Theresa May’s ‘legacy’ on child mental health is one of underfunding and neglect

Theresa May is approaching her final weeks in office and, unsurprisingly, she is looking to distract us from the Brexit-shaped mess that she has created in favour of leaving a rather more positive “legacy”. She has chosen children’s mental health as one of her policy areas, with an announcement that all teachers will be trained to identify early signs of mental health problems in young people as a means of prevention and early intervention.

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There is something to be said for this. Many children spend more time at school than they do engaged in meaningful conversation with their families, and difficulties can initially manifest more obviously at school than at home. Teachers are well-placed to identify those children who seem to be struggling to cope, and to give students the language to speak of mental health problems in helpful, rather than discriminatory, ways. Primary school is an ideal time to begin some of these conversations. And let’s not forget: teachers are able to do their jobs more effectively when their pupils’ pastoral care needs are well-met. I imagine the majority would welcome the opportunity to broaden their understanding of this area.

But this isn’t a sustainable policy in itself. Identifying problems is all to the good, but May hasn’t clarified exactly what help will be available to these young people once it’s been determined that they require additional support. Mental health services – including child and adolescent services – continue to be woefully underfunded, despite years of promises of extra money. Only a fraction of those who need help get any – and even then, they don’t always get the care and treatment they really need, because there simply isn’t enough in the way of staffing and skill mix. And, assuming that teachers do indeed receive specialist training, that shortage of services is going to become more apparent, because referrals into services are likely to increase sharply. But without a parallel increase in resource, thresholds for accessing care will simply get higher and higher. That is disheartening for the teachers who are trying their best to get their students the help they need, but it is dangerous for children who are told that their problems are not severe enough to warrant that help.

If May – or any other politician – really wants to “prevent” mental health problems they have to take a public health approach. Mental health issues rarely exist entirely within individuals; all too often they are the product of the society we live in. A decade of austerity has resulted in increased income inequality and an exponential rise in the use of food banks. Changes to welfare have thrust those who were just about managing to live into the depths of despair. Fourteen million Britons live in poverty; eight million of those in families in which at least one person is in work. You can’t separate mental health from the reality of people’s lives. If you live in substandard housing and haven’t enough food to eat you are extremely likely to have difficulties with your mental health. You can’t give people therapy for being poor, vulnerable, or marginalised. You need to tackle the poverty and the vulnerability and the marginalisation.

It’s laughable that this policy has been announced only two weeks after a report highlighted how successful Sure Start centres were in improving healthcare outcomes in the most deprived areas. They achieved this by integrating healthcare, family support and education, but local authority early years funding has been slashed by 62% since 2010. Of course Sure Start couldn’t survive in such a hostile funding climate. Predictably, use has plummeted most significantly in the poorest areas; in other words, amongst those communities who could have benefited the most from the programme.

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Almost anyone who works in this arena will tell you that early intervention is key, but that it won’t reap rewards in the short term. If you want to improve population-based outcomes you have to invest in your population. Often that means a decade or more of funding before outcomes can really be measured. But the policies of the last 10 years have shown very clearly that ringfencing funding to improve the health and social outcomes for poor and deprived people is seen as unimportant by the government. It is no surprise that we have seen such an explosion in the numbers of people experiencing mental health problems.

I understand that Theresa May wants a legacy bigger than Brexit. And, yes, more people should be trained to identify mental health issues early on. But these sound like empty words and empty policies. If she really believed in championing mental health she would be looking at tackling the root causes and she would be acknowledging the impact of her own party’s policies on the mental health of those who have borne the brunt of them.

• Masuma Rahim is a clinical psychologist