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Transforming Children and Young People's Mental Health Provision

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Transforming Children and Young People's Mental Health Provision Unite the Union (in Health) 128 Theobald’s Road, Holborn, London, WC1X 8TN T: 020 7611 2500 | E: [email protected] Unite the union response to: Transforming Children and Young People’s Mental Health Provision: A Green Paper This response is submitted by Unite in Health. Unite is the UK’s largest trade union with 1.5 million members across the private and public sectors. The union’s members work in a range of industries including manufacturing, financial services, print, media, construction, transport, local government, education, health and not for profit sectors. Unite represents in excess of 100,000 health sector workers. This includes eight professional associations - British Veterinary Union (BVU), College of Health Care Chaplains (CHCC), Community Practitioners’ and Health Visitors’ Association (CPHVA), Guild of Healthcare Pharmacists (GHP), Hospital Physicists Association (HPA), Doctors in Unite (formerly MPU), Mental Health Nurses Association (MNHA), Society of Sexual Health Advisors (SSHA). Unite also represents members in occupations such as nursing, allied health professions, healthcare science, applied psychology, counselling and psychotherapy, dental professions, audiology, optometry, building trades, estates, craft and maintenance, administration, ICT, support services and ambulance services. Len McCluskey www.unitetheunion.org General Secretary 2 1. Some key points contained in our response 1.1. The Green Paper is nowhere near bold enough to address the burning injustice of children and young people’s mental ill health (2.3) 1.2. The Green Paper consultation process is totally inadequate (2.4) 1.3. A revised Green Paper should commit to initiating a School Nurse Implementation Plan, similar to the previous ‘Health Visitor Implementation Plan’ (4.3) 1.4. A revised Green Paper should commit to reintroducing the Health Visitor Implementation Plan to address the crisis currently unfolding (6.4) 1.5. A revised Green Paper should ensure it addresses the total absence of focus on the first 1,001 critical days (7) 1.6. A revised Green Paper should address the significant problems in specialist Child and Adolescent Mental Health Services (8) 1.7. The government must reverse its austerity agenda that is causing untold damage to citizens and communities across England (9) 2. Introduction 2.1. Unite welcomes the opportunity to respond to ‘Transforming children and young people’s mental health provision: A Green Paper’. As part of this response, Unite has used its ongoing routes throughout the organisation to hear back the views of its members. These have been used to formulate this response. 2.2. Transforming children and young people’s mental health should be a priority for any government. It is welcome that the Prime Minister has recognised this, including in previous statements where she identified mental ill health as a ‘burning injustice’ that needs to be appropriately tackled. 2.3. Whilst it is welcome that the Department of Health and Social Care (DHSC) and the Department for Education (DfE) have laid out three core principles in this green paper, that Unite is sure will make some improvements to the care and support that children who are suffering from mental ill health will receive in future, this green paper is nowhere near bold enough to address this ‘burning injustice’. 2.4. It is concerning that the consultation process, alongside this green paper, is not sufficient to properly allow feedback on the significant omissions of the paper, with the questions asked showing evidence of implicit bias in favour of your preferred options. Unite asks that in future both departments make considerable more efforts to ensure that green paper consultations are much more meaningful. Unite have also included a copy of the response we have submitted online in appendix A. This full response must be read in conjunction with our online submission. 2.5. Unite strongly supports; guaranteeing access to NHS treatment and reducing waiting times, firm commitments to properly resourcing the NHS, including £30bn in extra funding, scrapping the NHS pay 2 3 cap, legislation to ensure safe staffing levels, re-introducing bursaries and funding for health-related degrees, boosts for capital funding, ring fencing and investing in mental health services particularly for children and young people. We believe all of these will have a positive impact of children and young people’s mental health. 3. Core principle 1: Designated Senior Lead for Mental Health 3.1. Unite believe it is right to ensure that every school in England has a ‘designated senior lead for mental health’. We are unsure however how the government can claim this principle is a ‘bold ambition’. As the green paper itself recognises, a majority (highlighted to be between one half to two thirds) of schools, already have an individual in place that performs this role (66). Further, with the green paper talking about incentivising rather than mandating for this role to be in place, we are unsure how this will improve the situation, and would argue that the schools least likely to be won over by an incentive may be the schools that would benefit most from having this role in place. We therefore recommend that this role is not just incentivised but becomes a requirement, and this is monitored via Ofsted alongside its regular school inspections. 3.2. It is unclear why, when the government requires schools to have a ‘designated safeguarding lead (DSL)’, which includes the need to have the role specified in the individuals job description1, it is not laying out the same expectation in the Green Paper for the designated senior lead for mental health. It seems sensible to give this new role the same statutory footing and we ask that this be done. Further, we note that the DSL role has not been evaluated for its effectiveness2, we recommend that this is done. 3.3. As well as ensuring that this role is in place, we believe a set of standards should be adopted to ensure that this role is sufficient enough to deliver improved outcomes for children at each school. A good starting point for this would be to mirror those laid out for the DSL role3; “This person should have the appropriate status and authority within the school to carry out the duties of the post. They should be given the time, funding, training, resources and support to provide advice and support to other staff on [children and young people’s mental health], to take part in strategy discussions and inter- agency meetings – and/or to support other staff to do so – and to contribute to the assessment of children”. We believe these are critical to ensure that the person holding the role maintains competence and the confidence of others, including pupils, parents and fellow staff. 1https://www.nspcc.org.uk/globalassets/documents/information-service/schools-factsheet-role-designated-safeguarding-lead- dsl.pdf 2http://www.parliament.uk/business/publications/written-questions-answers-statements/written-question/Commons/2018-02- 08/127756/ 3https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/550511/Keeping_children_safe_in_education .pdf 3 4 3.4. Although the Prime Minister has stated that ‘record amounts of funding are going into education’4, independent assessments paint a different story. One analysis5, by Prof. Sandra McNally, highlight that ‘per pupil’ funding between 2010/11 and 2015/16 was ‘largely frozen’. Looking in to the future, with the government’s current plans of freezing, in cash terms, real terms school spending, this translates into a reduction of around 6.5% of per pupil spending between 2010/11 and 2019/20. This would be the biggest real-terms fall in school spending per pupil in 30 years. McNally also points out that the outlook for spending in further education (age 16-18) is even worse, with the likely fall to be around 13% between 2010/11 and 2019/20. 3.5. We are concerned that, with these significant cuts to schools funding, this designated senior role could become something in name only. This will do nothing to improve outcomes for children. We therefore recommend that the green paper ensures focused funding, that is ring-fenced to this role, and this funding must include appropriate backfill to ensure the lead has appropriate time to discharge their duties effectively. The government must also address it’s cuts to schools funding as a matter of urgency. 3.6. Our members in the NHS also highlight that the approach may mirror one often taken in their [health] services, whereby rather than appropriately funding someone to lead on an issue, a champion is appointed who is unable to properly develop the role because of a myriad of other demands on their time. If a school has already cut its teaching staff, something has ‘to give’. 3.7. Whilst this proposed new role is focused on children and adolescents in school, we also recommend that similar roles are mandated for; 3.7.1. Pre-school (Designated Senior Leads for supporting Infant Mental Health): We have provided more information about concerns regarding the absence of support to under-5’s in the Green Paper later in our response. 3.7.2. Universities: This would help to address the ‘mental health crisis’6 in our Universities. Surveys have shown that “almost nine in 10 (87%) of first year students find it difficult to cope with social or academic aspects of university life”, and in the Institute for Public Policy Research report, ‘Not by Degrees: Improving student mental health in the UK's universities7’ they highlight that “Our survey reveals that HEIs have – over the past five years – experienced significant increases in demand for (overall) student services… 94 per cent report an increase in demand for counselling services, while 61 per cent report an increase of over 25 per cent” 3.8.
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