My Lords, I will speak to Amendment 8 in my name and indicate my support for Amendments 4 and 5, also in this group. In addition, I warmly welcome Amendment 1, which the Government have tabled in response to discussions in Committee. The addition of mental health to the corporate parenting principles is an important step forward towards ensuring that mental and physical health are treated with equal importance by local authorities when they are making decisions about the services and support available to children in care. The Minister’s amendment, therefore, is an important signal of principle—but principles alone will not improve the outcomes for children in care.
My amendment is designed to ensure that we can achieve some practical improvements to the care that children receive. It introduces mechanisms that will ensure that the mental health needs of children entering care are properly assessed and that they have access to specialist support if this is needed. Basically, the amendment has two elements: first, a mental health assessment for children entering care, carried out by a qualified professional; and, secondly, a designated health professional in each local authority who has strategic oversight of the outcomes of the assessments and matches those with the services that are available for children in care to support their needs.
In short, this amendment seeks to establish a mechanism that will identify children’s needs early on, refer the children to the right services and ensure that services exist that children in care are able to access—and access easily. This joined-up approach is supported by the Alliance for Children in Care, a coalition of leading children’s charities, as well as the Royal College of Nursing, the Royal College of Paediatrics and Child Health, and the Royal College of Psychiatrists.
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I will address briefly some of the concerns about this approach that have been raised by the Government. First, why do we need to assess all children entering care? Many of us here know very well that the vast majority of children entering care do so in the first place for reasons of neglect or abuse, with all the detrimental impact that that has on their emotional health and well-being. We also know that over 40% of children entering care have a mental health condition: indeed, research from the US suggests that nine out of 10 children who have been abused will develop a mental health condition by the age of 18. It is staggering to find that over 70% of children entering residential care have a diagnosable mental condition.
The Government have suggested that offering assessments to every child in care will be an inflexible approach, and indeed a burden on already overstretched local authorities. I am of course mindful of these concerns, but I firmly believe that it is the right course of action. I will be clear: this amendment does not propose that every child entering care is forced into an assessment by a clinical psychologist, but that all children in care should be offered an assessment by a trained professional—be it a counsellor, a trained
mental health nurse or a similarly trained professional—who is able to conduct an assessment that is sensitive to the specific needs of looked-after children. By conducting a fuller assessment, local authorities will be able to more accurately consider the needs of every young person and ensure that they are offered the appropriate support.
Again, I am not suggesting that every child entering care needs some sort of clinical intervention, but children need to live in a supportive and protective environment with the appropriate therapeutic support—be that peer support, group work or counselling—to help promote their emotional well-being. I contend that such an approach would undoubtedly see a reduction in the number of children ricocheting between placements and that placement stability would rise. I would add, in case people think that it will be complicated to draw up a new mental health assessment tool, that a very good one already exists and is used for all young people in contact with the youth justice system, or in the secure estate—and, of course, many children in contact with the justice system have been in care already.
I will talk briefly about the designated professionals, also proposed in this amendment. The proposal is based on a recommendation made by the Education Select Committee’s enquiry into the mental health of looked-after children. Designated health professionals would fulfil a similar function to virtual school heads. There have been some encouraging results over the past few years, as I am sure the Minister knows. The underlying principle is that each local authority will have a professional who has oversight of the provision of services and is responsible for ensuring that children in care actually get those services at the time that they need them and that they do not, as so often happens at the moment, fall through the net because of placement instability, which means that they never get to the top of a waiting list. Those professionals would also have a pivotal role in feeding into local transformation plans.
I hope that I have set out the reasons why this amendment is so important. I hope that the Minister agrees that this is a crucial matter and will at least commit to meet me to consider the issues that I have raised between now and Third Reading. Without such an undertaking from the Minister, it is only fair that I signal at this stage that I would wish to test the opinion of the House.