upon Tyne East and I think all of us in the Chamber are advocating is this: a safe environment for young people where mental health is no longer the unknown or unaccounted for. If we are ever to achieve genuine parity of esteem, that is the very least we should be doing.
The second element of prevention must be considering extending the school day for extracurricular activities. I welcome the Government’s £5 billion for educational catch-up, but this should also be about extracurricular activities, because we know that young people who participate in after-school clubs are 20% less likely to suffer from a mental health disorder. The Education Policy Institute found that a longer school day increases educational attainment by two to three months, and the Department for Digital, Culture, Media and Sport found that an extended school day can boost numeracy skills by 29%.
Why on earth will the Department for Education not at least pilot proper experiments of extended school days in some disadvantaged areas of the country, using civil society to provide those extracurricular activities, so that we can really see the difference they make; and then make that case to the Treasury? Headteachers such as the head at Newham would love to be able to offer their students extracurricular activities, just as the private schools do, but they simply do not have the funding to do so.
The Local Government Association estimates that the annual cost of mental health problems in England is about £119 billion, but rolling out counselling services to all state-funded secondary schools could cost £100 million per annum. That would provide for access to a school counsellor for at least two days a week for more than 90% of schools. It makes economic sense to invest in prevention, given that most mental health problems emerge before the age of 25.
Finally, we know that social media is a wrecking ball for young people’s mental health and wellbeing; it is damaging all of us, but particularly young people. Research from the Education Policy Institute and the Prince’s Trust found the damage that social media is doing to teenagers’ mental health, and 79% of Barnardo’s practitioners reported that children between the ages of 10 and 15 have accessed unsuitable or harmful content. One in three girls said that they were unhappy with their personal appearance by the age of 14.
The links are clear. Social media providers should not be allowed to duck their responsibilities, and I urge the children’s Minister to work with the Treasury to introduce a mental health levy for social media giants so that they can take responsibility for what is happening to our young children. Ofcom published a report earlier this year that stated that the revenue of social media companies is £4.8 billion. Introducing a 2% levy could create a funding pot of around £100 million, which could be distributed to schools to provide mental health support and digital skills training for our young people to build the resilience and online safety skills that they need. If the social media companies knew that they had to pay the levy, they might at last behave more responsibly towards our young people.
Social media firms and tech giants must do more, given that much of the problem is caused by the very apps and platforms that they have built. We must rapidly deliver the commitments in the mental health Green Paper to ensure that there is a mental health professional based in every school—sooner rather than later. Priority should be given to initiatives that support prevention and teach resilience, as I highlighted with the example of Newham Collegiate Sixth Form Centre. Only by doing so can we deal with this epidemic and ensure that our children and young people emerge from the pandemic resilient and able to climb the education ladder of opportunity.