The Ministry of Defence (MOD) encourages personnel to consider their mental fitness as equally as important as their physical fitness promoting good mental resilience and mitigating the negative impacts of potential traumatic experiences.

The Department encourages early identification and intervention for those experiencing mental health challenges and actively promotes a culture where Personnel feel comfortable seeking help without stigma.

Personnel have access to a vast range of resources to support their mental health with both in-person and online options, briefings before, during, and post-deployment, a dedicated 24 hour phoneline for both personnel and their families and access to HeadFIT; an externally accessible website specifically designed for the Defence community. All Personnel, attend a mandated annual mental fitness brief which provides information on mental health, wellbeing, stress management, and provides signposting to appropriate help.

Personnel who are unable to be deployed due to mental health disorders are managed clinically by Defence Primary Healthcare (DPHC). DPHC provides a responsive, flexible, accessible, and comprehensive treatment service. DPHC has introduced standardised training for primary care clinicians incorporating emerging digital interventions to ensure Personnel can access initial mental healthcare at any Defence medical centre, strengthening the initial management of mental health disorders within primary care settings.

Defence Mental Health Networks (DMHNs) are located across the UK and are improving access to specialist mental health services for personnel. These specialist community mental health services provide enhanced access to expert assessment and treatment for personnel experiencing mental health disorders. By introducing new single points of access, enabling the sharing of specialist skills across network locations and consolidating clinical and governance processes DMHNs are reducing wait times to enhanced assessments and core treatment therapies.

The through life support now provided to Service personnel will have a positive impact on the veterans of the future, ensuring that Armed Forces Personnel have the psychological resilience they need to recognise mental ill-health in themselves, those around them and know how to manage it.

Defence is committed to ensuring that Service Personnel receive the care and treatment required to ensure they are fit to fight and can fight back to fitness.

The Ministry of Defence (MOD) encourages personnel to consider their mental fitness as equally as important as their physical fitness promoting good mental resilience and mitigating the negative impacts of potential traumatic experiences.

The Department encourages early identification and intervention for those experiencing mental health challenges and actively promotes a culture where Personnel feel comfortable seeking help without stigma.

Personnel have access to a vast range of resources to support their mental health with both in-person and online options, briefings before, during, and post-deployment, a dedicated 24 hour phoneline for both personnel and their families and access to HeadFIT; an externally accessible website specifically designed for the Defence community. All Personnel, attend a mandated annual mental fitness brief which provides information on mental health, wellbeing, stress management, and provides signposting to appropriate help.

Personnel who are unable to be deployed due to mental health disorders are managed clinically by Defence Primary Healthcare (DPHC). DPHC provides a responsive, flexible, accessible, and comprehensive treatment service. DPHC has introduced standardised training for primary care clinicians incorporating emerging digital interventions to ensure Personnel can access initial mental healthcare at any Defence medical centre, strengthening the initial management of mental health disorders within primary care settings.

Defence Mental Health Networks (DMHNs) are located across the UK and are improving access to specialist mental health services for personnel. These specialist community mental health services provide enhanced access to expert assessment and treatment for personnel experiencing mental health disorders. By introducing new single points of access, enabling the sharing of specialist skills across network locations and consolidating clinical and governance processes DMHNs are reducing wait times to enhanced assessments and core treatment therapies.

The through life support now provided to Service personnel will have a positive impact on the veterans of the future, ensuring that Armed Forces Personnel have the psychological resilience they need to recognise mental ill-health in themselves, those around them and know how to manage it.

Defence is committed to ensuring that Service Personnel receive the care and treatment required to ensure they are fit to fight and can fight back to fitness.

The information requested is not held by the department.

Creating school cultures with high expectations of behaviour is a priority for the government. The department supports head teachers in using exclusion where warranted as a part of creating calm, safe and supportive environments which bring out the best in every pupil.

The updated ‘Statutory Suspension and Permanent Exclusion’ guidance is clear that head teachers should consider any underlying causes of misbehaviour before issuing an exclusion, this may include where a pupil has attention deficit hyperactivity disorder. More information on the guidance can be found here: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/1181584/Suspension_and_permanent_exclusion_guidance_september_23.pdf.

The department’s guidance, 'Understanding your data: a guide for school governors and academy trustees’ also makes clear governing boards should carefully consider the level and characteristics of pupils who are leaving the school and deploy maximum challenge to the school on any permanent exclusions to ensure it is only used as a last resort. More information on the guidance can be found here: https://www.gov.uk/government/publications/understanding-your-data-a-guide-for-school-governors-and-academy-trustees/understanding-your-data-a-guide-for-school-governors-and-academy-trustees.

All teachers need to be equipped to teach pupils with special educational needs and disabilities (SEND). High quality teaching is the single most important factor within school in improving outcomes for all pupils, including those with oppositional defiant disorder.

Training and development to support children with SEND begins at the beginning of a teacher’s career journey, through their Initial Teacher Training (ITT), and is embedded throughout the Early Career Framework (ECF). ITT courses are designed so that trainee teachers can demonstrate that they meet the Teachers’ Standards at the appropriate level. This includes the requirement in Standard 5 that all teachers must have a clear understanding of the needs of all pupils. Careful consideration has been given to the needs of trainee teachers in relation to supporting pupils with SEND, and the ECF builds on that learning for early career teachers once qualified. Both the ITT Core Content Framework (CCF) and ECF were designed in consultation with the education sector, including SEND specialists.

Once teachers qualify and are employed in schools, head teachers also use their professional judgement to identify any further training, including specific specialisms, for individual staff that is relevant to them, the school, and its pupils.

The Department also funds the Universal Services programme, worth £12 million, which offers online training, professional development groups, bespoke school and college improvement projects, sector led research, autism awareness training and an embedded focus on preparation for adulthood, including employer led webinars. The programme commenced in May 2022 and will run until Spring 2025.

So far, 6,600 school and college staff have accessed free online training modules, and 81 schools and over 135 colleges have identified and led their own SEND focused school improvement project. These projects focussed on SEND governance, teaching assistant deployment, early identification of SEND and the curriculum.

Local authorities have a duty to assess the support needs of anyone who is affected by an adoption placement. The adoption support fund provides support for essential therapeutic services for eligible adoptive and special guardianship order families, on the basis of assessed need.

As addressed in the National Minimum Standards for Fostering Services and in the Fostering Services (England) Regulations 2011, the fostering service must put in place and implement a written policy to safeguard children placed with foster carers from abuse or neglect, that includes the procedures to be followed in the event of such an allegation (regulation 12 and standard 22). Working Together to Safeguard Children (2018) is the government’s statutory guidance that provides the framework within which agencies work together to safeguard and promote the welfare of children.

As with all children with behavioural needs, local authorities work with schools and other agencies to ensure that they can access the support for their specific requirements.

The number of children in custody has declined by 70% over the past decade, leading to a concentrated cohort of children with particularly complex needs, most of whom are serving sentences for more serious or violent offences. The safety of all children and staff is paramount, so we have taken the following measures:

• Last year, the Youth Custody Service published, and began implementing, a new approach to behaviour management – “Building Bridges” – developed with the NHS.[1] This is based on the importance of leadership, trusting staff-child relationships and the benefits of reward, prevention and proactive techniques.

• We are funding all our frontline officers to undertake a youth justice qualification up to foundation degree level, which will enable them to better analyse need and risk, and deploy more effective interventions.
• We recruited more psychologists and healthcare workers to work with children to help them overcome the issues at the root of their poor behaviour. For those children with the most complex needs, we have created two specialist enhanced support units so they can receive the intensive support they need.
• We have commissioned a review of pain-inducing restraint techniques, which we expect to publish shortly, and set up a taskforce to review separation practice and policy.

We anticipate this range of new measures will lead to improved behaviour, fewer incidents and better outcomes for children.

[1] https://www.gov.uk/government/publications/building-bridges-a-positive-behaviour-framework-for-the-children-and-young-people-secure-estate

Secure Children’s Homes provide specialist care in a secure environment for vulnerable children and young people aged between 10 and 17. They offer care for young people who have either been remanded or sentenced by the courts or detained for their own welfare or to ensure the safety of others. Local authorities are responsible for making sure places are available for their looked-after children and we are working with them to ensure the children’s homes system is joined up at a national level.

We recognise that there are only a small number of Secure Children’s Homes and that is why we are expanding provision available in England through our £40 million capital programme. We established and continue to fund the Secure Welfare Coordination Unit to help plan and coordinate placements based on individual needs. In addition, we provided funding to local and combined authorities to commission feasibility studies into opening new secure provision to increase available capacity.

More broadly, we are working across government to ensure we are aligned on key issues relevant to the broader children’s secure estate, including youth custody and mental health provision. We are also considering the needs and characteristics of young people across the estate and how provision can better meet the needs of those young people entering the system.

We are also supporting NHS England’s Framework for Integrated Care (SECURE STAIRS), which is being delivered in partnership across government to improve the overall mental health support of children in the secure estate.

The information requested is not held centrally, on the number of pupils who use medication to treat behavioural issues.

The Government is committed to pupils with medical conditions being properly supported at school so that they have full access to education.

In 2014, the Government introduced a new duty on schools to support pupils with all medical conditions and has published statutory guidance on this for schools and others. The guidance can be found here: https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3.

The guidance does not specify which medical conditions should be supported in schools. Instead, it focuses on how to meet the needs of each individual child and how their medical condition impacts on school life.

In June 2014, the Department issued non-statutory advice on mental health and behaviour to help schools identify underlying mental health problems in young people, which can be found here: https://www.gov.uk/government/publications/mental-health-and-behaviour-in-schools--2 .

The advice clarifies the responsibility of the school, outlines what they can do and how to support a child or young person whose behaviour may be related to an unmet mental health need.

The information requested is not held centrally, on the number of pupils who use medication to treat behavioural issues.

The Government is committed to pupils with medical conditions being properly supported at school so that they have full access to education.

In 2014, the Government introduced a new duty on schools to support pupils with all medical conditions and has published statutory guidance on this for schools and others. The guidance can be found here: https://www.gov.uk/government/publications/supporting-pupils-at-school-with-medical-conditions--3.

The guidance does not specify which medical conditions should be supported in schools. Instead, it focuses on how to meet the needs of each individual child and how their medical condition impacts on school life.

In June 2014, the Department issued non-statutory advice on mental health and behaviour to help schools identify underlying mental health problems in young people, which can be found here: https://www.gov.uk/government/publications/mental-health-and-behaviour-in-schools--2 .

The advice clarifies the responsibility of the school, outlines what they can do and how to support a child or young person whose behaviour may be related to an unmet mental health need.

It has not proved possible to respond to this question in the time available before Prorogation. Ministers will correspond directly with the Member.

The Prevention Vision confirmed there is a strong case for acting early with good pre-conception care, fit and healthy parents and taking a ‘whole family’ approach when responding to problems. Becoming a parent is an important period and opportunity to offer evidence-based advice and support whilst creating opportunities to support a child’s very early development. The Prevention Green Paper will set out our thoughts in more detail.

Through our new workforce of Mental Health Support Teams, staffed by a new role of Education Mental Health Practitioners, we are providing new capacity for addressing the needs of children and young people with mild to moderate mental health issues. The first cohort of trainees started in early 2019 and the first wave of trailblazer areas will become operational during 2019. The Support Teams will provide evidence-based interventions, which may include family-based behaviour change interventions, which can be successfully delivered to help reduce child conduct problems.

Perinatal mental illness covers a wide range of conditions. Although the Government has made no formal assessment of the links between perinatal mental health and intergenerational poverty, we stated in the Five Year Forward View for Mental Health that if left untreated, it can have significant and long-lasting effects not only on the woman but also on the emotional, social and cognitive development of children.

The Government is committed to improving both the detection and treatment of perinatal mental illness. General practitioners and primary care teams have a crucial role in supporting the identification and treatment of perinatal mental illness, including post-natal depression, and are part of an integrated pathway of services. Support includes monitoring early onset conditions, providing pre-conception counselling and referring women to specialist mental health services, including Improving Access to Psychological Therapies services and specialist perinatal community teams, if necessary.

To date, NHS England and Health Education England has also funded training for over 3,000 staff and professionals in mental health, maternity services and primary care to better identify and support women with perinatal mental health needs.

We are investing £365 million from 2015/16 to 2020/21 in perinatal mental health services to ensure that by 2020/21 at least 30,000 more women each year are able to access evidence-based specialist mental health care during the perinatal period. This investment is designed to improve access to specialist perinatal mental health services across England, resulting in better outcomes for women and their families.

In addition, the NHS Long Term Plan, includes a commitment for a further 24,000 women to be able to access specialist perinatal mental health care by 2023/24, building on the additional 30,000 women who will access these services each year by 2020/21 under pre-existing plans. Specialist care will also be available from preconception to 24 months after birth, which will provide an extra year of support.

The Department publishes a range of detailed statistics for PIP on Stat-Xplore: https://stat-xplore.dwp.gov.uk .Guidance on how to use Stat-Xplore can be found here: https://sw.stat-xplore.dwp.gov.uk/webapi/online-help/index.html.

These statistics include monthly clearances (decisions) since PIP was introduced in April 2013. Clearance figures can be broken down by clearance type (e.g. whether the claim was awarded, disallowed pre-referral to an assessment provider, disallowed at assessment or withdrawn), by reassessment type (i.e. whether the claimant was making a new claim or was undergoing a Disability Living Allowance (DLA) to PIP reassessment) and by main disabling condition.

Note that main disabling condition is only recorded for claims which reach the assessment stage. Claimants may often have multiple disabling conditions upon which their entitlement decision is based but only the main disabling condition is recorded and shown in these statistics. Main disabling condition is the disability recorded on the PIP administrative system. It is possible that a reassessment claim could have a different main disabling condition recorded on the DLA and PIP systems.

With regard to your question relating to “Behavioural Disorders” we advise that you group together the Disability Subgroups, “Conduct disorder (including oppositional defiant disorder)” and “Hyperkinetic Disorder – ADHD/ADD.” For the question relating to borderline personality disorder select Personality Disorder.

Funding for alternative provision (AP) comes from the dedicated schools grant (DSG). Local authorities provide place funding of £10,000 for each AP place in a pupil referral unit or AP academy from their high needs budget within the DSG.

In addition, top up funding for costs in excess of the £10,000 place funding may be required depending on the needs of the individual pupil. Where the local authority is responsible for a pupil in AP, the top up funding is paid from the local authority’s high needs budget. Where a school is responsible, the top up funding is paid from the school’s delegated budget share. Local authorities can also spend their DSG on other AP services.

The following table shows how much local authorities have reported that they have spent on AP in the last three years. Comparable data for 2013-14 and 2017-18, data on how much schools have spent on AP, and data held by age or need are not available. The figures below reflect the amount local authorities have chosen to spend on AP specifically, from their high needs budgets. Overall high needs funding has increased from £5 billion in 2013-14 to a record high of £6 billion this year, giving every local authority a cash increase in funding.

The department has not carried out an assessment of the efficacy of Ofsted’s registration process for children’s social care settings. However, the requirement to register and registration procedure is contained in part 2 of the Care Standards Act 2000 and this sets out a number of safeguards to ensure its efficacy.

Since 2011, local authorities have been under a duty to provide a range of short breaks services, sometimes known as respite care, which can provide support for children with a range of needs including severe and behavioural needs. Local authorities are required to publish a local short breaks services statement showing what services are available, how they are responding to the needs of local parents and carers, and how they can be accessed, including any eligibility criteria.

While responsibility for funding short breaks rests with local authorities, the Department for Education has offered support and to help make surelocal authorities meet their statutory requirements; has funded innovative grants that promote best practice for delivering services; and continues to consider how we can best support local authorities who are working to deliver sustainable short breaks provision.

The government is able to oversee how much local authorities have planned to spend on short breaks provision through authorities’ annual section 251 returns. This information can be found at https://www.gov.uk/guidance/section-251-2016-to-2017.

Departmental surveys such as the Children’s Services Omnibus also gather information on Special Educational Needs and Disabilities (SEND) services provided by local authorities, including short breaks.

There are also opportunities through the new Ofsted and Care Quality Commission SEND inspections framework for local areas to consider how well they are providing for the education, health and care needs of those with SEND, including their need for short breaks services. A thematic ‘one year on’ report published by the two inspectorates in October 2017 found that “children and young people who have SEND and their families typically had good access to high-quality short breaks” (full publication here: https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/652694/local_area_SEND_inspections_one__year__on.pdf).