It is a pleasure to follow the hon. Member for Southport (John Pugh) and his contribution to the debate. He made extremely good points.
I should like to refer to an experience I had some 12 or so years ago of running an organisation in Birmingham called Malachi Community Trust, which worked with young people with emotional, behavioural and mental health issues. More often than not, it also worked with their families, including parents and their wider families, to resolve their issues. We worked with qualified cognitive behavioural therapists and teachers—they were primary age children—in the school setting. It is interesting but deeply saddening that so many items in this extremely good report take me straight back to some of the conversations of 12 or 14 years ago.
I want to give a brief outline in the unfortunately few minutes that are available of what Malachi did—it is still going strong. It used musical theatre to engage with young people and as a tool to identify their issues. It enabled processes to be set up to work with those
children and young people who had more profound mental health issues. Pertinently for today’s debate, it acted to stabilise the situation for children who were on waiting lists to see CAMHS staff. Back then, there were three, four and five-month waits, or longer. Malachi was not the only group that did that work, although it was and still is particularly good—I have fond memories of what it did. Malachi and other organisations were very good at that stabilisation. They were good at holding those young people in a place where they were not deteriorating while waiting for CAMHS workers. My fear then, and sadly now, is that an awful lot of children—some of our most vulnerable citizens—are waiting for CAMHS workers and their conditions are deteriorating, and their needs are getting worse and not better, because of the waiting lists.
One of the big issues we identified was family breakdown. Parental conflict and family breakdown is a very strong factor in mental ill health in children. A statistic suggests that one in four young people in Stoke-on-Trent are affected by family breakdown and divorce. That means that approximately 15,500 children in Stoke-on-Trent alone will be affected by parental breakdown and divorce. That does not immediately mean that those children will have a mental health issue, but it is a factor that makes them more vulnerable. To pick up on some of the comments made by the hon. Member for Southport, children need the skills and the ability to have resilience, so that if there are factors that might tip them into having mental ill health issues, they have the resilience to address them. Sadly, for all too many of our children there is not the ability to build that resilience.
My hon. Friend the Member for Sheffield Central (Paul Blomfield) referred to local authorities. The ability to gain that resilience from services such as those offered by local authorities is not possible in Stoke-on-Trent, where local budgets have almost been wiped out for some children’s services. I seem to be constantly talking to people who used to work for the local authority in children’s services, but have now gone off to do other things because they can no longer be afforded. The main thrust of what I want to say is that more than 10 years ago there was a shortage of access to CAMHS. We do not seem to have gone anywhere with that. It seemed to get better, but it is now getting dramatically worse.
Healthwatch Stoke-on-Trent helpfully brought to my attention a list of issues that they are concerned about. When I say “they”, I mean children, young people and the adults supporting them. It makes deeply saddening reading. The first item on their list of what they want is a single point of access for real-time professional advice and guidance that can refer them to mental health services with the support they need when there is a crisis. This was again being talked about more than 10 years ago when I was attending meetings in what was still then, despite the fact it had been going for 10 years, a fledgling CAMHS. Nevertheless, even back then there was talk about having a single point of access. We have come full circle on the need for a single point of access.
Those children, young people and the adults supporting them talk about information, options and guidance to navigate the range of services and pathways available to them, and evidence-based interventions that are appropriate to them, with follow-up support as needed—the right service, first time. It is sad that here we are, so many
years later, without that service—or, where a service has been developed, it has gone because of the cuts. The Government are now having to undertake a review to take us back to the probably better work being done in the period leading up to 2010.
These people want a greater use of technology and access to online support. Technology has come a long way in the past 10 years, and I welcome that good suggestion from the children and young people themselves. They would like more support from schools and direct interventions on school premises in the school day, such as counselling, peer mentors and quiet spaces. There are quiet spaces in some of the good schools that I am blessed to have in Stoke-on-Trent. For example, St Thomas More school has a specific arrangement and understanding that young people who feel that they need to go out and get their head together can use the space that has been made available. I am sure other schools do that as well, but that example was highlighted to me. Malachi was doing innovative work on support in schools 15 or 20 years ago. I made the point in an intervention on the hon. Member for Totnes (Dr Wollaston) that when Malachi lost bids to big national charities, those charities would then subcontract back to Malachi, because they knew they had an in with the schools and could provide the service.
Going back to the list, those children and young people and the adults supporting them want clearer step up, step down work given that their mental health needs change and fluctuate, as well as more early support from non-mental health practitioners and their peers and/or older mentors. Their final point is that they do not want to be stigmatised when seeking and accessing help, which is so important. In addition to those things that the children and young people want, they have asked for clear referral routes and pathways through services, so that they get the intervention they need quickly, without being referred to multiple services—often waiting some time for an assessment—before finding that the service is not the right one for them anyway: having waited three or four months to get into the system, they then find that it is not what they needed and they have to start all over again.
The children and young people have also asked to be involved in planning their own care, to be part of setting their own outcomes and goals, to be consulted when changes are made to service provision and for their parents to be given support so that they can support them. The parents themselves, the carers, have asked for there to be clear access to services—that comes up time and again—and parenting support in the community that is easily accessible and non-stigmatising. Going back to my Malachi days, one of the hugely important things we did was to work with the parents, supporting and helping them, enabling them to take on a lot of the work of maintaining and helping their own children.
There are a few more items on the list, but I am conscious that I will rapidly run out of time if I am not careful, so I want to move on to a few of the risk factors. Again, they are not new, but things that we have come across too often, and it is important to raise these in the context of Stoke-on-Trent. In a report on this, the first factor listed among those that will have an impact on children and young people’s mental health is—this comes up time and time again—deprivation and poverty:
“The close association between mental disorder”—
as it is termed—
“and economic disadvantage was clearly illustrated by income analysis in the Mental Health of Children and Young People in Great Britain in 2004 survey”,
so this is not new evidence. That is a huge problem in places such as Stoke-on-Trent, where we still have such high levels of deprivation—indeed, they have been made worse recently.
I have mentioned parental conflict and breakdown, but there is also communication/speech and language delay. In Stoke-on-Trent there is a huge problem with language delay. Fantastic projects such as Stoke Speaks Out are addressing it, but if a child is having difficulty expressing their needs, how much more difficult will it be for that child—that young person—to be able to eloquently, or indeed adequately, put across what they want from the system that is trying to help them? Attainment in education is still an issue, despite the dramatic improvements that we saw in Stoke-on-Trent. Then there is housing and homelessness; and again, the poor standard of so much housing still in Stoke-on-Trent is a tragedy.
I want to make an observation about children in care and some of the organisations. The local authority in Stoke-on-Trent has seen a rise in the number of children in care in just a short period. From July 2010 to June 2013, there has been an increase of 38% in the number of children needing support in care in Stoke-on-Trent. That is a massive increase in the number of young people in the care system, which is a huge risk factor for mental ill health.
I close by observing a couple of things about Stoke-on-Trent. There is, as I have mentioned, Healthwatch Stoke-on-Trent and the good work it does. There are other organisations doing fantastic and excellent work, including Young Carers—part of North Staffs Carers Association. I have had the huge privilege on a number of occasions to meet the young people from Young Carers and hear about the amazing things that they—children—are called upon to do, quite often looking after their parents, and the huge impact that has on their mental health. Finally, there is another scheme, whose details I have unfortunately lost in the pile of papers in front of me. Home Start has been running in Stoke-on-Trent for about 30 years. Sadly, because the local authority is so strapped for cash and has had to cut its budget, after all that time and after helping thousands of families, Home Start is now closed. It is gone. It is another resource that is no longer there to help the people of Stoke-on-Trent.
That is the backdrop to the report by the hon. Member for Totnes and to what the Minister is doing with his investigation, both of which I welcome. It saddens me so much, however, that we seem to have gone nowhere in 10 years. Let us try to make sure that we do something about this in the coming months rather than in the years ahead.
5.40 pm