Child and Adolescent Mental Health Services: North-east — House of Commons, 2019-07-10
Topic: Health
Jacqueline Doyle-Price (Conservative, Centre-right): There might be something we can do on standardising the approach, but that brings us to another challenge. We apply these targets to try to achieve a standardised service and to ensure that people get treated when they need it, but that encourages some perverse behaviours, and the hon. Lady has just outlined one of them. The challenge for us is how we apply standards of behaviour and targets without driving perverse outcomes and bad outcomes for patients. I still think we have a lot to do on that, and probably a lot of learning. We need to identify those areas that really are doing it well so that we can spread good practice throughout the system. But there is obviously a good reason why we must make sure we get child and adolescent mental health services much better: because we know that people who suffer from mental health issues tend to develop those conditions when they are children—when they are young. We all know that early intervention is the best way, not least for the individual concerned, because they will suffer less harm, but it is also good for the taxpayer because it costs less money to help people sooner. So we must make sure that we continue to give children’s mental health much more priority than it has had hitherto, and central to that will be greater provision of services in the community I am really concerned about the story the hon. Lady has just told. The process that Jane has been taken through appears to have completely failed, and the communication with her and her father appears to be extremely poor. Again, I think we can go away and look at how we communicate with patients and their families, and particularly at the tone that is used. We are dealing with people who are in a very vulnerable position, and to put it bluntly, it should not be "take what you’re given", should it? Ultimately, our NHS is there to serve all of us, and it needs to do so with sensitivity and tact The hon. Lady rightly challenged me about money and the need to ensure that it delivers extra appointments. We are ambitious to see many more children, through the investment we are making, but unfortunately I do not have a magic wand and I cannot roll it all out overnight. As she points out, we need to ensure that we are investing in the appropriate workforce to deliver these services I would like to make another point about NHS commissioners. While we are delivering this real step change in mental health provision for children, there are other things that can be done by local health commissioners—and by local authorities, for that matter—while people are waiting for referrals and appointments. There is still additional support that can be given by organisations doing good voluntary work to give wraparound support and take some of the pain out of the experience. I often say that good mental health care is not all about clinical interventions; it is about the wider support that can be given in the community as well Our reforms to mental health in schools have that kind of support very much in mind. We are rolling out new a new workforce, which is going be based on people who are trained in psychology and therapies, but the ethos will be very much that they are working with voluntary sector organisations that will be able to provide that additional support to people who are going through periods of mental ill health. We want to ensure that many more children who are going through mental ill health are seen, not least because we are seeing increased prevalence and it will take substantial extra effort to ensure that we are providing that service I turn specifically to waiting times. We have introduced new standards for mental health services, and in particular, we have introduced targets with regard to eating disorders and to a first episode of psychosis. We are making good progress on those, but as the hon. Lady says, Jane had clearly gone through significant trauma and it would not be unanticipated that that would impact on her mental wellbeing. Our targets for psychosis and eating disorders would perhaps not capture someone with that level of need, but it is still important that she has access to that support. Sunderland clearly has longer waiting times than many other areas of the country. I understand that the trust has been successful in bidding for additional NHS England funding as part of a national waiting list initiative, and I sincerely hope that that will improve access for the hon. Lady’s constituents When we hear of cases such as that of Jane, I can understand why people feel that our commitments on transformation ring a bit hollow. I know the hon. Lady will understand that we see this as a long-term process of rolling out improved services. That is the only way we are going to embed the change in culture that we really need in how we prioritise mental health, but we need to redouble that progress, as she says. We are determined that NHS funding for children and young people’s mental health services will continue to rise The hon. Lady asked me about making sure there is a proper ring fence. We have demanded that CCGs increase mental health spending on children’s services by more than their budget rises, but I think we will be taking a more interventionist approach. I know that NHS England is having robust discussions to ensure that all commissioners do exactly what is expected of them. We expect to have been able to treat an additional 345,000 children by 2024 through the additional funding, and we are already seeing some benefits I understand that in Sunderland, local commissioners have commissioned Mind to work with young people aged 11 to 25 and give direct support in that way. In addition, there is the new Lifecycle service, which includes access to adult therapies—one of the issues the hon. Lady raised. I am told that in Tyneside 90% of young people are seen within five days for triage into the service, but on the basis of what the hon. Lady has told me, I would like to do a bit more digging to make sure that the figure is robust We know that the mental health sector is showing imagination and innovation in filling the skills gaps in mental health nursing and psychiatry, but it is worth noting that one of the upsides of us talking about this subject and giving so much more attention to mental health is that it is raising the profile of the sector as somewhere to work. The really nice thing is that people do care about it. Applications for psychiatry are increasing, in part, I guess, because would-be psychiatrists can see that there will be plenty of demand for their services. Although we are making the sector more attractive, providing the workforce will be a big challenge, so we need to encourage more imagination about how that is delivered New roles are emerging, such as peer support workers, making use of lived experience. It strikes me that people going through mental health issues often find it intimating to talk about it and to respond to treatment. Getting support from someone who has been through a similar experience can be enormously important to their recovery, and we want to encourage much more of that. We have the new nursing associates, and we want to encourage more mature workers—perhaps women re-entering the labour market—to explore careers in mental health. We will need much more imagination in the coming years if we are to continue to deliver the workforce we need.