Order. We now recommence with item 5, which is the debate on the Children, Young People and Education Committee's report, 'Mind over matter: Two years on', and I call the Chair of the committee to move the motion, Lynne Neagle. 

Motion NDM7518 Lynne Neagle

To propose that the Senedd:

Notes the Children, Young People and Education Committee Report, 'Mind over matter: Two years on', which was laid in the Table Office on 9 October 2020.

Motion moved.

Thank you, Acting Presiding Officer. It's two and a half years since I stood in this Chamber to say that I was both proud and privileged to address the Senedd on the Children, Young People and Education Committee's 'Mind over matter' report. At the beginning of that debate, I said that the emotional and mental health of our children and young people was one of the most important issues, if not the most important issue, for us to tackle as a Parliament. Two and a half years later, with a global pandemic as a backdrop to our debate today, it is clearer than ever that we have a fundamental responsibility to support our children to be resilient, to be mentally well, to be equipped with the tools they need to tackle the challenges that will come their way.

Two and a half years ago, our committee made our commitment to this area clear. We called for the emotional and mental health and well-being of our children and young people to be a stated national priority for Welsh Government. We called for an urgent step-change in the support provided for our children and young people, arguing that provision had been too limited for too long. We called for drastic action at the preventative end of services, to stem the flow of mental health problems earlier, and to prevent the distressing—and in many cases, unnecessary—escalation of issues. We said that a whole-school approach was needed, as part of a whole-system approach, to support the mental health and well-being of our children and young people. We made it clear that we were unwilling to allow this significant issue to be handed on in a legacy report, yet again, for a successor committee in the sixth Senedd. Reaching the end of this Parliament with conclusions of 'more needs to be done' has not been an option for us. Our children and young people expect—and deserve—better than that.

So, how have we sought to deliver on our promise to this Chamber and to our children and young people that we wouldn't let this one lie? We have followed up our original 28 recommendations, regularly and forensically, over the last two and a half years. We have been supported in this work by dedicated professionals, parents and carers, children and young people, and the third sector. I would like to take this opportunity to thank them, and to place on record my admiration for them. Without them, our scrutiny would not be possible. Based on their views and experiences, we were able to produce our follow-up report. As part of this work, they assessed progress against each of our recommendations, and outlined where actions were needed before the end of this Senedd. I know other committee members intend to speak to specific areas, so I will largely focus on the headline issues they helped us to identify.

First of all, while change is starting to happen, and people are very committed to making things better, children and young people are still struggling to find the emotional and mental health support they need. We were told that change simply isn't happening quickly enough. People recognise it's difficult, and that the pandemic has placed significant pressure on our public services, but we believe the impact of COVID makes progress more vital than ever. The collateral damage to our children and young people caused by this pandemic makes pace and action in this area even more crucial.

Secondly, we need whole-system change to be our focus. We really commend the work that's been done to deliver a whole-school approach, and the significant work under way to deliver early help and enhanced support. Progress is visible and evidenced, and that is much to be welcomed. But we have made it clear that a whole-school approach alone will not deliver the step-change our children and young people need. From the beginning, we've said a whole-system approach is essential to realising our ambitions in this area. Schools cannot carry this alone. On that basis, we recommended that the Welsh Government expand the scope of the joint ministerial task and finish group, so that its remit covers a whole-system approach.

I'm pleased to see that the Ministers have put that recommendation into practice and that the group's remit has been expanded as a result of our call. But our work can't stop there. While we are reassured of progress in relation to education, we are far less confident that the pace of change in health and local government—including social services—is sufficient. It is clear to us that, on the health and social services side, progress hasn't been sufficient, and we are deeply concerned about this.

While we welcome the progress made in relation to early help and enhanced support, it's vital this is rolled out as quickly as possible. It's clear from the work we've done that many of the children and young people who find themselves in crisis care, or in specialist tier 4 settings, are, in fact, those we describe as the 'missing middle'. They are children and young people who would not have deteriorated if they had received early help and support. This is not good enough.

Furthermore, we are particularly concerned about what we consider to be a lack of progress in relation to supporting children and young people from CAMHS into adult mental health services. The Government’s response tells us that its transition guidance is being reviewed, but, from our work, it's apparent that this guidance has never been properly implemented. We think this is still too much of a work in progress, which is concerning two years after our report highlighted significant worries about this.

In addition, crisis care and tier 4 remain an area of real concern. Significant workforce capacity issues have been reported to us in the last two years, and we know that problems have continued during the pandemic in terms of accommodating children and young people in appropriate in-patient settings. Our report is clear that more work is needed to address the range of complex care and safe accommodation needs of our children and young people.

We remain to be convinced from the Welsh Government's response that the progress we want to see is being made, and that the join-up between policy and practice in tier 4 of the system is where it needs to be. On that basis, I call today on the Minister to put in place a formal mechanism to plan this work, and to bring all the relevant people together to deliver the outcomes we need across this specialist end of support.

We've also consistently flagged our concern that certain workstreams, including this vital area of specialist support, no longer sit under the remit of the Together for Children and Young People programme, and join-up with that programme is absolutely crucial. 

The final headline issue I'd like to raise relates to how we treat our most vulnerable children and young people, particularly those who are care experienced. David Melding has championed their cause for many years. Most recently, he has done so as chair of the outcomes for children ministerial advisory group. I cannot let this debate go by without marking his contribution to the cause of children and young people. There are many reasons we will miss David in this place, but, as Chair of the children’s committee, I can certainly see the large gap that he will leave behind in our area of interest.

With regard to implementation of 'Mind over matter', a significant role has been given to the outcomes for children MAG. Looking to the future, the interface between the joint ministerial group, the Together for Children and Young People programme, and the outcomes for children MAG will be crucial. We cannot afford to let any of our children and young people fall through the gaps between these groups. For our looked-after children, this is even more vital; it is incumbent on us not to fail them. On that basis, I would welcome an indication from the Minister of how she, as the new Minister for mental health, will ensure that the structures that have been created will continue to work together. As our follow-up report states, continued commitment and leadership from the Welsh Government and sector leads are essential to drive this agenda forward and facilitate the joint working that is so necessary.

In drawing my opening remarks to a close, I'd like to acknowledge the work of officials and Ministers in response to our 'Mind over matter' recommendations. While I don’t apologise for our persistence and determination, I do recognise the effort and work that it generates. Undertaking constructive scrutiny and working together with the Executive to deliver on its results is at the core of a good and effective committee system. The successful development of a whole-school approach to emotional and mental health demonstrates what can be achieved when we work together effectively. The promise that the Minister for Education made yesterday to include emotional and mental health on the face of the Curriculum and Assessment (Wales) Bill does the same.

I hope our work can continue to deliver concrete results for our children and young people between now and the election. As Chair, I commit to doing all I can to drive progress in this vital area in the remaining months of this Senedd.

I wanted to close by repeating what I said when I spoke to the Welsh Youth Parliament recently. I told them how, after a speech about 'Mind over matter', where I had emphasised how central young people's voices were to our report, a delegate had come up to me and asked me what the young people who had died by suicide would say if they were there that day. That has always stayed with me. Above all, it is the voices of the young people who are no longer with us that must drive our relentless focus on delivering the emotional and mental health support that our children and young people need and deserve. Thank you.

Thank you very much, Lynne. And I'm very grateful for what you said about the ministerial advisory group. I must apologise to Members. I should have given you a full two minutes after the bell was rung, and I fear you only had 20 seconds. So, the breathless get my apologies, and I won't penalise anyone who turned up slightly late because of my error. Suzy Davies. 

And for that I'm extremely grateful, Presiding Officer—Chair, sorry. Yesterday, my colleague Mark Isherwood highlighted once again the vulnerability of looked-after children. He said that, although looked-after children are taken into local authority care to improve their welfare, they are over represented in child criminal county lines exploitation and are therefore far from being effectively safeguarded. It's disappointing, then, that looked-after children merit just one mention in Welsh Government's mental health delivery plan 2019-2022, which is

'to ensure specialist mental health services...are equally accessible for...children and young people' in

'or on the edge of care.'

I don't think that is the greatest ambition that should be reflected in that report. 

And still, this year, Welsh Government was still expecting to be at the stage of developing proposals for better integration between health and social services and agreeing the scope of work streams. What happened to the prompts in 'Listen. Act. Thrive.', the report that was presented to David Melding's advisory group? And where is the particular attention for looked-after children in the £15 million that has gone to the regional partnership boards? Have they even caught up with children's mental health needs yet?

These young people, even if they remain looked after for longer, thanks to the When I am Ready policy, and even if they've been with the most nurturing and restorative foster families, will inevitably find any transition to adult mental health services very challenging. Not all looked-after children will need formal mental health care when they are younger, but you can see why the challenge of moving into independent adult life could trigger or exacerbate poor mental health. 

It's not only looked-after children who face that challenge. I spoke to a constituent today who feared that their teenage autistic child—very loved and very supported, doing very well at a specialist school—would really struggle once they had to move to the oversight of adult social services. And while that's not mental health services, they were worried that the collapse of the child's familiar support system and the loss of parental responsibility would result in that young person needing mental health support too. 

Just as When I am Ready recognised the arbitrariness of a birthday as the signal to switch services, so did the Together for Children and Young People programme. We heard in evidence for the original 'Mind over matter' report that young people felt that they were expected to become adults overnight, that it was scary, that it was like jumping off a cliff edge to move from CAMHS to adult services. The Royal College of GPs said that young people disappear into a black hole. Youth workers told us that some young people find even basic things impossible. 

And, yes, guidance on how to transition well existed then and subsequently, but the essential failure remains, and that is delivery. And it matters acutely, because it's amongst those 18 to 19-year-olds that we see suicide rates rise. The impact of the guidance, which Together for Children and Young People prepared then, was due to be reviewed by this month. So, did you discover, Minister, any delivery on our recommendations? 

What we heard two years later—well, the attempt to move away from the arbitrary transition date of a person's eighteenth birthday isn't consistently successful. Many young people are still being automatically transferred to adult services on that birthday, and that inconsistency and lack of continuity is setting young people back. While we understand that extending CAMHS to the age of 25 would incur cost, what does it cost us and that young person if they have no real chance to wean themselves away from previous support?

We also heard from Welsh Government in February this year, and remember, please, that 'Mind over matter' was published in April 2018, that a draft consultation on draft transition guidance was beginning. Beginning—almost two years later. The recent expectation on health boards to monitor and evaluate implementation of the guidance, Welsh Government's commitment to a review of those approaches, Professor John's very welcome review of suicide and self-harm incidences in the last five years—I just really don't feel that Welsh Government's response to our recommendations on this issue of transition has been urgent, and it needed to be urgent. 

In the mental health delivery plan, there is no mention in the 'progress to date' section of transition, and that's not surprising, because there are no proposals to even develop the arrangements to monitor the use of the guidance until next year or the year after. Why on earth is this taking so long? There was already good guidance in 2018, enhanced by the subsequent work of Together for Children and Young People, and yet you still wanted to review it.

In short, Minister, I'm afraid that our fears have been realised. By absorbing responsibility for the mental health of children and young people into an all-age plan, it has lost its priority. For all the hard work that has been done—and we acknowledge that, and the millions poured into this—we are, to all intents and purposes, no further on in helping young people transfer seamlessly, with support, into adult services. 

Thank you very much, Chair. I'm very pleased to take part in this debate on the importance of support for mental health to our young people. There are several years that have passed now since the Centre for Mental Health published a report on mental health services across the United Kingdom—a report that found that children and young people who face mental health issues go, on average, 10 years between the start of their issues and receipt of support for the first time. That obviously isn't acceptable.

So, there's nothing new about underlining these issues with mental health services. I think that's why the report that we're considering here, the 'Mind over matter' report, says that we're not willing to let this issue be passed on once again to another committee, with the same suggestions and recommendations being made—that we need to do more.

So, I think that it is very good, where there is a critical report published, that there is that follow-up work being done. That's vital. Knowing that there are some things that people aren't going to let go—remembering that can drive improvement in services. I very much hope that committees in future Parliaments will continue to monitor this.

I'm going to focus on a lack of services for that missing middle, as I call it—children who don't quite reach the criteria for access to specialist services, but who clearly need help. This has been a common theme in several reports over a period of 20 years.

Of course, there is some provision—school counselling, for example. The development of mental health in the new curriculum is ongoing too. But that transition between youth and adult services, the major gaps in services, the constant gate-keeping of people being told that they are not ill enough, remain major problems that have to be addressed.

That's why Plaid Cymru has proposed creating youth one-stop shops, which we're basing on a model that seems to be working very well in New Zealand. Within New Zealand's youth one-stop shops, several services are offered by physicians, by nurses, counsellors, social workers, youth staff, providing primary care, sexual and reproductive health support, mental health support, drug and alcohol services, counselling, smoking cessation, family planning, health promotion, education services—a whole raft of services. In other words, they treat and help the individual that they work with. They don't pathologise or medicalise the individual. They're based on a social model of mental health.

Now, we'd want to establish hubs to provide these comprehensive youth-focused services, including mental health services, in a single community-based setting, and 'youth' would be defined to include both adolescents and young adults, but, crucially—and I think that this is very, very important—nobody would be turned away because they don't quite meet some arbitrary age that would mean some people being turned away when they clearly need support. We'd aim to provide specific mental health services to young people who, as I say, aren't ill enough to require advanced psychiatric treatment, for example, but do certainly require support. But they can offer other services to treat the whole person in an age-appropriate manner. There could, for example, be the opportunity to co-locate other services around employment and specialist education and so on in these areas.

We've worked out the budget that we believe needs to be set aside to do this. We'll commit to doing that, and we're pleased to be facing questions on the finances; it's really important to look at the finances of an initiative like this. But we really should be asking what the financial cost is of not getting this right. What is the cost of lifelong use of specialist mental health services because we didn't have the services in place to intervene early and to support early? I guarantee you that the cost will be substantially more if we don't invest in our young people right now.

Can I say I'm very pleased to be contributing to this debate, as a member of the Children, Young People and Education Committee, although I wasn't a member of the committee when the original report was published? Can I start by thanking our Chair, Lynne Neagle? This, of course, has been my first term in the Senedd, and I've learned a lot from the way in which I've seen Lynne apply herself to this subject area, with passion, diligence, and speaking truth to power where required, all to seek improvements in services and provide vital support to others, particularly children and young people. So, thank you for that, Lynne.

I just want to cover two areas in my contribution. Firstly, and partly the area that Rhun has just covered, which is about the missing middle; and secondly, around psychological therapies. I think we do need to acknowledge the fact that the pandemic has heightened all our concerns and brought into sharp focus the monumental task that we still face as we consider the well-being of our children and young people. And, as with many issues that we've scrutinised in this report, there has been progress, which is always to be welcomed, but that scrutiny has also highlighted that further progress is still needed in a number of areas. But, overall, I do agree with the education Minister in her written reply to us, in which she says,

'I think we can agree that much has been achieved over the last two years.'

So, firstly, I'll just talk about the missing middle, and I won't repeat the points that Rhun ap Iorwerth made, much of which I do agree with. Instead, I think I'll just remind Members of what the Senedd said in that original 'Mind over matter' report in 2018. It talked about

'urgent work was needed to address the lack (and in some cases absence) of services for children and young people who need support but do not meet the threshold for specialist CAMHS'.

Now, I think it's fair to say that our recent update is more confident that progress has been made. During this Senedd term, we should see the frameworks develop and the staff appointed to help embed the culture of a whole-school approach to well-being; an approach that not only works in our schools, but also in the wider network of Public Health Wales and other public services, as we aim to deliver what Lynne referred to earlier on as the 'whole-system approach' to the mental health and well-being of our children and young people. If the Welsh Government deliver on their spring 2021 target, then that is progress that we can indeed welcome.

My second point is around psychological therapies, and the committee is of the view that, certainly, not sufficient progress has been made in that area. And while we welcome the Welsh Government's action to implement our follow-up recommendations on psychological therapies around ensuring that there are sufficiently trained therapeutic practitioners to support children and young people, we do need to see evidence of the development and implementation of the workforce plan for mental health that will deliver this.

We appreciate, of course, that there has been disruption to workforce plans and that work around prescribing trends was also delayed, due to the pressures of the pandemic. But the committee believes that it is important that the Welsh Government quickly re-establishes timelines for the work that has been delayed or interrupted by the pandemic. Indeed, some of that very work, which the committee originally recommended, may in itself provide answers to some of the additional pressures that will face the system as and when we slowly emerge from the shadow of COVID-19, and more fully understand its impact on our children and young people.

I believe that the inquiry that lies behind the 'Mind over matter' report, and the changes in services that are now happening, is one of the most significant achievements of this Senedd. But, as with all change, it must become embedded and the identified weaknesses overcome, because only then will the benefits of that whole-system approach to improving the mental health and well-being of our children and young people be fully realised. Thank you.

I'd just like to concur, obviously, with what my colleague Suzy Davies has said today, but also with what the Chair, Lynne Neagle, has said today. I think that you lead our committee extremely well, and your passion is abundantly clear and infectious, and you've done an awful lot, so thank you very much, from the bottom of my heart, and I'm sure from many people across Wales, for all that you've done.

The 'Mind over matter' report was published back in April 2018, providing an ambitious and exciting template for the reform of child and adolescent mental health services in Wales. It reflected the views of the majority of stakeholders, and outlined plans to end years of repeated restructures.

I'm going to focus today on crisis care. Amongst the latest findings was that support for 24/7 services was not always available across Wales, and there was an over-reliance on A&E departments and police to respond to young people in serious distress. Today, two years on, concerns still remain about a lack of consistent, 24/7 access to crisis support across Wales. Young patients and their families feel let down because they're unable to access help at the time that it's most needed, and crisis services are often too adult focused, as many services are that will be mentioned today.

Further to this point about crisis services being too adult focused, the report called on the Welsh Government to look at how mental health professionals can support the police when responding to calls, and how crisis teams can provide training to front-line staff. Children and young people in distress can find their condition worsened by being in an adult setting, such as an emergency department, and being handled in an insensitive manner by staff. Urgent action is needed to improve training for those front-line services, so that they deliver a more compassionate response to young people in distress. We also need to ensure that there are designated under-18 hospital beds for use by young people in crisis.

The committee welcomes positive reports from the collaboration between police and mental health services to help support young people in crisis. However, the committee expressed its disappointment that information provided by the Welsh Government about steps being taken to improve crisis and out-of-hours care is, sadly, lacking. Last year, the committee said the situation was not acceptable, and still the Welsh Government cannot provide an accurate picture of how 24/7 crisis and out-of-hours services look across Wales. It's not good enough. We need to see action taken to provide a plan, including timescales and deadlines, for crisis and out-of-hours care for young people in Wales.

The report points out that looked-after and adopted children have a much higher prevalence of mental health issues, often as a result of neglect or trauma. Many have lived in families where they've been exposed to mental illness, substance misuse, violence, abuse or neglect. The 'Mind over matter' report highlighted other potentially vulnerable groups who may also need specific emotional and mental health support. These included young carers, young offenders, homeless young people, black and ethnic minority children, young people, care leavers and those with substance misuse problems. Greater priority needs to be given to the emotional and mental health needs of looked-after children and young people to ensure they receive the support they need at an early stage, and prevent problems from worsening or deepening in further years ahead. People reported that children entering care are not systematically assessed or reviewed regularly. It is essential that care plans should address a child's or young person's emotional well-being needs. I also would really like to know how this Government is working to provide mental health services online these days, because I think that's a real way of getting to young people, and for them to be able to access services more quickly.

Two years ago, the Children, Young People and Education Committee's report said that those experiencing mental health problems needed urgent help, and highlighted deficiencies in crisis and out-of-hours support. It is vital, Minister, that these weaknesses highlighted in the report are addressed, and that we really deliver for young people because they deserve it. Thank you.

And I call the Minister for Mental Health, Well-being and Welsh Language, Eluned Morgan.

Thank you very much. I'd like to thank members of the Children, Young People and Education Committee for their ongoing focus on improving the mental health of children and young people. I'd like to pay particular tribute to the Chair, Lynne Neagle, for her personal ongoing commitment to this issue.

We know that most mental health issues begin before people turn 18 years of age, which highlights just how important this work is. We are all concerned about the impact of the pandemic in this area too, and I can assure you that I am focusing on working across Government to mitigate the impact as much as possible and to ensure that the right support is available where and when it's needed.

The 'Mind over matter: two years on' report gives us a perfect opportunity to take stock of the progress that's been made. I'm pleased that the committee has recognised the action that has been taken by Government, key partners and stakeholders. Implementing the recommendations agreed continues to be a key priority for this Government, and my appointment highlights our commitment and provides an additional focus at ministerial level in order to do so.

Although we have made real progress over the past two years, we recognise the committee's concern about the pace of that progress with some of the action points. I have taken steps to hasten the change already. Myself and the education Minister have agreed to refocus the task and finish group from the whole-school approach to a whole-system approach by expanding its remit and reviewing its membership. We met this week, and we intend to meet on a monthly basis to build momentum in order to implement improvements to the system. And in addition to that, I have ensured that the latest information on the action points on CAMHS are a standing item on the agenda.

I have also met with the deputy chairs of the health boards and emphasised the need for them to focus on CAMHS improvements and to incorporate an early assistance framework and higher level assistance when that is available, and we expect that to be published in April. I will meet with the chairs of the regional partnership boards and other stakeholders in order to ensure a co-ordinated approach in supporting the needs of young people.

In this difficult period, I can also provide assurances that mental health services will continue to be key services, including, of course, for children and young people. Our framework ensures that health boards do note plans to meet new demand and changing demand for mental health services as a result of the pandemic. It's crucially important, and health boards do need to ensure that their communities understand how to access mental health services, particularly if service models have changed because of restrictions, and the new information will be included on all health board websites over the next week.

Having said that, I do recognise and acknowledge the concerns on accessing support. This is an area that I am focused on in order to ensure that there is not a lack of connectivity between the assurances that we receive and the quality of the care that children and young people who need assistance are experiencing. To understand that better, I have met the Wales Alliance for Mental Health, and I will continue to do that. I've also met with the Children's Commissioner for Wales, and I will be meeting with the youth stakeholder group to understand what's important to them in terms of mental health and mental health support.

Turning now to crisis care, which is of particular interest to Laura Anne Jones, improving crisis care is a key theme in 'Mind over matter', and recently we've received the results of the review of urgent access to mental health services. The review looked at data across a range of services—111, the police, the ambulance service, the third sector and so on—in order to better understand the demand for services. And the review highlights the breadth of the social and well-being issues that are the basis for much of this demand.

The need for a multi-agency pathway to meet the needs of people is clear. This is not something that the NHS can do alone. Specific recommendations in the review relate to children and young people, and we will be focusing on delivering those at a meeting of the task and finish group in future. A multi-agency sub-group has been established to co-ordinate the response to the review, and that group met for the first time last week. I expect to see a plan put in place on how that work is to be developed before Christmas. It's worth emphasising that we are not beginning at the beginning, and we do need to build on the work of the group on crisis care. We've already looked at the pilot schemes of the 111 service, which will look at the experiences of service users in mental health crisis, and this will commence in January.

I have committed to improving support for those children and young people who have the most complex needs, and we have two clear work streams in order to do this: improvements to the level 4 provision and our work on secure accommodation.

The Llywydd took the Chair.

On tier 4, we've introduced a bed management panel, which meets on a weekly basis, managing the flow of patients between community and in-patient care. A review of age-appropriate beds is also under way to help us understand usage and how we can improve discharge pathways. The NHS quality assurance and improvement team provides intensive support to our two CAMHS units to improve patient flow and to make recommendations for improvements. And on safe accommodation in relation to complex care, we continue to support and encourage regions to use the integrated care funding and transformation funding available via regional partnership boards.

I've asked specifically both the Welsh Local Government Association and the health boards to look at this again to come up with new proposals. Regional partnership boards bring together all of the right partners and can provide the right vehicle for jointly commissioned health and social care residential accommodation in particular for complex care. Whilst work in some regions is already advancing, with proposals for therapeutic residential care models emerging in Powys and in Cardiff and the Vale, we continue to seek proposals from across Wales to develop this provision at pace.

The Together for Children and Young People programme remains a key driver for improvements to mental health services for children and young people, and I'm really excited by the potential of the early help and enhanced support framework, which we will ensure will work together to promote integration across the system. We want to embed this framework in the coming months so that it will be in place just as we stop as a Senedd term. So, that will be ready in April, and we hope that it will be embedded by the summer. 

Addressing that issue of the missing middle, which Rhun and Dawn talked about, is absolutely essential, and I think it's important that we don't overmedicalise mental health at all times. Previously, the Together for Children and Young People programme, in partnership with Barnardo's, developed transition guidance and a young person's passport document, and this is to make sure that there's no gap in support between people being children and adults. We remain fully committed to improving transitions for young people. They must have the choice to move services not based on a fixed point due to their birth date, but based on a time that's appropriate to their needs. And Suzy, I'm sure, would be pleased to hear that on the review of the guidance along with the NHS guidance, the broader transition, not just about mental health, we're expecting that early in the new year. 

Prevention and early intervention is critical, and that's why we've significantly strengthened the tier 0 and 1 support services, including the youth mental health toolkit and SilverCloud. Laura Anne Jones asked about what we're doing in relation to online support, and SilverCloud is our answer to that provision for over-16-year-olds. And of course, there's the CALL helpline. We've also invested £1.25 million to extend school counselling, ensuring contacts in every local authority were available online for people who weren't attending school in person. And just to touch on a point that Dawn Bowden made about psychological therapies, the guidance for delivering evidence-based psychological therapy for young people, Matrics Plant, will be issued, I'm sure she'll be pleased to hear, before Christmas. 

We have a range of regional approaches to reduce suicide and self-harm, including bereavement support, training and awareness raising. We've published guidance to help respond to these issues, and alongside broader mental health funding, we've committed an additional £0.5 million per year to suicide and self-harm prevention. As the committee's always maintained, education plays a crucial role in meeting the well-being needs of children and young people, and this report recognises the tangible progress that has been made, but there's still more to do. Work is being built around the new curriculum and the health and well-being area of learning and experience, which places—as you've heard—well-being at the heart of the learner's journey, and it was good to see that go through yesterday.

Early next year, we'll be publishing our whole-school framework guidance to help schools, local authorities and other partners develop their own consistent whole-school approaches to well-being. The Minister for Education and I have agreed funding in principle until March 2022 to establish whole-school implementation leads to help the sector implement the guidance to share best practice and learning. We've provided £5 million this year to support this work, enabling us to improve and expand the school counselling scheme, funding local authorities to recruit and train counsellors in age-appropriate interventions. We're also working with Welsh universities to develop professional learning modules for school staff on well-being issues, and to train teachers and wider staff on children's mental well-being. I'd also like to pay tribute to the work done by David Melding on the outcomes for children in the ministerial advisory group. Thank you for everything you've done in that space.

Finally, we've recently revised our 'Together for Mental Health' delivery plan to support the changing mental health demand as a result of COVID-19. The revised plan reaffirms our commitment to prioritise the mental health and well-being of children and young people. I'm committed to driving this work forward and yesterday I announced that I'm establishing a 'Together for Mental Health' ministerial delivery and oversight board to make sure that this happens. The board will meet early in the new year and will provide greater clarity and assurance for our mental health work programmes and the mental health response to COVID-19.

Once again, can I thank Members for their hard work and their continued focus? I just want to reaffirm the Welsh Government's commitment to all our children and young people, and the best provision and protection for their mental health and well-being now and in the future. I'm glad you've recognised that we've done some work, but we also acknowledge that there is still work to be done. Diolch yn fawr.

The Committee Chair to reply to the debate. Lynne Neagle.

Thank you, Llywydd. Can I thank everybody who has participated in the debate for their contributions? I'll try and respond in the time that I've got available to some of the key points that were made.

Can I thank Suzy Davies for her contributions and her very well-made points about looked-after children? In our original inquiry, the evidence that we received on looked-after children from the heads of children's services in Wales was probably one of the most damning evidence sessions I'd ever sat through. It is a cause for concern that we still need to make so much progress in this area, and it is particularly important that we hear from the Minister how that link-up is going to work with the ministerial advisory group, the task and finish group and the Together for Children and Young People programme, particularly because of David leaving the Senedd. Thank you, Suzy, for the points on transition; it's crucially important that we get that right and make urgent progress in this area. The problems that we had with transition are, I think, a symptom of the fact that we are always too ready to fit children into the services, rather than the services around the children and young people, and that needs to change.

Can I thank Rhun for his contribution on the missing middle? It's important to recognise that when we talk about the missing middle, they are by far the biggest group of children and young people that we need to reach. I've met with many families over the years, and have met very few where a child has a diagnosed mental illness, but many, many where children and young people are experiencing acute distress. Rhun made some points about Plaid's proposals for one-stop shops. I think where I certainly agree with him is the importance of that 'no wrong door' approach, which is something that the children's commissioner has also been promoting. We're already seeing good practice in places like Gwent, where every referral goes through a panel, and help is found for that young person. There's no question of being told that they don't meet the threshold.

Can I thank Dawn for her contribution, also on the missing middle, a vitally important area? But also for highlighting the importance of psychological therapies, which has been a long-standing concern of the committee, not just in this area, actually—we've also raised concerns in relation to perinatal mental health, and I know the health committee has raised this regularly as well. It's good to hear that Matrics Plant is being published soon, and the committee will look forward to hearing the workforce plans that will support that work being taken forward, because it is crucially important.

Thank you, Laura, for your kind words, and also for your contribution, and for highlighting the issue of crisis care. Too often, the young people who end up in a crisis situation are actually 'missing middle' young people, who wouldn't have ended up there if they'd had the support earlier on. I'm pleased that the Minister has reiterated her commitment to addressing this issue, and the task and finish group is going to be focusing on that, which is very welcome. What I would say, though, is that it's vital that the solutions that we find are child-centred solutions, and that we don't try and squeeze children and young people into an adult focus of crisis care.

Can I thank the Minister for her contribution, and obviously recognise that it's early days? We welcome the fact that there is now a dedicated Minister to drive this work forward. I do look forward to working with you on these issues. They are thorny and complex issues, such as the complex care issues that you touched on in your response, but it is absolutely vital that we address these issues, and we can't simply leave these things to RPBs. There has to be a very clear expectation from Welsh Government that they deliver on this now, as Powys has done. That has to be done consistently across the whole of Wales. The Minister also referred to the progress that's being made in the early help and enhanced support work stream, which is indeed very welcome, being led by the wonderful Dr Liz Gregory from Gwent. We look forward to seeing that rolled out across Wales at the earliest possible opportunity.

Can I, just in closing, then, thank everybody who's participated in the debate? Just really to reiterate my commitment and the committee's commitment to continuing to drive change in this area. In the 21 years I've been in the Senedd, we have constantly discussed the shortcomings in this service area, and I am absolutely determined that by the time we get to the end of this Senedd, we will be in a position where things are much better, not just in education, but across the whole system that is so crucial for our children and young people. Diolch yn fawr. 

The question is that the committee's report be noted. Does any Member object? I don't see or hear any objection, and so that motion is agreed in accordance with Standing Order 12.36.

Motion agreed in accordance with Standing Order 12.36.