Written evidence submitted by The All-Party Parliamentary Group on a Fit and Healthy Childhood (CYP0115)
The list below is not exhaustive; some items require more explanation than others. However, all would enhance a reformed 1983 Mental Health Act pledged for delivery during this parliament by Boris Johnson in the Queen’s Speech (December 19th 2019).
- A preventative approach to children’s mental health. Instead of waiting for difficulties, a proactive approach from early years settings onwards can decrease the likelihood of problem behaviours, promote positive behavioural choices and anticipate contentious issues at an early stage. The curriculum at both primary and secondary level must embed within it an understanding of emotional wellbeing, the principles of good mental heath and the certainty of therapeutic health for children who need it. An optimum standard and quality of provision enabled by ring-fenced funding should be ubiquitous, replacing the predominant pilot schemes and post-coded trials. All staff should receive Initial Training (IT) and Continuous Professional Development (CPD) in the principles of good mental health and emotional wellbeing in addition to the provision of allocated in-school professional counsellors/therapists
- Guaranteed protection for children. Children are currently insufficiently protected because too many unqualified and unsupervised people are practising. An individual wishing to work therapeutically with children must be registered as fit to practice through an independent government-approved agency such as the Professional Authorities’ Accredited Register programme, the Professional Standards Authority or the Health and Care Professions Council. Acceptance on a register and annual re-validation should be contingent upon the practitioner supplying requisite data about their therapeutic work, supervision reviews, continuing professional development and acquiescence to regular ‘fitness to practice’ checks. This supplies members of the public and employers with a reputable practitioner evidence bank and gives additional assurance to commissioners when placing service contracts for working with children’s social, emotional, behavioural and mental health problems.
- Data sharing as the hallmark of a holistic approach to the children’s emotional and mental health and wellbeing. ‘Joined up working’ would prioritise appropriate data-sharing between all agencies and bodies concerned with child welfare. Therefore the responsibility for children’s mental health would encompass all relevant Departments in addition to the Department for Health and Social Care; the Departments for Education and Digital, Culture, Media and Sport being two obvious examples. Making data sharing a legal requirement would prevent duplication, improve efficiency, promote higher standards of care and facilitate more effective working and practice at local level.
- Broadening policy-making; informing it by the best available and appropriate evidence. ‘Evidence-Based-Practice’ (EBP) is predicated upon the Randomised-Control Trial. The RCT is designed to be robust to the threats to internal validity by controlling elements or systematically manipulating them and selecting patients at random to eliminate bias.
However, such environments differ from routine healthcare settings making it contentious to generalise from such controlled trials. The research gathering paradigm should be broadened to include real-world practice and therapy results; particularly when examining mental health interventions for children. Reliance on controlled trial methods should be supplemented by an active, collaborative collection of data from real-world therapy sessions. Research gathered in this way often makes more sense for work with children than controlled methodologies. Real-world therapy/counselling results produced straight from clinical practice holds clinical practice at the centre of shaping policy on children’s mental health provision by using data born from it. Routine clinical practice is captured, evaluated and improved from the ‘bottom up’ – starting with practitioners collecting evidence from their own work on the ground and moving up to policy. For the best outcomes, decision-makers should credit evidence of what works in real time with real patients as well as the customary use of clinical trials.