Green paper on Child Mental Health lacks ambition, says select committee

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, says the Education and Health and Social Care Committees in a joint report.
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.”
The 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.

Exam pressure

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, informal 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.

Reactions to the green paper

Geoff Barton, general secretary of the Association of School and College Leaders (ASCL), said: “This report confirms ASCL’s concerns that the government’s plans for improving mental health support for children and young people do not go far enough or fast enough. The government’s green paper fails to address the critical problem facing schools and colleges, which is the fact that real-terms funding cuts are forcing them to cut back on existing counselling and support services at exactly the time that mental health issues are rising. The proposal for a designated senior lead for mental health in every school doesn’t address this problem, and may actually add to workload. And there are many unanswered questions about how the mental health support teams envisaged in the green paper would work.
“The green paper also fails to adequately address the most important issue beyond the school gates, which is the lack of capacity in local NHS services for students with serious mental health problems. Its ponderous plan to roll-out pilot projects to reduce waiting times over the course of several years is simply not good enough. The crisis is happening now.”
Paul Whiteman, general secretary of school leaders’ union NAHT, said: “We’ve been ringing the alarm bell about the mental health crisis in our schools, about the growing numbers of children and young people who are struggling, and more worryingly, about how long they have to wait to get help, even when they’re in crisis.”
“School leaders are reporting a serious – and growing – concern for children’s mental wellbeing. The demand for professional mental health services has increased in recent years, but funding has plummeted. This means that schools are finding it very difficult to get children the support they need.”
Sarah Hannafin, Senior Policy Advisor for NAHT, said: “The scale and pace proposed by the government’s Children and Young People’s Mental Health Green Paper does not go far enough. Just 20-25% of the country will be involved during a ‘Trailblazer Phase’ over the next five years. This means that significant numbers of schools, children and young people will not benefit as there will be little, or even no, improvement to provision in their area. This can only exacerbate the existing inequalities in accessing timely treatment and support for children and young people.”
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.”