Part of the debate – in the Senedd at 3:58 pm on 4 July 2018.
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.