Written evidence submitted by Professor Lord Richard Layard[1] (CYP0045)

The 2017 Green Paper set out an excellent roadmap. But the subsequent speed of rollout has been far too slow. Mental health problems are a torment for children and their families, and they are the best predictor of mental health problems in adulthood.[2] So services for children should, if anything, be better than those for adults.

But they are not. When adult IAPT was rolled out, its scale over the first few years was more than double that of Mental Health Support Teams (MASTs) in schools. It also included a stream of “high-intensity” therapists who could treat moderately severe problems effectively; but MHSTs only include “low-intensity” therapists. I would therefore propose the following.

1. MHSTs should cover half the country by 2024-25 (not a third or less as currently planned)
2. A new high-intensity workforce should be developed, with a good system of training.
3. Conduct disorder should be treated in MHSTs in a way it is not at present. The best treatment is parent training (the Incredible Years). If necessary, this should be provided off school premises. There were 4,000 people trained to deliver it in 2008-12, some of whom could be re-employed.

The final issues concern schools.

4. Every school should have a senior teacher who is the mental health lead and has been trained for this role. This is not yet the case and should be a high priority.
5. The curriculum. The government has taken a momentous step in making Relationships, Sex and Health Education mandatory.
1. There should be an indicative guideline requiring the equivalent of an hour a week to be devoted to this.
2. The government should promote the use of evidence-based ways of teaching these difficult topics (e.g. Healthy Minds for 11-15 year olds).
6. Teacher training. All teachers teaching this subject should have some training in teaching it, and each secondary school should have a professionally-trained teacher in charge of the subject. All other teachers should receive a short course on mental health.
7. Measurement. To ensure that schools take pupils’ wellbeing seriously, they should measure their wellbeing annually. This would involve questionnaires to teachers and to pupils in secondary schools. To minimise the burden (as in the Netherlands and South Australia) the questionnaires should be provided from the Centre and processed centrally. Results would be made available to schools and inspectors.

With these changes, the mental wellbeing of our young people could be substantially improved in a very few years. The results would focus on changes in wellbeing over time rather than levels, and be made available to schools and inspectors.

February 2021

References

Layard, R., & Clark, D. M. (2014). Thrive: The power of evidence-based psychological therapies. London: Penguin.

Layard, R., & Ward, G. (2020). Can We Be Happier? Evidence and Ethics. London UK: Penguin Random House.