Policing and Crime Bill — House of Lords, 2016-11-30
Topic: Health
Elspeth Howe (Crossbench, Unknown): My Lords, I think I will leave aside the contribution of the noble Viscount, Lord Hailsham. I do not really agree with what he said. My name is on this amendment and I support it because it would create a clear and explicit referral pathway for child victims of a sexual offence or other forms of child abuse for an assessment of their mental health needs As we have heard, the amendment would deliver on the Government’s own commitment in Future in Mind and work to put in place policies that go a step towards creating parity between physical and mental health. The Government say that they want to develop: "A better offer for the most vulnerable children and young people", including by ensuring that, "those who have been sexually abused and/or exploited receive a comprehensive assessment and referral to the services that they need, including specialist mental health services" The amendment would deliver on that ambition It is important to recognise that the Government have made welcome steps in this area, in particular through their investment of £1.4 billion over the course of this Parliament in children’s and young people’s mental health services. However, there is evidence to show that this is not yet reaching the most vulnerable. According to research from the Education Policy Institute, in the first year of funding, of the expected £250 million only £143 million was released—and of that, only £75 million was distributed to clinical commissioning groups. For 2016-17, £119 million has been allocated to clinical commissioning groups—but this has not been ring-fenced, risking that it will be spent on other priorities It is clear from the evidence available and what we have heard today that these young people are at extremely high risk of developing a mental health condition. Lifelong difficulties can result in drug and alcohol abuse, mental ill-health, homelessness, gang affiliation and/or disability if the underlying trauma of their experiences is not met with swift and appropriate intervention. Research has found that up to 90% of children who have experienced abuse will develop a mental illness by the time they are 18. In the spirit of parity between physical and mental health to which we all aspire, in a comparable physical situation people would be screened and have regular check-ups, yet we do not offer the most vulnerable children the same opportunity to receive the help they so vitally need National policy is increasingly focused on the social determinants of long-term health. Evidence has shown that adverse childhood experiences are a key risk factor for poor outcomes such as worse health, coming into contact with the criminal justice system and worse employment and educational outcomes over the life course. Children who are victims of a sexual offence are often left without support for their mental health difficulties, which are likely to develop into more entrenched mental health conditions later in life, because they do not meet the thresholds for clinical interventions or because a suitably trained professional does not properly assess their mental health needs This amendment would provide national consistency, as we know that the situation across the country is inconsistent and young people are not always getting the holistic assessment they need to meet their needs. Thresholds for mental health clinical interventions are inconsistent across the country and referral routes into CAMHS are varied, with some areas not allowing the local voluntary sector to refer directly. Some sexual assault referral centres refer children for mental health support, but others do not In her response in Committee, the Minister mentioned the commissioning framework for adult and paediatric sexual assault referral centre—SARC—services, published in August 2015. However, case-tracking evidence from the Havens in London found that, of the 24 children under 13 who were reviewed, only three were referred to CAMHS and that, of the 56 young people aged 13 to 17 who had their cases reviewed as part of the study, only five were referred. It was acknowledged in the same report: "Few children are referred to CAMHS from the Havens, most likely as interventions are generally at the forensic examination stage and it is difficult to determine longer term emotional support needs at this … stage" It is therefore necessary to ensure that other agencies have a duty to refer for a mental health assessment, in order to guarantee that a young person’s holistic mental health needs are assessed after their traumatic experience. Alongside providing national consistency, this amendment would introduce a referral for an assessment and enable better understanding of the level of support that needs to be provided both by CAMHS and outside CAMHS. This will lead not only to better responses and referral routes for young people but a greater understanding to inform commissioning at local level, so I hope that the Minister will be able to accept this amendment.