Suicide Prevention and the National Curriculum

(Limited Text - Ministerial Extracts only)

Monday 13th March 2023 Westminster Hall

[Kerry McCarthy (Bristol East) (Lab)]

It is a pleasure to serve under see you in the Chair, Mr Stringer. I pay tribute to my hon. Friend the Member for Oldham East and Saddleworth (Debbie Abrahams). That was clearly not an easy speech to make. Coming from a large family—I am up to about 20 nephews, nieces, great nephews and great nieces; even the children are having children now—I cannot begin to imagine what it would be like if one of them sadly went down the same route as Jack, and her speech was incredibly brave. Having spoken in a debate last year after the death of one of my very close friends by suicide, I know you feel powerless when it happens but, at the same time, you think, “Well, by speaking up and using what powers we have in this place to try to draw attention to it, I am at least doing something that will help others.”

Before getting to the main thrust of my speech, I want to pick up on a couple of things that my hon. Friend mentioned. I too attended my friend’s inquest, and a prevention of future deaths notice was published. I did quite a lot of digging around beforehand as to what was going to happen at the inquest. There is an issue about how long these things take. He ended up having a fairly quick hearing, but some cases take a long time to get to that stage. It is not entirely clear what happens when these notices are issued, and I asked some parliamentary questions about this matter. It is one thing a coroner issuing a notice, but does it just end up in a big pile? Is action actually being taken and are efforts being made to ensure that lessons really are learned?

The other thing I would pick up on is what my hon. Friend said about university students. Sadly, University of Bristol had a spate of suicides, which was again why my attention was drawn to this issue. The issue also came up at an event I did last year with the band New Order, talking with the Campaign Against Living Miserably —the suicide prevention charity. One thing that came through was that, in some cases, universities do not feel that they can talk to the parents because students are classed as adults and, even though there are signs of distress, they feel they cannot go back to them. There is a need for a named adult when students register, so they can ensure parents know what is going on. Again, there were a few cases where that had not happened.

In some cases, as we have heard, there are few signs from young people and children, and families can be shocked by sudden incidents when they were not aware their child had mental health problems. However, a record number of children have mental health problems that are known and are on the NHS mental health waiting list. The situation is worsening rapidly, in part because of the pressures on children because of covid and the years of lockdown.

NHS stats from November last year revealed that one in six children aged between seven and 16 show signs of a probable mental health condition, and that jumps to one in four among young people aged 17 to 19. Half of all mental health problems are established by the age of 14, so it is imperative that we ensure today’s school pupils do not end up as tomorrow’s suicide statistics, whether that is when they are still young people or, as in my friend’s case, 30 or 40 years down the line.

I recently asked about adverse childhood experiences at Prime Minister’s questions. I think the Prime Minister just heard the words “children” and “mental health” and replied about what mental health support is available, rather than actually addressing my question. I do not particularly blame him for that, but I was asking about how we prevent children from reaching a stage when they are in mental health crisis because of things going on in their lives. We need to address not just the consequences, but the causes of poor mental health in children and, ideally, prevent those adverse childhood experiences from happening in the first place.

I entirely support calls to talk more about mental health. I encourage children to seek support if they are struggling, and I encourage teachers and professionals to try to identify whether children are in that place, but it should not just be about helping children cope. It should be about trying to ensure that children are happy and healthy right from the word go, whether that is trying to stop things like online harms; dealing with problems at home, including parents who may not be getting the help they need themselves, which will obviously have an impact on their children; or any of the other factors we know lead to children feeling in a dark place. Any strategy also has to include that.

As has been said, about four children a week—200 a year—lose their lives to suicide. I commend 3 Dads Walking for drawing attention to the issue, and for its work with the charity Every Life Matters. Going back to my earlier point, I see that the dads feel this work is the least they can do. I hope that we can do justice to them today, and that the Minister can show them that something will come of all their efforts. I also commend Papyrus and other charities for their work.

Bristol City Council published its updated suicide prevention plan last August. One of the seven action points is about targeting mental health among specific groups, including children and young people. That includes providing mental health first aid, a course called SafeTALK, and self-harm training to school mental health leads. I am sure we will hear more from the shadow Schools Minister, my hon. Friend the Member for Portsmouth South (Stephen Morgan), about Labour’s plans for mental health professionals in every school. The council’s plan also includes a “suicide pack” and a “self-harm toolkit” produced in Bristol, which are practical resources. Members have mentioned quite a few local charities. In Bristol, Off the Record works mostly with young people to offer them outreach, mental heal workshops, one-to-one counselling and so on.

People have already flagged that any sort of education in schools needs to be done in a sensitive and age-appropriate way. My concern is that talking generally to a group of children who are in a reasonably good place might be fine. If a child is already in a dark place, I am not entirely sure that is the best way of reaching out to them, particularly for an introverted child who has gone inside themselves. That is a question for the professionals, but I wanted to flag that up.

[Mr Robin Walker]

The hon. Lady raises an interesting point in paying tribute to 3 Dads Walking and everyone who has campaigned on this issue. We have heard strong support from across the Chamber for doing more. Does she agree that it is important to work with the experts to ensure that any curriculum materials are properly sourced and age-appropriate? Elsewhere in the RSHE curriculum, there has been a big backlash and concerns when parents feel that might not be the case. If this is to be done, it needs to be done well. Organisations such as Papyrus and CALM, which the hon. Lady mentioned, can play an important part in informing that.

[Kerry McCarthy]

That is absolutely right. We always talk about the value of tailoring things to the individual, whether that is job seeking or health support. That can be difficult when resources are tight. My plea is that we have the teaching assistants and extra staff in schools so they can get to know the children and learn their individual characteristics.

I want to flag the issue of neurodiversity. We already know that children mature at different ages, so determining what is age-appropriate can be quite difficult. I have personal experience of one case where a child was in mainstream secondary school, but was so distressed and alarmed by what she was being taught about drugs, crime, gangs and so on, that she ended up in a full-blown mental health crisis and went to residential provision, where she was diagnosed with autism. She went into a special school because that was a safer environment for her. That is just one example of how being taught about something is different for every child. Some of the available therapies, such as cognitive behavioural therapy, might not be appropriate for somebody with an autism diagnosis whose mind does not work in that sort of way.

The special educational needs and disabilities review, which was published last year, was jointly authored by the Health Secretary and the Education Secretary, but there was very little about the overlap with CAMHS. I know the Minister is not here to speak for the Health Department, but the role of CAMHS is crucial.

My other point is about what support is provided once lessons and that individual’s one-to-one support are over. I will end on that. I do not know what has happened to the suicide prevention strategy; I hope that we see it. I think I was told that it was imminent when I did my Westminster Hall debate last year, but I look forward to hearing from the Minister.

--- Later in debate ---

[The Minister for Schools (Nick Gibb)]

It is a pleasure to respond to this debate under your careful stewardship, Ms Nokes. I start by congratulating my hon. Friend the Member for Don Valley (Nick Fletcher) on the way he opened this important debate. It has been a debate with many deeply emotional testimonies from families who have lost loved ones to suicide, including a moving speech from the hon. Member for Oldham East and Saddleworth (Debbie Abrahams).

I also thank Andy Airey, Mike Palmer and Tim Owen for being here today and for their tireless efforts to increase awareness of suicide prevention. Through their campaign, 3 Dads Walking, Andy, Mike and Tim took on the challenge of walking between all four Parliaments, a 600-mile walk that has raised over £1 million to support suicide prevention, in memory of their daughters Beth, Sophie and Emily. Through the campaign, Andy, Mike and Tim shared personal stories of their kind, talented and much-loved daughters and the devastating impact that losing them has had on their parents, siblings, and wider families and friends. My right hon. Friend the Secretary of State for Education has taken a keen interest in the campaign after she met Andy, Mike and Tim in 2022, when she was serving as Minister for Care and Mental Health. I know she has written to them recently and hopes to meet them again soon.

In 2020, as Minister for School Standards, I helped with the introduction of education on mental wellbeing through the relationships, sex and health education curriculum. As my hon. Friend the Member for Ynys Môn (Virginia Crosbie) said in her intervention, we need to be able to talk about mental health. That is an important first step, but I recognise the concerns raised in the petition and in this debate and will do my best to address them.

The death of any young person is tragic, and we need to do everything that we can to prevent it. It is heartbreaking to think that some young people have suicidal thoughts and do not know how to address them, and it is heartbreaking that families have to go through the loss of a child with possibly no indication of their state of mind, as movingly pointed out by my hon. Friend the Member for Chatham and Aylesford (Tracey Crouch). We know that going to school can in and of itself be a protective factor for many young people, and we want schools to be places where emerging issues are identified and supported early and where pupils are taught to identify their own feelings and seek the right support at the right time. We need, as the hon. Member for Wythenshawe and Sale East (Mike Kane) put it so well, to help young people back to the path of hope.

The statutory curriculum guidance for RSHE sets out the detailed content that pupils should be taught. They are taught about the building blocks needed to develop positive and safe relationships and good physical and mental health. The content includes how to recognise the early signs of mental wellbeing concerns, such as anxiety and depression. Pupils are taught where and how to seek support, including who in school they can speak to if they are worried about their own or someone’s else mental wellbeing. I hope that that valuable knowledge will stay with children as they progress into adulthood, so that they will continue to look out for friends and know how to seek the help that is needed when they or someone they know is struggling and not able to take the first step in supporting themselves.

In addition to mental wellbeing, the health education curriculum provides content on the benefits of daily exercise, good nutrition and sufficient sleep, which can all have a positive impact on a young person’s health and wellbeing. Ensuring that pupils understand the links between good physical and mental health will provide them with valuable tools for managing their emotions. We want schools to develop curriculum content that is helpful to their pupils. Our approach is not to dictate how and when schools teach this content, but to ensure that they recognise that it must be covered in an age-appropriate and sensitive way, as my hon. Friend the Member for Don Valley said. The RSHE statutory guidance is clear that the subject of suicide and self-harm can be discussed as part of this topic, but it is important that teachers approach it carefully, because we have to acknowledge that, taught badly, it has the potential to do harm. We need to consider the issues carefully before making it an absolute requirement.

We know that mental health awareness, as already covered by the curriculum, can have an impact on preventing suicide. We have been funding a large-scale randomised controlled trial of approaches to improving pupil mental wellbeing in schools. The trial will provide evidence on what works to support children’s mental wellbeing and how it can be delivered in schools. The “aware” arm of the trial is testing approaches to mental health awareness teaching, including a school-based programme for young people aged 13 to 17 called Youth Aware of Mental Health, for which there is good international evidence that it reduces suicidal ideation. That has the potential to add to the work that we have already done to improve teacher confidence and the quality of teaching by developing online training materials and implementation guides that give advice to schools and staff on how best to support pupils’ mental and physical health.

The issue of social media came up during the debate. Teaching children to be safe online is another aspect of suicide prevention that is covered by the existing curriculum. The inquests into the tragic suicides of Frankie Thomas and Molly Russell found that unsafe online content, and in Frankie’s case the failure of the school to support her in the online environment, contributed to their deaths. As the hon. Member for Barnsley East (Stephanie Peacock) pointed out, life for this generation of teachers has changed beyond recognition, compared with the previous generation and generations as far back as mine.

We know that social media can be a force for good in relation to mental health. It is part of life and relationships for young people, but for it to be helpful we need to make sure the online environment is as safe as possible. The hon. Member for Blaydon (Liz Twist) raised that concern. Technology and the risks and harms related to it continue to evolve and change rapidly. As the hon. Member for York Central (Rachael Maskell) said, we need to be wary of the toxicity of TikTok, as well as of the dark web, which my hon. Friend the Member for Ashfield (Lee Anderson) mentioned. As my hon. Friend the Member for Colne Valley (Jason McCartney) put it, we must switch off the unrealistic expectations of social media.

Through health education, we are equipping children and young people with the knowledge they need to use the internet and social media safely, and understand how to deal with the content they encounter online. In addition to the statutory health education content, we have published guidance for schools on teaching online safety, which helps them deliver internet safety content in a co-ordinated and coherent way across their curriculum.

To check that RSHE teaching is having an effect, we are monitoring its implementation. We want to test whether schools are implementing the requirements with sufficient quality to understand what helps and hinders good teaching. As the Prime Minister announced last Wednesday, we have brought forward the review of the RSHE statutory guidance, which was originally due to commence in September 2023. The current content I have already set out on mental health and wellbeing covers a large amount of what it is important in suicide prevention, but we will look further at this as a priority area for the review and decide whether to add requirements on teaching about suicide. As part of taking a comprehensive, evidence-based approach, we will make sure we speak to the experts in the field. We plan to start the review as soon as possible.

[Kerry McCarthy]

The Minister talked about testing whether RSHE is having an effect by monitoring its implementation, looking at what is being taught in schools and so on, but what is being done to take it beyond that and look at outcomes? It is one thing to prove that children are being taught about the dangers of drugs, but we must see an impact on the number of children suffering drug-related harm, getting involved in gangs or, in this case, going down that path. How do we judge whether it is having an impact, rather than just whether it is being implemented?

[Nick Gibb]

The hon. Lady makes a very important point. The review will be thorough. It will not only talk to experts, but will look at the data and evidence and statistics from Ofsted and other bodies to ensure it is thorough and leads to the RSHE guidance document being the most effective it can be to deliver the aims and objectives of the RSHE curriculum.

[Tracey Crouch]

On the review, will the Minister commit to speaking to the parents and loved ones of those who have taken their lives to hear them tell their stories and explain why they believe passionately that this should be on the curriculum?

[Nick Gibb]

Yes, I can give my hon. Friend that assurance. Debates such as this are illuminating, and I am sure hearing such stories will help those carrying out the review of the RHSE curriculum.

Teaching about mental health is only part of the story. Schools can play a vital role by providing safe, calm and supportive environments that promote good mental wellbeing and help prevent the onset of mental illness. We should not, however, expect teachers to act as mental health experts, nor to make a mental health diagnosis. Education staff are well placed to observe children day to day, and many schools provide excellent targeted support for pupils with mental wellbeing issues.

To help education settings implement effective whole-school or college approaches to mental health, we are funding all schools and colleges in England to train a senior mental health lead. Over 11,000 schools and colleges have already taken up that offer, including more than six in 10 state-funded secondary schools in England, and we have invested a further £10 million this year to ensure that up to two thirds of state-funded schools and colleges can benefit by April this year.

That is in addition to record funding for children and young people’s mental health support through the NHS long-term plan, which commits to increasing investment in mental health services by at least £2.3 billion a year, putting mental health on a par with physical health, as my hon. Friend the Member for Penrith and The Border (Dr Hudson) has been campaigning for. That means an additional 345,000 children and young people will be able to access NHS-funded mental health support by 2023-24.

A number of hon. Members raised the issue of access to mental health services for young people. Despite significant extra funding, we know that too many young people must wait for too long before they are seen by a mental health professional. Last year, the NHS set out its plans to introduce new access and waiting time standards for mental health services. One of those standards is for children and young people to start to receive their care within four weeks of referral, but hopefully sooner than that.

As a result of the 2017 Green Paper “Transforming children and young people’s mental health provision”, which is a very significant piece of work, more than 2.4 million children and young people now have access in schools and colleges to a mental health support team, which delivers evidence-based interventions for mild to moderate mental health issues; supports each school or college to introduce or develop its approach to promoting and supporting mental health; and advises and liaises with external specialist services to help children and young people to get the right support and stay in education.

[Liz Twist]

I am looking at the petition organised by 3 Dads Walking. The Minister has given us some very important information about mental health support in schools, but this is quite simple: it is about talking to young people about suicide prevention and knowing that it is okay for them to talk about their feelings. Will the Minister say how he will approach that specific point in the RSHE review?

[Nick Gibb]

The hon. Member makes an important point. That is a matter for the review. It needs to be carried out with thoroughness and speed, but we also need to consult experts on the issue, as well as talking to families and young people who have important experiences to convey to the review. I would not want to pre-empt that review with my own opinions. We want to ensure that it is a properly carried-out review; we will then get the best possible outcome from it, not just in this area but across the whole of the RSHE curriculum.

[Rachael Maskell]

I would like to raise two further points. One is about teacher training, and ensuring that teachers get the right training put to them when they are going through their training. The second point is about parents. Schools are part of a wider community, and parents are obviously part of that community—knowing how to have those conversations with their children is really important. How will the review look, in a wider scope, at being able to provide the support in the right place?

[Nick Gibb]

I will take both of those points under advisement. The hon. Member is talking about the wider issue of parents; we are really talking here about a curriculum for schools. Of course, in due course those children become parents—they become adults and parents. Teacher training is a wider issue. First of all, we need to get the curriculum right, and that is what will come out of this thorough review of the whole RSHE guidance, which we are starting right now.

The Government have also committed to publishing a new national suicide prevention strategy for England this year. The strategy will reflect new evidence and national priorities for preventing suicides. The Department for Education has worked closely with the Department of Health and Social Care throughout the development of the strategy to understand what more we can do to reduce suicide and self-harm among children and young people. In answer to the question from the hon. Member for Bristol East (Kerry McCarthy), my Department and the Department of Health and Social Care are committed to publishing that strategy this year.

In conclusion, the mental health of children is a priority for this Government, and we know that schools can play a critical role in supporting children’s mental wellbeing. We will monitor implementation of the new curriculum and continue to work to improve teacher confidence to deliver these broad-ranging and sensitive topics to the best of their abilities—a point raised by the hon. Member for York Central. We will also continue the roll-out of training for senior mental health leads and mental health support teams to ensure that schools are getting the best support possible on pupil mental health.

I have set out the measures already in place and the ways in which schools can and do support pupils, including those with suicidal feelings. Once the review of the RSHE statutory guidance has concluded, we will be able to consider what more can be done to support pupils further.

[Caroline Nokes (in the Chair)]

I call Nick Fletcher to wind up.