More than half of schools let down by lack of mental health support

29 December 2014

"First of its kind" think tank survey welcomed by the Deputy Prime Minister Nick Clegg and Care and Support Minister Norman Lamb among other senior figures

Children and young people are being left without the mental health support they need, leaving schools struggling to cope, according to an England wide survey of head teachers published today.

The research conducted by the CentreForum Mental Health Commission, chaired by former Care and Support Minister Paul Burstow MP, has identified gaps in the treatment of mental health needs in schools across England.

The survey reveals that 54% of head teachers find their local mental health services ineffective in supporting pupils.  It also reveals that almost half of head teachers believe that increasing workloads are affecting their ability to identify pupils' mental health problems at a time when mental health problems in schools are on the rise.

In addition, the survey found:  

  • Confidence in child and adolescent mental health services (CAMHS) were even lower among head teachers at pupil referral units (37%) and special educational needs schools (43%)
  • 47% of all schools surveyed say that an increased workload is lessening their ability to identify mental health problems at the earliest possible point.
  • 65% of schools do not assess the severity of mental health needs among their pupils. Yet where such screening tools are used, 85 per cent of schools reported it to be effective.

Nick Clegg MP, Deputy Prime Minister, said:

"Schools would never ignore a child with a physical health problem, so the same should be true of mental ill health too.

"Early intervention is crucial in tackling mental health problems, which is why school leaders have a major role to play.

"In government we have already set up a cross government mental health task force to evaluate current provision, and the Liberal Democrat manifesto will set out our plans to ensure that children and young people can access the services they need."

Norman Lamb MP, Care and Support Minister, said:

"I am committed to improving mental health care for children and young people - that's why I've formed a task force to advise on improvements. Crucially, members include experts from the education sector and we're engaging young people directly to get their views.

"We've also invested £3 million in MindEd, a website to help anyone working with children - from teachers to dinner ladies and sports coaches to Scouts leaders - to make sure children get the mental health support they need."

Paul Burstow MP, Chair of the CentreForum Mental Health Commission, said:

"With three children in every classroom experiencing mental health problems, teachers need the right training and support to identify issues early and ensure children and young people get the help they need to recover and thrive.

"The results of this survey suggest schools and young people are often let down and left to fend for themselves.  With a price tag of up to £60,000 per child per year the lifelong impact of mental illness on young people and their families is something we can't afford to ignore."

The survey is the first of its kind and follows a 12 month review by CentreForum Mental Health Commission on the state of mental health in England. 

Since the commission published its final report in July 2014, the Prime Minister David Cameron has promised to "look carefully" at CentreForum's recommendations.

The government has also established a task force to examine child and adolescent mental health.  This followed a Liberal Democrat announcement that the party will commit to increasing mental health research funding beyond 2015.

At the party's autumn conference in Glasgow, the Liberal Democrats adopted all of the CentreForum commission's recommendations as party policy.

Professor Dame Sue Bailey, Chair of Children and Young People's Mental Health Coalition, said:  

"The findings from this report are both important and timely. School is a critical environment where young people should be able to flourish across all domains of their lives.

"The gaps and concerns this report so clearly identifies reinforce the need to provide young people with the help, support and self-empowerment to develop and maintain resilience to say mentally healthy in order to achieve and develop to their full potential."

NOTES TO EDITORS

1. The survey also finds:

  • One in ten schools report that no mental health and wellbeing training is available to staff.
  • As many as one in ten state schools report behavioural and emotional problems among their pupils, and the problem is though to be getting worse each year. Head teachers say that environmental factors including economic pressure, parental separation and the impact of social media are to blame.
  • On the positive side, 81% of schools raise awareness of mental health and wellbeing on a routine basis.

2. The Chief Medical Officer previously found that three quarters of vulnerable pupils miss out on mental health support. See Chief Medical Officer's Annual Report 2012, 'Our Children Deserve Better: Prevention Pays', Department of Health, 2012

3. The CentreForum report 'Perceptions of wellbeing and mental health in England's secondary schools: a cross sectional study' can be accessed here.

Earmarking tax revenue for the NHS won't guarantee increased spending, think tank warns

24 December 2014 

Earmarking specific tax revenue to narrow the projected £30 billion funding gap* in the NHS has major flaws, a new report from CentreForum argues.

The report studies the merits of so-called 'strong hypothecation', where a particular tax funds an entire service, and 'weak hypothecation', where tax revenues are notionally earmarked for an area of government expenditure.

It concludes that strong hypothecation is the more viable of the two because it promotes accountability, transparency and trust in government. Weak hypothecation, on the other hand, is described in the report as having "significant disadvantages".

An example of weak hypothecation is Labour MP Frank Field's proposal to increase National Insurance and then allocate the revenue raised to the NHS. The Institute for Public Policy Research (IPPR) has made a similar argument.

But CentreForum says that such measures would not guarantee increased government expenditure, because any subsequent spending reviews would not treat the earmarked revenue as additional to the health budget. The absence of a guarantee would lower public trust in the government that introduced the policy, the report notes.

The think tank also highlights conflicting political motives among proponents of hypothecated taxation. It points out that while those on the left support earmarked tax increases as a means of raising revenue for the NHS, proponents on the right consider it an opportunity for a fundamental rethink on how the NHS should be paid for.

Conservative peer Lord Finkelstein, for example, has emphasised the role that strong hypothecation could play in deciding "how much healthcare we should offer people free at the point of use".

The report says this indicates that the right's solution to the NHS funding gap is at odds with the left's.

It adds that strong hypothecation, while good for transparency, will make health expenditure dependent on macroeconomic shocks and cycles, rather than health need or demand.

India Keable-Elliott, Economics Researcher at CentreForum, said:

"Talking abour earmarking tax X for increased spending in area Y may be good politics, but it is pretty awful policy. Raising National Insurance to fund an increase in the NHS budget will not guarantee increased spending because cuts can be made elsewhere."

"Funding the NHS entirely through a single earmarked tax is more credible in theory. But it will leave NHS spending levels at the whim of macroeconomic shocks and cycles rather than need or demand for services."

Professor Stephen Lee, Chief Executive at CentreForum, said:

"There are big choices to be made around funding health, particularly when costs and demand for services are increasing so rapidly. If hypothecated taxation is pursued as government policy, then politicians need to be clear about its implications."

* * By 2020/21, the NHS could face an annual funding gap of £30 billion. Source: NHS England

Autumn Statement 2014: Government to adopt CentreForum postgraduate loans proposal

3 December 2014

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The postgraduate loans model designed by CentreForum featured in the Chancellor’s 2014 Autumn Statement.

Professor Stephen Lee, Chief Executive of CentreForum, commented:

"We warmly welcome the adoption of CentreForum's postgraduate loans scheme and look forward to the consultation. Investment in skills, and particularly higher level skills, is vital to Britain's international competitiveness, and for fostering academic talent at home. Widening access to postgraduate education is also good for social mobility. The government estimates that 10,000 students who would not otherwise be undertaking postgraduate study will benefit from the scheme each year."

"We are pleased that the scheme is to cover all degree disciplines including the creative ones."

"On the specifics, we understand that it is important to have an age cut off point for entitlement to ensure debt is repaid, and the government is restricting this policy to under 30s. But it is important to remember that a majority of postgraduate taught students are over 25, so the policy might not capture every person for whom loan entitlement would be a decisive factor in a doing a master's degree. We urge government to consider raising the age limit to include people in their thirties."

"It is not yet clear whether the loans scheme will cover fees, maintenance or both. There are certain advantages of not linking it just to fees because that could act as signal to institutions to raise their fee levels to £10,000."

"A further question is whether those individuals who have both undergraduate and postgraduate loans will have to pay back their debt at higher annual rate than those with undergraduate debt only?"

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"Equitable playing field" needed in HE regulation

27 November 2014 

Alternative providers of higher education in England should come under the same regulatory framework as public institutions, a new report from CentreForum argues.

The think tank's research indicates that alternative providers (APs) play an increasingly important role in widening access to higher education, promoting innovation in programme design and delivery, and significantly enhancing student choice as a consequence.

Yet it points to a continuing perception among APs that they suffer from the lack of an "equitable playing field" in the way public and private institutions are regulated, inhibiting their capacity to operate effectively in the higher education market.

Whereas public institutions are set to benefit from the removal of the student numbers cap from 2015/16, restrictions on the number of students APs can recruit have been retained at 2012/13 levels or below. This places them at a competitive disadvantage, the report says.

Other barriers to AP growth cited in the report include retention of the tuition fees cap at £6,000,* and the continuing imposition of a traditional university model of academic governance and quality assurance which "often lacks applicability, economic viability and effectiveness" in the context of a diverse AP sector.

The report 'Access and equity: positioning alternative providers in higher education provision' calls on government to implement a common regulatory framework for all higher education institutions in England.

The proposed framework of regulation would include a commitment to parity of treatment in regulation and institutional review. There would also be a stronger focus on quality assurance and effective collaboration through accreditation and validation across different institutions.

The report highlights Regents University, New College of the Humanities, the British and Irish Modern Music (BIMM) Institute, University of Law and GSM London as examples of APs bringing greater choice, innovation and cost effectiveness to the higher education market.

Professor Stephen Lee, Chief Executive of CentreForum and author of the report, said:

"A range of new providers in higher education are delivering greater choice and access to students who might otherwise not benefit benefit from higher education. Their central focus on teaching - blending academic knowledge with technical and vocational expertise - offers an important additional option to an increasing number of students. Too often however, it would appear that they are confronted by a regulatory framework that hinders rather than promotes these endeavours."