26/06/18 – launch of the ‘Mental Health in Childhood’ Report and the case for a Secretary of State for Children.

Speakers: Helen Clark, Lead Author of the Report; Vicky Parkinson/Kate Day from the National Counselling Society; Steve Franks, Children First and CEO of Water Babies

26th June 2018

All-Party Parliamentary Group on a Fit and Healthy Childhood

The Launch of the ‘Mental Health in Childhood’ Report and the case for a Secretary of State for Children.

Chair: Baroness (Floella) Benjamin

Chair’s Opening Remarks:

Good evening everybody and welcome to this, the 36th meeting of the All-Party Parliamentary Group on a Fit and Healthy Childhood.

We have two matters to address this evening but they are connected. Firstly, we are here for the launch of our extremely timely report ‘Mental Health in Childhood’. (Download the report here.)

We will hear from our lead author, Helen Clark, and our sponsor, Vicky Parkinson, the Chief Executive of the National Counselling Society.

In all of our 10 reports, we call for a Secretary of State for Children and so we have invited along Steve Franks, the leading spokesman for Children First, to speak about that. Many of you may know Steve as the Chief Executive of Water Babies

I am sure you will have noticed the announcement over the weekend of chapter 2 of the childhood obesity plan, including Government’s aim to halve childhood obesity by 2030. Of course more needs to be done, especially on the activity side, but it is a step forward.

This Group has consistently campaigned through our reports and the work done by myself and other Officers for action.

Chapter 2 of the plan is a powerful endorsement of how your work on these reports leads to change.

It includes proposals for:

  • advertising  ban up until the watershed on TV ads re junk food
  • clearer and more consistent labelling on all food products in shops and supermarkets
  • trenchant action on energy drinks
  • ban on two for the price of one deals
  • ban on checkout confectionary displays
  • extension of items included in sugar tax
  • Daily Mile for primary school children

I know other organisations have pressed for some of these measures but I believe this Group is the only one which has campaigned for them all.

Many thanks are due to everybody who assisted in the writing, research and production of the report we are launching this evening on ‘Mental Health in Childhood’.

Our reports are truly a joint effort and represents the views of a wide group of people and organisations.

That’s really important because the issue itself is so important! As the Chief Executive of NHS England, Simon Stevens, said in his keynote address at the recent NHS Confederation Annual Conference in Manchester:

‘It is obvious that there is more unmet need for young people’s mental health services than probably any other part of the health service.’

Now, barely a day passes without the nation being assailed by all sections of the media with the latest horror story about a crisis in mental health services for children and young people. Everybody knows that in schools, colleges and universities, they’re at the height of the examination season.

It’s good at last that the stress that young people undergo, often in embarrassment, crippling isolation and with negligible sources of help, is being brought, (all too often, kicking and screaming) out into the open.

Something must indeed be done and there is not a moment to lose, both for today’s young people and those who will come after them. But something that not so many people realise, is that elsewhere, and away from all the publicity, children as young as three years of age are suffering mental health problems; in desperate need of help that they just aren’t getting.

As Simon Steven says, the nation is in the grip of ‘an epidemic of mental health challenge for our young people’ and urgent action is needed to reverse a potentially devastating train of events.

The Government’s recent green paper on Mental Health is nowhere near a full solution to the problems.

However, rather than damning Government’s efforts to confront the problem, as many have done, our report instead chooses to be constructive.  We welcome the fact that the Government has at least addressed the thorny and difficult issue of mental health services for children in the first place.

Some of the core Green Paper recommendations are absolutely correct, such as the insistence upon early intervention and that counselling services should be based in schools.

Yet all Green Papers, whatever their good intentions, are ‘works in progress’ and the time between them and eventual legislation is a window of opportunity for organisations to work together to influence policy-makers to ‘get it right’

Of course we support the recommended move to establish essential counselling services in schools – but these must be properly resourced so that we don’t have services in some parts of the UK starved of resources, forced to play ‘catch up’ and cut corners to devastating effect on children’s life experiences now and their prospects for the future.

I hope that today, we’ll start by discussing some of the themes and ideas in this APPG  report and that you will take them back to your colleagues and professional  organisations. We want UK children to get well, stay well and this means that we will all gladly join forces to ensure that the eventual mental health legislation from the Government is as good as it possibly can be.

I will be tabling Parliamentary Question based on the report but we must all do our bit. Please do send the report to your local MP and other contacts in Parliament and make the case for vastly improved mental health services for children. Please share it widely with your colleagues and friends.

Thank you once again to everybody who worked on this report.

Helen Clark

The take-home messages from this meeting are firstly, that this is just the start. Having produced the report, the hard work starts as soon as we all walk out of that door, by spreading the word and campaigning and keeping up the pressure on Government.

Secondly, it has been a strange experience while writing this report that various themes seem to have been hitting me on all sides from the media. Coincidentally, this report was being put together at one of the most stressful times in the academic year for our children: exam time. As in previous years, there was a lot of media attention on exams but, unlike previous years, this time the focus shifted and there was a lot of coverage on what children suffer when they are facing exams but also afterwards, when they move on from school to university, apprenticeships etc.

The other topical story has been mobile phone use and screen time, with Matt Hancock (Secretary of State for Health and Social Care) hitting the headlines with an article about the banning of mobile phones in schools. The subsequent discussion focussed on classroom management and discipline, missing the point that we make in Chapter 10 of our report that it is screen time itself that is detrimental to health, with excessive screen time leading to Screen Dependency Disorders.

Today’s Evening Standard includes an article entitled “Use Health & Safety Laws to Protect our Children on Social Media”. This article focussed on controlling negative content rather than time spent online, and again missed the serious point that, although of course negative content needs to be addressed, the time that children and young people spend online is an equally pressing problem. It’s not just that this detracts from the amount of time they could be playing outside or doing more active things, but also that it is detrimental to their mental health. An extreme example recently was that of a child who had developed a severely dilated bowel through not going to the toilet because of his addictive online gaming habit.

The doctor who reported this quite rightly said that the problem has crept up on us: we noticed problems with obesity and sleep first but now we are seeing more and more physical and mental health problems in young people who cannot tear themselves away from their screens to meet basic bodily needs like eating, toileting, sleeping, etc. The World Health Organisation (WHO) has recently acted to classify computer gaming disorder as a mental health disease.

We’ve got to get the Government to recognise and act on this and persuade them that we need regulation in terms of screen time and smart phones, and to move it all to where it should be: into the Department of Health.

You can download the report here.

Vicky Parkinson, National Counselling Society

This is a timely and important report which we can use to lobby and campaign for change. As shown in this report, 850,000 children and young people have a clinically significant mental health problem. That’s not just a general problem: that’s a clinically significant problem. 1 in 4 children show evidence of mental ill health, mental health services are turning away on average 25% of referrals, and less than 1% of the NHS budget budget is directed at children & young people’s mental health. These figures should be a concern for all of us as things are only going to get worse if something doesn’t change.

Although we’ve seen increasing discussions about mental health of late, including promises from Government to address to increase funding to support better services, the reality is that the level of support within schools and education settings is still poor.

There is not enough money to suitably remunerate qualified therapists, which leads to a  shortage of professionals and considerable pressure to those we do have to take on larger caseloads to reduce waiting lists. Of course, that just leads to burn out, disillusionment, and people leaving the profession.

Early intervention is highly cost-effective in preventing the escalation of any condition. As shown in the report, targeted therapeutic interventions in schools cost about £229, but derive an average lifetime benefit of £7252: a cost-benefit ratio of 32-1. Money is an important driver here and those figures should warrant some serious consideration.

Placing services at the heart of schools makes sense but we must have the resources there to facilitate this whole school approach. Mental health is not “one-size-fits-all” – we need a flexible and person-centred approach to improve people’s lives. The report recommends a whole-school ethos with strong community links promoting emotional wellbeing in children and young people, and preventing the development of mental health problems should be a major priority for this Government.

We’re certainly committed to the recommendations that are in this report and to making sure they come to fruition and make a real lasting change. Now I’d like to hand over to Kate who will give you a real insight into the day-to-day experience of being a therapist.

Kate Day, National Counselling Society

I’ve spent over 20 years working with children, young people and families, and I’d like to share with you “a day in the life” of what a therapist in a school actually does. Obviously, I’ve asked all the young people for permission to share details with you, and they were all very enthusiastic that a wider audience should hear their stories.

Before arriving at school I start off with a walk which gives me time to reflect on the young people I’ll be seeing. I find that this gives me support during the day. When I arrive at school I’m greeted with welcoming smiles from teachers and pastoral workers, who are so pleased that I’ve arrived to help their young people: they care just as much as we do.

In my practice room there will be a pile of messages from reception and a few notes pushed under the door from children who want to see me. The room has a calming décor and atmosphere which can offer the children an escape from the chaos that is going on in their minds.

My first session is with a 16-year-old boy who, when I first saw him, was selectively mute. I knew his background: he has been fostered since the age of 10 because his dad is in prison and his mum suffers from agoraphobia and schizophrenia. After a time spent building trust (crucial for long-term intervention) he has shared his story about the day his father was arrested in front of him, the subsequent bullying and isolation that he suffered and the recent recurrent nightmares of the day of the arrest. I believe him to be experiencing post-traumatic stress disorder.

Next is a 12-year-old girl with high levels of anxiety whose mother (a single parent) has recently been diagnosed with breast cancer. She’s understandably anxious about who is going to take care of her mum, but also about who will take care of her.

Next is a bright, clever, funny 14-year-old boy who has recently been excluded twice for dealing drugs on school premises. He lives life completely on the edge, believing that his drugs habit makes him calmer and stimulates his creativity. I gently reflect back to him over time how he has stopped playing his guitar, distanced himself from friends and lost interest in learning. He has recently suffered feelings of depression and paranoia.

In the afternoon I support a teenage girl with a history of sexual abuse, who tells me that she has been blackmailed online about some naked pictures. She is incredibly vulnerable and suicidal. I work with her to discuss how the photographs might be reclaimed before they are further circulated but more importantly we work with her feelings of shame and to help her realise that this is not her fault.

After seeing a 15-year-old with an eating issue and OCD who is being supported with long-term counselling, there’s a new client. He’s an angelic-looking 13-year-old boy who has been referred with anger issues after smashing another boy’s head against a lamppost. He is struggling to understand why it happened and describes a sudden rage and blind panic. Later that week in another session he appears frozen as he remembers his step-dad doing a similar thing to his mum. He feels guilty that he didn’t protect her. I remind him that he was a child and reassure him that we will find ways to address his anger issues, and he wells up with thanks.

I conclude by writing notes, writing letters to GPs, CAMHS and other services, and I push and I push for the rights of the child to access crucial services. When I’m working with individual children I’m increasingly becoming aware that I’m not always enough, and I’m also becoming acutely aware of the dismemberment and privatisation of NHS and mental health  services in my area.

I’d like to end by sharing with you how much I do love my job. I feel humbled but also privileged to have the one-to-one human contact – just us in the room with no phones or distractions. It is my belief that it is this relationship that heals, that makes the biggest difference. It is this that drives my practice. I believe that every child has the potential to thrive even when faced with the darkest of times. It is our moral responsibility to urge our Government to ensure that crucial and effective mental health services are available to be delivered to every child, in every school, in every area.

Steve Franks, CEO, Water Babies

I’m here to make the case for a Secretary of State for Children – a voice at Cabinet level to champion the needs of children at the highest level of Government.

Now I know that I am mostly preaching to the converted here. You are all – like me – deeply involved in the world of children.

You are all – like me – members of this excellent All-Party Group that has worked tirelessly through its many powerful reports to lay bare the severe challenges facing children today and, most importantly, to propose solutions.

What has become apparent is that every aspect of what it takes to have a fit and healthy childhood is under pressure.

I know that we all struggle in our particular fields to resist, challenge and reduce those pressures –  fighting for space for children to grow strong and healthy, and equipped not only to survive in the adult world but to flourish in it, and to contribute to a healthy and happy society.

But the challenges are enormous and affect every aspect of children’s lives. Wherever we look, we see major problems.

We all know about the dreadful and still growing obesity crisis – at least this is getting a lot of attention, and Government needs some thanks for taking some real steps. Much more needs to be done but we must offer support as well as criticism to Government.

We all know about the drastic reduction in physical activity, so vital for physical development, socialisation and mental wellbeing. Not much is being done about this.

Our latest report sets out in detail the rapid rise in mental health problems amongst children. Government must be made to pay attention to this. Their Green Paper is nowhere near strong enough and even that is only a discussion paper.

The education system itself is under severe financial pressure and teachers are so demoralised that huge numbers are leaving the profession. Schools need to play a much greater part in healthy development and many try but it is hard to demand it from them when so many other pressures exist.

And it is also hard to demand it from them when many children start school unable to speak more than a few words, understand basic instructions or even use the toilet.

The reduction in time and space for play, the very variable quality of nursery provision, the physical inactivity and mental pressures created by social media and screen time, the constant stream of marketing especially for unhealthy foods. I could go on and on and on and still miss topics worthy of mention.

The awful truth is that the challenges are so wide and so deep that our children could become the least healthy adult population in living memory.

Of course, it is important to remember amongst all of this is that many children still do have happy and healthy upbringings – but this is becoming more difficult in areas of deprivation. There are social, economic, cultural, ethnic and geographical divides.

I know we are all doing what we can to fight the good fight in our own fields. We campaign for better provision, and for greater understanding of the needs of children, and for more priority to be given to those needs.

And sometimes we make progress, and celebrate those achievements, but more and more it is becoming obvious that firefighting on an individual policy front is just not good enough.

One step forward, two steps back is not good enough if we are really going to turn a tide that sometimes seems unstoppable.

We need Government to recognise the severity of the challenges and the consequences of failing to address them.

The sector needs to come together and we need leadership to help us to do that.

We need a real champion at the heart of Government to bring all these issues together and devise solutions that will be more than just firefighting.

There is a voice for women in the Cabinet – why not a voice for children?

I am determined to drive this agenda forward and I have asked Phil and Helen to help me with this.

On your seat you will have a short statement calling for a Secretary of State for Children. We want as many organisations as possible to endorse this.

Please let Phil know if we can add your name. He can also send you a long briefing document making the case at greater length for circulation in your organisation.

I thank you for your time. I hope that you can support us. Best wishes for all your efforts on behalf of children. I’m happy to take questions.

Questions and Comments

Questions, comments and a little more discussion followed, and then the meeting closed at 7.15 pm.