Health and Social Care Committee and Education Committee

Wednesday 10th June 2026

(began 4 months, 4 weeks ago)

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09:30
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None Portrait Speaker 2
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Absolutely. And thank you so much for inviting me to, to give evidence today. So my background is that I, I basically studied medicine because I saw what A and E was kind of like on the front line. I was really interested in kind of dealing with emergency care. I liked the idea of science. I didn't really have a particular interest when I was younger in going into mental health. Um, but when I started working as a junior doctor, I think the thing that shocked me the most wasn't necessarily the car accidents and so on.

It was the sheer volume of mental illness you see in A&E. In fact, it was just utterly shocking. And not only the presentations we'd see, but the number of people who come back. And I quickly realised that there were so many young people that were coming in with, say, self-harm. I was patching up their wounds and getting them referred, and then they'd come back in a few weeks or months later. In fact, there's one girl I remember who I repeatedly would patch up her wounds.

And as a human being, that is just utterly devastating to see. So I think that was my first realization that we clearly have a problem. Um, started campaigning in 2018. I first went to Downing Street to meet Theresa May, who was the PM at the time, and spoke about the changes that were needed in education, because I felt like that was a huge area that we could support young people. Um, and then as you kind of alluded to, um, during the pandemic, while I was working in A&E in Lewisham, unfortunately, my brother died by suicide.

Um, he was 19 at the time. He had a whole career future ahead of him. Wanted to be a doctor, had a place at Southampton Medical School and yeah, he took his own life and that was, um, you know, my life has always been before and after that moment and it's, it's been pretty horrendous for my family, but we've tried to kind of use, um, what has happened to, to prevent. It happening to other people because it's utterly devastating. And as my mum says, you know, when, when you lose a young person to or anyone to suicide, it's like dropping a pebble into a bucket of water.

The ripples go far and wide, and the effect on everyone who's ever met is is huge. So off the back of that, I started campaigning. Um, gained huge traction on social media with some of the key things that people felt needed to change the, the government at the time brought me in and said, look, let's look at some of these issues. Why don't we have you as a volunteer?You can sit between. So my role as mental health ambassador was to sit between kind of ten Downing Street, sit with the Department of Education and Health and also the charity sector in young people to try and sit as a middle person.

So, um, there are many things that I kind of saw that were positive, but also things I think were quite challenging. One thing I'd like to acknowledge today is one of the biggest things I saw that was a real challenge for us. Was that different departments, um, didn't really speak to each other enough. And I also, I found that often people you'd go to Department of Education and say, actually, this is actually a Department of Health issue.
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None Portrait Speaker 2
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So, I mean, there are there are so many factors that seem to be contributing to what's happening right now. And it's not just young people, it's parents. I hear from teachers. I did a talk the other day to around 600 people. Many of the audience was not just young people, parents, but also teachers as well. And clearly this issue is multifaceted. There are many compounding elements that come to cause what we're seeing today. And that's kind of what I'm saying about the kind of need for across government approach to this, you know, yes, social media is definitely part of the challenges that we're, we're seeing, um, not just the harmful content, but actually the way that the algorithms are designed to keep you endlessly scrolling, for example, there's huge concerns to the effect on that of that on the developing brain and the effect on that in causing kind of loneliness amongst young people who are not safe outside and meeting friends and, and doing these kind of things.

I think the social media is definitely a big part of the issue. But also I think young people are saying, actually, when they do want to get help, because actually they are much more emotionally literate than perhaps older generations, the waiting time for, say, early intervention, early support is incredibly long. And so what I heard literally the other day when I was speaking to parents and young people is that they are actually recognized by the teachers, for example, of having early emergent mental health issues, often quite early.

But the the time between that issue and actually receiving the support they need can be very long, which means that allows a lot of time for issues to become very big. I mean, it's one of the main reasons that I worked for a long time on the Early Support Hubs initiative, which actually spoke to Prime Minister Keir Starmer just before his, um, just before the general election. I'd worked on that for a very long time, because the point of those hubs is to sit there in the middle of the community to support people with emergent issues, and I think that is such a key problem, is that it's all very well people talking more about mental health.

But when someone comes forward with struggles, they need to be seen and supported early. And I think that there's no doubt that the earlier you intervene, the quicker you can get people back into education or back, you know, feeling well, but also economically, and this is a big thing we worked on with the hubs. It's a hell of a lot cheaper as well. It's really expensive to provide care and tertiary level. You know, in terms of seeing a psychiatrist, community based support is really important.

So if I was to summarise, social media is a huge impact. Definitely the need for early intervention, but also the recognition of the challenges young people face. I mean, the report that's coming out, about a million young people struggling to find work, one of the top cited, um, concerns around mental health and the challenges young people face in the working world. So a holistic view, I think is, is desperately needed.
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None Portrait Speaker 2
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To be perfectly honest, when I came into the role, I kind of felt entirely overwhelmed because there's so much to do. And I had a very good bit of advice by someone, um, in this area who said, focus on focus on a key thing here, really target what you want to achieve. And for me, that was the support hubs. When I came into the role, it was the agreement was getting 80, 90 million towards mental health support teams, which I achieved coming into the role.

And I was calling for the national roll out, but my focus was on these hubs. So I was there since the start, and I have seen even, um, hubs that have been run in charitable ways. The impact it has, it is, it is utterly unbelievable. It brings communities together. Young people have a place to go, not only just for support, but there is a sense of belonging. I think young people say like, you don't have youth clubs anymore.

There's not the playground, I guess, that you can kind of go to. And there's many reasons that that has happened, but these hubs provide a real 360 for young people. And I guess I was very happy to see that the pilot hubs were funded. I was slightly disappointed to see we didn't go to national rollout, because I think our evidence and what we put forward was strong enough to actually go for national rollout. But to answer your question, I think it's so important, like we are desperate.

If you ask GPS, if you ask teachers and parents, we need to have a community based support system, the mental health support teams in the schools that they're in that I visited are doing a great job. And obviously, Camhs is there to provide high level need, but people are lost in the middle. And these hubs can provide that support. I genuinely believe that national rollout of those early support hubs would be a cost effective strategy, but also one that would be hugely welcomed by young people, parents, teachers and GPS.
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None Portrait Speaker 2
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Social media?It's important to say, and I'm someone that. Well, I educate through social media. I create content that goes out to millions of people. Hundreds of millions of views across videos that I've talked about, um, spotting signs of, of, of people struggling how to look after your mental health. There are many other creators, big and small, who really have positive impact. I mean, Ben West is probably worth a mention with his reasons to stay campaign of wonderful person that in many ways have a very parallel story.

And I believe as of yesterday, when we spoke, 3.5 million letters have been received by people who were looking for reasons to say so. There are many reasons that social media is very good, but that doesn't mean you can ignore the harm that it can cause. So, um, you know, when you look at that sector, my big concerns are a few things. First of all, um, are we actually regulating what social media companies do?And the online safety bill, which was something I was very supportive of.

And I'm really pleased that that step has been taken. It's really important. It looks a lot, I think, at content. But what about design?So how are these how are these platforms designed?Are they allowing children to endlessly scroll, for example?Yes they do. So I think a big part of our our focus needs to not just be about content, which is hugely important, but how are these designed?And I guess the question which which comes up is what do we do?I think part of it needs to be education at school.

Um, the education system was built, but the world is moving much faster than it evolves. Um, AI, social media, all things that young people are now going to have to deal with. I think they need to be educated on how to use it safely. I mean, there's a lot of conversation about a ban at 16. The challenge is if you don't train people, basically train people how to use it, you'll get 16 and still have no idea. And a lot of parents I literally spoke to the other week were saying, it's really hard because I'm trying to support my child and I have no clue what half of these apps are, how to use them.

You know, the education piece goes far and wide. But on the other side of it, we have to look, as I say, at the social media apps and consider that, yes, they play important role. I think that there can be a positive impact, but we can't just allow a free for all. There needs to be control. There needs to be responsibility. And these companies do need to take a a look at themselves and think, actually, are we doing everything we can?Because I don't think they are.
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None Portrait Speaker 2
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I think the, the truth is here is that when you look at the number of people benefiting from social media, it's huge. And even for me personally, when I was diagnosed with ADHD and autism, the sense of community I had from those communities who feel like me, look like me and experience what I've experienced has been, quite frankly, more important and helpful to me than than any other health care that I've received, to be honest, because it's belonging and there are many people who are marginalised who actually a lot of their connection comes through social through social media.

So that's important to, to recognise. But fundamentally, for young people, the risk of harm, yes, through content, but also through addiction, through phones and the algorithms is something you you cannot ignore. And, you know, my, I guess my, my concern of a, a ban, for example, would be, how are we going to police that?Because in Australia, my understanding, my understanding as we speak today is that there's been a huge challenge of enforcement. For example, there is a ban right now under 13 year olds in this country are not allowed to use social media.

And yet all parents, we all know that they're getting on there. And the question is, if they can't access that, will they go to darker parts of, of, of the web?So it's a very complex situation. My concern is that if we focus too much on just the ban without considering the role of the social media companies and putting pressure on them, will we just miss you know what I mean?We focus so hard on this that we forget to push them. That's my kind of concern.

I don't think social media is going it's it's a huge thing. It's a part of everyone's lives. So now it's a question of how do we manage it?And yes, police it to an extent.
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None Portrait Speaker 2
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Uh, well, I have to say early support hubs, clearly, I believe in them wholeheartedly. And that that had cross-party, uh, sorry, cross coalition support, which is, is not always the case for interventions and mental health support teams, not just from a data perspective in schools that they've been rolled out in, but also like going to the schools themselves. You know, I got to speak, I went with Will Quince, actually, and we spoke. I went to many schools, but I went to one school where the teacher was saying, I cannot tell you the difference this has made, not just in the experience of the child, but in the experience in the classroom.

Because when you look at um, say, class behaviour, even class attendance, children that are struggling, that are unhappy, that are facing friction, that friction isn't just held within the child, it's spread across the classroom. And I actually have a person in my life who's, who's a teacher, who's a primary school teacher. And we were literally speaking yesterday, uh, about this. And, you know, it supporting the mental health of young people isn't just supporting their mental health. It's supporting teachers, it's supporting parents as well.

I mean, let's be frank, we are losing so many teachers. I mean, look at newly qualified teachers in the first five years. The dropout rate is huge that we can't ignore that. And one of the most common cited reasons is burnout and workload. And also managing classroom, um, experience and behaviour. So mental health support teams are hugely important. I think the general, general thing that I saw over the years and what I've learned, I guess I have an interesting perspective because I don't see huge depth in everything.

I've kind of got to see a little bit of a lot, which in itself is a useful perspective. Moving things upstream as much as possible seems to be the most effective way of supporting mental health, not just in terms of the individual, but economically as well. So as much as you can move into early intervention and even prevention based approaches, it seems to really improve the outcomes. And I guess that's just sometimes stepping back and realizing like, are we actually preventing?And when there's a problem, are we intervening early?Because if we're not doing those two things, the problem is going to come back later.

It's going to be to start just to finish.
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None Portrait Speaker 3
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Sort of.
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None Portrait Speaker 2
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I think if you go back to actually what was I heard some say the other day that if you look at the role of, say, for example, the teacher, you know, a teacher's role is a very important in a young person's life. And we can easily get pulled in thinking about exams and learning education, even one good adult in a young person's life can provide stability and ability for that young person to, to grow and move through that system and develop into a, into a healthy, resilient adult. And the pressure on, for example, teachers is so high, they're not able to spend time on that core relationship that they have with children.

So I guess what I'm trying to say is that we need to make changes to create a school approach, for example, that as a whole school approach towards young people's health. So yes, that's educating on how to look after yourself, finances, for example, people are often shocked when I say we should be teaching about financial health. What is one of the biggest causes of stress and anxiety in adults finances?I often I've gone to loads of universities, also workplace and I say, hands up who left school here with a basic understanding of what a savings account is, what is inflation?What's interest rate?You know, for example, a topical thing at the moment.

How many people in this room has gone to university actually understand how the student finances funded?Like what have you signed up to?Do you have any clue?And yet that is obviously a big cause of stress in an adult. So we need to teach people about all of the things directly and indirectly that affect their health and also provide an environment that is supportive of that. And yes, of course, that goes beyond the classroom that goes into housing and social care, that goes into your policy, that goes into supporting groups that are marginalised, for example.

And that's why it isn't easy. I mean, the clear thing I learnt of the 4 or 5 years isn't easy. What you have to do. And but that doesn't mean we we shouldn't take action. We have to pick our things and we have to go for it.
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None Portrait Speaker 2
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I think, you know, speaking quite frankly, I'm speaking in a room of people that clearly care about this issue. You're all here. We're all here because we care about it. But I think that, um, a lot of conversations that I heard when I was doing the work I did, um, were not so positive. And it was kind of like it's, you know, snowflake, it's, it's, it's all, I think kind of slightly. People have a view that was overhyped.

And this is almost like making something out of nothing. I mean, we've heard even recent comments about ADHD, which are infuriating. And, you know, people still ask me, you know, are we overdiagnosing?Is it a bit of a fuss?You know, a Cambridge University study showed that, um, the. A woman undiagnosed with ADHD and untreated on average lives eight and a half years, a shorter life than a neurotypical woman. It's six years for men. There's actually a very interesting question about the disparity, by the way.

Um, between the two, but I think a lot of that was very frustrating at the time. I think we have shifted on, and that's why I feel that we're in a good position to act, because I think there is political will. The fact that we sit with cross-party and cross-departmental conversations like this, we've got multiple different inquiries and evidence sessions into social media, into what we're doing here today. We are well placed to do something, but we do actually have to act. And I guess my concern is that this was done like ten years ago, one of these inquiries, right.

And not a huge amount was really achieved in that time. I think my, my hope and my plea, I guess to you, to all of you, is that we do need to act based on what we hear. And that isn't easy. I think there's difficult decisions. And clearly, again, as I was told by Treasury and by departments, there's finite amount of money, but money that you spend on young people is very well spent because your working adults, they're the people currently that are struggling to the million people that are not getting into the working world, and there is no area of life that won't benefit from a healthier group of young people on.
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None Portrait Speaker 2
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Yes, there is. There is a risk. And, you know, I'm aware that, um, just during the Covid times when I was in hospital saying, look, things are really bad here in Lewisham, seriously bad. Other people were trying to say, no, it's not, not a problem. So sometimes very noisy voices become very loud. And that is a challenge in itself. Misinformation online is a huge challenge, but the opposite is, you know, staying silent and not contributing to that conversation is a mistake in itself.

But I yes, I think it's so important that that is not the primary and certainly shouldn't be the only place that people get information part of, to be honest. And I actually spoke about this recently, that I think part of what we need to do at school, particularly with AI, which is a separate, broader conversation, but also social media, is to give young people the skills of critical analytical thinking. It doesn't need the same level, perhaps, as what we have to, to look at evidence or I've had to do at medical school, but I think we should arm young people with the skills to question who is talking, what is their credentials?Does this sound too good to be true?Does this sound extreme?And if I'm in doubt, where do I check this?So, for example, I tell young people, you know, if you see something you're not sure about, about mental health, look on the hub of hope, or go to young minds and actually check what they're saying.

And if in doubt, you know, get, get information from your doctor. So giving children those skills is important because ultimately you're not going to silence those, those voices. So yes, it's a concern, but I think the answer is probably equipping the skills to deal with it. Thank you.
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None Portrait Speaker 4
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Thank you.
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None Portrait Speaker 10
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Yeah, I'd agree with everything that's just been said. And just add a couple of things to that. I think if we look at when children and young people's mental health starts to decline, we go back to the early 20 tens. So around 2012, that's when their mental health starts to deteriorate. And we need to look at some of the patterns of what have been happening over that time. We've talked about rising child poverty, rising inequality, lower living standards, but also the infrastructure of support that builds resilient young people and children.

So our early intervention services like children's centres, youth clubs in particular, there was a 70% decline in investment in youth clubs in that period. We know they're really great for building young people's resilience, but also the patterns in how young people have been playing have changed. So we know that play is kind of fundamental to our development and to our wellbeing. Children play 50% less now than the previous generation, has a range of contributing factors to that. And then I'd also just add the way that our education system has shifted in that time.

So we've gone in that period of time towards an education system that prioritizes attainment above all else. That relies on a high number of high pressure exams that young people tell us, make them feel very anxious, make them feel like that period of their lives is very high stakes, and make them worried about their future. And we heard, um, also, I would echo the point around uncertainty. Young people describe an incredibly turbulent time and the huge disruption of the pandemic, but also the feeling of precarity in the geopolitical landscape, the worries they see their parents have about money, about the future, and the worries they have for themselves, about their own futures, create a feeling of anxiety.

And I absolutely echo the point about girls and young women. I think we too often forget young girls and young women in the discussion about children and young people, and particularly at that older age, you know, they experience almost double the rate of poor mental health as boys and young men in that 16 to 25 age group. So I'd really encourage the committees to look into that, too.
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None Portrait Speaker 4
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Sorry.
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None Portrait Speaker 10
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Can you repeat.
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None Portrait Speaker 1
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Thank you. Caroline.
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None Portrait Speaker 10
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Thank you. Yeah. We're seriously concerned about what we're seeing in children and young people's behaviour with social media. We're looking at a generation of young people that are addicted to their phones, that are spending hours upon hours every day on their phones. Childhood has become more isolated, more lonely, and more time is spent indoors. Um, and we're really worried that the impact of that will ripple through generations to come in terms of how that's shaping the minds of young people, I think we need a cultural shift in terms of how we approach social media.

There is no other product that we would let be shipped out to young people in the way that it has been, and we would not be letting anything that physically harmed young people to the extent that it harms their mental health and be permitted to be in their phones, in their bedrooms all the time. In terms of the evidence, I think we have a challenge at the moment with the conversation around waiting for the evidence of the causal link between social media and children's mental health, there is evidence to suggest there is a clear pattern.

Children who spend more time on their phones have worse mental health. That was clear in the Amy Orben review that the government commissioned. We also know that social media has significant impacts on things like children's sleep, and poor sleep has terrible impacts on our mental health and wellbeing. Children who spend more time on their phones have lower confidence, but it also catalyzes a lot of the problems that we've heard described that our kind of broader. So if we think about girls and young women, um, sexual violence and harassment that has skyrocketed in terms of their experiences of it on their phones.

So it's also about the way that the unsafe content they're seeing is influencing their experiences. So we think we need to stop waiting for the evidence, and we need to take a precautionary approach, get children off their phones, and place the onus on tech companies to prove they're safe, rather than holding out for that causal link.
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None Portrait Speaker 4
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Thank you.
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None Portrait Speaker 8
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I'd like to start this response by what a young person directly told us. I think as someone who was thrown out of education because of my health issues and had a period of time when I was completely housebound, I didn't leave the house for months on end because my health was that bad. Social media at that time for me was an anchor because I stayed connected with people online. Without that, I wouldn't have any connection at all. But I think part of the issue with it being so much of an anchor was that I was more impressionable because I kind of clung to whatever content I could because it was all I had.

And so I was a lot more glued to social media than perhaps I should have been. But there was no alternative. I guess. And I share that quote with you because the young people who we work with have told us quite clearly that for them, the. Line space does bring a sense of community, and it brings a sense of community at a time where other spaces for young people have disappeared. But equally, they're also cognisant to the risks, the concerns, the worries of social media that I think we all are.

So for young minds and what we've heard for young people, our focus really is putting the responsibilities back onto the tech companies and start making sure that we always think of safety by design. And I go back to this cross-government strategy in mental health. It is a cross-government response and another opportunity to take into account something that does cause harm to young people if it is not delivered properly.
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None Portrait Speaker 4
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Um.
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None Portrait Speaker 4
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Thank you.
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None Portrait Speaker 10
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Thank you. A public health approach or a precautionary approach, we mean that we think we need to get children and young people off social media with immediate effect. We know we can see the really significant harms that are playing out on children and young people's phones and in their lives. And we don't think that we should be waiting for anything for tech companies to do anything before we make that happen. We think that we, in any other industry, we would not let a product out into the world until it was proven that it was safe for children, and that that's the approach we should take to social media.

Um, I'd count within that. Um, AI um, we do really need to take a close look at the experiences that children are facing on chatbots. Increasingly, children are turning to AI for mental health support. And that is seriously concerning. Those are environments that are designed to only positively reinforce what they're saying and do not have the mechanisms in place to, um, get young people to urgent help. So, so we think children should be taken off those tech companies as off those platforms as soon as possible.

The onus should be placed on those platforms to help children, to help make them safe before they're allowed back into the hands of children. But also, we need to look at the alternatives. So we know that children's the grip of social media in children's lives has increased just at the time, as the alternatives for them outdoors, um, in real life have been pared back. If you look at the pandemic, children's social media use skyrocketed just at the time when they had nothing else to do.

I think we have a boredom problem, um, for young people today, for teenagers today. So we also, as part of that public health approach, need to be investing in play and in youth spaces and in those offline alternatives to help young people have more enriching things to do in their lives than Doomscrolling.
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None Portrait Speaker 2
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Yeah. So I think it's fair to say we haven't talked about children and young people's experiences of those mental health services yet, but we have a system that is fundamentally failing young people. It is failing them across the board from that kind of early intervention stage through to the way that crisis and specialist care is working. Um, record high referrals. And we have incredibly long waits that children are facing. Parents and families are at the end of their tether.

So the system is completely failing. When we look at that real life, in-person, regulated mental health, high quality mental health support. And we think we need to see two things shift, really prioritization and reform within that system. So we need to prioritise children and young people's mental health much more within our health systems. And perhaps we can come on to a conversation about where we spend money, how targets shape the decisions that are made by the NHS. But we also need to see reform.

We are really strong believers at the centre of young lives in early intervention and prevention, and so we need to see a shift. It's really welcome to see the plans in in the ten year plan for a shift towards community interventions. We need much more of a focus on what that looks like for children and young people and things like early support hubs, which were mentioned by Alex George earlier, and mental health support teams, both expanding that provision, but also making sure it can meet a high level of need, um, and bringing some of that specialist mental health support to our youth spaces.

We know that in youth centres, for example, youth workers say they are dealing with really high levels of need and they don't know what to do, and they don't have the capacity to deal with it. So we need to bring those professionals into the community where those young people are. But fundamentally, we need to prioritise children's mental health so we have the capacity to do that.
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None Portrait Speaker 12
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Yes I do. I do think it's more complex. And the thing that really struck me in the interim report from the Fonagy review was that you can very clearly see an increase in distress in young people. And to me, that makes it not plausible. When some people try to make an argument that young people are simply, um, need to toughen up in some sense, um, it's quite clear that that, um, the symptoms are more severe for young people. And we definitely know on the depression and anxiety side that the more severe the symptoms are and the distress is, then the more impaired those young people will be in terms of being able to go to school, benefit from education, move into the world of work, etc., and socialise with their friends.

Um, so for me, that was a really key point. And I also think that there is something to explore further in the point that was highlighted about how the structure of services and systems can itself generate more need in young people. Um, and it links back to what Connie was saying about early intervention, you know, and the fact that it is so much more difficult to treat mental health difficulties the longer they have been left to fester and the young person has been left to come up with their own means of coping, which may not have been ideal, but they were all they had available.

So I think it's it's really important that we do take steps to tackle the capacity issues in Camhs. The fact that there is that gap in the middle of the range of severity with children with moderately severe needs, not many services at all. And then looking at the more preventative picture, the mental health in schools, teams and and that sort of level, and the non um, clinical non-specialist type services, what the evidence is telling us is that that's still very patchy. It varies from location to location.

And there's no guarantee that any particular young person is going to be able to access it.
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None Portrait Speaker 2
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Yeah. I'm actually going to zoom out and not talk about interventions for the priority really for this year, because I think it is about prioritisation. Um, so I think particularly from the report, which we'll talk about the prevalence of poor mental health, um, and obviously the drivers of those challenges, what that, um, the problem we've seen here is that we have actually known about these issues for some time. This committee met, um, nine years ago, almost a decade ago, our founder appeared before these two committees to talk about children's mental health.

And it's taken until now to get a review of the prevalence of children's mental health problems. What we need to see is some really tangible shifts to respond to that. So we want to see shifts in what we spend on children's mental health. We spend less than 1% on children's mental health across the NHS, and mental health more broadly gets only 10%, despite making up 20% of the overall disease burden. So it's about a shift in how we prioritise. It's about targets.

We know the health system responds to targets. Um, it's an absolute crying shame that we have really strong targets for elective health and nothing for children's mental health that we're prioritizing bunions over children with serious mental health problems. But also, um, it's about how that system shifts. So the review in particular is looking at the drivers and also the system response that the system intervening later is exacerbating need and making interventions less effective. Because the more you wait to respond, the less effective that intervention is.

So we also need a response to those two reviews, which looks at a truly cross-departmental strategy. I don't want to see a strategy where each government department repeats the things that they're already doing. We need a strategy where each government department takes responsibility for this generation of young people. Department for Work and Pensions. Department for education and Department of Health and Social Care and beyond. Each, taking responsibility for this generation, each investing, and each making sure that they have shared accountability to really shift the dial.
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None Portrait Speaker 2
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This missing middle we talk about. It's worth saying that we we fail on all fronts firstly. So we fail on the early intervention. We fail at specialist and crisis care. There are problems across the system, but there is clearly a problem for this missing middle of children and young people who were told they are too high need for those early intervention services and not high need enough to meet the threshold for Camhs. I think that's because our systems are highly overburdened and because they're having to rely on very high thresholds, because of the very scale of children that are coming forward for their support and their inability to respond.

And to take an example of mental health support teams, um, we're seeing examples. That's an intervention, a really welcome intervention. And there are really positive, ambitious plans to scale that up. But it is for mild to moderate needs. We're hearing examples across the country of young people that are being told that they are too complex for those mental health support teams, but that are then seeking a Camhs referral and being turned away. Around a third of Camhs referrals are closed, so we need to be looking into the experiences of those young people, what's happening to them, what alternatives are they being offered?The answer is very little, and that leaves children and families really at their wits end with nowhere to turn.

So we do need to really look at that missing middle. There are interventions that we know work. So the previous evidence session talked about, um, the early support hubs. We really need to see commitment from the government to make sure that there is meaningful mental health support in hubs across the country. And we really welcome the Young Futures Programme. It's a programme that we recommended as part of the Commission on Young Lives. We've been working with the government on that programme.

We really want to see a robust mental health offer within that. It cannot just be a wellbeing offer, otherwise we will have the same problem of young people being referred on and referred on and the waiting lists just expanding. So we need to meet that middle need meaningfully in the community. And crucially, no child should even know that they are too high or too low for this service or that service. They should be oblivious to it, and it should be the responsibility of the health system and the education system jointly to find a place for that young person and the right support.
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None Portrait Speaker 15
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Thank you.
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None Portrait Speaker 2
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Yeah. Um, so I think this is it's partly about the interventions that we prioritise. So, um, we've talked about mental health support teams, early support hubs, but also harnessing the opportunity we have with the youth strategy to get mental health support into those community services. I think the MSF is important there because it helps, um, drive consistency in those services. But the strategy itself, it's also about bringing together those departments and thinking about how, how can each of the different reforms that are coming through the special educational needs reforms, the youth strategy and the reforms, how can they all be working towards promoting children and young people's mental health?But to zoom out a little bit, I also think when we talk about prevention, there's a real opportunity here for a bit of a cultural shift and a conversation about how we can build the foundations of good health and what does good mental health look like, or what does building the foundations of good mental health look like?When we think about a child and their experience, we think about children growing up in a home where there's domestic abuse, where their parents might have poor mental health or where there's substance misuse.

We think about a child that is experiencing um is at risk of exploitation in their community, a child growing up in poverty. There are we've heard at the beginning of this conversation about the drivers of mental health. I think the strategy is an opportunity to build the foundations, on the flip side of that of good mental health, um, starting with those drivers. Um, but then also, um, as I said earlier, looking at how we can expand those early intervention services, and that is also about how you shift and prioritise within the system.

We talk to local commissioners all the time and they say there is money in the system. It's about how you prioritise it. And we know it's much cheaper to to invest in those early intervention services.
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None Portrait Speaker 9
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Um, if Jo goes with.
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None Portrait Speaker 7
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Me. Oh, wait.
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None Portrait Speaker 9
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Jo. Andrew's here.
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None Portrait Speaker 16
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That's really interesting, and the best way for me to do that is to tell you what children have told me themselves. So when I came into role in 21, I went out and did a major survey. In fact, we got the biggest survey response in the world to the big ask. And we asked children coming out of Covid, what?How are you?Um, what, what are your vulnerabilities?What do you need to thrive?What do you want for your future?What's interesting is back then that half a million children talked to me about their mental health as an absolute top priority.

Um, they wanted to get back to school. We had all those huge worries about school absence at that point. Um, and they talked a lot about, um, they ought back then they were very ambitious. They wanted great jobs and they wanted school to support them, to help them. And that was very much the picture. And that was children in every part of this country. And there were some really, really vulnerable children. And there were some real vulnerabilities about it.

Was that time of explosion when everyone was talking about mental health?Very interesting. Six years on, I'm out now in my final year doing my big future survey. We're hoping to hear from a million children this time, so I'm sure we'll be up in your area. Um, started up at Hadrian's Wall. We've been in Carlisle, Birmingham, Blackburn, Preston, Leicester, Nottingham just in the past two three weeks. We've already got 100,000 responses. It is so different.

What children are talking about feels really different. Six years on. Um, so look, these are the children who have had the Covid shock. They've had the cost of living shock. We've got the whole social media issue. But what are they saying?Well, just before I started my survey and I've been triangulating what I found in my polling, we did a YouGov polling of 13 to 17 year olds said, what are your biggest concerns?Cost of living.

You didn't hear that six years ago. Cost of living, getting a great job, real worries about that friendship, no mental health in that top group war. You know, peace in the world. Completely different set of frontrunners. And I think that tells you something that children are now and social media children are talking to me a lot about being stuck on social media, being unable to get off it, wanting to cut down. So they have become far more sophisticated in their conversations about what makes them happy, what makes them well, what is causing them to be upset.

And of course, I've triangulated that by surveying every single headteacher in the country. So I have that data for you on what they think about this. Um, and also we do a mental health, um, a piece of mental health data on mental health waiting times, prevalence numbers every year. Um, and I've got six years of data for that on you, but in children's own voices, it really is just a feeling that somehow childhood just isn't as good anymore. They're wanting to get out and play, not being able to, being stuck on their phones, money being a big issue, parental poverty, parental financial issues been a big problem.

So it feels quite different. And that wanting and not not not being able to get a job. I'll give you two children's examples that I think capture this one. We've been talking to the kids about AI. One little girl up in Carlisle. I want to be an author, but what's the point?Because AI can write the book in ten minutes. And then another boy, a 16 year old, saying, I've applied for 200 jobs.

Um, and all I've got back is an AI response. No person has spoken to me. And I think it's that that's actually now impacting our children more than that. 2021 we've been locked away coming out of Covid vulnerability. It feels different. So that's what I wanted to share with you today.
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None Portrait Speaker 16
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Okay. So so mental health itself, I think one of the the best way to answer that is, is from our specific mental health data. So I do a report every year. I think committee might be shocked to realize that in 2021, when we thought probably mental health issues would be at their peak, um, you know, we are now six years later, it's nearly a million children have got an active referral. Last year, nearly a million children had an active referral to Camhs.

That is double 20 double 2021 numbers. So I think, you know, whilst government I think has attempted to. And on top of that, um when I surveyed every headteacher in the country, what is your number one concern for your local area?We asked them for top five concerns for their local areas. We asked them how many professionals they had in their schools because nobody had that data. Like for the past, you know, 20 years. I was a head teacher for 20 years.

Nobody knew who who you couldn't map, who's got a youth worker, who's got a councillor, who's got a mental health health worker, worker who's got police in the school head teachers. Number one, concern for their local area was mental health support for children. And that was last year. And 90% of head teachers in this country responded to me. And that was their number one concern. So what have what has government done and has it been, uh, has the response been adequate?So I pushed very hard for the rollout of mental health support teams to try to support schools, to be able to intervene early.

Um, so I think I'm pleased that that rollout is now at 52%. I'm pleased that the government has committed to continuing with that. Um, I've got the exact figure. I think there are now 11,800 schools, uh, settings benefiting from a mental health support team, up from 10,000 last year. So, you know, that that rollout is happening. I'm doubly pleased because most head secondary headteachers told me 82% of secondary head teachers told me, and that's of all our heads, um, that they had a counsellor.

I've always worried about governance. I've always worried about where did your counsellor come from?How do you know they've been effective?Um, so the mental health support teams will allow us to do that and should actually cover the far. Far less, uh, a smaller amount of mental health support in primary schools. Um, so the mental health support teams really, I would get my focus there and get them in there. Um, so I think that's a, that's a good thing.

Camhs. So, you know, my data over the past five years has shown that more money is going into Camhs. So, you know, the government is spending more. Um, but unfortunately, because the need has increased, need has increased at a far greater rate than the expenditure. So unfortunately, it's not adequate. I mean, when I've got in, I was, I was just looking, um, looking through my um, so we've got a million children with an active referral in our last report.

So that's doubled. Nearly a third of those closed without treatment last year, although a slight slight improvement on previous years. The most common referral. And it fits with what I'm saying. The most common reason for referral is anxiety, followed by neurodevelopmental conditions. They go down the same pathway. Um, and so one of the big things I think we need to do is think about the pathway for diagnosis for MND, because that same pathway. So that would be something government could and should do.

Um, I mean the most common. Yeah. So the most common reason anxiety followed by MND, one of the fastest growing reasons is autism. Again, I think I'm on the prevalence review. And I think I think the Department of Health really needs to think about what's happened over the past six years in terms we've been diagnosing ADHD, diagnosing autism for longer. The way we do it has changed. And the way diagnoses are given just just through practice.

And so that prevalence review really does need to think about that and think about the wider impact there on, on mental health as well. So average waiting times are around a month. About 8% of children wait for over a year for second contact with Camhs. There's huge variation in waiting times across the country. Um children in the Isle of Wight and Hampshire are waiting the longest. So they're the two places that have the longest waiting times. Um and the reports have looked at expenditure at ICB level.

Again a postcode lottery in terms of expenditure per child. So it ranges from 2500 per child in northwest London to £550 per child in Coventry and Warwickshire. So I think that's given you a sense of there is still a postcode lottery, there's increasing demand, more money has been spent, conditions, the way we're diagnosing them and and what we're calling them have changed. I think have have sort of stretched at the ends. And we need to get that sorted out.
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None Portrait Speaker 16
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So, you know, I there's a level at which, um, you know, I would hope it would look almost invisible at the early, early stages. I don't I don't mean that literally because actually if we get um support for children where they want support, which is in school, um, or in the places that they go to play, you know, in, you know, how they're experiencing their families and their family life, what they're doing, you know, in those, if we get that bit right and we support those professionals to do that bit well, and we pick up with those early mental health support teams on that bit, then we should get the problem solved.

You know, we should we should be able to make a difference there. You know, so many I've just been asked by the government to do. I've just done 0 to 5 screen time and I'm doing 5 to 16 screen time guidance at the moment. Um, and you know, what I'm seeing are parents saying to me like, you know, I know, and children and children right across the country saying to me, I know how I feel is impacted by scrolling for three hours a night.

You know, I know I give my two year old an iPad, uh, for an hour before bed. Do you think that's going to change their behaviour?And, you know, we know that these and we're like, so I'm hoping with that screen time guidance, we can help as well by starting to address things like at what age should you have a, have a mobile phone?You know, should you take these things to bed?These it's actually the practical things when you talk to children across this country, they want to play out.

They want to have fun things to do. They want to have friends. The boundaries of school can protect and support them. Um, we can do so much if we actually focus on childhood and get that bit right. Um, and support that. Well, with those early mental health support teams, the Camhs waiting lists are another thing, right?And the, some of those issues are a wider issue, but I honestly think a bigger focus on, uh, and that's why I was pleased to do screen time because often politicians don't want to go there to talk about, you know, what is a healthy childhood and what should family life look like?Could, could, could look like we need to go there.

Um, particularly around things like the online world, which I have to say, we might not have all the longitudinal data yet. We've got data showing time matters, but I have to say in years to come, I think it's going to show there's going to be more than just a correlation between, you know, what we're doing now.
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None Portrait Speaker 1
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Thank you.
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None Portrait Speaker 16
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So look, I'd like to see a mental health mental health support team or, you know, properly evidence based, evidence based, trained counsellor and support in every school. But I think it's so much more than that. Um, and I think we don't even have to talk about it because sometimes it's counterproductive. If you set your whole school up to talk about it's just mental health, you know, it's like everything's mental health. Actually, when you start talking about wellbeing, that can really impact on children far more.

We need to think about, um, we need to think about, um, training for senior leaders and all leaders so that you get the ethos of the school, right?So that they're not putting unnecessary and unimportant pressure on children. I can't tell you how many 14 year old girls will tell me, you know, I was told, you know, if it was the biggest thing in my life, if I didn't pass this exam, it's those simple things like that. We also know the evidence base shows us friendship.

Actually having 1 or 2 good friends is the biggest determinant of good mental health later in adult life. So what are we doing about, um, you know, wider activities at school?Pretty much every child I've met in my last few weeks touring the country has talked about the football club, the games, the chess, the arts, the, you know, the place where they can be themselves. It's recognising that those things have a massive and positive impact on children's health. Then I'd add we mustn't.

We mustn't ignore those particularly vulnerable children who are also vulnerable for, um, for, you know, mental health concerns, but it's because of their lives. It's because their parents are poor. It's because they've got problems at home. It's because they're in care. It's because, you know what?Those vulnerability issues. So making sure and all the headteachers, 90% of headteachers of this country, when I asked them, would you do more if we could put the professionals around school to support these children, would you do more?Their answer was a resounding yes.

They know that that is where children need to be met, so we can really and want to be met so we can support their wellbeing and support their family's wellbeing.
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None Portrait Speaker 7
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Oh that's good.
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None Portrait Speaker 16
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So the first thing I would say is that they should know know who those children are. Um, and this is one of my bugbears. One of the things I've found in my survey of headteachers and I was one, so, you know, I love the profession, but I'll call it out when it's not what it should be, particularly in secondary school heads. Didn't know necessarily who those children were. And part of being able to do that, I've been a massive proponent of the unique identifier.

You know, we really need to get a move on in terms of, um, joined up data. And I don't know why it's going so slow and it should be, I would say, particularly for this government, the thing they're most ambitious about, if they could get to the end of the five years saying, we've done a fantastic unique identifier, health could lead it. They're brilliant. They know what to do. Um, and so children don't have to get lost in the system. And we know who they are and we know when they're waiting.

And then heads would know, right?We need to make sure the council is checking in. We need to make sure that the family worker is checking in. Do we know the story?And let's get underneath it instead. Many children are lost. A child who does, whose school does not know that they've just been bereaved by their closest adult, has just died. Of course, they're going to end up needing needing support and care, you know, and it could get worse, you know?And that is a reality.

Not not so much in our primaries, but in our secondaries that could not they could not give me the numbers.
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None Portrait Speaker 8
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So in answer no.
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None Portrait Speaker 7
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Thank you.
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None Portrait Speaker 14
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Thank you very much.
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None Portrait Speaker 1
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I think the point you raise is what I wanted to come on to next. In our severe mental, severe and moderate mental health inquiry, we spoke very we heard very strong evidence that co-creation is how you create something that actually works for the people. It's meant to be helping. Um, and I, uh. I will ask the committee for their patience, but this is so moving. We had a strategy day in Abingdon where youth came together with civic leaders, with businesses, and they wrote us a letter, um, and it's a letter for the future.

I'll just take a small excerpt, but they talk about how, uh, young. People today are growing up feeling isolated, angry, anxious, unheard, lost. They feel there's nowhere to go, nothing to do. And no one really fighting for them. When support disappears, problems don't disappear with it. But they go on to say, um, that they want today. That was Friday to not be another meeting. They want a commitment from us to hear their voices, a commitment to work together, a commitment to create a strategy that actually reflects the reality of young people in their community today.

Not assumptions, not statistics alone, but our real lives. It was genuinely heartbreaking in the room, but really inspiring. And what I got from the day was they know what to do. And they were they were bossing the businesses and the counsellors and everyone else in that room was listening to what they were saying, and they were coming up with the answers themselves. And then they, the adults sort of just helped to make it work. Um, what scope is there for that in this?Do you feel that co-creation with children is possible?And how can we do it in a way that's embedded in the forthcoming mental health strategy?
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This debate has concluded
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