Children and Young Persons Bill [HL]

I add my voice to those who have spoken about the need for improved mental health services. I want to talk about my perception of the practical problems. We have heard a lot about the need for CAMHS to respond positively. Certainly, I would not doubt that. I recognise that the Government since 2001 have funded a large number of very helpful initiatives to set up specialist teams for the assessment and prioritisation of looked-after children and specialist services in CAMHS. At present they work well. There are still difficulties in other areas. The real difficulty is getting the initial health assessment appropriately carried out when a child first comes into care. The children arrive very late. Often they have already had several different placements. One of the reasons services can be reluctant is that they know the children may not stay with them very long. But the real problem is that they are not getting the primary assessment of healthcare when they first come into care. The health assessment has been a sort of ““take it or leave it”” one. Some children object to the assessment. They say, ““Other children do not have to have an obligatory medical, why should I?””. The truth of the matter is that these children are so disadvantaged and the rate of mental disorder is so high—particularly psychosis, as the noble Baroness, Lady Meacher, has already outlined—that it is crucial that we get these children and young people into treatment very early on. That means quite a simple but well trained assessment by a nurse who is familiar with the process and the questions that need to be asked, and who understands that conduct disorder is often a symptom of very serious mental illness and should not mean the child is dismissed as a ““difficult kid””. The real problem here is that we must get these children assessed. While I accept entirely that PCTs must set up the appropriate services and have those obligations in mind, I think that really it is too late and too little. We need a proper assessment in the early days. I strongly support the amendments of the noble Baroness, Lady Meacher, in this respect.