Recommendations & Conclusions
40 items
1
Recommendation
Eighth Report - Children and young peop…
Children and young people’s mental health is an all-society issue. The problems discussed in this report can only be addressed by Government departments, local government and the health system acting together to promote good mental health and prevent new crises emerging. We recommend setting up a Cabinet sub-committee to bring …
Government response. 20. We accept this recommendation in part. 21. The department frequently engages other government departments, local government, private companies, and voluntary, charity and social enterprise ( VCSE ) organisations to ensure that the promotion of children and young people’s mental …
Department of Health and Social Care
2
Conclusion
Eighth Report - Children and young peop…
Although the full long-term impact of the coronavirus pandemic on the mental health of children and young people under the age of 25 is as yet unknown, it is already clear that the mental health needs of these groups have been much exacerbated by the pandemic. This has been supported …
Government response. 24. We accept this recommendation in part. 25. The department agrees that the gap between the 2004 and 2017 NHS Digital Mental Health Surveys was too long. 26. The department has committed to conducting a comprehensive national survey every 7 …
Department of Health and Social Care
3
Recommendation
Eighth Report - Children and young peop…
The gap between the 2004 and 2017 NHS Digital Mental Health Surveys was too long, and this must not be repeated. We recommend that NHS Digital regularly collect and publish robust prevalence data for mental health conditions every three years, starting from the end of 2021 disaggregated by age, ethnicity, …
Government response. 28. The government is considering this recommendation. 29. NHSEI has published [footnote 1] details of the MHSTs being rolled out, up to and including the teams commissioned during FY 2021 to 2022. 30. Over 180 teams are currently operational, meaning …
Department of Health and Social Care
4
Conclusion
Eighth Report - Children and young peop…
During the pandemic, children and young people’s mental health has significantly worsened and the scale of the backlog mean that the NHS will not be able to treat its way out of this crisis. The need for early intervention and prevention in children and young people’s mental health has been …
Government response. 41. The government is considering this recommendation. 42. We welcome the committee’s finding that commitments in the 2017 green paper and the NHS LTP have been taken seriously. 43. There has been good progress: the NHS exceeded over a year …
Department of Health and Social Care
5
Conclusion
Eighth Report - Children and young peop…
The Department of Health and Social Care—in partnership with the Department for Education and all other relevant Government departments—must take radical steps to shift the focus in mental health provision towards early intervention and prevention. This must ensure that all children and young people under the age of 25 can …
Government response. 47. We accept this recommendation in part. 48. Although record numbers of children and young people are accessing support and the NHS exceeded the ambitions of the 5 Year Forward View for Mental Health nationally, we are committed to supporting …
Department of Health and Social Care
6
Conclusion
Eighth Report - Children and young peop…
We expect a full and comprehensive update from the Department on what measures it will implement, how this work will be funded and a timeframe for key outcomes relating to increased early intervention and prevention. We expect this information by the end of January 2022. (Paragraph 36) Increasing access to …
Government response. 51. We accept this recommendation in part. 52. NHSEI has been piloting a 4-week waiting time standard, as committed in the green paper on ‘Transforming children and young people’s mental health provision’, to inform the department’s assessment of the merits …
Department of Health and Social Care
7
Conclusion
Eighth Report - Children and young peop…
Commitments in the 2017 Green Paper and the NHS Long Term Plan have been taken seriously by NHS England and led to a significant expansion of provision. We are, however, concerned that many commitments may not yet be ambitious enough to ensure every young person with a diagnosable mental health …
Government response. 55. The government is considering this recommendation. 56. Improving mental health care and support for young adults is a priority for us. We know people aged 18 to 25 can, when trying to access mental health support, face challenges including …
Department of Health and Social Care
8
Recommendation
Eighth Report - Children and young peop…
We recommend that NHS England & Improvement set out a clear action plan including key milestones, deadlines, and funding for how they will meet their target set out in the NHS Long Term Plan of 100% access to specialist support for all children and young people aged 0–25 by 2029, …
Government response. 58. The government is considering this recommendation. 59. We acknowledge that a lack of appropriate growth in the mental health workforce has led to negative impacts on staff workloads, burnout rates and morale, and that these issues have been further …
Department of Health and Social Care
9
Recommendation
Eighth Report - Children and young peop…
We further recommend that NHS England & Improvement hold Clinical Commissioning Groups, which have consistently failed to meet national expectations, to account on key measures such as expenditure, waiting times and access rates. National ambitions should be raised in line with the best performing areas so that best practice becomes …
Government response. 67. We accept this recommendation in part. 68. Following publication of the NHS LTP and the Mental Health Implementation Plan, in January and July 2019 respectively, Health Education England ( HEE ) has been working with the department, NHSEI , …
Department of Health and Social Care
10
Conclusion
Eighth Report - Children and young peop…
We welcome and support the proposals in the recent access and waiting times consultation that concluded on 1st September, including crisis response times and a four-week waiting time limit for children and young people, and call on NHS England to publish a detailed roadmap as to how it will be …
Government response. 83. Please refer to the response to recommendation 3
Department of Health and Social Care
11
Conclusion
Eighth Report - Children and young peop…
It is clear that young adults between the ages of 18 and 25 face some of the widest gaps between the support that they need and the support that is available to them. 56 Children and young people’s mental health We welcome NHS England & Improvement’s commitment to shift away …
Government response. 84. The government is considering this recommendation. 85. MHSTs are specifically designed to provide a tailored offer of direct interventions to individuals and groups of children and young people with mild or moderate mental health needs like anxiety. This approach …
Department of Health and Social Care
12
Conclusion
Eighth Report - Children and young peop…
NHS England & Improvement must accelerate the implementation of the 0–25 offer in every local area as a national priority so that young people do not continue to face a cliff edge in accessing the care they require as they transition from children to adult services.
Government response. 89. We accept this recommendation in part. 90. Implementation of this recommendation will depend upon the outcome of annual business planning, and the Department for Education will later this spring confirm its position on issuing grants for FY 2022 to …
Department of Health and Social Care
13
Conclusion
Eighth Report - Children and young peop…
One of the largest barriers to increasing access to mental health provision for children and young people remains the size of the mental health workforce. We have seen that children and young people’s mental health practitioners face staff shortages, increasing demand and high levels of work-related stress which in turn …
Government response. 94. We accept this recommendation in part. 95. The department and the Department for Education are committed to supporting schools to adopt and deliver an integrated, whole-school approach to mental wellbeing, which is tailored to the needs of their pupils. …
Department of Health and Social Care
14
Conclusion
Eighth Report - Children and young peop…
In addition, it is paramount that a plan is implemented to increase the size and wellbeing of the children and young people’s mental health workforce based on independently verified estimates of the number of people needed in different disciplines and the training places required to deliver them. The strategy should …
Government response. 100. Please refer to the response to recommendation 3.
Department of Health and Social Care
15
Conclusion
Eighth Report - Children and young peop…
We have seen that Mental Health Support Teams, where they have been rolled out, are well-placed to facilitate early intervention for children and young people as part Children and young people’s mental health 57 of a whole school approach. They appear to have delivered positive outcomes for children and young …
Government response. 101. The government is considering this recommendation. 102. The government welcomes the committee’s recommendation and agrees that the social care sector is essential, in its role of identifying needs and supporting and referring children and young people, to the provision …
Department of Health and Social Care
16
Conclusion
Eighth Report - Children and young peop…
We therefore recommend that the Department of Health and Social Care fully fund and scale up the roll out of Mental Health Support Teams to cover two thirds of schools in England by 2024/25 and 100% by 2027/28.
Government response. 107. We accept this recommendation in part. 108. The Health and Care Bill will build on the work of existing non-statutory integrated care systems ( ICSs ) by establishing new NHS bodies known as integrated care boards ( ICBs ) …
Department of Health and Social Care
17
Recommendation
Eighth Report - Children and young peop…
Furthermore, in light of the rise in both prevalence and severity of children and young people’s mental health difficulties, the training of Education Mental Health Practitioners should be reviewed to integrate their skills into a new psychological professions structure. This must include training experienced practitioners in more sophisticated psychological therapy …
Government response. 111. We accept this recommendation in part. 112. All patients detained in hospital under the Mental Health Act are continually assessed and supported, and their need for detention is regularly reviewed. The government does not see the benefit in introducing …
Department of Health and Social Care
18
Conclusion
Eighth Report - Children and young peop…
A whole school approach to mental health and wellbeing should include the promotion of good mental health as well as the early identification of those who are at risk of mental health difficulties. Designated Senior Leads for mental health can have an extremely important role in overseeing and leading this …
Government response. 122. We accept this recommendation. 123. The NHS LTP commitment is all children and young people experiencing a mental health crisis will be able to access crisis care 24 hours a day, 7 days a week by FY 2023 to …
Department of Health and Social Care
19
Conclusion
Eighth Report - Children and young peop…
It is vital that the Department rolls out the training for Designated Senior Leads to all schools urgently with a commitment to completing the roll out before the end of the current Parliament. Moreover, given the worrying trends in self-harm and eating difficulties among children and young people, it is …
Government response. 133. The government is considering this recommendation. 134. Where inpatient care is needed it should be the highest quality, close to home and for the shortest possible time. 135. We are focussed on ensuring all patients, including people with a …
Department of Health and Social Care
20
Conclusion
Eighth Report - Children and young peop…
Whilst Mental Health Support Teams and Designated Senior Lead training is being rolled out, the Department of Health and Social Care and the Department for Education should work closely together with all schools to ensure that they have the support they need in order to offer a whole school approach, …
Government response. 144. We accept this recommendation. 145. As part of the reforms to the Mental Health Act, we plan to expand eligibility to Independent Mental Health Advocated services to informal patients, including children and young people, who are admitted to hospital …
Department of Health and Social Care
21
Conclusion
Eighth Report - Children and young peop…
For some children and young people where schools are not their preferred place to access support, drop-in hubs that operate on an open access, self-referral basis provide a valuable alternative opportunity to access help. We have heard that the large-scale roll out of a similar style system has improved outcomes …
Government response. 147. The government is considering this recommendation. 148. Within specialised commissioning, there are a number of programmes of work to reduce restrictive practice. 149. The National Quality Improvement Taskforce for children and young people’s mental health inpatient services has a …
Department of Health and Social Care
22
Recommendation
Eighth Report - Children and young peop…
We recommend that the Department of Health and Social Care fund and roll out open access models to every area across the country so that there is a consistent, comprehensive community offer to complement available school-based and clinical support across England. The hubs should also offer outreach support to vulnerable …
Government response. 159. We accept this recommendation. 160. A single data set now collects all the information from both NHS and private sector services and is completed by all providers. It is able to analyse at a provider and ward level all …
Department of Health and Social Care
23
Conclusion
Eighth Report - Children and young peop…
The social care sector is essential to the provision of mental health services to children and young people and it is essential that it is funded to do so as part of the forthcoming social care white paper.
Government response. 161. We accept this recommendation in part. 162. The government is accelerating the role out of MHSTs . 163. We agree that education settings can have an important role in prevention and early intervention. MHSTs , where established, are a …
Department of Health and Social Care
24
Conclusion
Eighth Report - Children and young peop…
Equally vital is the role of the new Integrated Care Systems and it is essential they publish detailed plans with timescales as to how community provision for the mental health needs of children and young people will be improved working jointly with the local social care system.
Government response. 172. Please refer to the response to recommendation 3.
Department of Health and Social Care
25
Conclusion
Eighth Report - Children and young peop…
For those children and young people who prefer accessing help online, digital services can be an important way of reducing barriers to access so it is important that a digital offer should be available for all young people. To prevent over-medicalisation of mental health conditions this should include self-help options …
Government response. 173. We accept this recommendation in part. 174. As set out in the introduction, the department plans to launch a public discussion paper later this year to inform the development of a new longer term mental health strategy. This will …
Department of Health and Social Care
26
Conclusion
Eighth Report - Children and young peop…
Inpatient units have a role to play in treating some of the most severe and complex mental health conditions, especially those that are resistant to community treatment. However, in most cases the most compassionate and effective care for children and young people is provided in the community–and increasing its provision …
Government response. We accept this recommendation in part. All patients detained in hospital under the Mental Health Act are continually assessed and supported, and their need for detention is regularly reviewed. The Government does not see the benefit in introducing more legislative …
Department of Health and Social Care
27
Recommendation
Eighth Report - Children and young peop…
We therefore recommend that the Department accelerates the shift towards increased community-based provision and a reduced inpatient bed base as a national priority to ensure that children and young people with the most complex needs receive good quality care in a setting that is right for them. A national strategy …
Government response. We accept this recommendation in part. All patients detained in hospital under the Mental Health Act are continually assessed and supported, and their need for detention is regularly reviewed. The Government does not see the benefit in introducing more legislative …
Department of Health and Social Care
28
Conclusion
Eighth Report - Children and young peop…
In order to achieve this shift towards community-based care, every area should have a community service for children in crisis which is available 24 hours a day, seven days a week. A clear map is needed of where current gaps in this provision are and a plan should be in …
Government response. We accept this recommendation. The NHS LTP commitment is all children and young people experiencing a mental health crisis will be able to access crisis care 24 hours a day, 7 days a week by, 2023/24, with a single point …
Department of Health and Social Care
29
Conclusion
Eighth Report - Children and young peop…
For those children and young people for whom inpatient admission cannot be avoided, a continued focus is needed to increase the quality of this care. As well as much improved data collection, this should include access to therapies, activities and education, including from private sector providers. It should include a …
Government response. The Government is considering this recommendation. Where inpatient care is needed it should be the highest quality, close to home and for the shortest possible time. We are focussed on ensuring all patients, including people with a learning disability and …
Department of Health and Social Care
30
Conclusion
Eighth Report - Children and young peop…
It is disappointing that the Government’s 2021 Mental Health White Paper leaves expanding the legal right to support from an advocate to all children and young people subject to future funding availability. There is a compelling case that Independent Mental Health Advocates have a valuable role in helping inpatient children …
Government response. We accept this recommendation. As part of the reforms to the Mental Health Act, we plan to expand eligibility to Independent Mental Health Advocated services to informal patients, including children and young people, who are admitted to hospital on a …
Department of Health and Social Care
31
Conclusion
Eighth Report - Children and young peop…
The Department should commit to expanding Independent Mental Health Advocates support so that all children and young people admitted to hospital informally have the same legal right to an Independent Mental Health Advocate as those admitted under legislation without qualification. This advocacy should all operate on an opt- out basis.
Government response. The Government is considering this recommendation. Within specialised commissioning, there are a number of programmes of work to reduce restrictive practice. The national Quality Improvement Taskforce for Children and Young People’s Mental Health, Learning disability and Autism Inpatient Services has …
Department of Health and Social Care
32
Conclusion
Eighth Report - Children and young peop…
We welcome the Government’s commitment to reducing the use of seclusion, segregation and restraint for children and young people in inpatient units and the Mental Health Units (Use of Force) Act in particular. However, we have heard that 60 Children and young people’s mental health restrictive interventions, and particularly restraint, …
Government response. The Government is considering this recommendation. Within specialised commissioning, there are a number of programmes of work to reduce restrictive practice. The national Quality Improvement Taskforce for Children and Young People’s Mental Health, Learning disability and Autism Inpatient Services has …
Department of Health and Social Care
33
Conclusion
Eighth Report - Children and young peop…
In addition to our recommendations on the use of restraint that we set out in our report on the treatment of autistic people and people with learning disabilities, the use of prone restraint on children and young people should be banned in all inpatient settings and in transit. Further action …
Government response. The Government is considering this recommendation. Within specialised commissioning, there are a number of programmes of work to reduce restrictive practice. The national Quality Improvement Taskforce for Children and Young People’s Mental Health, Learning disability and Autism Inpatient Services has …
Department of Health and Social Care
34
Conclusion
Eighth Report - Children and young peop…
It is vitally important to be able to monitor the experiences of children and young people in inpatient care, particularly how often restraint is used in each setting and whether there is appropriate access to advocacy. This is key to ensuring individuals in inpatient care are receiving quality support and …
Government response. We accept this recommendation. A single data set now collects all the information from both NHS and private sector services and is completed by all providers. It is able to analyse at a provider and ward level all the listed …
Department of Health and Social Care
35
Recommendation
Eighth Report - Children and young peop…
In addition to the recommendations on data we set out in our report on the treatment of autistic people and people with learning disabilities, we further recommend that NHS England and Improvement regularly collect and publish high quality data including from private sector providers on: • the basis of children …
Government response. We accept this recommendation. A single data set now collects all the information from both NHS and private sector services and is completed by all providers. It is able to analyse at a provider and ward level all the listed …
Department of Health and Social Care
36
Conclusion
Eighth Report - Children and young peop…
We are deeply concerned about the increasing numbers of children and young people who experience self-harm and suicide and the quality of care they are able to access. Much more needs to be done to tackle suicide and self-harm amongst children and young people. In particular, given the link between …
Government response. We accept this recommendation in part. The Government is accelerating the role out of MHSTs. We agree that education settings can have an important role in prevention and early intervention. MHSTs, where established, are a key part of this. MHSTs …
Department of Health and Social Care
37
Recommendation
Eighth Report - Children and young peop…
We recommend that the Department implement a new system of early intervention to support children and young people who self-harm and are at risk of committing suicide. Educational settings, as a universal provision, can have an important role to provide effective early intervention to pupils who may be struggling with …
Government response. We accept this recommendation in part. The Government is accelerating the role out of MHSTs. We agree that education settings can have an important role in prevention and early intervention. MHSTs, where established, are a key part of this. MHSTs …
Department of Health and Social Care
38
Conclusion
Eighth Report - Children and young peop…
For those children and young people for whom school is not the most accessible place to seek support, there must also be a community-based offer. This could be based on the network of drop-in hubs outlined in Chapter 4 of this report, which provide open- access mental health support without …
Government response. Please refer to the response to Recommendation 3.
Department of Health and Social Care
39
Conclusion
Eighth Report - Children and young peop…
Preventing the worst mental health outcomes means first creating the conditions across society that are conducive to good mental health and wellbeing. We welcome the support provided by the former Minister for Patient Safety, Suicide Prevention and Mental Health to a ‘cross-governmental’ strategy to prevent the worst mental health outcomes …
Government response. We accept this recommendation in part. As set out in the introduction, the Department plans to launch a public discussion paper later this year to inform the development of a new longer term mental health strategy. This will set us …
Department of Health and Social Care
40
Recommendation
Eighth Report - Children and young peop…
We recommend that each Government Department, led by the Department of Health and Social Care should set out specific, measurable objectives for mental health promotion in each policy area. This should include policies that aim to build mental health resilience in the population as a whole, as well as specific …
Government response. We accept this recommendation in part. As set out in the introduction, the Department plans to launch a public discussion paper later this year to inform the development of a new longer term mental health strategy. This will set us …
Department of Health and Social Care