The following amendments have been selected: amendment 1 in the name of Lesley Griffiths, and amendment 2 in the name of Siân Gwenllian. If amendment 1 is agreed, amendment 2 will be deselected.

The next debate is the Welsh Conservatives' debate on child and adolescent mental health. I call on James Evans to move the motion. James Evans.

Motion NDM8005 Darren Millar

To propose that Senedd:

1. Notes the impact of the COVID-19 pandemic on the mental health of children and young people.

2. Regrets that child and adolescent mental health waiting times continue to be poor, with less than one in two under 18s receiving a local primary mental health support services assessment within 28 days of referral.

3. Expresses its concern about the number of section 136 detentions of children and young people under the age of 18.

4. Calls on the Welsh Government to:

a) conduct an urgent review into the viability of child and adolescent mental health services;

b) ensure a 24 hour crisis service is available for children and young people across Wales; and

c) consider the feasibility of opening an eating disorders unit in Wales.

Motion moved.

Diolch, Llywydd, and I will just wait for Members to exit the Chamber so that it quietens down just a little bit.

Yes. Carry on. It's fine.

Thank you, Llywydd. This vital debate today on the mental health of children and young people, I think, is one of the most important debates we've had in the Senedd, and it is a shame that so many Members have just left the Chamber when we are debating such an important topic.

The Deputy Presiding Officer took the Chair.

A lot of people in this Chamber have personal experience of dealing with mental health problems. I have suffered with mental health problems myself in the past, and I think it's very important that more people come forward to talk about mental health issues, so that we can destigmatise mental health and allow people to come forward to seek the help and support they need.

Young people today have far different issues facing them than those of previous generations. Today's youth live in both the real world and the digital world. They can be influenced and contacted by organisations and businesses that they've never heard of, on social media and online forums, creating, for them, a warped perception of what life is. Many young people are vulnerable and susceptible to being influenced in this way, and if they are sucked down the wrong path, they could struggle to find a way out or seek the help that they need.

I speak with young people regularly. I even consider myself a young person, Deputy Llywydd, so I understand the struggles that many of my generation are going through. There is huge concern by many that they can't earn enough money to meet the standards they think society has for them. Many try to portray that they live a glamorous life on social media in order to impress others on platforms. Sadly, this has become very common, with people only sharing the good times and not wanting to show the bad, while they sit at home suffering in silence. A survey by Mind Cymru found that 75 per cent of young people said their mental health had worsened in the early months of the pandemic. I would say that this is due to the media and political choices and the resulting lockdowns, which saw a huge surge in people's mental health declining.

This led to a growth in people suffering with eating disorders, with support services very nearly being cut off overnight and many left to suffer on their own. We need to ensure that more staff are trained to identify and support children who are suffering with eating disorders. Currently, medical students receive less than two hours of training on eating disorders, and that's over four to six years of undergraduate study. Many young people who need specialist services are removed from their communities, away from their family with no support network. So, we need to explore the possibility of setting up an eating disorder unit here in Wales.

Our schools also play a major role in preventing and dealing with this issue. Schools should be building an emotionally resilient population of young people. Sadly, UNICEF estimates that more than one in seven adolescents aged 10 to 19 live with a diagnosed mental health disorder. If we then add those who are undiagnosed, this is an extremely worrying picture going forward. Our child and adolescent mental health services also play a major role in this area. Sadly, after being the shadow Minister for mental health for over a year now, I've been told by many young people that they have been let down by these services, with too many left waiting for an appointment with nowhere else to turn, and feeling isolated and alone. So, we need urgent reform to CAMHS to make sure that their support is there when they need it.

One of those reforms could be increasing the number of support teams in schools, and I believe, and I know the Deputy Minister believes, that every school should have a dedicated member of staff who deals with mental health within schools, to make sure that they're supported. Another thing that the Deputy Minister and I agree on is utilising the third sector so that the void between referral and appointment is filled, so that that young person gets seen straightaway and is not left waiting to suffer at home.

Filling historic vacancies in specialist CAMHS posts is also an issue that I'm sure everyone is well aware of, and it's one that now needs to be urgently addressed. For the last year, I've been told on a number of occasions that this is a priority, but things are not getting better; they're getting worse. This is an issue too great for politicians to just simply declare that it's a priority yet fail to deliver the resources needed to match the statements. More money has been welcomed and is welcome, but we need to make sure that that money is delivering the outcomes that we want for our young people in Wales.

There are many challenges facing young people in Wales, and, sadly, those challenges will continue to get worse unless politicians in here do more. There are many triggers that can cause detrimental mental health in children and young people, whether it be bullying in school, forms of actually not knowing where you want to be in life, not being able to get appropriate housing, school pressures. It goes on and on, and I could talk about that for hours. We must ensure that appropriate support is available for children and young people, but also take steps to address the triggers that can cause detrimental mental health. So, we need to set up 24-hour crisis services for children and young people right across Wales, so that when they reach out for help that help can be provided. Too many young people are waiting far too long for an appointment and many are getting to a crisis point before anything is done, and this simply cannot continue.

I do look forward to hearing many Members' contributions to this debate today. It's a shame that the Government did their standard—as they do every week—'delete all' to our motion. We will be supporting the Plaid Cymru amendment today. This is not a day to pat the Welsh Government on the back, but to do our jobs in this place, to hold the Government to account and get an urgent review under way into the viability of child and adolescent mental health services here in Wales. It's time to act, and I urge all Members right across this Chamber to support our motion today.

I have selected the two amendments to the motion. If amendment 1 is agreed, amendment 2 will be deselected. I call on the Deputy Minister for Mental Health and Well-being to formally move amendment 1, tabled in the name of Lesley Griffiths.

Amendment 1—Lesley Griffiths

Delete all and replace with:

To propose that Senedd:

1. Notes the impact of the pandemic on the mental health and emotional wellbeing of children and young people.

2. Recognises the impact of the pandemic on waiting times for CAMHS.

3. Welcomes the Welsh Government's focus on supporting services to improve as they recover and continued work with partners to prevent escalation to crisis and provide an appropriate, multi-agency response.

4. Notes the NHS Delivery Unit’s review of CAMHS services, commissioned by Welsh Government, due to report by the end 2022.

5. Welcomes the continued roll-out of 111, press 2 for mental health for adults and young people across Wales.

6. Notes the current Welsh Health Specialised Services Committee: Mental Health Specialised Service Strategy for Wales consultation with key stakeholders, which includes scoping the feasibility of an Eating Disorder Unit for Wales.

Amendment 1 moved.

Formally.

I call on Rhun ap Iorwerth to move amendment 2, tabled in the name of Siân Gwenllian.

Amendment 2—Siân Gwenllian

Add as new point after point (2) and renumber accordingly:

Notes the planned pilot project to establish community-based facilities, for young people to easily access mental health and wellbeing support, in order to offer early intervention and avoid escalation, and urges the rollout of early intervention facilities to the whole of Wales.

Amendment 2 moved.

Thank you very much, Dirprwy Lywydd. I'm very pleased to be able to contribute to this debate, and I'm very grateful that it has been proposed. Mental health is an issue that we discuss often in the Senedd now, and that's good to see, as opposed to the situation in the past where mental health had next to no attention and was swept under the carpet. But, as I said, it's good to have an opportunity once again today, because it's by diligent work that we'll ensure that actions are taken that will, hopefully, assist people with their mental health, and I'm pleased that we once again are giving attention to mental health amongst young people in particular.

We'll support the motion today. We agree with regard to the impact that the pandemic had on the mental health of children and young people. It was an unprecedented period of anxiety about missing school work, of loneliness, of missing out on those experiences that are so important to young people, of losing support networks and so on. I'm a father to three children, and I saw that for myself amongst them. We also regret the time that far too many children and young people are having to wait for support and treatment.

The third point, then, with regard to the use of section 136 powers takes us to an area that we haven't been giving as much attention to, namely serious mental health issues and the implications of those. Looking back on the past two years while researching for today, I don't see that Ministers in Welsh Government have spoken about serious mental illness at all, and it's very important that that is given due attention.

Serious mental illnesses, SMIs, such as schizophrenia, bipolar disorder, often first develop between the ages of 14 and 25. It's a critical stage for young people, because of the neurological, biological and cognitive changes of adolescence to young adulthood. It's a time of big change in their lives, reaching major educational milestones.

We often talk, don't we, about the need for early intervention to avoid mental health issues deteriorating. Plaid Cymru's long championed early intervention, including in more informal ways, or perhaps in less formal ways: the one-stop-shop drop-in centres, you'll have heard us promote, along the New Zealand model, and our amendment today refers to pilot schemes being introduced under the co-operation agreement, which I look forward to seeing develop, and they must develop. But these less formal interventions can affect clinical outcomes. Being aware of early signs of serious mental illness is a crucial first step in people getting the help they need, and clinical prevention is important. For many, it's the intervention of clinical teams that prevents further deterioration and illness. Early intervention and preventative strategies offer the opportunity to mitigate the stressors that impact on physical, emotional and psychological well-being at this really vulnerable time in a young person's life.

Psychosis affects one in 100 people. The first episode is most likely to happen between the ages of 18 and 24, but recent research says that fewer than one in five young people would be confident in spotting early signs—a quarter had never heard of it. So, Welsh Government has to meaningfully invest in specialist psychiatric medical provision in Wales, both now and in the long term.

We've spoken a great deal about health inequalities recently. We spoke about them in the context of women's health a few minutes ago. The inequalities that people with serious mental illness face are very significant. They're more likely to face physical health issues and they die, on average, 15 to 20 years younger. It's estimated that two out of three people with serious mental illnesses die as a result of preventable physical conditions. So, we have to ensure that there's careful monitoring of the physical health of people who are suffering.

Part 2 of the Mental Health (Wales) Measure 2010 says that every young person receiving healthcare from a specialist child and adolescent mental health service should have a comprehensive care and treatment plan to help them to recover. It appears that many young people don't even know about that. 

Dirprwy Lywydd, in closing, we can't support the Government's amendment today. Even though there is good work being done in some areas, we can't just accept things as they are. It would be a mistake to do that. Even though we have our own amendment and I have explained the importance of what is mentioned there, it's possible that we might not even get to that stage, so what we will do today is we will support the original motion as it is laid out to increase the chance of receiving support for some of those core principles that are in that original motion.

There are so many things that we could touch on when we talk about mental health, but I'm pleased to be able to make those few comments there. 

I'd like to start by thanking James Evans for bringing this debate to our Senedd today. It is a very, very important subject to discuss, but as the Member for Ynys Môn said, it's wonderful to see that we are talking about it now and that these conversations are real, because the situation that we face is very real, and it's nice to see that it's no longer a taboo subject, as you said, Rhun.

As James said, mental health is something that affects us all in one way or another, most recently, as has been said already, with our youngest in society with the struggles and pressures that they faced in education and growing up during the pandemic. Sadly, despite Welsh Labour continually claiming that the mental health and well-being of our children and young people is a priority, as James said, the reality is very different. Children and young people are waiting longer for mental health services and, in some health boards, well over nine in 10 are waiting longer than the target time for assessments. Clearly, these problems are historic. Before COVID-19 hit in Wales, waiting times for children and young people were already long, and concerns had been raised by the Children, Young People and Education Committee nearly four years ago now about these problems within the child and adolescent mental health services.

Will you take an intervention?

Yes.

I'm not sure whether you recall the numerous reports the Children, Young People and Education Committee did in this area, but our landmark one, 'Mind over matter', recognised that, actually, waiting times had significantly improved and that the focus needed to go to early intervention. Maybe you ought to have a look at some of those reports.

They've gone back, Lynne, since then, though.

I'm going to cover that.

Nearly four years ago we were talking about these problems, and still a lot of action has not been taken, Deputy Minister. I find it staggering looking at the latest figures, which show that less than two thirds of young people are receiving their assessments within 28 days and, on average, over the last six months, 48.5 per cent—less than one in two—were seen within this time period. In my own region in South Wales East, we see waiting times for specialist CAMHS is in a bad way, with over 14 per cent of young people waiting over four weeks for that first appointment. It is clear now that this isn't good enough and that our current services cannot deal with the pressure it's facing. We're now nearly three years since the joint thematic review in 2019, and more than two years after the fifth Senedd's Health, Social Care and Sport Committee's report into section 135 and 136 detentions. The committee at this time noted that improving crisis care services, particularly out-of-hours services, is a key to both reducing the overall use of section 136 and ensuring those discharged from section 136 following assessment go on to achieve adequate care and support in their community. As waiting times get longer, more and more children and young people are needing crisis support, with 30 under-18s being detained under the Mental Health Act. Simply detaining children and young people won't provide the specialist support they need, so it's crucial that a 24-hour crisis service is made available so that they are treated in a safe and appropriate environment, something which, of course, is a debate on its own.

It is clear to me and others on these benches that proposed mental health crisis centres must be set up so that we can ensure people who have mental health issues have a safe place to be assessed and treated, simultaneously lowering the number of people who are detained and transferred.

Sadly, we also see this with autism waiting times. There are an estimated 30,000 or more autistic people in Wales, and although everyone has heard of autism, too few people understand what it's actually like to be autistic and how hard life can be if autistic people don't receive that right support. Thousands of children are waiting many months or even years for assessment. A recent study found that 28 per cent of autistic pupils in Wales felt their teachers understood autism, and new Office for National Statistics data suggests that just 29 per cent of autistic people are in any form of work. Without support, many autistic people develop mental health problems, sometimes to the point of crisis.

The time for talking is over. The longer we wait to tackle the true root and causes of the mental health crisis and its treatment, the worse the situation will get. We need clear action and regular updates in this Senedd, outlining just how this Government plan to tackle the crisis and if their methods are working.

I want to start by thanking you for bringing this debate to the Chamber today. Child and adolescent mental health is one of the key issues that young people raise with me across Bridgend and Porthcawl. In Bridgend last week, it was great to host our young person's fair on this very topic with Bridgend Youth Council, where schools, pupils and local support groups came together to discuss how we can make mental health provision better for young people in our community. Because, as with a lot of issues, or all issues related to young people, there are often very well-meaning adults who assume what is best, and this shouldn't be the case. Any decisions that impact young people should at least have the consultation and engagement to ensure that we provide support that will make a difference. I know that our Deputy Minister is absolutely committed to this. I also wanted to add in that one of our Youth Parliament Members from Bridgend, Ollie, who represents the Carers Trust Wales, did also want to say that people's voices and opinions sometimes are overlooked and undervalued in decision making, so we do want to make sure that that is always a priority.

I believe it is worth as well remembering the integral role that I think young people have played in bringing the conversation around depression and anxiety into our daily lives. We owe much of the work that has been done to break down barriers and the shame of talking about mental health to young people across our communities, and I know this is a priority for our Youth Parliament Member for Bridgend, Ewan Bodilly, who said that, since the pandemic, it has been easy for young people to feel alienated, and it is only through engaging with young people that things will improve. And at the mental health fair, our youth mayor, Xander, said young people have been calling for mental health to be a priority for too long, but the pandemic has shown how important it is that we make sure services are available and mental health is a priority, going forward.

I also want to say that I am thankful to the Welsh Government for their commitment to prioritise mental health for young people through schools with the whole-school approach. There are already schools across my constituency doing this work, with Porthcawl Comprehensive School working with local mental health support groups to destigmatise reaching out and ensuring that all young people know where to turn to if they need to. But this should be standardised, and every child and young person should know where to reach out to. Every child should be given the tools to have access to support when and if they need it, for whatever the circumstance is.

I want to end by saying I didn't actually plan to speak on this today, but, James, I want to say this in support of your call for an eating disorder unit in Wales, and preferably a residential eating disorder unit. I myself had anorexia nervosa when I was 14. It was absolutely terrifying for me and my family, and for my friends and my teachers, and I actually had a chat with my mum about it a couple of months ago—I think it was weeks ago, sorry—when we were doing the debate on eating disorders, because I wanted to speak on it. And my mum actually told me something that she'd never told me before, which was that my paediatric consultant at the time wrote to my counsellor, and didn't even tell my parents this—didn't give them the heads-up—that I was two days away from them admitting me to the adult psychiatric ward at east Glamorgan hospital, when I was 14. They would have locked me up in an adult psychiatric ward at east Glamorgan hospital. I would never have come out. I would never have come out. So, the only other option at the time was a residential unit, which was in Bristol, and it was full, and my parents were just so scared. I think, to be honest, I was so unwell I don't even think I was scared anymore; I didn't know what was going on.

I did recover, and I'm very rare. If you look at the statistics, it's very rare to recover from this, and I did. And I can't even really tell you how I did, even now. But I just wanted to say that that was 20 years ago, and we still don't have a unit in Wales. And in my community of Bridgend, we do have Mental Health Matters Wales, and it was only, actually, a couple of years ago I met Michaela at Mental Health Matters Wales, and she had an eating disorder group where people who are suffering with it, but also their families, can come together to get support. And I'd never really talked about this, and I went in and it all just came out, and we laughed, which I know sounds really strange, but there are just things that are sometimes bizarre, especially some of the things you do when you're going through this. And she just made me feel so—. I just thought to myself, 'God, I wish I'd had you when I was that age. I wish I'd had you, I wish my parents had had you at that age'.

So, I know, Minister, you're doing so much on this. I know that we've talked about it before as well, and I always really appreciate your support, but if there is any way that we can have a residential eating disorder unit in Wales so that people—just so that there's more space—don't have to move away from their home. Again, at 14, I don't know how I would have gone off to Bristol like that. So, yes—thank you.

I just want to end by saying to any and all young people out there, as I always say to you, you are not alone—there is nothing wrong with you, there is help available, and you can get through this. [Applause.]

I refer Members to my register of interests.

I don't think any apologies should be made for this debate this afternoon being not a comfortable one, and every contribution we hear is incredibly pertinent to this debate. I'd like to pay tribute to Sarah Murphy for sharing with us her incredibly personal story. Thank you for taking the time to share that with us. 

I don't believe this debate is to shame the Welsh Government or whip up disgust; rather, as the Member for Brecon and Radnor rightly said, it's to hold the Government to account, and it's to draw attention to the real entrenched failures within Wales's child and adolescent mental health services. These failures have seen the lives of children and young people torn apart and thrown into turmoil. However, I do wish to use my contribution this afternoon to draw Members' attentions to the situation in rural communities right across Wales, one that has seen our mental health services under-resourced and lacking in funding. 

Now, it is true that growing up in rural Wales is a blessing, and that's not to say it isn't without its challenges and difficulties—a situation that is especially the case when it comes to our young people. Rural isolation is an issue that transcends every societal group, but it's often our young people who are left without the support network they need to develop relationships and emotional growth. Lacking these networks and without the required support and the preventative measures, our young people are often left to battle depression and other mental health illnesses, a situation that then requires the professional intervention of child and adolescent mental health services. Looking around this Chamber, how many of us have to deal with directly and intervene directly in an individual CAMHS case because resources were not available to get a child or young person the vital help they need? One of the very first cases I dealt with after last May's election was that of a young girl with an eating disorder. And for me, representing a rural constituency, interventions such as this are all too common and far too familiar.

The latest CAMHS waiting list figures show that less than two thirds of young people are receiving the required local primary mental health support service assessment within 28 days. In the Hywel Dda University Health Board region, which includes my own constituency of Carmarthen West and South Pembrokeshire, just 3.2 per cent of CAMHS referrals are seen within 28 days—3.2 per cent. In comparison, Cardiff and Vale University Health Board conduct 91.3 per cent of their local primary mental health support service assessments within that 28-day window, a difference that, for many, could be the difference between getting the support and access that these young people need or a further darkening of the clouds around them.

But let us be clear, these problems aren't a result of the pandemic; they are unfortunately a symptom of a historic trend of limited access and diminishing resource. It's where failures such as this occur that our local communities and, as the Member for Brecon and Radnorshire rightly pointed out, the third sector pull together and provide the support that is needed. And nowhere better has this been done than through Wales's young farmers community. As I've said on a number of occasions in this Chamber, Wales's young farmers clubs provide more than just an opportunity to develop agricultural skills and knowledge; they also provide a number of life skills, but also a sense of companionship and support. Lifelong friendships are developed and support networks created, both on a local level and throughout YFC. It's not easy to quantify the value that these relationships have in supporting those members who may be experiencing mental health issues, but, on an informal basis, to have a confidant who understands the challenges and uncertainties that many young people have growing up should not be undervalued. I'd like to take this opportunity to draw attention to a Llys-y-frân member in Pembrokeshire YFC, Hannah Rees, who off her own back brought forward to Wales YFC a plan to provide further assistance to young YFC members, through competition days. Given the fact that this is a young person knowing that there is a gap there and looking to fill that gap herself, I do pay testament to Hannah Rees for the work that she is doing.

But these organisations shouldn't be alone, and it isn't always enough. That's why ensuring that our children and adolescent mental health services are equipped with the resources they need is so important. Regardless of our political affiliations, we have a duty in this Siambr to ensure that every child has access to the health services they need. But, as you've heard this afternoon, that sadly isn't occurring. Waiting lists are exacerbated, demand is too high and staffing numbers too low. This motion before us is our opportunity to change the way in which our CAMHS services operate, making sure our children have access to the mental health services that they need and deserve. Diolch, Dirprwy Lywydd. 

Can I thank James for bringing this debate forward? Diolch yn fawr iawn, James. I'm very grateful to you. I speak as a former child protection social worker who worked for around 25 years with children and young people. Part of the battle for me was actually getting those children and their families into CAMHS services.

I just want to recognise a few things in Wales that I think have gone well. I'm really pleased to see the whole-school approach to mental health continue to be rolled out, because a focus on prevention and trauma-informed school environments are incredibly important in nurturing positive mental health among children and young people. But we are in a really difficult place. I'm going to listen to the rest of the debate to decide how I vote this evening, because it really does concern me that there are two major issues. One is the CAMHS waiting time. It is far too long, and I'm looking forward to hearing from the Minister what the figures are around the waiting times, because I'm a little bit unclear what they are. And we heard some from Laura Anne Jones in the debate, but I read some different figures this morning, so I would ask the Minister just to clarify what the waiting times are for four weeks or more. 

My own view is that we need a panoply of services. I'm not sure it needs a whole new service. We've got some really good services. The crisis resolution and home treatment service provide a rapid, community-based service 24 hours a day, seven days a week, 365 days a year, but it's only for young people over the age of 18. We're talking here about getting to those situations long before.

I think there are two important issues. One is, as I've said, that waiting list. In my experience as a child protection social worker, it is far too long. If you can get in early, you can prevent those children and young people and their families struggling with those mental health issues, and potentially becoming looked-after children, which is a terrible state, to think that's what happens to many children and young people.

Secondly, I would like to pay tribute to the voluntary and third sector services across Wales. There are some amazing ones, and in my experience, young people actually prefer to go to those volunteer services much more than they do to statutory services. They feel much safer going to a service that doesn't have 'NHS' over it. We actually need to work much closer with those volunteer services. There are many, like Youth Shedz in Blaenau Ffestiniog, which I visited last summer, Brecon Mind, the Amethyst project in Aberteifi, and the Sanctuary in Pembrokeshire. My view is that the Welsh Government needs to look at these services, and map them out for us to see how we can create further capacity for them to meet the needs of children and young people who are experiencing mental health difficulties, and to give them sustainable long-term funding and to see whether they can provide the 24/7 approach, which I believe is absolutely invaluable.

I'm going to end with a quote I heard from a young person: 'It's always the ones who are making others laugh and smile who are struggling the most.' We have to take that into account, and we have to see that young people are really suffering in silence. We need to reach in there and help them. I believe that is through a form of 24-hour, seven-days-a-week service that really helps those children and families at the time that they need it, before it's too late. Thank you. Diolch yn fawr iawn. 

Thank you for the opportunity to contribute to this debate. Delivering high-quality and effective mental health services for children and young people must be a greater priority. There needs to be a greater focus on prevention, not just reactive provisions, supporting good mental health as part of a programme that ensures measures are put in place to reduce the likelihood of ill-health occurring in the first place.

There have been calls for a review into the transition phase between young person and adult services within the NHS. The ITV news recently covered the story of a young woman with autism. She called for a change in the system, so young people moved into adult care don't experience a significant drop in the services they receive. It was suggested that psychiatric sessions were reduced from one hour to just 10 minutes. This can be significant for young people at such a vulnerable period. In response, the Welsh Government announced an additional £50 million for mental health services in the period 2022-23. But what is the strategy to make sure this money is used effectively to allow young people to make a smooth transition into adult services? And how confident are Ministers that they are doing all they can to reduce the risk of harm to those moving from child to adult care? 

I want to turn to the challenges and the impact on young people. The YoungMinds survey report found that 80 per cent of children and young people with existing mental health problems agreed their mental health had deteriorated during the lockdowns. This figure does not include new cases of mental health decline. Ninety-one per cent of young people have accessed a mental health service at some point. Young people from low-income households seem to be particularly affected. Isolation from friends and family, and the shutdown of vital services, have contributed to this. 

Worryingly, nearly half of young people experiencing mental health declines have used negative coping techniques such as self-harm. Some have experienced significant dietary changes. Even though isolation is a major contributory factor to mental health deteriorations, over half now feel anxious about returning to normal life. It is clear that the impact of the pandemic will be felt for a significant time. These facts are concerning and must be considered by the Minister planning for the future of mental health. In February 2022, a Senedd report found that 60 per cent of children and adolescents who required specialist care had to wait more than four weeks for a first appointment.

I have a few suggestions, which I hope the Minister will consider. The Welsh Government need to consider a new mental health Act, which would update current legislation and would include the latest thinking about mental health provisions in Wales. The UK Government are currently making changes to the Mental Health Act 1983, which must be considered when changing the mental health legislation here in Wales.

To ensure a new mental health Bill is fit for purpose, the overarching principles should be: ensuring patients' views and choices are respected; ensuring that the Act is used in the least restrictive way possible; ensuring parity between mental and physical health; and lastly, that the patient should be treated as an individual. Additionally, the Welsh Government should consider changes to section 136 of the 1983 Act, which could help significantly reduce the number of detentions. For someone to be detained, it must be clear that the best interest of the patient can only be achieved through detention. This principle will reduce 'warehousing' of patients, allowing for better care for those who need to be detained, and remove undue stress for those who don't need it.

The Welsh Conservatives welcome dialogue between Westminster and Cardiff. However, mental health is devolved, and this provides an excellent opportunity to deliver a mental health Act that not only includes the benefits of the UK Government proposals, and that ensures parity between mental and physical health, but that is also fit for Wales. We also need to ensure collaboration with mental health charities such as YoungMinds, who, with additional funding from the Welsh Government, can provide specialist support for children and young people. This will address the prevention agenda. For children, a poor experience can be life-changing, so let us up our game. Thank you.

I call on the Deputy Minister, Lynne Neagle.

Thank you, Deputy Presiding Officer, and thanks to all Members today for their contributions. There is nothing more important to me than improving, protecting and supporting the mental and emotional well-being of children and young people in Wales. I have stated and restated my commitment many times in this Chamber, and I remain determined for us to make the progress needed to transform their lives for the better. It is, in fact, the very reason I came into Government, following five years of campaigning on this in the last Senedd.

We all have a role to play in this. Young people have said to us, 'Don't medicalise growing up.' We can all help to challenge the narrative that all young people need specialist support when they are struggling. Most young people won't need it, and every one of us in this Chamber should be raising awareness and supporting young people to access the appropriate level of services, when and where they need them.

I absolutely recognise the impact the pandemic has had on mental health and mental health services, and as I said in my intervention to Laura Anne Jones, we were in compliance with the waiting time targets prior to the pandemic, which is precisely why the previous children's committee called for a renewed focus on early intervention, because they—the committee I chaired—recognised the progress that had been made on waiting times.

Waiting time performance has deteriorated significantly from pre-pandemic levels, but this is in the context of increased referrals and patients presenting with higher acuity and complexity to a dedicated but pressurised workforce. Whilst waiting times in some areas have increased, health boards provide assurance that waiting lists are clinically reviewed on a regular basis, with patients prioritised based on clinical needs.

The latest data published this morning does show steady improvement in waiting times since December, which I cautiously welcome, but I'm in no way complacent about the ongoing challenges we face. And can I say to Jane Dodds that all the data on waiting times is published every month? I'm pleased to say that in Powys, we are meeting the target to see 80 per cent of young people within four weeks, but there is variation in Wales, particularly with Cardiff and Vale distorting the picture, with more than 50 per cent of the young people waiting being in Cardiff and Vale. I'll give way to Darren Millar.

Thank you, Minister. I know how committed you are to this cause and you've been very passionate about it for many years. It's not just about the 80 per cent target, though, is it? It's about making sure that people get access to the talking therapies, in particular, that they're currently having to wait very long times for, even after they've been assessed as requiring them within the target time. Can you tell us what progress is being made to address that particular issue?

Thank you, Darren. As you say, it's not just about the waiting times. I have myself called for there to be more of a focus on outcomes and what happens to young people once they have that assessment. We are currently working on validating the data so that we can provide more public information on access to psychological treatments. But I think what you've just said, really, shows that it has to be a whole-system approach, which is what we are trying to do.

We've strengthened our arrangements to monitor both the quality and performance of NHS mental health services by meetings with the NHS delivery unit on a monthly basis. Given the variance in waiting times performance, we've also commissioned the NHS delivery unit to undertake a review of both primary and specialist CAMHS. This will help us understand the variance, and will support our improvement programme, because we have to have the correct data.

As we emerge from the pandemic, our services need time to recover and to develop models that can meet the changing needs of individuals, and do it sustainably, without destabilising other parts of the service. My focus is on prevention, early intervention and strengthening specialist services for those young people that need that level of support. This includes our joint ministerial whole-system approach which has our schools at the centre of improving the emotional well-being of young people. Our approach includes supporting good mental health through the curriculum, helping schools to identify and support young people who need help sooner, but also linking to advice and support from CAMHS with the roll-out of the CAMHS inreach service. So, indeed, James, we are actually doing all the things that you have referred to.

We continue to drive implementation of our NEST/NYTH framework across Wales via regional partnership boards, and we're supporting the framework implementation in a systematic and integrated way. All young people need safe, nurturing relationships, with trusted adults wherever they live their lives. This is at the very heart of our NEST framework. Crucially, this will help provide early emotional and mental health support for those who do not need clinical support or intervention. I've been pleased to hear first-hand from RPBs of some of the new and expanded services implemented as a result of the NEST framework, a framework that has been co-produced with a wide range of stakeholders, but crucially with young people themselves.

We continue to strengthen our tier 0/1 offer for young people, providing easy access to a range of support without the need for referral. We've updated the young persons mental health toolkit, which links young people aged 11 to 25 to websites, apps and helplines that deal with anxiety, low mood, bereavement, advice on keeping well and building resilience. We've extended our roll-out of online cognitive behavioural therapy via SilverCloud  to include a new model for young people.

To progress our transformation of specialist services, we are implementing single points of contact for CAMHS services in each health board, ensuring easier access to the right level of support. To improve how services respond to mental health crisis, health boards are working towards the full roll-out of '111, press 2' for mental health for all ages. This will provide immediate access to a mental health practitioner over the phone, 24 hours a day, to provide advice, support and referral. Health boards are phasing in this service, and the early evaluation is promising.

We will be supporting Plaid Cymru's amendment today and it's reflection of the joint commitment we have made in the co-operation agreement, but I want to be crystal clear that our commitment is to pilot community facilities to support young people in crisis. They will provide an alternative to hospital admission, but will also be able to provide clear referrals into NHS services if needed, and will be available on weekends and evenings. We are in the early stages of four pilots in Llanelli, Aberystwyth, Wrexham and Swansea to test sanctuary provision for young people. These models will aim to support the young person and prevent the need for escalation. If successful, this model could also provide an alternative to section 136 detentions when appropriate. But I also want to emphasise that this Welsh Labour Government is already taking an approach to protect the mental health and emotional well-being of children and young people, which has early intervention and prevention as its very core. Our whole-school approach, NEST, CAMHS inreach and improved access to tier 0/1 services are already being funded and rolled out across the country to ensure we make progress on this agenda. 

Having a sustainable, multiprofessional mental health workforce is, of course, fundamental to the improvements I've talked about, and I met Health Education and Improvement Wales and Social Care Wales yesterday to receive an update on their new mental health workforce strategy following their extensive consultation. And, of course, the approach I have set out today is supported by our continued additional investment in mental health services, with £50 million additional funding this year, rising to £75 million next year and £90 million in 2024-25. Over £21 million of this extra funding this year will go directly to the NHS to support priority areas, including CAMHS, eating disorders and crisis care. This is significant and recurrent investment that underpins the whole-system approach we are taking to supporting the mental and emotional health of all children and young people in Wales. Diolch yn fawr.

I call on Gareth Davies to reply to the debate.

Thank you very much, Deputy Llywydd. I'd like to thank everyone who's taken part in the debate this afternoon on such a vitally important topic. Childhood and adolescent mental health services have been severely stretched for many years, but the problems have been compounded by the pandemic, which has been widely referred to during today's debate, both in terms of waiting times, but also in terms of increasing the numbers needing support. Barnardo's Cymru staff are reporting there has been an increase in mental health and well-being issues amongst the children and young people they work with. As a member of the health committee, I was able to take evidence from witnesses on the state of mental health services during our inquiry into waiting times. We heard from the Royal College of Psychiatrists, amongst others, who highlighted how mental health services were struggling well before the pandemic. They said that waits and barriers to access would be unacceptable in any other area of medicine. And we heard from stakeholders the very real costs of these waits, as delays in treatments have significant consequences for young people, not only intensifying their suffering, but often leading to more complex needs and increasing treatment costs. We are forcing more young people into mental health crisis because of our lack of early intervention.

The fact that half of young people receive an assessment within 28 days of referral should be a matter of national shame, particularly when we have been aware of the issues facing CAMHS for many years. It is past time we had an urgent review of CAMHS provision in Wales, as James Evans outlined in opening the debate. He was very brave to stand up and talk about some of his personal—

Will you take an intervention?

Yes, of course.

Did you actually listen to what I said when I explained that we are having a review, a delivery unit review, of CAMHS services in Wales? So, we are actually doing what you've now stood up and called for. Maybe it would help if you paid attention.

Yes, I was actually paying attention, but it was to highlight the actual need for the review into CAMHS services, which has been long delayed and is well overdue. So, Minister, I'd really welcome some urgency on that CAMHS review, and be keen to hear a statement from yourself in due course as to how you're getting on with that.

As mentioned, James mentioned personal experiences, which was very brave of him to stand up in here and say that, and we need more people to come forward to raise the profile of mental health and tackle some of the stigmas around it. Some of the social media, the modern platforms and the grandiose nature of some of the social media platforms often portray a false view of life that can feed into some anxieties around some social situations. And, of course, the COVID-19 pandemic, and calling for the need for an eating disorders unit, which is all great progress, and the need, indeed, for 24-hour crisis centres for children and young people—.

Then we heard from Rhun ap Iorwerth who, again, mentioned the COVID-19 pandemic and school pupils missing out on school work and contact with peer groups, which is all too important with young people growing up. A main point he raised was the serious mental health issues, because we hear too often in the media about anxiety and depression, which do play a big part in mental health, but it's also the recognition of the more serious mental issues, sometimes, like bipolar, schizophrenia, psychosis and the need for the first-episode prevention in psychosis, to treat people as they're coming in to services, and rather than spending a lifetime in services, it's nipping that in the bud when they're quite young. And I think that that was a really good point that you raised today, Rhun.

We heard from Laura Anne Jones about the disparities of some of the Welsh Government provision and what's actually the reality. And the point I made that two thirds of people aren't being seen within the 28-day period, which we really do need to see improvements on, and getting the right support for children with autism and learning disabilities in schools and in the general public.

And then we heard the personal case from Sarah Murphy. I'd really like to applaud you, again, on showing that bravery, because it takes a hell of a lot of bottle to get up in here and talk about something that you've really suffered with as a young girl, and I really take my hat off to you. And you've come, obviously, a long way from that and regardless of party politics, the good people of Bridgend and Porthcawl have put their trust in you to represent them here and I applaud you for that, and you're doing really well.

And then we heard from Sam Kurtz about holding the Welsh Government to account, and the variations in rural communities in comparison to larger cities and urban areas, which we know all too well about. We heard from Jane Dodds about her experience in the social work profession and seeking clarification on those waiting times, which the Deputy Minister was able to respond to you on—I was listening, Deputy Minister, just for clarity—and the positive stories coming out of some of the services in terms of home treatment teams and the voluntary and third sector support that's available as well, which, you rightly say, is a preferred method of seeking care for some people, particularly younger people and children, who we're speaking about today.

Altaf Hussain mentioned the transfer between the children and adult mental health service, the smooth transition, and I think if those reassessments were more prevalent between those transitions, and between those services, we could see a more seamless transportation between those systems, which I'd be keen to see progress on, and, of course, the mental health Act in Wales, and what that can mean for Wales itself in a UK context.

I thank the Deputy Minister, also, for your response today and updating the Senedd today on some of those initiatives that the Welsh Government are working on. I'd like to see regular updates to the Senedd about, like I mentioned, how you're getting on with that, as it's such an emotive and personal issue for a lot of Members and people across Wales. So, we'll be keeping a good eye on that. I'll just end my contribution in urging Members that if you do feel passionate about this and agree with the points that have been put forward by the Welsh Conservatives today, then I'd urge you to support our motion today. Thank you very much.

The proposal is to agree the motion without amendment. Does any Member object? [Objection.] I heard an objection, so I defer voting on the motion until voting time.

Voting deferred until voting time.

And we now have reached that time. In accordance with Standing Order 12.18, I will suspend the meeting before proceeding to voting time.

Plenary was suspended at 18:40.

The Senedd reconvened at 18:43, with the Deputy Presiding Officer in the Chair.