Government response to mental health green paper
New approach to be rolled-out to a fifth of country by 2022-23
Published on 30th July 2018
The government has published its response to its consultation on transforming children and young people’s mental health.
‘Transforming children and young people’s mental health provision: a Green Paper’ outlined a three tiered approach to supporting children and young people with mental health problems with the following core principles:
1. To incentivise and support all schools and colleges to identify and train a Designated Senior Lead for mental health.
2. To fund new Mental Health Support Teams, which will be supervised by NHS children and young people’s mental health staff.
3. To pilot a four week waiting time for access to specialist NHS children and young people’s mental health services.
In its consultation response last week, the government pledged to ‘trial all three elements in new trailblazer areas, identifying the first wave to be operational by the end of 2019’.
“We remain committed to rolling out our new approach to at least a fifth to a quarter of the country by the end of 2022/23. The precise roll-out will be considered further following the development of the NHS long term plan, and will be informed by the evaluation of the initial trailblazers,” the government response added.
The response said that there was support for the overall aim of the proposals, in particular, better joining up between health and education and providing earlier support in or near schools and colleges.
However, there were concerns about ensuring that implementation should be flexible and not creating new requirements that would increase teacher workload and pressures on school funding.
The government said that it has looked at the current training available for Designated Senior Leads for mental health in schools and colleges and reconsidering, in light of our teaching and leadership innovation fund process, whether there are sufficient high quality courses and will work with providers of suitable courses to make sufficient places available to offer training to one-fifth of schools from September 2019. There will be provision for further high quality courses to be included in later years of the roll-out where these are developed.
It added that it is open to a range of delivery models for the Mental Health Support Teams. The government will fund Mental Health Support Teams via Clinical Commissioning Groups (CCGs), and expect schools, colleges and other local partners to have a central role in the application process and in designing and leading delivery.
The government will encourage sites in the trailblazer programme to test many of the issues raised in the consultation, such as how the teams can best work with vulnerable children and young people. Trainees for the teams will be recruited in autumn 2018 with the first Mental Health Support Teams being operational from the end of 2019.
From 2018, pilot areas will start planning for and providing access to evidence based treatment within four weeks. Pilots will take place in some of the trailblazer areas, and are likely to cover a greater area and population than that covered by the Mental Health Support Teams, given the wide range of numbers of schools in different sized CCGs.
“Our decision to pilot four week waiting times, rather than simply requiring all services to meet this ambition immediately is to mitigate the risk of unintended consequences, and ensure waiting times are improved in a fair and sustainable way. Through the pilots, and through monitoring the impact of Mental Health Support Teams on referrals and specialist NHS children’s mental health services, we aim to establish a clear understanding of the costs, benefits, challenges and indicators of success of introducing a four week wait,” said the government response.
The new approach, including the Mental Health Support Teams, Designated Senior Leads and in some areas, the four week waiting time standard, will be rolled-out to at least a fifth to a quarter of the country by the end of 2022/23.
The government said it will take other proposals from the green paper forward including:
- Its manifesto commitment that children will learn about mental health through the curriculum.
- Making health education a compulsory part of the curriculum for the first time, with all schools teaching it by September 2020.
- Action on social media and potential harms to children and young people’s mental health through our response to the Internet Safety Strategy Green Paper.
- Introducing transparency reporting for social media companies that will provide data on the amount of harmful content being reported to platforms in the UK and information on how these reports are dealt with.
- Having a trained member of staff in mental Health First Aid in a further 1,000 state secondary schools by this time next year to reduce stigma and promote awareness.
Leaving young people without support
The government will also support the launch of a new University Mental Health Charter in June 2018, aiming to drive up standards in promoting student and staff mental health and wellbeing. Universities will be awarded a new recognition for meeting improved standards.
“In addition, the Department for Education is setting up a team with representatives from across the sector to review the support needed for students in the transition into university, particularly those with or at risk of mental health issues. The Department has also committed to consider development of a workable disclosure agreement for universities that would give them permission to share information on student mental health with parents or a trusted person,” the response concluded.
Cllr Izzi Seccombe, Chairman of the Local Government Association’s Community Wellbeing Board, said: “Measures to tackle the crisis in children and young people’s mental health are long overdue and we are pleased the Government is taking steps to address this.
“However we remain concerned that the Green Paper doesn’t go far enough to tackle the challenges children and young people are experiencing to get the vital care they need. With only an estimated fifth to a quarter of the country’s children benefitting from the government’s proposed scheme by 2022/23, this risks leaving many young people without vital support.
“We need to develop a system that says yes to all children and young people, rather than no, when they ask for help. Children and their families need help and support right now - depression, anxiety, bereavement, and family crises do not wait.
“As a starting point, we want to see councils and schools given the funding to offer independent mental health counselling so pupils have access to support as and when they need it.
“Government also needs to work with the LGA and councils to make sure this is a local area-led approach, rather than just NHS,” she added.
Sleep-walking into a crisis
Barnardo’s has warned the government that it is “still sleep-walking into the deepening crisis in children’s mental health”. The charity says it remains supportive of government plans to improve mental health services, but thinks it’s too little - reaching only 25% of the country, and too late- spread over the next four years.
Whilst it welcomes the announcement of a new NHS mental health workforce dedicated to supporting children in schools and colleges, Barnardo’s says the government’s response to the children’s mental health Green paper consultation has failed to significantly address concerns on its ambition to transform.
Barnardo’s is also deeply concerned that the announcement does not mention the importance of early intervention in primary schools, regarded by the charity as crucial to transforming and stemming a deepening mental health crisis.
Barnardo’s is calling on the government to use some of the £20.5 billion extra funding promised to the NHS in England by 2023/24 to help stop the children’s mental health crisis and bringing waiting times down across the country, not just in a handful of pilot sites.
Actions speak louder than words
Barnardo’s Chief Executive Javed Khan said: “Theresa May has described mental illness as a burning injustice that required a new approach from government.
“However, actions speak louder than words. The government’s response to the Green Paper consultation does not show enough action on how as a society we are going to stop sleepwalking into a children’s mental health crisis.
“The response has let down the children who gave their views about the problems with the Green Paper and if the government does not rethink its approach, it runs the risk of letting down future generations too,” he added.
Matthew Reed, Chief Executive of The Children’s Society, said: “While the government’s commitment to put more support into schools is welcome, it doesn’t do nearly enough to address the crisis in children’s mental health services.
“Hundreds of thousands of young people are struggling with mental ill-health and these proposals fall short of what is needed to urgently tackle long waiting times and shortcomings in support.
“As little as one fifth of the country would benefit from the planned pilot schemes, meaning the current postcode lottery will continue for the foreseeable future and it could be years before the changes are rolled out.
“Many more children could be reached, and quickly, by committing to the provision of counsellors in all secondary schools and colleges as soon as possible.
“More funding is needed if trusts are to meet the four-week waiting time target, and there is little in the plans to improve early support for the most vulnerable groups of children - including those affected by sexual abuse and neglect, domestic violence, those excluded from school and refugee children - which can prevent mental health problems from escalating.
“The proposals do not do enough to improve provision for older young people, particularly in colleges, and we would urge the Government to ensure all young people can access Children and Young People’s Mental Health Services up to the age of 25, rather than 18 or 16. We have seen through our own services how this model can help address the worrying problem of young people falling through the cracks between children’s and adult mental health services.
“These proposals do not reflect the urgency of the situation facing young people in desperate need of help right now and we would call on ministers to think again and strengthen these plans,” he added.
Anne Longfield, the Children’s Commissioner for England, responding to the government’s latest plans on children’s mental health services, said: “While I welcome the government’s commitment to developing a new children’s mental health workforce in schools over the coming years, I remain extremely concerned that significant improvements for all children are many years away. Five years is a lifetime to a child, and even under these new plans the majority of children will see little improvement over the course of their secondary school life. Too many children will still not be able to get help or will be waiting an unacceptably long time for treatment.
“I know NHS professionals and schools are working hard to improve services and the introduction of trailblazer pilots and the training of hundreds of new counsellors will make a difference. This is a positive step in the right direction which quickly needs to be followed by a quantum leap to accelerate implementation to get help to all children who need it.
“I would like the government to set really ambitious targets that would see a counsellor available to every secondary school, so that we give children suffering from mental health problems every chance of getting better before their illness becomes worse and they reach crisis point. This will require political will and leadership and a sea change in children’s mental health care funding, to close the enormous spending gap between adult and children’s mental health services. I will continue to press the government to make the changes needed to make sure every child has access to the support and care they need as soon as possible,” she concluded.
Transforming children and young people’s mental health provision
Government Response to the Consultation on Transforming Children and Young People’s Mental Health Provision: a Green Paper and Next Steps
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