Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government, further to the Written Answer by Lord O'Shaughnessy on 29 October (HL10675), whether they intend to take steps to reverse the 26 per cent increase in referrals to children's mental health services in England over the past five years; and if so, what steps they intend to take.
Answered by Lord O'Shaughnessy
The Government is committed to widening access to children and young people’s mental health services to address unmet need and ensure that more children and young people get the support they need, at the right time.
Through the Five Year Forward View for Mental Health, we have made an additional £1.4 billion available for children’s mental health service transformation. Overall investment in children and young people’s mental health services was £1.05 billion in 2017/18. We are on track to meet the commitment to ensure that an additional 70,000 children and young people access community mental health services annually by 2020/21.
In addition, the Government has announced further plans to improve early intervention for mild to moderate mental health conditions, through better join up with schools and colleges, to address rising needs and ensure that referrals to specialist services are appropriate. To deliver the key proposal to improve access to services, we are creating a new workforce of Mental Health Support Teams, working in and near schools and colleges, with trained staff to deliver interventions to young people to support their mental health.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what are the health and well-being consequences for children who were not accepted for treatment last year despite being referred for specialist mental health care.
Answered by Lord O'Shaughnessy
Some children and young people might find self-help or accessing support in schools more beneficial than a course of treatment in a specialist National Health Service mental health service and there are a range of reasons why children and young people may not access NHS services. A significant proportion of children and young people who seek help are legitimately signposted to other sources of help.
For example, a child displaying signs of anxiety due to a troubled home environment might need a social care response. We know that some children and young people or their parents might prefer to receive help from voluntary sector services.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government when they expect that all children and young people requiring specialist mental health treatment and care will be able to access such provision.
Answered by Lord O'Shaughnessy
Implementing the Five Year Forward View for Mental Health sets out plans for expansion of National Health Service children and young people’s mental health services so that by 2020/21 at least an additional 70,000 children and young people a year will be receiving evidence-based treatment.
Implementing the Five Year Forward View for Mental Health also includes two waiting time standards for children and young people, that 95% of children (up to 19 years old) with eating disorders to receive treatment within a week for urgent cases and within four weeks for routine cases. A copy is attached.
Transforming Children and Young People’s Mental Health Provision: a Green Paper was published in December 2017. This sets out measures to improve access by bringing mental health services into schools through a new workforce of Educational Mental Health practitioners.
The Green Paper also announced the piloting of a four-week waiting time to improve access to NHS mental health services, which we will roll out in a number of trailblazer areas alongside the support teams. The precise rollout will be determined by the success of the pilots trialling a four-week waiting time standard and the securing of funding in the next spending review. A copy of the Green Paper is attached.
Further plans for development of mental health services will be set out in the NHS Long Term Plan.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government how they intend to respond to the finding by the Education Policy Insititute that there has been a 26 per cent rise over the past five years in referrals to children's mental health services in England.
Answered by Lord O'Shaughnessy
The Government does not plan to issue a formal response to the findings of the Education Policy Institute.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of the implications for the NHS if additional resources for social care are not secured.
Answered by Lord O'Shaughnessy
The Government recognises that National Health Service and social care provision are two sides of the same coin. It is not possible to have a plan for one sector without having a plan for the other. Indeed, we have been clear with the NHS that a key plank of its plan must be greater integration of the two services. We will not allow the pressure from the social care system on the NHS to increase further.
We are committed to creating a sustainable system of social care in England, and that is why the Government has given councils access to up to £9.4 billion more dedicated funding for social care over the three years up to 2019-20. This funding will allow councils to support more people and sustain a diverse care market. It will also help ease pressures on the NHS, including by supporting more people to be discharged from hospital and into care as soon as they are ready.
The Department commissioned a study, finalised in 2008, which explored the relationship between additional spend on care home services and expenditure relating to hospital utilisation. The results indicated that for each additional £1 spent on care homes, hospital expenditure falls by £0.35.
Looking forward, it is right that social care funding is agreed alongside along the rest of the local government settlement at the forthcoming Spending Review. We will ensure that social care places no additional pressure on the NHS.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what estimate they have made of the suicide rate among students compared with the general population of the same age; and what measures they propose to address any concerns identified.
Answered by Lord O'Shaughnessy
Public Health England and the Office for National Statistics are working with stakeholders to develop new analyses of suicide rates within higher education institutions. The findings will be published in due course.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what action they are taking to remove barriers preventing young people from receiving essential mental health support, following the findings set out in the survey by YoungMinds.
Answered by Lord O'Shaughnessy
We have made an additional £1.4 billion available over the course of 2015/16-2020/21 to transform services and ensure access to specialist mental health services for an additional 70,000 children and young people a year by 2020/21. This funding will also ensure that, by 2020/21, 95% of children (up to 19 years old) with eating disorders receive treatment within one week for urgent cases and four weeks for routine cases and 50% of patients (all ages) experiencing a first episode of psychosis receive treatment within two weeks of referral. We are currently exceeding or on track to meet these waiting time standards.
The recent Green Paper, Transforming Children and Young People’s Mental Health Provision: a Green Paper, published by the Department of Health and Social Care and the Department for Education, is supported by an additional £300 million and contains key proposals to improve access to mental health support for children and young people. This includes through the creation of new Mental Health Support Teams, which will deliver interventions to children and young people with mild to moderate mental health needs in or close to schools and colleges (and be able to refer those with more severe needs to specialist services). The Green Paper also announced the piloting of a four week waiting time to improve access to National Health Service mental health services for those requiring more specialist help, which we will roll out in a number of trailblazer areas alongside the support teams. A copy of the Green Paper is attached.
We will also ensure that at least one teacher in every primary and secondary school will receive mental health awareness training by the end of the Parliament (and by the end of 2019 for secondary schools). This will improve the capability of school staff to promote awareness of mental health needs, and provide them with the skills, confidence and knowledge to spot common signs and triggers of mental health issues, and to help children and young people receive appropriate support.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what assessment they have made of (1) failings in the mental health system, (2) the identified causes of such failings, and (3) remedial actions proposed by the Care Quality Commission, especially to reduce the number of detentions made under the Mental Health Act 2007.
Answered by Lord O'Shaughnessy
The Care Quality Commission (CQC) report The Rise in the use of the MHA to detain people in England, published on 22 January 2018, identified a number of issues which may have contributed to the rise in detentions under the Mental Health Act 1983.
These issues include changes in mental health service provision and bed management, and the fact that patients may be admitted more frequently than before, either as part of a plan of care or because of premature discharge. The report also acknowledged that demographic and social changes have resulted in an increase in the size of population that is at risk of detention.
A copy of the CQC’s report is attached.
The Government is aware that rates of detention under the Mental Health Act 1983 have been rising and welcomes the CQC’s report. The report acknowledges that the Government is improving services and that these may help to reverse the increases in detentions under the Act, pointing to NHS England’s national access standard for Early Intervention in Psychosis services and the £400 million dedicated as part of the Five Year Forward View for Mental health to enhance crisis resolution home treatment teams.
The rise in detentions under the Act is one of the reasons the Government has commissioned an Independent Review of the Mental Health Act. The Review, chaired by Professor Sir Simon Wessely, has been tasked with reviewing issues around the legislation itself and the practice surrounding it, and it will make its recommendations to Government in autumn 2018.
The CQC is one of a number of organisations working closely with the Independent Review and its report was produced with the expectation that it be considered by the Review.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government what consideration they have given to the preventative work done by the non-statutory sector in providing support to children and young people with mental health illnesses in vulnerable families; and what assessment they have made of how such provision can be boosted with additional resources to complement and enhance the work undertaken by health care professional staff.
Answered by Lord O'Shaughnessy
The non-statutory sector plays a vital role in supporting children with mental health needs, including those in vulnerable families. To support local leadership and accountability for local transformation, Future in Mind introduced cross-agency Local Transformation Plans for children and young people’s mental health services. These now form part of local Sustainability and Transformation Plans and provide a basis for local areas to work with commissioners and providers across health, social care, education, youth justice and the voluntary sector, bringing everyone together to plan strategically, reflecting the needs of local communities. All plans must provide evidence of effective joint working with the voluntary sector.
This programme is supported by an additional £1.4 billion available from 2015/16 to 2019/20 to transform children and young people’s mental health services. NHS England’s 2016 survey Children and young people’s mental health Local Transformation Plans – a summary of key themes, includes many examples of work with the voluntary sector. A copy is attached.
The Government is aware that more needs to be done to support children with mental health from vulnerable families. The Green Paper, Transforming Children and Young People’s Mental Health Provision, published last year, includes proposals to improve early intervention through Mental Health Support Teams linked to schools. We are consulting on the approach to implementing these proposals, including how they can best support vulnerable groups. The Green Paper also includes a commitment to commission research on how to engage vulnerable families, to provide information to local areas when referring children and parents to both parenting and parental conflict interventions. A copy of the Green Paper is attached.
Asked by: Lord Ouseley (Crossbench - Life peer)
Question to the Department of Health and Social Care:
To ask Her Majesty's Government in the light of research published by the BBC on 2 August estimating future shortfalls in care home places, what steps they are taking to ensure the sufficient provision of such places.
Answered by Lord O'Shaughnessy
High quality care is not just about care home beds. Of those aged 65 and over who need local authority support, 61% are cared for in their own home. Since 2010, there has been a growth in home care agencies of more than 2,900.
We have given local authorities in England an extra £2 billion over the next three years to maintain access for our growing aging population and allow councils to sustain a diverse care market including care home places.
In addition the Government has announced we will consult on plans to improve the social care system and to put it on a more secure financial footing.