Political will to improve mental healthcare has gathered momentum over the past few years. Norman Lamb, minister of state for care and support, has always been vocal about the need for equality between physical and mental health services.
Last year Mr Lamb set up the Children and Young People's Mental Health taskforce to investigate how children and young people's mental health services could be improved. Growing evidence supports the need for early intervention and spotlights the way services are failing young people. The taskforce published its findings in March and IN asked Mr Lamb how the recommendations might affect nurses in primary care.
'The school nurse can be a pivotal role here in achieving better mental health care for children. I think the way that the system has evolved, we have ended up with this awful dislocation between schools and mental health services with schools often not knowing who to contact,' he says.
The report outlined the need for a dedicated mental health professional to be integrated into every school and practice to support the other healthcare professionals based there.
When asked whether this specialist mental health professional could be a nurse, he answered that it could be, but said he didn't want to be 'prescriptive'. 'In essence, the school nurses can play a vital role but there could be other professionals who could do this as well, like those in the third sector,' he says.
'The report is a blueprint for the modernisation of children and young people's mental health services.'
Mr Lamb's motives for championing equal rights for mental health services stems from his son's experiences with OCD. This only serves to strengthen his cause. It is this personal experience that adds weight to his words when he says: 'I say this not as a minister but as a father, a teenager may well want to talk to someone who is slightly independent from the school, to feel that they can talk confidently without the school officially knowing about their problems.'
Historically, funding for children's mental health services has been low, with only 6% of the NHS mental health budget (in itself only around 10% of the entire NHS budget) allocated to children and young people's services.
A serious imbalance between funding for physical health and mental health is a key reason why services do not function to full capacity. The government has invested an extra £1.25bn over the next five years. Extra money has been poured into children's community eating disorder services, increasing access to talking therapies and decreasing waiting times. The report states that Child and Adolescent Mental Health Services (CAMHS) is 'financially vulnerable' and needs to be overhauled to properly work for children and young people.
'We have four different organisations, schools, local authorities, CCGs and NHS England all commissioning services and it always seems to me to create a fragmented service. The report is very clear that we need a lead organisation in the locality, so you have much more coherent commissioning of services,' he says.
According to Mr Lamb the reason mental health loses out financially to physical health is partly due to the raft of access targets in physical health. 'So if you have suspected cancer, you will see a specialist within a fortnight of referral by your GP, there are four hour targets in A&E which is massively politically resonant and every CCG in the country focuses on these access standards. If you look at mental health, and there is nothing. We need to have what I call an equilibrium of rights to ensure that CCGs treat mental health as seriously as they treat physical health.'
Another reason for the lack of parity is likely to be a significant lack of prevalence data on children and young people's mental health. In fact, the last time that any prevalence data was collected was in 2004. 'In my view this is long overdue,' says Mr Lamb. 'It needs to happen regularly every five years or so. I've secured the money so we will now get up-to- date evidence on the prevalence of mental health problems.' Mr Lamb identifies that the pressures facing young people have changed significantly in the last decade, such as cyber bullying, 'sexting', drug and alcohol pressures, and sexual pressures. He believes that addressing these pressures can help to improve the mental health of young people.
He concludes: 'If you go into politics to try and achieve something, there is no worthier ambition than trying to make an impact on young people's lives, to give them opportunities, and that's what I'm intent on doing.'