Item 5 on the agenda is a debate on the Children, Young People and Education Committee's report on its inquiry into the emotional mental health of children and young people, and I call on the Chair of that committee to move the motion. Lynne Neagle.

Motion NDM6756 Lynne Neagle

To propose that the National Assembly for Wales:

Notes the Children, Young People and Education Committee report on the Emotional and Mental Health of Children and Young People in Wales which was laid in the Table Office on 26 April 2018.

Motion moved.

Thank you, Deputy Presiding Officer. I usually begin by saying I’m pleased to open this debate, but, today, I’m more than pleased; I’m proud and privileged to address this Chamber on the Children, Young People and Education Committee's 'Mind over matter' report.

For me, the emotional and mental health of our children and young people is one of the most important issues, if not the most important issue, for us as an Assembly. Ensuring that our next generation of leaders in this place, and in our nation’s schools, hospitals, farms and factories are resilient, mentally well, and equipped with the tools to tackle the challenges that will inevitably come their way, is a fundamental responsibility for all of us.

It is estimated that one in 10 young people will experience a mental health problem, and nearly three in four young people fear the reaction of friends when they talk about it. Half of all mental health problems begin by the age of 14, and three quarters by a young person’s mid twenties. And that is why we chose to dedicate much of the winter term to this crucial inquiry.

Our predecessor committee in the fourth Assembly undertook a comprehensive review of specialist mental health services for children and young people in Wales. We wanted to revisit that and to hold the Welsh Government to account on its progress. But we wanted to go further. We were also committed to looking at what support could be provided to avoid escalation to specialist services. The costs of emotional and mental ill health—not just to the public purse, but, most importantly, to the children, young people and families involved—are too high for us not to try to stem the flow earlier.

We know that, without support, mental distress can have a severe impact on children’s well-being, their development and their attainment. But evidence also shows that, with appropriate and timely support, children and young people who have encountered emotional and mental health issues can live well and happy lives. This need not, and should not, be an inevitable spiral.

Before we continue, I want us to hear from children and young people themselves. We are committed to giving them a voice in all the committee's work, and this inquiry was no exception. I want to put on record my thanks to all those who spoke with us, but particularly to those children and young people who let us visit them and who spoke so openly and powerfully about issues that, even as adults, we often struggle to articulate.

During the course of our inquiry, we collected the experience of young people in a variety of ways. One of them was a video, with young people participating in Newport Mind’s Changing Minds project, which provides peer support for young people who are struggling with their mental health. I know some of them are in the gallery today. I’d like to welcome them here and give everyone a chance to listen to what they have to say.  

An audio-visual presentation was shown. The transcription in quotation marks below is a transcription of the oral contributions in the presentation.

Hayden: 'My issues started around year 8, so I was about 13 or 14, and I was always offered a counsellor, but that would never really happen. So, I just sort of dealt with it on my own, and then, one day, it was just enough was enough; I didn’t know where to turn to.'

Tristan: 'It was just a taboo subject to talk about mental health and just how you’re feeling, particularly for men it was, I know.'

Thomas: 'I think if I’d got these issues addressed a lot earlier, it wouldn’t have boiled over to the point—.'

Regan: 'I feel like there should be more access to support within schools and a lot more notice that that support is there, available for people.'

Tristan: 'Trying to help young people is different tools, so it's like exploring different avenues from a young age, like meditation, just yoga, it could be exercise—not just simply, "Oh, you’re not feeling well; go and speak to someone". Life isn’t like that. You’re not going to have someone to talk to all the time, and that doesn’t work for everyone.'

Thomas: 'If the teachers had a little bit of training, just enough to catch bad mental health—it doesn’t matter if you have depression or anxiety, bad mental health is bad mental health. From not having enough sleep to worrying about exams, it all affects us.'

I’m sure that you’d all like to join me in thanking the young people for sharing their views and experiences with us. I hope that gives everyone a taste of some of the things that came up during our inquiry.

So, what did we conclude? We believe that a step change is urgently needed in the support available for the emotional and mental health of children and young people in Wales. What is available has been too limited for too long. We have called our report 'Mind over matter', because we think the time has come to do just that—to put mind over matter; to deliver appropriate, timely, and effective emotional and mental health support for our children and young people, once and for all.

While we recognise that improvements have been made in specialist child and adolescent mental health services in the last two years, it is not enough. More is needed, particularly in relation to primary care services, crisis care, and how we refer our most vulnerable children and young people into support services. Medical diagnosis alone should not be the key that opens the door to support. Being without a diagnosed disorder does not diminish the severity of distress and harm experienced. It should not act as a barrier to getting help with services.

We need to urgently help this so-called 'missing middle'. Our predecessor committee was told in 2014 that too many children and young people entering specialist CAMHS were being referred there incorrectly and ought to be helped in other parts of the system. By 2018, not enough has changed. The pieces of the jigsaw that need to be in place to support children and young people outside the most specialist settings are simply not there. Four years since the last inquiry, this is unacceptable. It must be addressed urgently by the Welsh Government.

As a committee, we believe that something drastic must be done at the preventative end of services. If we continue failing to provide emotional well-being, resilience and early intervention support, children and young people will continue suffering unnecessarily. It also means that the sustainability of more specialist mental health services will continue to be under threat.

So, what needs to happen? We think that a major step change is needed in the priority given to the emotional resilience and well-being of children and young people. We have called on the Government to make this a stated national priority. But words alone will not do. They need to be underpinned by the planning, resource and commitment to deliver real change. We think that ring-fenced resource is needed to make schools hubs of cross-sector and cross-professional support for emotional and mental well-being based in our communities. We also think that those who work with children and young people should be trained in emotional and mental health awareness, to tackle issues of stigma, promote good mental health, and enable signposting to services where necessary.

Reform of the curriculum in Wales offers a once-in-a-generation opportunity to embed well-being into our children’s lives, and schools are very well-placed to make a significant contribution to building an emotionally resilient population of young people. But they cannot do it alone. We are certainly not expecting teachers and other school staff to become experts in mental health. Support from other statutory and third sector bodies, most notably health, is crucial. The whole-school approach, where an ethos of good mental health runs through everything, needs to be a cross-sector responsibility and a genuine step change is needed to deliver it.

Our report makes one key recommendation and 27 in support of it. Taken together, we believe that these will deliver the step change that is needed to build a population of emotionally resilient and mentally healthy children and young people in Wales. They are detailed, demanding and ambitious, and I make no apologies for that. Our children and young people deserve our ambition to be high, and our demands to be significant on their behalf.

That is why I regrettably have to say that I and the committee are deeply disappointed with the Welsh Government’s response to our recommendations. Firstly, too many vital points have been rejected. Secondly, while many recommendations are accepted in principle, this is largely on the basis that the Welsh Government perceives that the things we have called for are already in place. Well, I say to the Welsh Government today: we do not agree with you. We do not believe sufficient attention has been given to the robust and comprehensive evidence that we have presented in our report. Finally, the Government’s response does not meet our expectation of, and demand for, a step change in approach. As a committee, we reject this response; it is not good enough. Neither the detailed evidence we’ve outlined, provided by a range of experts with significant experience in the field, nor the recommendations to which we have given considerable and serious thought have met with the acknowledgement, analysis and respect they deserve. The step change we have called for is not visible in this response as it stands. Our ambition is not met with the ambition we expect and demand of our Government. As such, today, I invite the Cabinet Secretaries to reflect again on their response, and to come back to us early in the autumn term with a renewed approach. Our committee will then use our time to explore these important issues with the Cabinet Secretaries in the forensic detail this important topic deserves.

Now, I do not wish to conclude my remarks on a negative note. Our report has been welcomed on a cross-sector, cross-party basis. It has been welcomed as an important step towards the transformative change that our children and young people deserve. It has been welcomed as a key part of the important journey that I and my fellow members of the committee are determined and committed to travel and complete in this Assembly. As our report says, this is a subject that touches us all, and an area in which we all have a responsibility and an ability to make change happen. We are unwilling to allow this vital issue to be handed on in a legacy report yet again to a successor committee in the sixth Assembly, saying, 'More needs to be done.' The time has now come to put mind over matter, and make the step change that is so urgently needed.

Thank you. There are a number of Members who wish to speak in this debate. Therefore, I will be applying the five-minute rule very strictly. So, it's no good looking at me and smiling if you've got another half a page. The answer will be 'no', the button will go off, and I will call the next speaker. I'm sorry to do that, but we have a number of people who want to speak who are not committee members, and I think that is a great testament to the work of the committee, that others want to take part. So, I just ask you all to bear in mind the five-minute rule strictly, and we'll see how we get on. Darren Millar.

Diolch, Dirprwy Lywydd. Seven point two billion pounds, 6,000 emergency admissions into our hospitals and 300 lives per year; that is the cost of mental health every single year here in Wales. And I'm sure that everybody in this Chamber recognises the severity of needing to get to grips with this problem, and the urgency, given that we've had very little progress to date, to take action to tackle it. We know that around three quarters of all mental illnesses start before a child reaches their eighteenth birthday, and that children from socially disadvantaged backgrounds, or those with parents with existing mental health illnesses themselves, are more likely to develop mental health problems of their own. It's very clear from the Children, Young People and Education Committee's work that we need to build more resilience in childhood and adolescence, and to take some urgent action to address the difficulties that many of our young people face when needing to access more specialist care too. Our 'Mind over matter' report sets out the challenges and the details and provides a host of sensible, practical recommendations to address them. It was universally welcomed by stakeholders, but not—or so it seems—by the Welsh Government.

I have to say, I don't think I've seen a single Government response, in the 11 years that I've been a member of this National Assembly, that is so disappointing and complacent. Just seven recommendations have been accepted, nine have been rejected in whole or in part, and of the rest, those that have been described as 'accepted in principle' frankly should have 'rejected' sat beside them, because 'accepted in principle' is not an accurate description of the response that we read on the paper. There's no wonder, therefore, that we've had a chorus of voices from stakeholders who have been in touch with committee members and other Members of this National Assembly prior to the debate this afternoon to express their concerns. The Cabinet Secretaries for health and education have managed to unite not one, not two, but 73 psychologists to sign a single letter calling for all of the recommendations in our report to be implemented in full. The children's commissioner has said that the response that's been received is a missed opportunity, and said that the current system it not adequate or coherent. The NSPCC have said that it won't deliver the step change that's required and they are absolutely right. We need to see that step change, and it's a shame that the only one that some people seem interested in is a step change from one office into the First Minister's office. 

I really do feel that the Welsh Government needs to tear its response up and go back to the drawing board and to produce something that is a little bit more respectful, not just to the committee, but to those stakeholders and those individuals who provided the evidence on which our report is based. We're fed up with empty words. We've seen reports that have identified problems before in previous assemblies, and I'm afraid we haven't seen the action coming from the Welsh Government, from successive Ministers, to be able to deal with the challenges. We saw good practice in the evidence that we received—good practice on building mental health resilience in our schools. Schools such as Ysgol Pen y Bryn in my own constituency and their mindfulness programme—a wonderful opportunity that we presented and suggested should be rolled out further in other schools. Yet, your response to our recommendation 3 was complacent, it was inadequate, and it simply suggested more of the same and suggested that you're already doing the things that were necessary. That isn't the case. 

You've rejected our recommendation 9 and part of our recommendation 11, which call for simple things like data to be collected and published on a regular basis on mental health waiting times for children and young people seeking assessment and intervention, whether in primary or secondary care. It is shocking—absolutely shocking—that those recommendations have been rejected, and it suggests a complete lack of priority for our children and young people here in Wales. Unless we have that data, we're not going to be able to hold people to account. And it's no wonder that organisations like the Betsi Cadwaladr health board have got in excess of 1,000 young people, more than all of the other health boards in Wales combined, on waiting lists for more than a year, waiting to access assessments and waiting to access treatment for their acute secondary care issues in mental health. It's completely unacceptable. And it's for the sake of those 1,000 individuals in north Wales, and the others around the country, that we need to see the step change that our report refers to.

So, I think we need to stick this particular response in a place where the sun don't shine, the shredder, and come up with something much better in accordance with the wishes of the committee, because that's the only thing on which we're going to see any change. 

May I say at the outset that I and my party agree with the main recommendations of the committee? The main recommendation, of course, is that this should become a designated national priority. We've heard reference to previous reports done by committees—one in 2014, for example, which led to some changes in terms of care in this area. But we now need to move to the next level, and the statistics insist upon that. We've heard some already. In 2017, for example, Childline Cymru saw a 20 per cent increase in the number of calls on suicide. In the 12 months to October 2016, there were 19,000 referrals to CAMHS services in Wales, 3,000 more than the previous year. So, emotional well-being and mental health problems among children and young people are growing, and we need an uncompromising emphasis on the preventative side of the care pathway—resilience, emotional well-being and early intervention. We've heard about the missing middle, and if the Government doesn't introduce transformational change, as the committee has recommended, then the services at the top of the spectrum will become entirely unsustainable because we won't be able to cope with the numbers that will require those services.

Schools, of course, can't shoulder this burden alone, and that is why we want to see a whole-systems approach, where children, young people, schools, social care, health and the voluntary sector all work together and collaborate in order to provide the service and support and do so to the best possible standard. But, while the committee's ambition is clear—that we need this transformational action—I have to say that the Government's response, as I said to the First Minister yesterday, is very weak, is complacent and is inadequate. It is disappointing, and I share the disappointment of other Members that so few of the recommendations have been accepted and that so many are accepted in principle and, indeed, that many have been rejected entirely. They've rejected the recommendation that we should map out the availability of staff who don't teach in school but are there to support the emotional health and well-being of pupils. 'Oh, that's the responsibility of local authorities and health boards', according to the Government. But that is buck passing, because this is a national problem. It is the role of Government to look at that national bigger picture and to take it into account. More data available and more information to the public in terms of how health boards spend their funds on mental health services for children—that, again, is rejected, and that tells you something about transparency, I would say, too.

The committee recommended that we need to ensure that everyone who cares for children and young people are given appropriate training in terms of the emotional and mental health of children and young people and can refer people then, or feel confident in referring young people, to other services. How many times did we, as a committee, hear school staff saying that they didn't feel empowered to respond to what they were picking up on in the classroom? Indeed, they are overwhelmed by these cases, and they need assistance, as does the broader workforce. The curriculum, of course, will contribute to this, but, as I say, there is a broader workforce.

There is another point here too, which has emerged more and more. Clearly, Cabinet Secretaries and Ministers share responsibility in this area. That can be a strength at times, but clearly I feel it can also be a weakness because the risk is that nobody drives this issue, and nobody takes ownership and provides that momentum to the effort to tackle these problems. As a result, 'accepting in principle' becomes some sort of default response that, to all intents and purposes, means 'business as usual' and not transformational change. I support the comments made by the Chair and her criticism of the Government. It is a clear failure, in my view, in this case. I suggested yesterday that, if we are serious about sharing responsibilities across Government, then we should be looking to the leader of that Government to be driving this, as the only person, I would have thought, who has sufficient status to ensure that this truly is a national priority.

Briefly, to conclude, I want to talk about one specific scheme that I have come across, which is SAP—the student assistance programme. It's a programme for children and young people between 14 and 19. It is implemented at the moment in schools in Wrexham, where children come together to discuss their feelings and problems, so that they can access the support that they need. They are referred to services where necessary too, and groups of peers come together. They meet on a weekly basis in secondary and primary schools, and this allows them to identify the problems that we are talking about at an early stage. It has been—

Right. Thank you.

Of the key recommendations in this report, the only ones the Government accepts are the ones that either require no action or are not measurable. They accept the recommendation to state the emotional and mental well-being and resilience of our children and young people as a national priority, but when it comes to the recommendations that mean they have to take action, the Government start to fudge and spin their responses with either rejections or only accepting recommendations in principle, which we all know means that nothing meaningful will be done.

I don't know what more this committee can do to get the Government to take the actions needed. The situation is desperate. As Darren has mentioned already, more than 1,000 children and young people are waiting 12 to 18 months for neurodevelopmental assessment in Betsi Cadwaladr, and the committee has recommended that the Government immediately develop a recovery plan. What's the Welsh Government's response? They say they'll write to Betsi Cadwaladr, asking them to set out a recovery plan. First, this problem has been growing for years on Labour's watch, so why have they not asked Betsi to do this previously? If they have, why ask again? Secondly, the current board presided over this disgusting, inhumane backlog and helped create it in the first place, so what makes the Government think that one of the main creators of the problem have any idea how to fix it? The Government talks about establishing baselines for the delivery of neurodevelopmental pathways, but that's pointless when it comes to health boards that are under this Government's watch that routinely, and by increasing margins, miss the existing baselines.

In the week we celebrate 70 years of the NHS, and Labour try to claim they're the sole guardians of Bevan's legacy, it is important to remember he said that people should have access when ill to the best care that medical skill can provide. Well, the Cabinet Secretary for health is nowhere near providing that. The longer the wait, the more mentally ill a sufferer can become. The risk of suicide or self-harm increases, their education will be further damaged and life for their families becomes increasingly difficult.

As a committee, we looked at this in great detail, as a group of AMs from very, very different parties, coming together to try to improve the lives of children and young people, so why does the Cabinet Secretary think it will be okay to reject some of the recommendations and only accept in principle most of the others? At point 4, you say you accept it in principle, but then you actually reject its key recommendation, saying you won't endorse a specific programme the committee are asking you to, even though that project involves the Samaritans, who I think have a much deeper insight into mental health issues than you, Cabinet Secretary.

Point 9 of this Government's response tells Welsh youngsters and their parents all they need to know about what the Labour Government think of their own management of this issue. The Government are refusing the committee's recommendation, a very sensible recommendation, to publish data on waiting times for assessment and interventions for children and young people since the commencement of the provisions of the Mental Health (Wales) Measure 2010. I'm sure that if the data were good news, the Cabinet Secretary would have already announced it. So, I do wonder what positive reason there could be for the Welsh Government to withhold this information from the public.

The situation has become so intolerable that nothing less than a full acceptance and commitment to implement all of the recommendations from the committee is going to be good enough. The Government still has its head in the sand over this problem, and their attitude of 'Make the right noise, but do nothing' is what led to this problem in the first place. The Cabinet Secretary should be bending over backwards to apologise to the young people and families he and his Government have so badly let down and do everything the committee has recommended.

So, finally, my despair at the scale of the problem is topped only my despair that, still, even in the face of a report such as this, they are still trying to spin their way out of it while Welsh children and young people suffer. The Government's response is disgusting, and I will leave my comments there. 

I'm a member of the committee, and I think this is one of the most important inquiries that we have actually undertaken. I know the Government does acknowledge that children's emotional and mental health is an issue that crosses so many boundaries between so many different people and so many different organisations—health, schools, youth support organisations, youth clubs, CAMHS—so I welcome the committee's recommendation and the Government's acceptance that it should be a national priority, but I think if you have something as a national priority, you have to go all out to achieve it, and it's in the more detailed recommendations that we don't really have the response that we were hoping for.

I agree very strongly with the committee's view that it should be the business of everyone who comes into contact with children to have their well-being and mental health at the forefront of their minds, because what could be more precious than a child's state of mind? We must aim for a generation of emotionally secure, happy children with a positive mindset, but to do that the Welsh Government does have to take action.

The report recommends that everyone who cares, volunteers or works with children and young people be trained in emotional and mental health awareness so that they can tackle issues of stigma and promote good mental health. Now, the Government accepts this, but only accepts it in principle. It is disappointing to see this described as 'unrealistic'. Surely, most people who work with children receive, as a minimum, some initial training, so why could not this include an element to at least raise awareness of the importance of looking out for children's emotional and mental well-being? I can't see that there's any problem at all in that, and I don't see that that's unrealistic at all. I think it's essential that initial teacher training has this built in, and the training that youth workers have, the training that health staff have, and I really think that that is something that could be incorporated into the training that already takes place with no problem. So, I do not accept that it is unrealistic that that recommendation should be taken forward.

Now, I think when a child's mental health suffers, it does cause a huge amount of stress and upset for their family, their friends, for the school, for everybody who works with them. The ripples from a child's mental health, I think, go so far, and many of us have experienced that issue. Families can do their best to provide for their children emotionally and materially, but problems with your emotional and mental health can happen to every family. So, children's mental health is a great leveller. But I think we do know that there are particularly vulnerable groups, and two of those are looked-after children and adopted children, and I think it's important to signal that out. 

Last week, I sponsored an event in which Adoption UK launched its report, called 'Bridging the Gap', about giving adopted children an equal chance in school. Adopted children do need extra support in school, and schools are maybe not sometimes as aware of this as they should be—there is an understanding gap. And it shows that 65 per cent of adopted children did not feel that their teachers fully understood how to support them, and this rose to 74 per cent at secondary school age. So, I think this is very concerning that the feedback from adopted children—who, we know, because of attachment issues they may have had early in life, are more vulnerable to have mental health problems—didn't feel that they could turn to their teachers. I do think that our report has reflected that, really, in most of the aspects that we've dealt with—that children have to seek support and wait for support in a way that the Chair has described that is not acceptable.

I feel it should be the burning mission of this Assembly to ensure that our children do grow up with sound, healthy bodies and minds, and that it should be our burning mission to make this happen. So, I feel that this report does lay it out, but I do think it is up to the Government to ensure that this is their burning mission as well, and that together we can all work together to make our children happy and fulfilled.

Today is 4 July, and in Jefferson's sparkling prose, we are reminded that we are born with inalienable rights, and the most important are

'Life, Liberty and the pursuit of Happiness'.

Now, 'the pursuit of happiness' we would define as some form of emotional well-being today, and there's absolutely no doubt that the denial of effective help and diagnosis of emotional and mental health conditions in childhood has a huge impact on the person and their development as adults, and the potential for their happiness and the pursuit of all sorts of goals in life.

I speak from my own experience. It was not something picked up. I have lived with periods of depression and, more particularly, anxiety, throughout my life. A lot of my coping mechanisms have been self-learnt and, more latterly, through effective health interventions. But, you know, it's an incredibly alienating experience, and I remember, even at university, being completely perplexed by some of my symptoms and not having a basic apprehension of what they were. That, I think, is a terrible situation to be in.

I commend this report. I think it is outstanding, as is Lynne Neagle, who has to be one of our greatest backbenchers, and the way you hold your side to account is a masterclass about how people should pursue the national good, and that takes you way beyond partisan politics. You're held in the highest esteem across the Chamber. 

Can I just say that I have the privilege of chairing the Government's ministerial advisory group on outcomes for children? We met on Friday, and this report, 'Mind over matter', was one of the agenda items, and it was received with great enthusiasm, particularly amongst the third sector representatives that are crucial to the working of that group. But there was some concern, in particular, about this practice of accepting in principle. Now, I explained, in a fairly neutral way, that this was something that had been the practice in Governments' responses to reports for many years, and that a committee would usually spend a lot of time returning to the items that had been accepted in principle, and examining how deep that was after six months, a year or whatever, whether something had practically been done, or whether it was a way of basically putting something on the shelf. So, I know you will return to this when you come to your in-depth scrutiny post report, and I know the Ministers will be aware of this as well, and they will know the concern and the frustration of some Members here. But I do remind the Cabinet Secretaries that the Permanent Secretary last year said that the Welsh Government would move away from the practice of accepting recommendations in principle and say frankly whether they accept the recommendation as it's framed or not, and then they can give their reasons for that. I do think that's at the heart of real accountability. It is somewhat frustrating to see what happens in this report.

Can I just turn to some of the detail? I think the need to focus now on the preventative end of the pathway is really, really important, otherwise we will see further difficulties with the acute end, and the referral via CAMHS in the inappropriate referrals out of not knowing where else to go, so you make a CAMHS referral. I think some of the practical suggestions—the national approach for schools, including the need for a guidance teacher model, so that lead members of staff have responsibility and enable other teachers to pick up the things—this is basic pedagogy. I find it astonishing that it is referred to as somehow being impractical that, amongst the most highly professional people we have in our country, the teaching staff are not capable of this. They should receive the training and the support to do it. The importance of therapeutic intervention has been very, very key in my own experience, and the active offer of advocacy for children accessing mental health services.

Can I commend, in particular, recommendation 22—the assessment of the emotional and mental health needs of children entering care? That's of particular concern to the ministerial advisory group. And recommendation 23—the Welsh Government to assess the provision of emotional mental health services for looked-after children, and this should be informed by the work of the ministerial advisory group—[Inaudible.]

Yes, indeed, and I'm privileged to take part in this debate. I'm not a member of Lynne Neagle's excellent committee. I commend Lynne Neagle as Chair, in the first instance. I'm the lowly Chair of the health committee in this place, and I don't know if I've mentioned before that I'm a GP as well, in Swansea, for about the last 38 years.

So, from the front-line experience of dealing with the children's mental health service, it is really, really frustrating, I've got to say. We need an absolute step change—more than a step change, an actual revolution in the provision, not just of the mental health service for children and young people but in all the emotional and counselling support services as well, both in the voluntary sector and in the statutory sector as well. We need to increase statutory and non-statutory provision—actually, more people working to help our children and young people. Why is that? Well, over the years—. I used to do the baby clinic years ago, and beautiful babies that would be all happy, smiling, but I see them growing up now—they're now grandparents, as I told you yesterday—but growing up—. Sometimes if you're unlucky to be in a traumatised household, you suffer a horrendous childhood—beautiful babies become brutalised toddlers—and then you become a traumatised teenager, mistrusting everybody in authority, even those trying to help you. You self-harm, you're emotionally damaged, and who can you turn to? So, you try your GP. So, GPs, yes, we're programmed to help people, but unless I can convince secondary care that you've got a describable mental health disorder, they won't take you.

Referrals to CAMHS are bounced back to the GP. That's because the element of a young person's distress is not taken into account at all. There has to be a proper diagnosis—that's the missing middle that this excellent report is going on about. And we have to muddle through with the missing middle, and that's not how we should be doing things in Wales in the twenty-first century. So, I keep seeing people, they are still growing up, my children and my young people, and some of them are horrendously damaged. And yet, I've got to wait for them to be bad enough to access CAMHS. Now that's not the stuff of early intervention.

It's not the stuff of early intervention; that is about reaching a threshold of treatment and that's not what we're about nowadays, since we passed the excellent Mental Health (Wales) Measure under Jonathan Morgan's leadership here in 2010. It's about early intervention, it's about prevention, and we're still not doing it. We have to get those services on the ground. I don't want to keep seeing people in distress with my limited capabilities, with nowhere to refer them to, because they're not bad enough or don't have a mental health diagnosis, to sort them out. We can't cope with young people so distressed because of things that have happened without there being an actual mental health disorder. Yes, some people have a mental health disorder as well, but some young people don't and the distress of the whole situation is just not bad enough for us as a society to do anything about.

It hurts us as GPs, having letters from secondary care saying, 'No, you can't refer this person here because there’s no recognisable mental health disorder.' So, what am I supposed to do then? Yes, back to the schools. I have no locus of control over school-based counselling services, though. I'm looking forward that the full implementation of the recommendations here means that primary care, the voluntary sector and schools will work together—GPs, primary care and teachers together. Because, at the moment, we're bombing back and forth by default, because I can't help them. Hopefully, the teachers can. But we’ve got to empower our teachers as well, let’s be fair.

Let’s be fair here now, because we're muddling through. Parity of physical and mental illness people say—well, if I've got a physically ill child, I pick up the phone, I ring secondary care, and they deal with it. I try getting hold of secondary care for children who are emotionally distressed, and nothing happens. That has to change. Diolch yn fawr.

I well remember when this building was opened, the national poet for Wales, Gwyneth Lewis, gave a reading where she described this Chamber as the cockpit of the nation—the place where we come together to discuss things of importance. And listening to this debate and reading this report, it's clear there's a cross-party consensus that the current system is inadequate. To be fair to the Welsh Government, the last time a report like this was written, they responded and there have been significant improvements in the quality of specialised treatment for young people with mental health disorders, and the same type of response is merited now for the central call of this report to treat the earlier stages of the development of mental health problems.

I'm not on the committee, but I've read the report in detail, I've read the children's commissioner's response, I've sat through multiple presentations from different groups, I deal with these issues on an almost weekly basis in my surgery and I've discussed it with my local health board—a health board, it must said, that has a waiting list of two and a half years to see CAMHS. Parents come to see me on a regular basis in a desperate state—a desperate state—and they have to wait for two and a half years to get a diagnosis. And when they get the diagnosis, their expectations are overly inflated, because the system has very little to offer them. There's despair on the part of GPs—this we've heard already. There's despair on the part of teachers. I was speaking late last night to a teacher from my constituency who told me, 'You don't always know where to look for help for these children, you just want something to be done.' The missing middle the report so effectively pointed out, where therapeutic or lower level support can help, is really the focus we should have on this report. I should commend this report. It's the best report of a committee I have read in my time in the Assembly and I pay tribute to all its members and particularly to its Chair.

But I should say it's a very tough report. It's very well crafted, it has SMART targets, the recommendations are specific, they are measurable, they are attainable, they are relevant, and they have time limits to them. It's no wonder the Government has struggled to respond to that in its formal response, which I too found bitterly disappointing. I understand the anger of the members of the committee and, looking at the faces of my friends and colleagues the Cabinet Secretaries, I too can tell that they are not happy with the position that they find themselves in. I think we need address this to the Welsh Government and not make poorly judged comments, if I may say to Darren Millar, to personalise this. 

I think the machine of Government is struggling to respond to this crisis we have with young people. This is a problem that has increased in intensity and volume over recent years and I think the system is struggling to know how to respond to it. The merit of this report is that it is evidence based from practitioners and from the third sector to give us a practical route-map, and I think it would be prudent for us to return in the autumn, perhaps with an individual Member's debate or another committee debate, to give Ministers a chance to reflect over the summer on the strength of feeling and on the evidence. 

I've lived the issues presented in this report. I hesitate about discussing personal matters in this Chamber, but I've reflected that we are elected here not just to represent our constituents, but because of our personal experiences too. When I first experienced the system when my son was seven years old, I was told, 'Come back when he's throwing himself against the wall', and sure enough, six years later, after a month of very expensive hospital treatment, we did get effective support. It was support from the third sector, from Action for Children, which we found to be superb, and from family therapy through CAHMS, which is also highly effective. This is the sort of support that we would have benefited from six years earlier, which would have prevented enormous family strain and distress, not just to my son, but to all of us. Its impact is profound and far reaching, and that's the type of intervention this report recommends—the smaller type of measures, the earlier interventions that can help before it gets to crisis.

There is a quote in here from young people in Abergele, where they say

'You have to have a crisis first', before the system will respond. The children's commissioner, in her very pointed response, describes the Government's response as a missed opportunity and she says there should be no wrong door. She says there hasn't been joint working within the Government, and I'd ask my colleagues on the front bench to reflect on that and come back to us in the autumn. Diolch.

First of all, I'd like to thank Lynne Neagle and her committee for this report. Lynne, you are fearless and tough and I have great admiration and total respect for you. I think the children and young people's committee is in very good hands, and if it was up to me I think the children of Wales would be good and safe in your hands too.

I think the 'Mind over matter' report has got to the heart of the issues, they've listened to the voices of the experts, they've listened to practitioners, young people and organisations, and they have made meaty and insightful worthwhile recommendations. I think that they are recommendations that deserve to be listened to.

I thought very hard about how I was going to pitch my contribution to this debate today. Would I reflect the chorus of shock and dismay of the committee and of witnesses with regard to the Government response, or should I talk about the effect that this has on children and young people in my particular constituency—the kids we've tried to rescue, my team and I, in my little office in Tenby with the help of county councils, both Carmarthenshire and Pembrokeshire—or would I talk about the multiple suicides that we've seen in Pembrokeshire over the last few years and the ongoing coroner's questions, or should I just do a forensic analysis of the Welsh Government responses? I've decided I'm not going to do any of that.

'Mind over matter', perinatal mental health, adoption services, children and adolescent mental health, child obesity, attendance and behaviour, adoption, advocacy services for children, placement of kids in care, youth justice, not in employment or education, autism in further education, dyslexia, post 19 with additional learning needs, mental health services: 15 committee reports by three different committees, each and every one of them since I've been an Assembly Member.

What does perinatal mental health have to do with what we're talking about today? Well, let me tell you. Recommendation 10, recommendation 22, recommendation 26, they all point to what David Melding encapsulated so well: that if we do not help at the very, very beginning, if we do not get it right at the very, very beginning, then all we're going to do is spend the rest of our time picking up the pieces. And it's a quarter—a quarter—of our population that is in distress at some point or another. Ninety eight per cent of the children who are not in education officially have got mental health issues of the type that this report talks about. No, they're not psychotic in a way that we can medicalise, but they have all the other issues. They've been badly let down. They have been neglected. They have been abused. They are lost, they're confused, they don't know where to go to, they have emotional and behavioural problems. 

In 11 years—I thought it was 10 years but, Darren Millar, you mentioned 11 years, and we came in at the same time—in 11 years, 15 reports, all of which touch on the fact that we have not got it right. What does it take? Because I say this to you: we have too many children out of education, we've got too many kids unable to cope with twenty-first century life, we've got too many wounded kids in our nation who will grow into adults who will not fulfil their potential, who will not be able to do all the things that those of us in this Chamber are lucky enough to do. How can we develop our maturity as a nation? How can Wales step forward into the twenty-first century when we leave so many people by the wayside? How can we hope to improve people's lifestyles? Because if we don't get them a firm bedrock to build on, how will we, Wales, afford to pick up the pieces in the years to come? 

The Government response, I thought, was off-hand. I thought it was unengaged, Cabinet Secretaries, and in parts I thought it was downright resentful. I felt there was a real whiff of inertia. Welsh Government, you are out of step with Assembly Members of all parties, including Members of Welsh Labour. The kickback to this report has been phenomenal—the children's commissioner, the Samaritans, the NSPCC, the psychologists. If you had any sense, you'd put Lynne Neagle in charge of a task and finish group to drive this kind of report through and make it happen, because my kids, your kids and your grandkids need this. These people up here, they need this change now.

Cabinet Secretary, I know that we all want to see the best possible outcome when it comes to the mental health of children and young people, but you must feel the palpable disappointment from Members across this Chamber with the Government's response to this report. We know the problems, we know the solutions, but the Welsh Government seems reluctant to act. 

Accepting ideas in principle will not lead to action, and action is what we need. Every expert agrees the Welsh Government needs to act to ensure that the regional partnership boards have a mechanism to focus on children and young people. They must also require all regions to ensure that CAMHS and social care services provide an integrated service to children with emotional, behavioural and mental health needs. A whole-school approach, mapped and led jointly by health, education and social care is needed to guide schools, and this will ensure that the help that should be available for children and young people will be at the foundation of an equitable emotional and mental health service for young people and children in this country. 

Cabinet Secretary, these are technical policy solutions. Acronyms and jargon make us feel disconnected from the real effects that poor mental health service provision leads to. If anyone knows any teachers, young people's mental health is a matter raised by them all the time. It's impacting now on so many people. As so many people have said today, there is so much despair out there.

When I was young and growing up, my mother's biggest fear for me was an early pregnancy. Now, I would say that most parents' greatest concerns are about their children's mental well-being. Quite late this morning, I posted on my Rhondda Facebook page that I was speaking in this debate, and the response was overwhelming. I want to make the Cabinet Secretary aware of some of the real stories behind some of these statistics. One person I'm not going to name gave the following account of their experience.

'I visited the GP four times to ask for help and was simply given links to online self-help guides in NLP. On the fourth and final occasion, I gave a full disclosure of my use of alcohol and cannabis as a form of self-medication and I said that I was suicidal. I wasn't leaving without him understanding how I felt and how desperate I had become. I was told that I would first have to stop drinking before I could access any further help and wait six months for the most basic counselling appointment. On 12 August, I attempted suicide. I was only interrupted by a friend coming home unexpectedly.'

Now, that moment was a turning point for this person. They turned to friends for support and I'm pleased to say that they got it and are now in a much better place.

A mother commented that her seven-year-old son suffers from anxiety. Despite the 28-day maximum waiting time for access to mental health support, she's now been waiting around four months. He is now on the verge of being excluded from school and even placed in a special school due to the school not being able to accommodate him without an official diagnosis. Anyone in a crisis cannot afford to wait, and, for children and young people, the urgency is even greater. Stories of children waiting months on end or being passed between child and adolescent mental health services were so prevalent in response to my Facebook post that I can't even scratch the surface here.

If you read these pleas for help, Cabinet Secretary, I'm sure that you would agree that this is heartbreaking stuff, and for the families that suffer as a result of the system's inaction it is doubly so. So, please, listen to Members here today. Act with urgency. For some, this question is literally a matter of life or death. A child mental health crisis is brewing, and if you do not make urgent radical changes now we could be facing true disaster. I fully support the calls made by the Chair of the committee, who has spoken excellently in this debate. We all owe it to our future generations to get a much better grip on this question.

Finally, Jayne Bryant.

Thank you for the opportunity to speak in this important debate today. It's a very important report and I'd like to commend the Children, Young People and Education Committee for conducting their thorough and timely inquiry and my friend and colleague Lynne Neagle for her leadership in that and for the way she's spoken today.

Research by the Office for National Statistics earlier this year found that 10 per cent of young people aged 16 to 24 describe themselves as always or often alone. This is the highest in any age group. These figures are reflected in the National Society for the Prevention of Cruelty to Children's announcement that they have seen a significant increase in children and young people contacting ChildLine about their emotional and mental health. It's now the most common reason for ChildLine counselling in Wales.

The excellent 'Mind over matter' report has been welcomed by clinical and health professionals and third sector organisations. They support the report's identification of the urgent challenges faced at the beginning of the care pathway and its key recommendation that emotional well-being, resilience and early intervention should be a national priority. The situation is urgent. Research has shown that around half of all mental health problems begin at the age of 14. Failure to intervene can lead to demand outstripping supply of specialist services and, like other Members here, I deal with many of these issues on a daily and weekly basis.

The report highlights the importance of measures that can be taken to prevent children and young people reaching crisis point and building resilience. Across Wales, there are some fantastic examples of projects working to support the emotional and mental health of children and young people, and I'd like to highlight a few that I know well. Earlier this year, I visited the nurture group in Pillgwenlly Primary School in my constituency with the Cabinet Secretary for Education. The group provides assistance to children who need extra support with emotional and behavioural needs by building relationships between pupils, teachers and parents. The group helps equip children with the skills and resilience they need to get the most out of every aspect of school. The children themselves are very open about how being part of the nurture group has changed how they feel, and this group makes tangible differences to those children's lives.

I'm very glad that the committee visited the Changing Minds project in Newport as part of their inquiry. I've seen for myself how the project at Newport Mind provides peer support for young people. Its preventative nature has had a marked impact on reducing the use of local primary mental health support services, and I'd like to thank the Chair today here for including their voices again this afternoon. Among those who gave evidence to the inquiry about the importance of preventative measures was Carol Fradd, director of Newport Samaritans. I met Carol not long afterwards, and she explained about the DEAL, the developing emotional awareness and listening tool, a teacher resource developed by the Samaritans. Following the success of DEAL, the Samaritans have called for emotional and mental health awareness to be included in initial teacher training qualifications, and work conducted by the Children's Society has shown that the school environment can have a big impact on children's well-being, yet the responsibility cannot fall on teachers alone, and, as others have said, it's the responsibility of all of us.

Establishing working partnerships with children's clinicians and professionals who have the skills to transform children's mental health care—Welsh Government must continue to enable them to share their experience and expertise. Barnardo's are among those who have highlighted the benefit of developing partnership working with local communities such as Millbrook primary in Bettws, which I visited with the Minister for children earlier this week.

A key contributing factor to the increasing prevalence of emotional and mental health issues is undoubtedly the influence and pressure of social media, and it's really difficult for all of us here today to imagine how social media affects young people's self esteem. Young people are increasingly experiencing a significant portion of their social interaction online, but this cannot replace human-to-human contact and the valuable skills gained from it. Scrolling through social media can magnify the mixture of emotions we all experience, unfortunately often reinforcing and prolonging negative thoughts and feelings. Today, we've really heard the strength of feeling, cross-party, about this. From a young age, we instil in children that they do not need to tolerate physical pain. The committee's report is an excellent and crucial reminder that we all have a responsibility to ensure young people grow up knowing that their minds matter as well.

Thank you. Can I now call the Cabinet Secretary for Education, Kirsty Williams?

Thank you very much, Deputy Presiding Officer. Firstly, can I thank the committee for their comprehensive report detailing the step change that they feel is needed in this area? I will join with David Melding in paying tribute to the committee's Chair, Lynne Neagle, for her dedication to these issues, not just in this report, but over her time here as an Assembly Member. Could I also join her in thanking those who gave personal testimony to the committee—that's never an easy thing to do—and also thank David and Lee who, today, have spoken of their own personal experiences in this regard? It reminds us that nobody is immune from issues of mental ill health.

Emotional and mental health support for young people is a matter that cuts across portfolios and an area where only effective cross-government and multi-agency working will effect the preventative and interventionist action that we need to take to make a change, and it's critical that we get this right. And I say that, Deputy Presiding Officer, not just as a Cabinet Secretary, but a mother of teenage girls. Improving mental health and well-being is a Welsh Government priority, and although the report acknowledges that there have been improvements in services, particularly at the specialist end of provision with mental health, it highlights the area where we can and we must do better for our young people. Overall, I believe the committee and the Welsh Government share the same ambitions, although we may disagree in some areas about how that is best achieved. But I can promise you this—that both I, myself, and the Cabinet Secretary for health are committed to working with the committee and its members to make progress on this agenda. We have come a long way, Deputy Presiding Officer, but I would be the first to acknowledge that there is still a very long way to go. And the speech by Leanne Wood, and the evidence that she's presented from her own constituency, backs that up. 

Our aim is to effect a cultural shift in Wales to direct focus on the well-being of young people. One of the outcomes of this new focus on well-being should be prevention, so that we move our emphasis from crisis management to the prevention of mental health problems from developing or escalating in the first place. As acknowledged by the Chair, this is the best thing for the individual, so we can limit their pain and distress. But it will also create the space within specialist mental health services to concentrate on those children and young people who, despite help and support, need those services the most.

We expect different areas to be able to work together so that we have a whole-system approach that truly puts the child or the young person at its heart, and, to this end, we need to continue to build and improve those relationships between different services.

If I may turn directly to some issues facing education, there is already a lot of work under way in our schools to support this renewed focus on well-being, such as the development of the new curriculum and the health and well-being area of learning and experience, changes to professional learning, and the schools' health research network, with the new data that they have collected on well-being.

Also, before the end of this term, I hope to publish the online safety tool for children to address some of the very relevant points that Jayne Bryant referred to in her speech and the effect of social media on the mental health of young people. With regard to the training of staff, which was mentioned by Julie Morgan, we are currently reforming the way in which our initial teacher education is delivered in Wales. The reforms require the newly accredited ITE providers—and they were announced on Friday of last week—to design and deliver courses that address the health and well-being area of learning and experience. If they don't do that, they won't be accredited.

Now, with regard to that recommendation that there has been a lot of focus on today, it is, of course, absolutely, Julie, right to expect that people working in our education profession and in our youth service have been trained in this regard. But the recommendation says that every volunteer working with a child also should be trained, and we need extra time to consider how, practically, that could be achieved, and how we can do it without any unintended consequences of maybe putting people off from volunteering with children. And we will need to consider more carefully how we can work with those who support children in their football club on a Saturday, or their Brownies or Guides or Scouts, or even people like me and my husband, who volunteer with our local young farmers' club—how we can make mandatory training work for all those people who give so much to their communities in their spare time and without any charge to the state. We don't want to have any unintended consequences.

There is a clear need for teachers to have help and support in responding to children experiencing difficulties such as anxiety, low mood or self-harm, and I'm very grateful that there's been recognition across the Chamber that this cannot just be the job of teachers alone. We're already asking an awful lot of our education system and our professionals, and I'm very grateful that Members have recognised this.

So, the NHS does have a role in training and consultation across sectors, providing early help in schools by suitably trained staff. That's why, in September of last year, the Cabinet Secretary for health and I jointly launched the CAMHS school in-reach programme, backed with £1.4 million of investment to provide dedicated professional support to schools. Such school-based services have benefits for the schools' staff and their learners, but also bring benefit to the NHS service by easing pressure on specialist CAMHS, by reducing inappropriate referrals, and, crucially, building those relationships that we need in between different sectors of the public service. [Interruption.] We need—. Yes, of course.

Just reflecting on a point you made a little earlier about the practical implications of one of the recommendations, and David Melding made the point: the Permanent Secretary had assured the Public Accounts Committee that the Government would stop this practice of accepting things in principle and be clear when they were rejecting it. I've written to the Permanent Secretary again this morning, asking her to reinforce that ruling in the light of this report. There will be times, of course, when it's not possible to accept it, but do you accept that it would be better to be clear about the reasons for that rather than accepting in principle?

Well, Lee, what I would say is that I would much rather, as a Cabinet Secretary, be in a position to be able to accept or reject, but sometimes—and I acknowledge the extra time that the committee has given my officials and myself to work on this—we need more time to truly understand what the implications of saying 'accept' are. Because if we say, 'accept', then we mean that that has to happen, and sometimes there are complex issues that need to be fully understood, and the unintended consequences understood and mitigated against. Therefore, I want to make progress on all of these recommendations where we say we've accepted in principle. And, as I said at the beginning of my speech, I give an absolute commitment that myself and the Cabinet Secretary for health will continue to work with the committee to be able to move those things forward. Indeed, since the time that the Government's report, recommendations and response has been published, ongoing work has happened, and already, as a Government, we've been able to be more positive about responding to this. If I could make some progress on my speech, Deputy Presiding Officer, I'd be able to give the Member a very real example of how, in the short space of time, we have been able to continue that work and been able to respond appropriately.

As I said, we need to take a whole-school approach, and have already recognised that our education institutions are key sites for both promoting positive mental health and well-being and providing evidence-based prevention and early intervention. In recent years, Welsh Government has invested significantly to improve CAMHS provision across primary and secondary care, with over £8 million of annual dedicated funding, which has enabled the recruitment of new staff, training of existing staff and the establishment of new services. However, the report rightly recognises that there are areas where we need to improve, particularly in the case of primary care. We have commissioned the NHS delivery unit to review activity and relationships with other CAMHS so that we can address provision challenges.

Since responding to the committee, the health Secretary and I have continued our discussions about how we can continue to move the agenda forward. We will, therefore, be accepting point 4 of the committee's key recommendation on reviewing the progress made in prioritising the emotional and mental health and well-being and resilience of our children. We will prioritise and strengthen arrangements to drive this agenda, working both strategically across the education and health departments to deliver sustainable approaches to mental well-being. With regards to evaluating our progress, we will work with the committee to ensure that we are setting the right parameters for that work. Although we have some concerns about what is the optimum time to continue to review, we will engage with the committee and report on progress at a time that we are able to agree with the committee Chair. I'm sure that other Assembly Members, as has been demonstrated across the Chamber this afternoon, will also be interested in this, despite not being members of that committee, and we will bring forward proposals as our thinking develops.

We have also had further discussions around recommendation 12—point 2—regarding distress. This has been mentioned several times this afternoon. Specialist CAMHS provide support for young people with more complex mental health issues and, as such, will always need to respond to the clinical needs of the individual. However, distress is considered as one of a number of factors to determine the most appropriate services to meet a person's needs, both for those who are referred to CAMHS and for those who do not meet the referral threshold. Therefore, we will be engaging with the Aneurin Bevan university health board to monitor the delivery of their services in Gwent, which are exceptional and doing very well, to see how we can learn from their experiences on the Gwent project to improve services across the length and breadth of our nation.

Could I ask you to wind up, please?

Of course. Apologies, Deputy Presiding Officer.

Therefore, can I finally thank the committee and the Chair again for their extensive engagement and their raising awareness of these issues? I also welcome the health committee's work that they're currently doing on suicide prevention, which is an important element to sit alongside this work. Deputy Presiding Officer, we can't allow any child or young person to feel that they have no-one to turn to, and I will, with Cabinet colleagues, work with the committee to secure the emotional and mental health support provision that we know we all need and we all need to deliver soon.

Thank you. Can I now call on Lynne Neagle to reply to the debate?

Thank you, Deputy Presiding Officer. I've got three minutes and 30 seconds to reply, which does rather limit what I can do. So, I hope that Members will forgive me if I don't respond to each individual contribution, but I would like to assure you that we will go through the Record and make sure that everybody gets a response to this really important debate. I would like to thank everybody who's spoken, from across parties. It is just so heartening to hear the massive support that there is in this place for the step change that the committee knows is needed. Particularly—although I said I wasn't going to respond to individual contributions—I would just like to thank David and Lee for sharing their personal experiences, which is not just courageous but helps everybody else realise that it's okay to talk about these things. So, thank you to both of you.

I should thank, as well, our brilliant clerk and our fantastic research team. We are really lucky, as a committee, to have such a brilliant team supporting us. I thank the members of the committee who've worked really hard on this important inquiry and thank again the stakeholders who have come to us so willingly and shared their experiences in such a powerful way. I think the committees are one of the huge strengths of this Assembly, and we're privileged and should be grateful that people come to us to share their views in that way. Nobody has a monopoly on good ideas, and I hope that is something that the Welsh Government will take into account. I'd like to thank the Cabinet Secretary for her response and thank her for her engagement with me, as usual. Even where we haven't agreed, there has been a willingness to engage, and I know that she personally is very committed to tackling these issues.

I hope that the Government will reflect on the response, because even the Cabinet Secretary's comments there highlight some of the anomalies, really. I am disappointed that the Welsh Government has got so hung up on the issue of everybody—or people working with children—having some basic mental health training, because I don't think that is too ambitious. There are loads of models out there. You only have to look at Dementia Friends—45 minutes to give you a really good understanding. The health committee has heard about 20-minute suicide prevention training. There are models out there, and I don't think it should be too much of an aspiration for us to try and do this for our children and young people.

I'm pleased with the movement that there's been, but there needs to be much, much more. What I would say is that the movement on the 'missing middle' recommendation just is a very powerful example, really, of how I don't think this response has been properly considered, because if people had read the narrative, understood the narrative and realised that this is happening in Gwent anyway, then there should have been no need for that rejection. So, it doesn't tell a good story about joined-up Government on such an important issue.

Can I just conclude, then, by thanking again the young people—the young people that are here for this debate, but also all the young people who have engaged with the inquiry and who I know this is so important to? I assure them that we have heard their voices and we, as a committee, will continue to do everything that we can with maximum urgency to get that step change that we need. This is about more than talking about early intervention. It's about more than claiming mental health has parity with physical health. This is about delivering this for our children and young people. If we get that right, not only will we improve the quality of their lives, but I believe we will save lives. Thank you.

Thank you. The proposal is to note the committee's report. Does any Member object? No. Therefore, the motion is agreed in accordance with Standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.