There are many reasons for mental health conditions becoming evident. In some cases, adverse childhood experiences, known as ACEs, can lead to mental health problems later in life, and there are explicit links to drug dependency and thus early death. A single instance of an adverse childhood experience can be traumatic, but often we see adults who have had to deal with multiple cases in their formative years. What happens to us as we grow up matters, and it's not just the more traditional horrors that some children face. Today's kids have so many pressures on them in this modern world.

Speaking as a mother of two young girls, I can tell you we have constant battles about body image, the content of social media, what the print media says. The pressure on children, and especially girls, to conform to a certain look or style has only been made worse in recent years, and we all know how cruel children can be to one another. Childline reported that in 2015-16 they received over 1,500 contacts from girls, the youngest being eight, worried about their body image—at eight, really? Cabinet Secretary, this is something the Government must find a way of addressing as quickly as possible, because today's raunchy, celebrity-focused world damages those yet to develop the thick skin and emotional resilience to shrug the nonsense off. The result? Anxiety, depression, eating disorders—all patterns that can have a negative influence on a person's life going forward.

This leads me to the second point of our debate, where I would like to focus on aspects of mental health treatment that we believe are not working well. The first, you will not be surprised to hear, concerns the lack of consistency across Wales in providing good-quality child and adolescent mental health services. Despite their fragile and often far more vulnerable nature, a small percentage of clients who fall under the CAMHS umbrella are seen within the recommended four-week waiting time. Worryingly, only three out of seven Welsh health boards provide a 12-hours CAMHS crisis team, working 12 hours a day, seven days a week. The one in Powys only operates until 5 p.m. Monday to Friday, and not at all weekends. What does that say about where our importance is on mental health?

I, and I know many other Assembly Members—and I'd like to single out Lynne Neagle on this—remain concerned that the CAMHS services do not work effectively. Lynne has been an enormous champion on this area. The criteria that they follow are often too narrow. Clients are treated according to their mental health condition as opposed to being treated as an individual. Children threatening suicide are not provided with help because they haven't been diagnosed with a medicalised problem. Children suffering from the effects of abuse or neglect or with attachment issues are refused access, as a children and young people committee report into post-adoption support highlighted very, very clearly. So where do they go? I fear they go nowhere.

I would like to draw attention to the Mind Cymru study that surveyed 400 people in February 2016 who had either requested or accessed psychological therapies in the previous three years. This found that 57 per cent of people faced a wait of more than three months just to get an assessment with the service, and 21 per cent faced a wait of more than a year to be assessed. We've just had a debate on loneliness and isolation, and that's a depressive thing. I cannot imagine; there you are, you're in that awful state, you desperately need help, your mind is struggling, all sorts of thoughts are in your head, but you've got to wait 12 months to be seen. The 'Together for Mental Health' draft delivery plan for 2016-19 requires health boards to report on the 26-week referral-to-treatment target in specialist secondary mental health services for all patients, including those in inpatient services.

Now, in the Welsh Conservative 2017 manifesto, we said that people should have parity of access, regardless of whether they are in primary or secondary care—a policy that's backed by Mind Cymru—and I call on the Welsh Government to introduce a target for all people to be able to access psychological therapies within 28 days. Cabinet Secretary, I ask if you would just look to see if you can make this possible. And in doing so, will you also review the way that training on mental health issues is structured, Cabinet Secretary? For example, GPs currently only undertake one training module, out of 21, dedicated to mental health. Numbers of trainee GPs undertaking a rotation in psychiatry is steadily falling and many GPs only see the most severe cases of mental health illness in primary care facilities during their training and therefore are less familiar and therefore find it harder to identify more moderate cases of anxiety or depression that may benefit from early intervention when those people cross the door into their surgeries.

Another issue that I've raised again and again is the way in which the ring fence on mental health spending has been applied by health boards. Despite being protected by a ring fence since 2008, mental health is an area of our health service that has been chronically underfunded. In 2015-16, just 5.1 per cent of NHS expenditure was spent on adult mental health, and just 0.7 per cent spent on children and adolescent mental health services. Although the ring fence highlights how important it is to protect spending on mental health, we know that it is not a true reflection of where mental health funding needs to be, because almost all of the health boards say they spend far more than that on mental health. But, we also know that the mental health ring fence or the use of the ring fence is open to interpretation with many of the health boards playing the system and stating that the ring fence can be used to incorporate all costs in relation to a patient. We heard evidence in the health and social care committee recently that, and I'm going to quote,

'For example, if a patient with a mental health primary diagnosis presents with a fractured hip the costs of treating the hip will be captured within the mental health ring-fence.'

Cabinet Secretary, would you pledge to review this ring fence on spending to ensure that the funding is being used to bring about much-needed developments in this service? Because if it's used on things like hips when you've identified it for mental health, then how can we transform how we deliver mental health?

As I bring my remarks to a close, I would like to highlight a couple of examples where innovative projects are changing lives. In my own patch, Hywel Dda, in conjunction with Dyfed-Powys Police, are setting up three crisis cafes across the region with the intention of allowing people to drop in and chat to relevant support bodies over a coffee. This is a vast change to the current use of police as first responders to so many people exhibiting signs of poor mental health. It simply adds to the fear and that stigma and ultimately criminalises those with mental health issues—and I make it clear I do not hold the police forces to account for this; they are often the only ones available.

Another example of best practice comes from England where six NHS trusts have trained teams in an open dialogue approach. This approach means that people are seen within 24 hours of becoming unwell. Meetings with psychiatric teams are held at home or wherever the patients feel comfortable, and it also ensures that the 'nothing about you without you' mantra is adopted and allows the patient to have full access to their notes. It's an innovative idea well worth the Welsh NHS looking at. There are clear calls now in Wales, not just from the National Assembly but also from those working across our public services and the third sector and individuals, to radically reform the way mental health services are delivered. We need to fully recognise the individual social and economic benefits of preventing mental health from deteriorating. We need to give mental health the same parity of service provision as physical health, and we need to ensure that our secondary and crisis services are able to support people safely and effectively when they are needed. Ultimately, it's about people. We are flesh and blood, but we are also mind and soul. We can only be well when all of us is treated as one.