28th September 2017
Submission by Children in Wales to the Children, Young People and Education Committee:Inquiry into the emotional and mental health of children and young people in Wales.
Background information about Children in Wales
Children in Wales is the national umbrella organisation in Wales for children and young people’s issues, bringing organisations and individuals from all disciplines and sectors together. One of our its core aims is to make the United Nations Convention on the Rights of the Child (UNCRC) a reality in Wales. Children in Wales campaigns for sustainable quality services for all children and young people, with special attention for children in need and works to ensure children and young people have a voice in issues that affect them.
Young Wales is a participation programme within Children in Wales, funded by Welsh Government so children and young people can express their views to Cabinet Secretaries, Ministers and other policy makers. Its aim is to inform and enable children and young people to participate effectively and have their views heard by Ministers and policy makers. The work of Young Wales is underpinned by article 12 of the UNCRC which relates to the right of the child to be heard.
For further information on the work of Children in Wales, please see www.childreninwales.org.ukand www.youngwales.wales
Children in Wales Response to the Inquiry
Children in Wales welcomes the opportunity to submit evidence to the Committee’s Inquiry into the emotional and mental health of children and young people. There are many key points that are important in relation to this Inquiry but we will focus on a few from the point of view of Children in Wales’s members and partners and several from the children and young people involved in Young Wales.
Children in Wales has been involved in the Together4Children and Young People programme (TG4YP) both at the Programme Board level through representation and also via the link from the Programme Board to Young Wales and back to the Programme Board from Young Wales.
Early Intervention and prevention is the key to promoting good mental health and this is required at the time when it is needed such as in a crisis or anxious period at home or school. Children entering the care system or the criminal justice system, children who have suffered abuse or separation or family breakdown can predictably need emotional support and in the case of children entering public care there should be an assessment of their emotional needs as well as their physical needs. Resources should be available for the services which children and young people identify as being the ones they would prefer to access. This may be the school counselling service, or third sector organisations some of whom may facilitate peer to peer activity as well as the usual health services such as GP’s. In relation to third sector organisations, many provide timely support but do not necessarily identify themselves as being linked to CAMHS or mental health services and their work should be recognised as being important in the promoting emotional well-being agenda. Others who have a history of successful mental health projects have been losing funding in these times of austerity.
A very important issue is in relation to the question of which children are receiving services and which aren’t. Training for those who are regular referrers of children to CAMHS is essential. There needs to be a high level of understanding of child development and behaviours to expect in children and young people as they are growing up. For instance teachers may or may not fully understand what lies behind, aggressive, withdrawn or disruptive behaviour. Sufficient access for front line staff to advice and support regarding what is normal, especially during periods of stress and what is a cause for concern could potentially ensure that only those with ‘mental illness’ end up in the specialist services and this could help to release some capacity therein. It is important that those children facing adversity are helped to become as resilient as possible before becoming a ‘medical’ case.
There is an urgent need to take a whole system approach from early intervention and prevention through to specialist CAMHS with joined up working between those involved with the child, including the child and the parents.
The T4CYP Programme Board has been connected to Young Wales through a children and young people’s reference group as well as supporting young people led workshops at conferences and events.
Young Wales welcomes the opportunities it has had to feed in the views of young people to T4CYP particularly as emotional well-being and mental health are top priorities for young people in Wales. There needs however to be a recognition that involving children and young people in expressing their views takes more time than consulting professionals or adults in general as face to face discussions are restricted to evenings, weekends and school holidays. Information received via social media is also useful. We believe that this work is just beginning to have influence.
‘Links with Education (emotional intelligence and healthy coping mechanisms).’
Young people believe that the world in which they live in Wales has many pressures on them and if not dealt with at an early stage may lead to later problems or mental ill health. As well as bullying, both off and online they report pressures in families possibly due to poverty and pressures in school causing worry and anxiety. We believe that institutions such as schools should seriously look at reducing the pressures that are passed down from staff to children – such as testing or preparation for inspections. This requires leadership and creating a positive whole school culture.
From the work of Young Wales, we know that well-being and good mental health is one of the issues that concerns young people in Wales, with many young people feeling that school could and should do more (but that better support in school isn’t the only solution).
Children and young people tell us that there needs to be more of a focus on good mental health. Whenever mental health is talked about in school it’s in a negative way, when things have gone wrong. There needs to be more of a culture and attitude to promoting good mental health and building resilience is key.
There needs to be a universal approach to supporting young people to maintain good mental health, to know what signs to look out for (in themselves and their peers) if things are starting to go wrong, to know how to support a friend who may confide in them and where to go for help.
We welcome the announcement by Welsh Government to invest £1.4m in pilot schools to strengthen the support from specialist CAMHS to schools. However, we would like reassurances that the pupils from those schools will be involved in the design of the new support package, in the evaluation of the pilots and also in feeding back to pupils in those schools not involved in the pilots. Children in Wales / Young Wales would be happy to help facilitate or support this.
Vulnerable children and young people:
It is widely known that children and young people in the care system and those that have had involvement with the youth justice system, are at a greater risk of poor mental health than the general population. Children in Wales would like to see a whole system approach with a greater emphasis on prevention in supporting the well-being and mental health of ‘looked after’ children and those in the youth justice system, ensuring that social services, health, education and the voluntary sector work together to support their emotional needs at an earlier stage.
Children living in more deprived households are also more at risk of poor mental health, however, it is concerning that the effects of living in poverty isn’t always recognised by schools and mental health professionals.
Young Wales recently worked with Caerphilly Youth Forum to explore issues around the links between poverty and mental health. They turned this into a workshop which was delivered at a Children in Wales Poverty Conference in June 2017.
Whilst discussing these issues it became apparent that the young people did not see school as a fair place, a place where all pupils were treated equally because although it is ‘free’ to attend school, those growing up in poorer households are not able to participate fully in school life. They aren’t able to afford extracurricular activities or school trips, the right equipment for PE, materials for subjects like DT and art, they may not have access to a computer and Wi-Fi at home to do their homework, nor can they afford a tutor to help them if they are struggling with a particular subject (like many of their wealthier peers). They then often get punished by teachers for ‘forgetting’ their PE kit or not doing their PowerPoint presentation because they feel too ashamed to say they don’t have access to a computer or their trainers are too small and can’t afford new ones. They end up feeling useless and stuck:
‘You can feel isolated as you don’t want people to know anything about you – constant anxiety.’
‘Don’t want people to know you have free school meals – carrying this around with you all day makes you anxious and constantly on edge.’
‘Housing – often no ‘personal’ space, you have nowhere to go to take 5 if you need it.’
‘Don’t want to talk to parents about problems as don’t want to add to their worries.’
In an online survey of paediatricians conducted jointly by the Royal College of Paediatricians and Child Health and the Child Poverty Action Group[1], it was found that children and young people’s mental health was affected by poverty and that wider evidence shows the environmental effect of living in poverty, such as sharing a bed with siblings and living in a cold house, negatively affects their mental health, as well as increasing the risk of ACEs.
What else are young people saying?
To follow are some examples of evidence that we have gathered from talking to young people at recent events:
· In a survey conducted by Young Wales at the Urdd Eisteddfod in Pencoed in May 2017, young people aged 11-18 stated mental health and well-being (including stress, anxiety and depression), and bullying (including cyber-bullying) as the top two biggest issues facing young people in Wales today. One person said: ‘Show us that it’s ok to have mental health problems and that help is available.’
· In a workshop at the Young Wales Annual Conference in February 2017 young people were asked what should be included in a ‘Curriculum for Life’. Better education about mental health and more support with mental health was one of the key topics they raised – this included:
‘Need support in school, counsellors and someone to go to, non-judgemental’
‘Need to raise awareness of where to get help and support in and outside of school’
‘Need extra support in school at exam time’
‘Learn how lifestyle can affect mental health’
· During July 2017 Young Wales ran three workshops across Wales focusing on Curriculum Reform. In these workshops the young people stressed the need for well-being support for everyone, not just those who are in crisis. They said that school counselling services are not publicised enough and pupils often don’t know about them or don’t know how to access them. In addition, the issue of bullying in schools and its impact on a child or young person’s mental health was widely discussed. Many young people felt that teachers were not interested, and those that did take an interest didn’t always follow up. The young people also recognised that teachers are over-worked and not always equipped to help pupils in need of support with their mental health.
· In a workshop on mental health at the Young Wales Conference, March 2016 young people explored issues around mental health and what they thought could be done to improve the situation for children and young people in Wales. Some of the comments they made were:
‘Educate us on different types of mental illness and stigma.”
‘Help us learn about having a healthy relationship with ourselves, food, body image etc.’
They also said that there was a need for support in their local community, a stage between school and CAMHS and that there should be more diversity in the workforce, ‘more counsellors that are like me, not all the same gender, religion etc.’
Conclusion:
Young people are telling us what they need to help them however, we have concerns about how much is being done to ensure that children and young people can access help and support early on, to help them with their resilience and wellbeing in order to prevent more serious mental health issues arising. As stated throughout this document there is an urgent need for better education on what is good mental health, how to keep your mind healthy and what to do / where to go if you need more support. There needs to be more of a culture and positive attitude to promoting good mental health and reducing the stigma associated with mental health problems.
Children in Wales believes that there needs to be more opportunities for meaningful participation so that children and young people are truly engaged in the work to develop the new curriculum and the development of emotional and mental health support services in Wales.
Finally, one of the biggest concerns for Children in Wales is that children and young people don’t know where to go for help with their mental health early on. There needs to be more of an emphasis on partnerships between, schools and colleges, youth services and the third sector to support young people. It is also important that there is a greater understanding of child development, emotional well-being and mental health issues by all professionals working with children and young people as well as by children and young people themselves and their families or carers.
The need to know who to ask for advice was raised by a young person at the T4CYP Conference in 2016 whose sister regularly asked her for help (as she was suffering on a regular basis), who said:
“Every child and young person in Wales should know who or where to go for help with their mental health, I don’t want another 16-year-old to have to ask the question – Where do I go now?”