Children’s Wellbeing and Schools Bill

Lord O'Donnell Excerpts

Tuesday 16th September 2025 Lords Chamber

[Baroness Tyler of Enfield (LD)]

My Lords, Amendment 462 is in my name. I thank my noble friend Lord Storey and the noble Baroness, Lady Finlay, for adding their names.

This is a very important group. It is about the mental health and well-being of children, something that is, or indeed should be, central to the Bill. It is the name on the tin. My amendment would ensure a dedicated mental health practitioner in all schools qualified to a level—and this is the critical point—that they can deal safely with the problems that are more complex than those currently dealt with by early-intervention CBT—cognitive behavioural therapy—support, which is currently delivered by existing mental health support teams.

To be clear, I welcome and applaud the Government’s commitment in the spending review to expanding mental health support teams to all schools and colleges in England. These teams work with children, parents and wider school staff to promote good mental health and, funded through the health system, provide effective prevention and early-intervention support for children with a range of mild to moderate mental health needs, including things such as low mood and anxiety. They are doing important work.

These teams are staffed by education mental health practitioners. The terminology can be a bit confusing here, but it is a relatively new role within the children and young people’s mental health workforce system. As these mental health support teams expand, these practitioners in training are recruited for a work-based placement, while they complete a diploma or postgraduate qualification over a period of one academic year. During this time, practitioners are trained to deliver low-intensity cognitive behavioural therapy to children or, in some cases, to parents, to allow them to directly support their children.

While this approach has been effective for children with lower-level needs, CBT is not appropriate for all. Evidence has shown that some groups of children are less likely to benefit from these interventions; this includes those with special educational needs, younger children, and children experiencing moderate to more complex mental health needs.

The problem is—and this is specifically what my amendment is designed to address—that these children with more complex needs still do not meet the very high threshold for child and adolescent mental health services, because their needs are deemed to be not severe enough. In short, they are currently falling through a gap in support, and it is often referred to as the “missing middle”.

In the last 12 months, CAMHS has closed 28% of referrals without offering any support. This results in mental health support teams in schools often being asked to hold cases that they are not trained to work with safely, leaving children at risk. These children include those who are at risk of or have indeed self-harmed, those who have experienced trauma, bereavement or loss, and those who have thoughts of suicide. These things are real; these children are not making those things up. These children are often clearly visible to the professionals within schools and the health service through repeat presentation at health services. Often, they are struggling, not attending school or unable to engage with learning.

It is worth noting that respected voluntary sector providers, such as Barnardo’s and Place2Be, have recommended that, as part of the Government’s rollout of mental health support teams,

“the model is expanded to include provision of funded … school-based counselling”.

They say it would fill this missing middle

“to ensure that all children in mental distress can access timely support”.

A dedicated mental health professional qualified at the right level, such as a school-based counsellor, would normally hold a degree in counselling or psychotherapy. That would improve outcomes for children whose needs are not currently being met and—this is critical—should help to reduce pressure on CAMHS in a cost-effective way. These professionals are trained to deliver a range of different therapeutic skills and approaches that allow them to understand the unique needs of each child. One size does not fit all; I am sure we can all agree on that.

Evidence from other UK nations demonstrates how embedding school counsellors can indeed reduce pressure on CAMHS. In Wales, where school counselling services are statutorily funded, only 1.7% of those accessing counselling need to be referred on to specialist CAMHS. Existing mental health support team staff and school-based counsellors have different routes of training, different qualifications and different skill sets. They each fill a different mental health need and working together could offer more support to more children than is currently the case.

In conclusion, my amendment proposes that the skill mix of the mental health support team workforce should be expanded to ensure that all children have access to an appropriately qualified mental health practitioner as part of the rollout. I very much look forward to hearing the Minister’s response on this.

Finally, I want to express my strong support for Amendment 472 in the name of the noble Lord, Lord O’Donnell, to which my name is also attached, and to Amendment 479 in the name of the noble Lord, Lord Watson. I will make a just a few very quick points on Amendment 472. This is a Bill about children’s well-being but, frankly, with very few direct references to the broader issue of well-being and, certainly, without any provisions for measuring well-being. This amendment would provide for a single, optional online well-being survey, delivered annually in schools and with centralised support made available to schools that wished to take up the option.

That is a modest but important ask. School data from the surveys would not be published or used to penalise schools in any way, or be part of the formal accountability systems. In case of any misunderstanding, this would not be a stick with which to beat schools. The survey would be optional. Schools would not be mandated to participate. It would be up to them, as indeed it would be for parents, carers and pupils, to opt out should they choose. However, we know from a recent YouGov poll that 75% of parents agree that, to improve young people’s well-being, we need to measure it. Critically, the data collected would allow the whole system to respond, including children’s services, education, health and the voluntary sector, at both national and local level.

I end by pointing out what I think we all know: happy and healthy children are most likely to be present at school, to engage in learning and to achieve to their full potential. Surely that is what we all want. We have a real chance here to progress that aim. I beg to move.

[Lord O'Donnell (CB)]

My Lords, I will speak on behalf of Amendment 472, which is in my name and that of the noble Baroness, Lady Tyler, who has spoken very well, and the noble Lords, Lord Layard and Lord Moynihan. This is a modest proposal, but it is probably the most important one. I have sat through all the hours of this debate and I would say to all noble Lords who have spoken that, if this does not go through, they will not succeed.

The reason I say that is that I have not spent over two decades in the Treasury without knowing that you need evidence: you need to prove what works. Your Lordships have talked various things. The noble Baroness, Lady Spielman, mentioned various interventions and wanting to know whether the costs and benefits were worthwhile; that is absolutely right. She mentioned NICE. The key thing about NICE is that it works out whether a given medicine is worthwhile by doing a cost-benefit analysis based on QALYs—quality adjusted life years. We now have more sophisticated measures known as WELLBYs—well-being years.

To understand whether a thing makes sense, we need to do the assessment and for that we need data. Your Lordships have all made suggestions: we want more physical exercise; we want less bullying; and we want to think about what things in SEND work. As the noble Lord, Lord Lucas, said, we need some common definitions. We need a common definition of well-being that we can use; the department can give us that. Then we can work on the basis of exactly how important and how effective all these things are.

If we think about how this debate started, we all talked about our favourite brand of school: free schools, academies, you name it. How do we assess which one is better? Well, either implicitly or, in some cases, very explicitly, it was a matter of exam results or Ofsted rankings. Nobody talked about these schools’ impact on well-being, for the very good reason that we do not know. We do not have data. The only data we have is the world’s most embarrassing data of all, which nobody has mentioned yet: the PISA data. The PISA data shows us that, out of all of Europe, our young people have the lowest well-being. Of the 38 countries in the OECD, where do we come? In 37th place. My favourite football team, Manchester United, is not even that bad in the league.

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[Baroness Spielman (Con)]

My Lords, I will be fairly brief. I mainly want to commend the Government on the restraint that they have shown in this Bill in clauses relating to mental health and well-being.

Despite the Bill’s title, there is a welcome absence of clauses that imply that well-being and activities that promote it are separate from, or even antithetical to, good education. In reality, they are strongly correlated. For most children, well-being is a likely outcome of being well taught, well supported, discovering and developing their wider interests, and forming good relationships with peers and with adults—developing a sense of belonging.

Further, there is a growing recognition that spending too much time talking about mental illness to young people who are not ill can be counterproductive. We may need less mental health awareness training in schools, not more. For those advocating more universal mental health interventions in their amendments, I recommend reading the findings published by DfE earlier this year on the effectiveness of several school mental health awareness interventions. These tests of established programmes found that they did not reduce emotional difficulties in the short term, and in the longer term appeared to be associated with greater emotional difficulties and decreased life satisfaction.

Those who have been around in education long enough may also remember the evaluation of the then popular SEAL programme; I think it was “social and emotional aspects of learning”. This study of the programme, which was for primary schools, showed not only that the positive outcomes expected did not materialise, but also that there was an unwelcome side-effect in that, to paraphrase, it taught the mean kids to be better bullies, using the techniques of emotional manipulation that the programme taught them. These findings are a valuable reminder that sometimes less is more.

A word of warning: much of what is proposed in these amendments is hugely well intentioned, but I am particularly nervous about some of the ideas around measurement. If we do not want measurement processes in themselves to harm children, we should not collect data by constantly asking children who are not unwell about their well-being, and especially about their negative emotions. I have seen so many dreadful examples in schools where even very young children are constantly prompted to express emotions and invited to say that they are experiencing negative emotions. You can see the change; they start to believe they are sad or worried or afraid, where this had not even occurred to them. Nothing could fit the phrase “throw the baby out with the bath-water” more accurately than to make children unhappy through well-intentioned measurement processes.

I therefore urge the Government to prioritise advice from expert clinicians in this field and to allow schools to do only—

[Lord O'Donnell (CB)]

I will just say one thing. The noble Baroness mentioned all the things on which she has been able to talk about the evidence because there was data. I just remind noble Lords that this amendment is talking about one annual survey. It is not asking people every couple of minutes how they are doing, just to be absolutely clear.

[Baroness Spielman (Con)]

Children are very frequently surveyed from different directions; another one would actually add to an extensive load of surveys that they already complete.

The wider point is that there are many ways of measuring indirectly. If we want to measure, we should look for indirect routes that do not involve constantly asking children to self-assess. We should make sure that schools are doing only what is genuinely likely to be helpful for children. The Government should resist the urge to launch crowd-pleasing but ultimately wasteful or even harmful initiatives.