1. Will the Minister outline the Welsh Government's strategy to support the mental health and well-being of young people in south Wales? OQ55956

Diolch, Llywydd. Improving the mental health and well-being of children and young people requires a multi-agency and cross-Government approach. Our 'Together for Mental Health' delivery plan 2019-22, recently refreshed in the light of COVID-19, sets out how we will work on this with our partners.

Diolch, Gweinidog. I'm pleased you mentioned that strategy and the need to keep policies updated with the ongoing pandemic. The lockdowns have clearly had an increasing impact on people's mental health, including young people. According to a recent report published by the Samaritans in England in October, people who self-harm face unreasonable barriers to accessing mental health services, and they are caught between being deemed too high risk for primary mental health services, while not ill enough to access secondary mental health services. We know that this is also the case in Wales, and this disproportionately affects the younger generation. What discussions have you had with groups like the Samaritans, and other stakeholders in this area, and what plans are you going to put in place to ensure that this growing problem is dealt with?

Diolch, Nick. Just to make it clear that we do have regular meetings with the Wales Alliance for Mental Health, who are the representatives of the third sector in relation to mental health, and of course, they do keep us updated as to what they see is the situation on the ground. And I'm very keen to make sure that I have a second view of what's going on; obviously, I get the information directly from our health boards, but I'm very keen to make sure that that is cross-referenced and cross-checked in terms of people's real-life experience.

In relation to the tier 4 support, one of the things that we're clear about is that we do need to see improvements in that area. And that's why I have made sure that our officials meet fortnightly to check what the information is, what the updated information is, in terms of numbers of people who are able to access, and those, more importantly, who are not able to access that support. I've been asking for a weekly update from my officials to make sure that that situation is something that we can keep abreast of. Just in terms of the tier 4 support, just this week, my understanding is there's only one person who's failed to access that tier 4 support.

Our young people have faced so many strains this year, uncertainty about exams, not being able to see friends, their normal routines just disappearing, and we know, as has been said, that the pandemic will have taken an inevitable toll on their mental health. But the most recent figures on NHS spending for 2018-19 show that less than 1 per cent of NHS funding was spent on children and young people's mental health. Per head of population, children and young people's mental health received just £18.17 per person that year, and this when we know from Mind that one in four people will experience a mental health problem in any given year. Clearly, our young people need far more investment in their well-being. So, will you assure me that the forthcoming Welsh budget commits resources that will meet the scale and the ambition needed to improve services and support?

Diolch yn fawr, Delyth. Just to make it clear that we already spend more on mental health than any other aspect of the health service—£700 million a year. And of course, in response to COVID we've topped that up by almost £10 million, to make sure that we are responding to the pressures that we know in particular are there amongst young people. We've heard the information that's come from the Children's Commissioner for Wales, but also the Youth Parliament has given us some very useful insights into the levels of anxiety that young people are facing. And that's why what we've done is to really focus attention in particular on, first of all, that whole-school approach, where we've given an additional £5 million this year, to make sure that we can give that really early intervention, to stop the problems from accumulating. And also now what we're doing is we're trying to make sure that that whole-school approach fits into a broader whole-systems approach, so that it can connect with the NHS. The key thing as far as I'm concerned, and certainly the information that we've got from the Wolfson centre, which is the expert centre in Cardiff University, which specialises in the mental health of young people, is that they are telling us that 80 per cent of the problems in relation to mental health start when people are young or when they're children. So, certainly, that is something that we're looking at, to make sure that we put that emphasis in the right place, with very early intervention, tier 0 and tier 1 support.

Minister, I know that you will be aware of the huge pressure placed on CAMHS, the child and adolescent mental health services. It's been this way for several years, before the additional pressures placed on our young people by the pandemic. Much of this is due to young people being referred into the system when their mental health needs are mild or moderate, which is the most sensible and important time, of course, to seek referrals for support, but a problem for the CAMHS system because it's designed only to support those with serious mental health issues. So, could you please provide us with some more information about those early interventions that you referenced in your previous answer, to Delyth Jewell, and how those early interventions can ensure that our young people are supported in a timely and appropriate way to ensure that their mental health does not deteriorate further?

Well, diolch, Vikki. I think we've got to be really clear that not all mental health issues are medical issues. There are many issues that are due to social problems, people suffering problems in relationships, and I think what we need to do is to make sure that we intervene very early, as you're suggesting, to make sure that young people have the capacity to deal with those difficult situations. And that doesn't necessarily mean a medical intervention, which is why that whole-school approach, I think, is the right way to go about this. 

You'll be aware that the young person's mental health toolkit has now been published on Hwb, and that really gives support to young people to make sure that they can really focus in on the issues that matter to them—anxiety, low mood, bereavement, even coronavirus information. And I think it's really important also for us to make sure that they're aware of the helplines that are available, the C.A.L.L. helpline is something that of course is there, but also now, for those who are over 16, we have this SilverCloud, which is an online approach to cognitive behavioural therapy, and I do hope that people will use the opportunity. Maybe sometimes, they don't want people to know about their issues, and they can do that in a way that doesn't mean that they have to attract the attention of their teachers. They can do it quietly and privately, and that option is now available to them as well.