Bishop of Carlisle highlights need for community mental health treatment for young people with learning difficulties

On 30th January 2019 the House of Lords debated a question from Baroness Tyler of Enfield, “To ask Her Majesty’s Government what assessment they have made of the recent concerns expressed by general practitioners that children and young people with mental health problems are unable to access National Health Service treatments; and what steps they will take to address them.” The Bishop of Carlisle, Rt Revd James Newcome, spoke in the debate:

The Lord Bishop of Carlisle: My Lords, this is a very timely debate, and I thank the noble Baroness, Lady Tyler, and congratulate her on securing it. We have heard some of the alarming statistics on children and young people with mental health needs, and we know that current NHS services are unable to meet this disturbing increase. In an ideal world, we would be asking ourselves why there should be such an increase—some of the reasons were mentioned by the noble Baronesses, Lady Chisholm and Lady Massey—and doing our best to tackle the causes rather than just attend to the consequences. But that is another debate.

For the moment, I would like to use the brief time at my disposal to focus on some of the most vulnerable young people in our society: those with moderate to severe learning difficulties, whose mental health needs can be either missed or inappropriately treated in hospitals. I believe that they and many other people with mental health needs would benefit hugely from the provision of good services in the community rather than in hospitals or other institutions. I was greatly encouraged to find that the NHS Long Term Plan, which we will debate tomorrow, comes to a similar conclusion in its treatment of this subject, on pages 50 to 53. In particular, it emphasises the need to embed mental health support for all young people in schools and colleges—a strategy that has already been shown to be therapeutically effective and cost-efficient and that was mentioned by the noble Baroness, Lady Tyler.

We also know that a lack of good support for children with learning disabilities and behavioural challenges can lead to crises in families and a lifetime of restrictive, high-cost, often residential treatments for individuals when they become adults. The charity Mencap is deeply concerned about this and reports that, over the last few years, the number of children with learning disabilities admitted to mental health hospitals has gone up rather than down. Between March 2015 and May 2018, the number of children under 18 in in-patient mental health units doubled, from 110 to 250. There were another 465 young people aged between 18 and 24 in in-patient units last year. The average length of stay has remained the same, at 5.4 years, since 2013. These figures contrast rather starkly with the laudable and ambitious Building the Right Support campaign launched by NHS England in October 2015. Its aim was to close up to half of the in-patient beds across the country for people with a learning disability and to ensure that local areas develop the right community support by March this year. To date, only about 20% of those in-patient beds have been closed, and I have already referred to the way in which local community mental health services are severely overstretched.

In other words, as we have already heard, we have a long way to go before the good aspirations of the NHS Long Term Plan for all young people with mental health needs—and those with learning disabilities in particular—will remotely be achieved. Given the urgency of the current situation, I would be most grateful if the Minister would comment on the proposed timeframe for closing beds in institutions and making sure that effective mental health support for children and young people is available in all our communities.


Baroness Manzoor (Con, Minister) [extract]…As the noble Baroness, Lady Tyler, and the right reverend Prelate the Bishop of Carlisle said, some children will, unfortunately, experience a mental health crisis and will need rapid mental health support. I want to thank the noble Baroness for contacting my noble friend Lord O’Shaughnessy on this important matter last month, when he was the Minister. Like the noble Baroness and the right reverend Prelate, I am pleased with the strong focus on crisis care in the NHS Long Term Plan, which sets out around £250 million of investment in crisis care by 2023-24…

…The right reverend Prelate the Bishop of Carlisle asked about better community service and support for those with learning disabilities. I agree that we need to increase community services, particularly for those with learning disabilities. That is why the long-term plan’s significant investment in children’s mental health services is so crucial. As I said, by 2024 an additional 345,000 children will receive this support…

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