Contribution
My Lords, I really want to challenge the assumption of some of the amendments in this group that what we need is more dedicated mental health practices and provision in schools. One of the problems is that there is too much emphasis on mental illness and mental health in education at the moment. That awareness is taking up too much time in school life, is over-preoccupying young people and is becoming a real problem.
If you look at what is going on in schools at the moment, there are indeed endless numbers of staff, volunteers and organisations with responsibility for emotional well-being: mental health leads, support teams, emotional literacy support and assistance, mental health first aiders, counsellors, and well-being officers. If you go into any school, the walls are covered in information about mental illness, mental health and so on; it is everywhere you go. Yet despite this booming, school-based mental health industrial complex, almost, the well-being of pupils continues to deteriorate—or that is what we are told.
Mental health problems and diagnoses are rising at the same time as all the awareness initiatives are taking place. Something is going wrong and that at least needs some investigation, but these amendments just assume that we should carry on doing the same and more of the same. Along with the noble Baroness, Lady Spielman, I think that real, critical thinking needs to be done around some of the awareness campaigns.
I want to challenge the idea that schools are the vehicle for tackling the undoubted spiralling crisis of unhappiness among young people. It is also important that we untangle that from the crisis of CAMHS. There is actually a serious problem in NHS mental health support for children, and I would like that to be taken on. That is very different from the kind of discussion we are having here about schools, which is that mental distress becomes such a focus of all the discussions in schools.
I tend to agree—for possibly the only time—with Tony Blair on this. He said,
“you’ve got to be careful of encouraging people to think they’ve got some sort of condition other than simply confronting the challenges of life”.
That is true. Starting with children, we are encouraging the young to internalise the narrative of medicalised and pathologised explanations and the psychological vocabulary of adopting an identity of mental fragility, and that is not doing them any good. That can then create an increasing cohort of young people and parents demanding official diagnosis, more intervention and more support at school.
Dr Alastair Santhouse, a neuropsychiatrist at the Maudsley, argues this in his new book, No More Normal: Mental Health in an Age of Over-Diagnosis. He says that it has become crucial to reassess what constitutes mental illness, so that we can decide who needs to be treated with limited resources and who can be helped in other ways. He is talking about the NHS, and he warns that the NHS has buckled under a tsunami of referrals for some conditions. He also says that other state services such as schools are straining to the point of dysfunction in dealing with this issue, and I tend to agree with him.
I admire the passionate intervention by the noble Lord, Lord O’Donnell, calling for measurement and evidence, but one of the problems is that I am not entirely sure we know what we are measuring. There is no clear definition of well-being to measure. The psychiatric profession is making the point that the definitions of what constitutes mental illness are now contended—there are arguments about them. What are you measuring? This woolliness of definitions is becoming a problem in schools.
The counsellor Lucy Beney, in her excellent recent pamphlet, worries that this means that mental illness in schools is leading to a kind of diagnostic inflation itself, as pupils compare notes on what they have got and go to different professionals to ask what they have got and so on. It can create a sort of social or cultural contagion, enticing the young to see all the ups and downs of life through the prism of mental health, which can be demoralising and counterproductive. There is no doubt that too many children and young people are not thriving mentally and emotionally in the UK today, and I would like to have that discussion, but I do not think that well-being and mental health is necessarily the way to do it. Schools are definitely not the places to solve it.
A lot of the well-being initiatives, counselling and therapeutic interventions encourage young people to look at life through the subjective filter of their own feelings and anxieties. That, in turn, is likely to lead to inward-looking, self-absorbed children. The role of education in schools is to introduce new generations to the wonders of the millennia, of knowledge outside their experience, which takes them outside themselves. That is what schools are for. That is what teachers are good at. It is not just about gaining credentials. In fact, I hate the credentialing aspect of it. But if you get into a brilliant novel, the law of physics, the history of our world or evolution, you forget your troubles. If you are constantly talking to the counsellor about your troubles, yourself and endlessly thinking of your own well-being, it is boring, demoralising and stunting. It is enough to make anybody depressed, including the young. It is important that schools do not get completely obsessed with this issue. I fear that they have, and it has made matters worse.