Sojan Joseph (Ashford) (Lab) I beg to move, That this House has
considered improving support for mental health. It is a pleasure to
see you in the Chair, Mr Dowd, and I am pleased to have secured
this important debate. As today is World Mental Health Day, it is
particularly appropriate that we have the opportunity to raise
awareness of mental health issues and the mental health system in
this country. It is important to reflect on how far we have come in
this...Request free trial
(Ashford) (Lab)
I beg to move,
That this House has considered improving support for mental
health.
It is a pleasure to see you in the Chair, Mr Dowd, and I am
pleased to have secured this important debate. As today is World
Mental Health Day, it is particularly appropriate that we have
the opportunity to raise awareness of mental health issues and
the mental health system in this country. It is important to
reflect on how far we have come in this country in removing the
stigma around mental health, and I hope this Parliament will play
its part in continuing that progress. However, if we are to do
so, we must be honest about the many challenges we still face. I
also want to declare a personal interest: before being elected in
July, I spent 22 years working in the NHS, primarily in mental
health.
One of my main motivations in standing for Parliament was to play
my part in building an NHS fit for the future. Improving support
for mental health will be an integral part of that. With that in
mind, I want to put on record my thanks to my former NHS
colleagues working in the mental health system. They do an
incredible job in incredibly difficult circumstances. It is
important to say at the outset of this debate that any criticisms
of the current system are not directed at the workforce. Without
their hard work and dedication, the problems faced by those in
need of mental health services would be far worse. I know from my
own experience that in recent years, their work has often been
made more difficult by policies imposed at a national level by
the last Government. Even when it was clear that those policies
were having a detrimental impact, Ministers were unwilling to
make concessions.
Although the mental health workforce has expanded in recent
years, it has only reached the same number of staff as it had
when the last Labour Government were in office in 2010. More
needs to be done regarding the recruitment and retention of
staff, as underlined by the high number of vacancies. NHS data
shows that in September last year, there were 28,600 vacancies,
amounting to 19% of the total workforce and causing an increased
reliance on agency staff. In the year to September 2023, there
was a 19% turnover in the overall workforce. Those figures from
the King's Fund highlight the extent of the recruitment and
retention crisis.
From my work as a manager in mental health services, I know that
experienced staff play a vital role, and a vast amount of time
has to be spent recruiting new experienced staff when they move
on to different posts. That has meant that often the most
challenging environments have been run by staff with the least
experience. That obviously has a negative impact on patient care
and can lead to an increased incidence of aggression and abuse of
staff. It is therefore not a surprise to see staff shortages
having a negative impact on staff morale. The King's Fund has
shown that in in-patient services, staff regularly work extra
hours or additional shifts and often find themselves in
environments and with patients they are unfamiliar with.
Similarly, staff in community services say they are worn out and
find their work frustrating and stressful.
For 14 years, we have had a string of Prime Ministers and
Ministers speaking about achieving parity of esteem between
physical and mental health in the NHS. While I do not doubt the
intentions behind achieving that goal, after 14 years of
Conservative Government we do not have that parity. Indeed, as
Lord Darzi made clear in his excellent report:
“There is a fundamental problem in the distribution of resources
between mental health and physical health. Mental health accounts
for more than 20 per cent of the disease burden, but less than 10
per cent of NHS expenditure.”
Although there has been increased investment in mental health
services at a higher rate than the overall NHS budget, there is
still a large gap between resources and demand. It is little
wonder that all the talk of parity has seemed little more than
warm words. I genuinely hope that under this Government things
will finally change. I should point out that when we talk about
waiting lists, those waiting in the mental health system are
never included. Will my hon. Friend the Minister say something
about that and explain how the Government plan to put parity of
esteem into practice? Can he also say whether the Government will
continue to increase investment in mental health services at a
higher rate than the overall NHS budget during this
Parliament?
Lord Darzi's recent report states that around 3.6 million people
are in contact with mental health services, and in April this
year around 1 million people were waiting for mental health
services. As he makes clear, it has become all too normal to have
to wait a long time to access mental health services. The NHS's
own data shows that in April this year, 10% of people who had
been in contact with mental health services and were waiting for
their second contact in adult community mental health services
had been waiting for at least 116 weeks. All the evidence
indicates that today we have a mental health system that is
overstretched and under-resourced. In fact, there has never been
so much demand for mental health support, with one in four people
experiencing a diagnosable mental illness each year.
Figures from the British Medical Association indicate that last
year there were a record 5 million referrals to mental health
services in England. That is up by 33% on the number of referrals
in 2019. The increase in the prevalence of depression over the
last decade is a good example of how our mental health as a
nation has got significantly worse. In 2012, the prevalence of
depression was 5.8%. By 2022 that had more than doubled to 13.2%.
In my own constituency of Ashford the figure was even higher, at
17%.
Given the increased prevalence of mental health issues, I was
pleased that in the first King's Speech of this Labour Government
we saw mention of legislation to modernise the Mental Health Act
1983. The proposed legislation has been welcomed across the
sector. It is an important opportunity to improve care and
strengthen safeguards for people who are admitted to mental
health hospitals. I hope the new Bill will address the fact that
someone who is black or living in a deprived area is almost four
times as likely to be sectioned under the Act.
Will my hon. Friend the Minister tell me when we can expect to
see the Government's legislation introduced in Parliament? As
Lord Darzi identified in his report, the lack of capital
investment in places where people are sectioned means that a lot
of those places are unsuitable, outdated and unsafe. From my own
experience, I know that nurses, managers and matrons spend a lot
of time trying to get capital works done in an NHS trust.
People living with a long-term physical condition are 50% more
likely to suffer from mental ill health, while those with
Parkinson's disease are twice as likely to be at risk of suicide.
That underlines the importance of a wholesale change so that
support can be accessed at an early stage. Too often, people can
access support only after they have ended up in crisis. NHS
figures show that in July there were just over 40,000 new urgent,
very urgent or emergency referrals to crisis care teams. At that
point, the treatment that patients receive is not only more
intensive for them, but more costly for the NHS.
The difficulty of accessing mental health services explains why
increased numbers of people who require support end up being
admitted to accident and emergency departments. To illustrate
that, I will use the example of my own integrated care board in
Kent and Medway, which has recently launched several safe havens
to provide support for anyone in a mental health crisis. They
have helped to reduce the number of people who seek support by
going to hospital emergency departments when they experience a
mental health crisis. In my constituency, there is not yet a safe
haven. That may explain why William Harvey hospital in Ashford
has one of the highest rates of individuals presenting with
primary mental health needs at an A&E. I welcome plans that
are under way for a safe haven at the hospital in the near
future.
When patients end up in hospital, there are significant
difficulties in getting them a bed. This is a challenge in Kent
and Medway, but the picture is not dissimilar across the rest of
England. The Royal College of Psychiatrists recommends a maximum
occupancy rate of 85% of beds for mental health patients.
However, between April and June, the average occupancy rate of
the 444 mental health beds in Kent and Medway was 91.7%. Across
England, the average occupancy rate was 89.9%.
Then there is the issue of discharging patients. When they are
clinically ready to leave hospital, there is often nowhere for
them to go. That leaves them stuck in hospital, causing blockages
in the system. In my own experience, nurses, doctors, managers,
matrons and directors spend many working hours looking into
moving people out of hospital, when they should be focusing on
patient care. I believe that more appropriate housing must be
built that is open for people leaving hospital. I urge the
Department of Health and Social Care to work across Government to
ensure that as the Government's planning reforms are introduced,
that point is taken into consideration.
We have seen an increase in adults being treated in hospitals for
their mental health, and the situation is the same for children
and young people. A recent report from the Education Policy
Institute shows that the number of young people admitted to
hospital increased by one fifth between 2017 and 2023. As the
report indicates, that suggests that more young people are
reaching a crisis point and are experiencing multiple admissions.
The evidence also indicates that a large number of young people
are not getting the necessary mental health support. A survey for
Young Minds revealed that at least 60% of children considered to
have a diagnosable mental health condition had not had contact
with the NHS.
Research from the Maternal Mental Health Alliance published last
week shows that more than 20% of women will face mental health
challenges either during their pregnancy or in the perinatal
period. It is clear from the research that many women struggle to
access support, particularly those from racialised communities,
young mothers and those experiencing domestic abuse or living in
poverty.
We know that intervening early to ensure that people are kept in
good health is not only better for the individual but tends to be
far less costly. However, until now, efforts to prevent mental
ill health have been severely underfunded and they have not been
given the priority they deserve. I hope we will see a marked
change in approach under this Government. With that in mind, I
ask my hon. Friend the Minister whether greater priority will now
be given to community-based support for mental health services. I
hope he will agree that the easier it is for people to access
mental health services locally, whether in a traditional health
setting or through more informal drop-in services, the quicker
they will be able to get the treatment they need.
Will my hon. Friend update us on the Government's plans for Young
Futures hubs for children and young people? These open-access
drop-in hubs will be an important step in providing
community-based mental health support for children and young
people. Will he say something about the roll-out of those
hubs?
Our manifesto commitment to introduce a specialist mental health
professional in every school will be important in helping to
identify mental health conditions early on so that they can be
prevented from developing into more serious conditions in later
life. Will that include access to counselling? Research from the
British Association for Counselling and Psychotherapy indicates
that children whose mental health difficulties are initially too
complex for lower intensity interventions but not complex enough
to be referred to higher intensity interventions, such as child
and adolescent mental health services, can easily miss out on the
mental health support they need. They could instead be helped by
forms of provision such as counselling.
All the evidence shows that being active helps people's mental
health. Helping them back to work will also help to grow our
economy. Lord Darzi's report identified that, since the pandemic,
the number of people who are economically inactive has increased
by around 800,000, with people with mental health conditions
accounting for most of the increase. I welcome the Government's
new initiative to work across Departments and create links
between long-term unemployment and health. I also hope that they
will look to reform the benefit system, ending the blame culture
identified by the Secretary of State, so that we can treat people
with mental health problems with dignity. I welcome the greater
emphasis that Ministers have said will be put on prevention of
illness, and I hope that my hon. Friend the Minister will be able
to reassure me that the same emphasis will also apply to mental
health.
As the Mental Health Foundation has said, there is clear evidence
that place and the circumstances in which people are born, grow,
study, live and work have a powerful influence on their mental
health. Therefore, there must be a fundamental reform of the way
in which we deal with mental health. We should be addressing the
complexity of interactions and relationships, and how they affect
individuals, families and communities. Rather than starting from
the point of treating mental health, we should put the emphasis
on creating a society that prevents mental ill health in the
first place.
Beginning with central Government, I want to see a co-ordinated
approach to developing effective policies to protect people's
mental health. With that in mind, the priority that this
Government have already given to cutting pollution and building
high-quality houses is welcome. I also welcome the proposed
pre-watershed junk food ban and the steps that Ministers are
taking to create a smokefree society. Going forward, I want to
see greater cross-Government working to address the social
determinants of our mental health.
In the coming months, the Government are set to publish their
10-year plan for the NHS. As my hon. Friend the Minister and his
colleagues work on that, I hope that they will consult with
campaigners and organisations working in mental health, as well
as representatives of the workforce. By doing that, the
Government will be able to grasp the opportunity to transform the
way we approach the issue of mental health, ensure that there is
true parity of esteem and provide real, meaningful change in the
mental health system.
Several hon. Members rose—
(in the Chair)
Order. This is clearly a popular subject. Lots of people had
indicated previously that they wished to speak; there are
obviously people who wish to speak who had not indicated
beforehand, and others will want to intervene. The Minister and
Opposition spokespersons have 10 minutes each. Having done the
calculations, we will regrettably introduce a formal three-minute
time limit on Back Benchers. You will be able to see the time on
the screen, and regrettably I will have to cut you off in your
prime if you go over three minutes. Just bear that in mind,
please. I am sorry for the tutorial, but it is worth having, I
suppose. Please bob if you do want to speak.
1.48pm
(Epsom and Ewell) (LD)
It is an absolute pleasure to serve under your chairmanship, Mr
Dowd, as I speak for the first time in Westminster Hall. I thank
the hon. Member for Ashford () for securing this important
and timely debate on World Mental Health Day, and for speaking so
well.
Mental health can affect any of us at any time, young or old.
Unfortunately, too many people simply do not get the support they
need and some go on to take their own life. Speaking personally,
husbands of two friends of mine, a friend's brother and a friend
have taken their life, destroying families who are left behind
figuring out how to cope.
Since becoming the MP for Epsom and Ewell, I have been shocked by
the lack of mental health support, but also amazed at the
ingenuity of local residents to provide it in its absence. I had
the pleasure of meeting Charley Moore the other day—a Surrey
female firefighter and founder of an all-female support group in
Epsom and Ewell called Grow and Glow. She had a mental health
crisis last year and found it very difficult to access support.
She found many mental health groups for men, but she could not
find any specifically for women, so she set one up.
I was also proud to meet two mental health charities the other
day that were recognised at the BBC Surrey and Sussex Make a
Difference Awards last week in my constituency. One was We Power
On, which is a men's mental health “walk and talk” support group
set up by Chris Waller after he and his friend reconnected during
lockdown and discovered that they were both struggling with their
mental health. He won the bravery award. He takes people out at
the weekend, walking on the lovely Epsom downs and sharing their
experiences.
The other charity, Joe's Buddy Line, was set up by Ivan Lyons,
who won the community award and is one of my constituents. Ivan's
son was an award-winning radio producer on Capital Radio. Sadly,
in 2020, Joe took his own life. Through Joe's Buddy Line, Joe's
family advocate for mental health to be treated equally and with
the same seriousness as physical health. The charity provides
mental health support, advice and resources for schools. It is
encouraging schools to put a mental health policy in place in
every single school, giving teachers the support that they need
to support the young people of today. The charity has highlighted
to me that currently it is not a statutory requirement for a
school to have a mental health policy. Such a policy would foster
a whole-school approach, so today I am calling for a statutory
requirement for all schools to have a specific mental health
policy.
Too many people are simply suffering and too many lives are being
lost, yet some of that is preventable. Early intervention and
prevention are absolutely key. First, to ensure that our young
people get the support they need before they reach crisis point,
we need to equip them with the tools they need to build
resilience to cope with modern life. We must ensure that no one
feels alone in their mental health journey, and we need to
normalise conversations about how we are feeling mentally. I am
absolutely proud that in my constituency, individuals such as
Ivan, Chris and Charley are taking the initiative to champion
mental health support for everyone and fill in the gaps that they
have identified in the services. Let us not forget—
(in the Chair)
Order. Please sit down. May I reiterate that this is a very
sensitive subject, and I do not want to have to stop people in
mid-flow when they are talking? This is a very sensitive issue
and it would sound rude, so I exhort hon. Members to keep to the
three-minute limit. It is regrettable, as this is a very
important subject, but please keep to the limit, because— I
reiterate—this is such a sensitive subject, and I do not want to
cut people off at a sensitive point.
1.52pm
(Folkestone and Hythe)
(Lab)
It is a pleasure to serve under your chairship, Mr Dowd. I pay
tribute to my hon. Friend the Member for Ashford () not only for securing this
debate but for his tireless, dedicated work as a mental health
nurse in the NHS. I thank him for his service. His analysis of
the problems and solutions was masterful, and Parliament is all
the stronger for having his expertise and experience in this
place.
The issue of mental health support is a policy challenge that
goes beyond party political lines. Any civilised society is
judged on how it treats its most vulnerable. The state of
people's mental health in our nations is incredibly concerning.
As a former trustee of South Kent Mind in my constituency of
Folkestone and Hythe, I have seen a downward trajectory in
people's mental health outcomes, particularly in deprived areas,
and how mental health services are increasingly under strain. I
also pay tribute to the incredible work done by South Kent Mind,
which provides invaluable advice and well-run and well-attended
classes, such as cookery and exercise classes, which provide
local people with a sense of community, togetherness and support.
Statistics from Mind have laid bare the reality. Each year, one
in four people in England will experience a mental health problem
of some kind, and one in six people report experiencing a common
mental health problem, such as anxiety and depression. The number
of people reporting self-harm went up by 62% between 2000 and
2014, and the number of people reporting suicidal thoughts in the
past year went up by 30% between 2000 and 2014.
The mental health of people in this country is undoubtedly
deteriorating, and we know that some groups are more likely than
others to be impacted by mental health problems, such as the
LGBTQIA+ community, black British people and women aged 16 to 24.
There are several reasons behind the steep increase in suffering,
such as the giant evils of inequality and austerity that have
ripped the heart out of our communities. Unemployment and poor
housing still plague people's mental health, just as they did in
the age of the Victorian workhouse. There are in addition recent
phenomena, such as the rise of social media, creating
unprecedented pressures on young people to look a certain way,
and the decline in physical health in our communities, especially
in de-industrialised areas.
As a society we say that one suicide is too many, and that we
want to remove the stigma around mental health. But as we know,
the stigma festers in too many houses, homes, offices and sports
clubs, particularly with men and boys, for whom talking about
feelings or being seen to be vulnerable can be perceived as weak
or embarrassing. I sense that I am out of time, so I will sit
down.
1.55pm
Dr (Hinckley and Bosworth)
(Con)
Thank you, Mr Dowd, for allowing me to take off my neck brace to
speak. I congratulate the hon. Member for Ashford () on speaking so powerfully on
this topic. I was a doctor before I came to this House, so for me
the topic is important. There is a clear distinction when we
debate this topic between mental wellbeing and mental health.
Lockdown proved that everyone's mental wellbeing gets punished,
but not everyone has a mental health issue. That is important
when we are trying to segregate services: how do we supply the
correct services to the people who need them the most?
I have spent the last five years in Parliament campaigning around
body image and for a men's health Minister, particularly with
regard to suicide. But I turn my attention to something close to
my heart that is really important: the issue of adolescent mental
health, because I am deeply concerned by the increase in children
who are suffering. It is not just things such as eating
disorders; we are seeing attention deficit hyperactivity
disorder, we are seeing anxiety and we are seeing autism.
I plead with the new Minister to think radically, in a positive
way, when it comes to the NHS. In my area of Leicestershire, 40%
of child and adolescent mental health services is taken up by
dealing with ADHD and autism. That takes a lot of attention away
from the kids who are self-harming, or have eating disorders or
significant serious depression or psychosis. There is a radical
solution: pull out education and health and pool those services
as specialisms. That would build on the work that the last
Conservative Government did on placing representatives and mental
health workers in school, and would allow GPs and CAMHS the
freedom to concentrate on what they need to deal with.
(Salisbury) (Con)
On that point, may I draw my hon. Friend's attention to the role
of care co-ordinators with adolescents, and the problems and
challenges of the transition to adult care? That moment can be
critical in securing a pathway to an effective outcome. Often,
the confusion over where responsibilities are delineated and
begin has been a difficulty for my constituents.
Dr Evans
My hon. Friend is absolutely spot on. The cliff edges that exist
in the NHS—and education and social services—cause a real
problem, particularly for families, because at 18 someone does
not just lose their diagnosis.
It is important to pool those areas because it allows us to
stratify the way that we use our limited resources, and we know
that health costs will continue to go up and spiral. I urge the
Minister to have a think about potentially creating almost a
national special educational needs and disabilities service,
which would pool education and health experts together, releasing
schools and relieving GPs' primary care and secondary care with
specialists. Now we have the set-up of ICBs, there is scope to do
that regionally across the 42 areas.
It is well worth thinking about pooling those resources together,
because it would be possible to give specialist help; and as the
hon. Member for Ashford said, identifying people early means that
they will not end up in a crisis. That brings us back to
preventive care, to identify those who are having problems with
wellbeing or who have mental health issues. For me, that is the
crux of what we need to do: how do we pool the resources in a way
that is sustainable for the taxpayer and, most importantly,
service users and providers—the children and adolescents, and the
staff who have to cope with some of the most difficult problems?
I leave the Minister with that thought.
1.59pm
(Ipswich) (Lab/Co-op)
It is a privilege to serve under your chairmanship, Mr Dowd. I
thank my hon. Friend the Member for Ashford () for securing this important
debate on World Mental Health Day. Sitting in the Chamber are
Members from every corner of the country and from all sides of
the House—evidence that the mental health crisis is undeniably a
national one.
My constituents in Ipswich, under the Norfolk and Suffolk mental
health trust, suffer a particularly desperate service in an
already broken system. Since its creation in 2012, the Norfolk
and Suffolk foundation trust has been—it arguably still is—the
worst-performing mental health trust in the whole country. It was
the first mental health trust to be put into special measures, in
2015, and it was then put into the NHS recovery support programme
when the body was set up in 2021.
We are almost entirely accustomed to the slew of reports that
find that the trust “requires improvement” or is “inadequate”,
but time does not allow me to give a detailed overview of the
litany of failures that have brought us to this point. However,
there are two key tenets to the scandal. First, there is the
scandal of the perhaps euphemistically named unexpected or
avoidable deaths. The 2022 Care Quality Commission report found
that there were 155 such deaths in the two years preceding the
report, and the NSFT's own “Learning from Deaths” report admitted
to 418 unexpected unnatural deaths in a four-year period. Many of
those deaths were entirely avoidable suicides, some while
directly in the NSFT's care. Those numbers, even taken at face
value, which is unfortunately hard to do given the trust's
record, are emblematic of what my hon. Friend the Member for
Norwich South () aptly called the “slow-motion
disaster” of mental health care.
Secondly, there is the cruel detail of unrecorded or unaccounted
deaths, which led to thousands of people falling through the
gaps, left off official statistics and totted up retrospectively
as if they were a mere glitch in the system—the dead dehumanised,
lost and buried in spreadsheets. It is not right that, after
facing allegations as serious as the NSFT has faced, it should be
allowed to mark its on homework on the matter.
But with a new Government comes an opportunity for a new
approach. I therefore ask the Minister to meet me to discuss a
pathway to justice and to change Suffolk's mental health
services. This is the crux of the debate. The families who have
suffered so much deserve justice, and all my constituents deserve
change. Those two things are inseparable—we simply cannot have
one without the other—and there is no time to waste in delivering
them.
2.01pm
(Gateshead Central and
Whickham) (Lab)
It is a pleasure to serve under your chairmanship, Mr Dowd, in my
first Westminster Hall contribution. I declare an interest: I was
a former national officer for Unison, representing mental health
workers and others. I thank my hon. Friend the Member for Ashford
() for securing this important
debate, timely as it is on World Mental Health Day.
Improving support for mental health is one of the key
recommendations of Lord Darzi's report that the House discussed
on Monday—a damning read, yet completely unsurprising to any
patient who has engaged with the NHS in recent years. The surge
in demand in respect of mental health needs in children and young
people is not being met by community-based services, and Lord
Darzi's report found that after years of cuts the number of
mental health nurses has only just returned to 2010 levels.
Indeed, the Department of Health and Social Care's own dataset
shows that in the year 2023-24 in my community of Gateshead,
1,745 children and young people aged between nought and 17 years
of age were left waiting for first contact with child and
adolescent mental health services, having waited at least six
months since referral—every single one an individual suffering
and part of a family in my community being let down. At the same
time, only 60 children and young people in Gateshead received
that first contact within six months. Those figures reflect the
trend across the country, with 109,000 children and young people
under 18 waiting a year or more for first contact. That is why we
need more support for children in their communities and schools,
but without continuing to overstretch teachers. I welcome the
Government's commitment to roll out mental health councillors in
every school and mental health hubs in the community, to cut
through the backlog and ensure accessible support.
Lord Darzi's report identifies a worrying normalisation of long
waiting lists. I am in no doubt about the brilliant NHS staff in
Gateshead, and elsewhere across our country, who work tirelessly
day in, day out—something I know from personal experience. It is
not the fault of mental health workers, nurses or GPs but,
unfortunately, that of a decade of austerity and the top-down
reorganisation of our NHS. To quote Laura Bunt, chief executive
of the charity YoungMinds:
“Lord Darzi's review confirms what we know already–that young
people and their mental health have been severely let down by the
system there to support them.”
It is our opportunity and responsibility to put that right.
2.04pm
Dr (Gravesham) (Lab)
It is a pleasure to serve under your chairmanship, Mr Dowd. I
thank my hon. Friend the Member for Ashford () for securing this
afternoon's important debate.
As we know, one in four of us will deal with a mental health
issue at some point in our lives. As is the case across the
country, following the decade of under-investment that has just
been referred to, my constituents in Gravesham are concerned
about the difficulty of accessing the right support in good time,
without waiting on waiting lists for years. We can all agree that
mental health is just as important as physical health, and that
the strain on the NHS at this moment in time is enormous. The
system is very close to breaking point.
If the system is close to breaking, so are our young people. The
lack of open access to universal provision was, I think, touched
upon by the hon. Member for Hinckley and Bosworth (Dr Evans). It
is about having a safe place to discuss mental wellbeing so that
we prevent those people then needing further additional help.
In Gravesham, we are fortunate to have the Elliott Holmes
Memorial Fund, a community interest company that aims to give
direct access for counselling to young people in Gravesham. At
the moment, there are no people on the waiting list, because they
are being seen by dedicated counsellors. Based on national
statistics, 1,200 young people in Gravesham between the ages of
13 and 19 are struggling with their mental health, but the fund
has helped 271 young people since 2022.
I would like to place on the record my thanks to the fund for
providing a space for young people's issues to be heard. The fund
was set up in memory of Elliott Holmes, who tragically took his
own life in 2020 after suffering from mental illness for a number
of years. After his passing, his family set up the fund to try to
keep other young people from that path. I would like to thank
them for that.
I know that this Government are committed to addressing the
mental health crisis that we are facing, and I am pleased to see
that the King's Speech included specific mention of legislation,
in the form of a mental health Bill. In particular, I would be
pleased to hear what further things we can do to prevent this
deepening, worsening crisis.
2.07pm
(Leicester South) (Ind)
It is a privilege to speak under your chairmanship, Mr Dowd.
I concur with everybody in thanking the hon. Member for Ashford
() for securing this vital
debate. I want to touch on something he said about ethnic
minorities. According to all the information we have, people from
all ethnic minorities are detained under the Mental Health Act
1983 at much higher rates than any other people. Furthermore,
they have the worst experiences and the worst outcomes. Would the
Minister please look into the issue and see to it that our
fantastic healthcare workers, whether they are in the education
sector or in the health service, look into this vital issue, and
are culturally sensitive when dealing with people from ethnic
minorities?
2.08pm
(York Central)
(Lab/Co-op)
It is a pleasure to see you in the Chair, Mr Dowd. I think we all
agree that, in introducing this debate, my hon. Friend the Member
for Ashford () gave an incredible speech,
as all contributors have.
I want to talk a little bit about the transitional approach that
we are taking in York, following the Trieste model. It is seeing
a real transition, in the way the Health Secretary has described,
from secondary care, which we know is just not able to cope with
the capacity and demand that is placed on it, into a more
primary-care and socialised setting. It is really transformative
for the people in my city.
We are setting up community mental health hubs in my city. We
have one, and we are going to have two more to follow, with one
working 24/7. The model is co-produced and multi-agency, and is
moving to provide open-access support to help people to manage
their own mental health challenges, with interventions from
health professionals, social prescribing and peer support, and to
look at issues around welfare, debt and employment support.
Particularly in respect of community outreach, the hub is taking
people who feel so neglected, because there just is not the
capacity, into a space where they can get support and then
progress on with their lives. It is centred around a café where
people are encouraged to engage and talk. The café is run by
service users, so it is a wholly-owned model, and it is
incredibly successful.
The Trieste model is considered one of the best models of service
provision in the world because of its emphasis on integration
with the whole community and with the self, with professional
support at hand if needed. In Trieste, very few depend on
secondary care or acute psychiatric care, and residential
placements are few and far between. We need to look at that,
particularly in respect of the transitions and the Government's
ambition. Following a social model means we do not pathologise
mental health but deal with it and help people to build on their
strengths and to build resilience into the future.
Our programme is linked with the local university, York St John
University, which runs the Converge programme that enables people
to use education not only as a way to deal with their mental
health issues but to learn new skills and feel included in our
community. It contrasts so much with the traditional model, which
we know just is not functioning given the demand on services. I
therefore urge the Minister to have a look at what is happening
in Trieste and to come and have a look at what is happening in
York. Let us put this into a model in which people live with
mental health as opposed to struggling with it.
2.11pm
(Hastings and Rye)
(Lab/Co-op)
It is a pleasure to serve under your chairmanship, Mr Dowd. I
thank my hon. Friend the Member for Ashford () for securing this important
debate on such an important issue. I speak for many when I say
that we are lucky to have his experience in the House; he has
such expertise in mental health. We are all here because for too
long mental health has not been given the same focus as physical
health. It has not been given the same funding or the right
focus, and there has been far too much stigma in talking about
it.
In my Hastings and Rye constituency, too many children and young
people are waiting far too long for mental health support. That
is why I am really pleased to see this Labour Government's focus
on children's mental health and cutting NHS waiting lists,
putting more mental health specialists into schools in
particular, and hiring 8,500 mental health specialists into our
NHS to cut waiting lists.
I recently attended a memorial for Phoebe, who sadly took her own
life in Hastings this July. Phoebe was aged just 14. She had been
on a child and adolescent mental health services waiting list
since January, and she never got the support she needed. She
never got that appointment with CAMHS. Her mum Tamzin and her
whole family are now showing amazing courage and amazing strength
in channelling this tragedy and their grief into campaigning to
make sure that this never happens to any child again, and that we
get more focus on children and young people's mental health.
I thank all the charities that are working on this issue in all
our constituencies, and I thank all the mental health workers who
work so hard to provide the support that is needed. In my
Hastings and Rye constituency, Eggtooth is a local mental health
charity that provides vital support and early intervention for
around 250 children in Hastings and Rother a year. I have been
contacted by many parents and healthcare professionals who are
extremely concerned to hear that the funding for Eggtooth is now
under threat from the local NHS integrated care board.
Does my hon. Friend agree that charities in her constituency, in
mine and in so many others provide the valuable resource that
helps us to deal with the crisis in CAMHS?
Absolutely. I thank my hon. Friend for that important point
recognising the important contribution that so many charities and
staff make.
I am extremely concerned to hear that Eggtooth's funding is now
at risk and I wish to share with Members some of the views of
local healthcare professionals about the importance of the
service. A local doctor says:
“The withdrawal of Eggtooth from children's mental health
services in Sussex would leave a profound gap in support for
vulnerable young people.”
A local paediatric nurse says:
“I have stories to tell which I cannot share where children and
young people have been helped…I worked in acute emergency
settings and safeguarding previously and often saw the outcomes
of no intervention.”
That nurse makes a vital point about the importance of early
intervention, as have many Members. We know that to intervene
early is better for the young person, and we know it will cost
the taxpayer less. To give an example, the support that Eggtooth
provides costs around £520 per child. By contrast, a CAMHS
referral costs almost £2,500, and an A&E intervention, should
that be needed, costs even more. I urge the integrated care board
to reconsider the decision.
I strongly welcome the Labour Government's commitment to cut NHS
waiting lists, cut mental health waiting lists and focus on early
intervention, particularly in schools, where we need it the most.
It is on all of us in this House to keep alive the memory of
Phoebe and that of all those who have lost their lives to
suicide.
2.15pm
(Chatham and Aylesford)
(Lab)
It is a pleasure to serve under your chairmanship, Mr Dowd. I
thank the many Members from across the Chamber for their
contributions, and I particularly thank my hon. Friend the Member
for Hastings and Rye (), who spoke about one of
her constituents, Phoebe. This year's World Mental Health Day
theme is about the link between safe and healthy workplaces and
safeguarding mental wellbeing, while unhealthy environments
marked by stigma and harassment can harm it. Poor mental health
not only affects individuals and their families but leads to
reduced performance, absenteeism and high turnover rates. I
therefore welcome the global campaign to challenge absenteeism
and the impact of mental health. Across the world, 12 billion
days are lost annually to these issues, costing the global
economy $1 trillion.
In my area, NHS Digital data and the House of Commons Library
show that mental health provision is not sufficient. We see an
increasing reliance on primary care services and an inability of
secondary care services to deal with the increased pressures.
Across the three key areas linked to diagnosis of depression,
17.3% of residents above the age of 60 in my constituency in Kent
now have a diagnosis. Dementia is a rising challenge, with 24,000
people in Kent and Medway and nearly 1 million people in the UK
experiencing it. As my colleagues have said, there are also
concerns around mental health provision for young people, with
13,000 children and 14,000 adults waiting for neurodivergent
condition tests, and ADHD and autism CAMHS referrals rising by
some 600%.
I welcome the Government's commitment to mental health, both in
the Darzi report and in updating the Mental Health Act 1983.
Within that, will the Minister review how we invest in mental
health care and infrastructure alongside the Darzi report, with
the mental health investment standard for capital spending, and
will he urgently reflect on how we effectively give hospitals
extra support with other standards? Will he also consider how we
can improve patient flow in hospital services, with support for
initiatives such as Right Care, Right Person, which has been
adopted by Kent police; specific and targeted mental
health-related discharge packages with support and home care; and
an expansion of psychological therapies for those with severe
mental illness?
Lastly, I welcome the intervention in schools with an increased
provision of specialist mental health support. Can we also look
at utilising other approaches to reduce waiting times for CAMHS,
as my hon. Friend the Member for Hastings and Rye mentioned, and
to reduce the stress on parents of navigating a special
educational needs system that is not fit for purpose? The
Government have made the necessary and correct interventions to
improve our health services, but a long journey remains
ahead.
2.18pm
Dr (Stroud) (Lab)
On World Mental Health Day, I am wearing this slightly ghastly
yellow tie. May I also do a little promotion? In room M in
Portcullis House at 3 o'clock, at the end of the debate, we have
some young people, through YoungMinds, telling us what they think
of the service. It is really important, particularly with young
people, to make sure that we develop services that they want and
that we do not dictate.
I am still a practising GP in Stroud. More than 90% of mental
health consultations take place in primary care and more than 40%
of GP consultations concern mental health. I am sure the hon.
Member for Hinckley and Bosworth (Dr Evans) will concur with me
on that front. I would like to divide mental health into two
sections. There is serious mental illness, which is serious and
enduring, affecting about 130,000 people in this country. I will
make a little plug: they tend to die 10 to 20 years earlier than
other people and we must promote their physical health.
The other area is anxiety and depression. We have 8 million
people in this country on antidepressants—selective serotonin
reuptake inhibitors—and at least 2 million of them are trying to
get off. We need to ensure we do not over-medicalise mental
health. I was pleased to hear what my hon. Friend the Member for
Ashford said about mental wellbeing and mental health. We all get
a bit pissed off sometimes—that is normal for humans—and it is
extremely important that we do not conflate that with mental ill
health.
May I just say how much I agree with that remark? We may disagree
about resourcing and what has happened over the past 14 years,
but we need the confidence to talk about building resilience and
prevention so that people do not get to the point where they need
medical intervention. We have the responsibility to talk about
that in this place and in our communities so that we get to the
root causes, which are not always to do with socioeconomic
matters.
Dr Opher
Absolutely; I fully agree with that.
I want to make a couple of comments about the state of mental
health services, for which there are extraordinary waits: a
patient of mine had to wait six months following a suicide
attempt. That is simply not good enough. In Stroud, we have to
wait four years for neurodiversity assessments because we do not
have enough resource. In my opinion, we need to move the resource
into the community.
I also support what my hon. Friend the Member for Ashford said
about health and education. We need mental health support teams
in our schools, and we must spread SEND provision evenly.
The Under-Secretary of State for Public Health and Prevention is
with us, so I want to talk about the prevention of mental health
issues. There is quite a lot of evidence about promoting maternal
and infant mental health, and also about parenting and bullying
at school. Using arts and culture is an incredibly strong way of
improving mental health.
I was impressed with what my hon. Friend the Member for York
Central () said about the community
basis of mental health treatment. For many lower-level
conditions, there is no need for consultant-led care. Support
that takes place in the community costs much less and can be
really effective.
The CAMHS waiting list is appalling, and we have a crisis with
SEND and delays with education, health and care plans. We do not
have enough educational psychologists either. I want to stress
what my hon. Friend the Member for Ashford said about care
co-ordinators. Young people's social prescribers are very
effective and tend to de-medicalise things that can be supported
in the community.
I am really impressed that we are going to get 8,500 more mental
health workers. I am also impressed by what they will be doing in
schools. We need to improve the physical health of people with
serious mental illness, reduce the number of SSRI antidepressant
medications, and promote social prescribing, the arts and
community care in our mental health services.
(in the Chair)
Can I just remind Members about modes of expression? I will be
diplomatic about it.
2.23pm
(Darlington) (Lab)
I rise to speak about this issue on World Mental Health Day. I
have championed it many times across my career and I will
continue to do so in my time in this place.
My constituents—and, I am sure, those of all hon. Members—want
something that we used to take for granted: a happy, decent life,
with a better future for their children. For too many in
Darlington, that is not the reality, and I believe that the
current mental health crisis is a product of our times. I will
focus my brief contribution not on those with severe mental
illness, who are often in crisis, but on those who are struggling
with day-to-day poor mental health.
I agree with the hon. Member for Hinckley and Bosworth (Dr
Evans), who advocated a cross-departmental approach. Poor mental
health is pushing people out of work, and that is a huge issue
for the Treasury and the Department for Work and Pensions. A lack
of child mental health support and a failure to tackle the online
safety crisis for children is leading to school refusals, which
is an issue not only for the Department for Education but for the
economy and for future generations. Loneliness is impacting the
physical health of our older people, which is an issue for the
NHS. The lack of opportunity, quality work, maternal mental
health services, veteran support and childcare support is driving
people in my constituency to despair.
I have mentioned this before, but I will mention it again on this
day: within my own network, I have lost seven men to suicide.
Only one of them had a severe mental illness. In my region, we
have the highest rate of male suicide and the lowest wages. I ask
that we, as a Government who are committed to equality of
opportunity for our regions, consider my constituency and my
region for a cross-departmental pilot to tackle poor mental
health before we lose any more people to avoidable deaths.
(in the Chair)
I now come to the Opposition spokespersons.
2.25pm
Dr (Winchester) (LD)
Thank you, Mr Dowd, for calling me to speak.
As a veterinary surgeon, I come from a profession that has a
suicide rate four times the national average. Like many people in
this Chamber, I have experienced the pain of losing friends and
colleagues to suicide. That led me to become a trustee of a
mental health charity for several years, and I am honoured to be
the spokesperson on mental health for the Liberal Democrats.
Although we have undoubtedly focused on NHS clinical services in
this debate, we often underestimate the profound impact that
non-medical issues, such as living in poverty, financial worries,
debt and insecure housing, can have on mental health and how they
can hinder people's recovery from a mental health crisis.
I am incredibly proud of a project that I visited just last week
in my constituency of Winchester that is run by Melbury Lodge
mental health hospital and the citizens advice bureau in
Westminster. This project provides one-to-one advice and support
to in-patients on matters relating to living in the community,
from relationship and financial advice to management of debt and
benefits and housing problems. Someone who ends up being admitted
to a mental health unit will find that their post—correspondence
relating to their benefits, mortgages and other bills—all goes to
their home address, and if nobody else lives there, they will not
receive any of it. When they are discharged, they may get out and
find that there is a problem with their benefits, or that they
have received a huge bill that they were not expecting.
Amazingly, the Melbury Lodge and Citizens Advice team have
demonstrated that for every £1 spent on this project, the NHS
system avoids spending on average £14.06, which is a huge return
on investment. As we extrapolate out, the research shows that
having the Citizens Advice service on site means that Melbury
Lodge has avoided spending nearly a quarter of a million pounds.
This cost avoidance is achieved through shorter in-patient stays,
fewer readmissions, reduced medication and better engagement with
community services. That is a staggering amount of money that can
now be spent directly on clinical care. I urge the Government to
look at the results of this initiative with a view to rolling it
out in other parts of the country, because it is good for
patients, good for NHS staff and good for the taxpayer. I am
really excited that this project has been shortlisted for an NHS
parliamentary award next week, and I look forward to supporting
the team in person.
We need to acknowledge the impact that the lack of mental
healthcare has on other public services. When I go out with the
police in Winchester, they tell me that they spend between 40%
and 50% of their time dealing with mental health issues in some
capacity.
The hon. Member for Hastings and Rye () mentioned the cost when
people in a mental health crisis, who are often already on a
mental health waiting list, arrive at accident and emergency
departments. One of the biggest issues raised with me by parents
in Winchester is the huge delay for children who are waiting for
diagnoses of ADHD and autism.
The hon. Member for Ashford () has already mentioned that
the Darzi report acknowledged that 20% of the NHS disease burden
is due to mental health issues.
Does the hon. Member agree that too often people confuse
neurodiversity, which we should celebrate; severe mental illness,
which we need to support people with and help them manage; and
poor mental health, which is a day-to-day thing that can often be
caused by circumstances?
Dr Chambers
That is a good and important point. We also need to acknowledge
that people with certain issues—neurodiversity, undiagnosed ADHD
or autism—who do not get the support they need are more likely to
develop mental health issues as a result. It is a bit of a
chicken-and egg-situation.
Finally, as I was saying, only 10% of the NHS budget is for
mental health, but it is 20% of the disease burden. The obvious
question people ask is: how do we afford that? When I look at the
pressure on the police, A&E and the education system, the
question I would ask is: how can we afford not to treat mental
health properly?
2.30pm
Dr (Runnymede and Weybridge)
(Con)
It is a pleasure to serve under your chairmanship, Mr Dowd. I
start by declaring that I am a former consultant psychiatrist and
that a family member is a consultant psychiatrist.
Listening to this debate has been a mixed experience. It has been
great to hear the wealth of talent and expertise that we have in
the House, but at times it has been harrowing to hear people
speak about their personal experiences or those of their
constituents. That is a reminder to us all of just how
substantial the impact of mental illness can be on people—our
families and friends. The tone in which this very sensitive
debate has been conducted is fantastic.
I thank the hon. Member for Ashford () for bringing forward this
debate, for the wealth of experience—22 years—that he brings to
this place, and for a very balanced speech in which he
acknowledged the catchment investments under the previous
Government and raised the importance of waiting lists. When I was
first elected, I brought up targets for mental health in a
private Member's Bill, which did not end up going anywhere, on
waiting times for getting an in-patient bed when one is requested
for somebody with a mental disorder. Of course, we all want
improvements in mental health care and treatment, and there need
to be improvements in mental health care and treatment. I am sure
there will be no disagreement across the House about that.
The hon. Member for Ashford was absolutely spot on to mention
housing, work and benefits. It is a testament to his experiences
in psychiatric nursing that he went on to mention the surrounding
holistic care. One of the challenges of debates on improving
mental health services is that we must acknowledge that that
involves many other areas of public policy, public provision and
cultural factors, and try to broaden that as much as
possible.
Dr Evans
The former Member for Doncaster, who is now sadly not in this
House, was a significant champion for men's and boys'
health—suicide in particular, which has been mentioned here, is
such a problem. My hon. Friend stated the case for mental health
being a pan-Government policy area—does he believe that
strengthens the argument for having a Minister for men and boys
to go across Government and think about all these issues,
especially as suicide is the leading cause of death for young men
under the age of 45?
Dr Spencer
My hon. Friend is absolutely right to point out that, sadly,
suicide is the No.1 cause of death among young men. My
understanding, although the stats change all the time, is that
below the age of 45, suicide is the No.1 cause of death among
both men and women. It is absolutely right that we look at
sex-specific approaches to intervention. Factors affecting health
in men will be different from factors affecting health in
women.
I want to go back to the social elements of mental health care,
which the hon. Member for Ashford mentioned, and a smoke-free
society and banning tobacco. Certainly when I was practising, 50%
of tobacco was consumed by people with a severe mental illness.
That raises a whole host of concerns and issues about what is
happening with tobacco consumption and people with a mental
disorder.
My hon. Friend the Member for Hinckley and Bosworth (Dr Evans)
was absolutely right, given his experience, about something he
has mentioned many times in the House: the importance of
delineating mental wellbeing and mental illness. I tend to think
about it in this way: we all have mental health, but we need to
separate mental wellbeing from mental illness. The two are
different and need different approaches, as was echoed by my
right hon. Friend the Member for Salisbury () and the new hon. Member for
Stroud (Dr Opher), who gave rise to a very fertile discussion on
his views on the area. The hon. Member for Leicester South
(), who is no longer in his
place, rightly pointed out inequalities in detention and outcomes
for those from minority ethnic backgrounds. That is a very
important issue.
That brings me on to our record in Government over the past 14
years; there are a few things I want to pick out. One is that we
set parity of esteem in law through the Health and Social Care
Act 2012, which was a big step forward. We still need parity of
esteem in outcomes, but nevertheless that was a very important
step. We expanded access to psychological therapies and I am
particularly pleased by the expansion of individual placement and
support, which has been shown to help people get into work,
particularly those with a chronic and enduring mental illness. We
have seen more people take up maternity care, and we also
invested in the mental health estate.
In fact, in my own constituency, we have a new mental health
hospital. The Abraham Cowley Unit is being rebuilt, which will
provide world-class care for people living in my patch. Perhaps
most important of all, given the conversation that we have had
today, is the decrease in in-patient and out-patient suicide that
we have seen over the years. Of course, I recognise that there
are a variety of factors driving that but we should be pleased
that things are moving in the right direction on suicides,
although there is more to be done.
Today is World Mental Health day and it is a very broad topic,
but in my time I would like to focus specifically on one area
that, as it certainly was in my former career, is often
neglected—psychosis. It particularly affects people suffering
from schizophrenia or bipolar affective disorder. It can be a
very disabling illness and has been responsible for quite a
degree of disability and health concern in the UK. Often debates
such as these, and debates in the media, do not focus on
psychosis and I think a big part of that comes from the stigma
attached to it. People who work in the sector, and those with
expertise here, will know that it is an area of great need both
in terms of community mental health teams and in-patient
settings. The hon. Member for Stroud was absolutely right and I
am glad he pointed this out: the 10 to 15 years of life lost
following a diagnosis of psychosis is something that we have to
fix.
I believe that we also need to improve access to treatments such
as clozapine, which is an excellent treatment for schizophrenia.
I am pleased to have previously worked with Clozapine Support
Group UK in its campaign to try to get more access to clozapine
for people for whom it is indicated. We have also seen the reform
of the Mental Health Act 1983, which the former Prime Minister
kicked off with the Wessely
review. I was part of the working groups on the Wessely review,
particularly looking at helping with the tribunal system, and I
was on the pre-legislative scrutiny committee as well. How we
look after people detained for treatment in the absence of
consent is very important, and I am pleased that this Government
have committed to take forward the work on reviewing that
Act.
I thank everyone who works in the care and treatment of people
with mental illness. As we have heard today, that is a very broad
sector; it is not only people who work in the NHS but those who
work in the third sector in a variety of organisations and
institutions. That is very important work.
(Doncaster East and the Isle
of Axholme) (Lab)
Will the hon. Member give way?
Dr Spencer
Very briefly—I have only a couple of minutes left.
My cousin died from suicide two years ago. We have talked about a
lot of facts and figures today, and we have talked a bit about
heart, but I can absolutely tell the hon. Member that a family
never recovers from that. My auntie and uncle will never recover
from the fact that they lost their child before they themselves
went.
All a person can do in that situation is put their energy into
something positive, and that is about how to help people going
forwards. One of the big things is absolutely those charities
that support people, such as the Jackson Hope Foundation. I have
gone along and spoken there myself even this last Friday, and I
talked about some of my experiences in Parliament really openly
and freely. It is a safe place. There are 16 men there talking
unbelievably openly about how they feel, and it makes such a
difference. I want to ensure that going forwards, whatever we do,
learning from those groups feeds into our plans and strategies
because it makes all the difference to people.
Dr Spencer
I thank the hon. Gentleman for sharing something so personal in
his intervention, and for sharing his experience of the impact of
suicide. Many Members have shared personal experience in this
debate. That is very important.
I am mindful that there will be people in the Gallery or watching
at home who may be affected by the topics we are discussing, and
I take a moment to point out that there are a variety of services
to help people in their recovery, if one can call it that, after
a loved one has tragically died from suicide, or to help people
who are in crisis, such as local crisis services, the Samaritans
or Mind. There is a variety of third sector and charity helplines
that can help. Men's Sheds is one organisation I know of that is
very helpful. I am really pleased that the hon. Gentleman raised
this issue.
I will finish with a few questions for the Minister. The
Government do not have a mental health care and treatment
strategy or a psychosis strategy and, following an answer to a
written parliamentary question I tabled, I understand that there
are no plans for a mental ill health strategy to be brought in.
Given today's debate, I wonder whether the Minister will
reconsider that position. What are the Government's plans on
taking forward our suicide prevention strategy, or a specific
psychosis or mental ill health strategy—however he wants to cut
the cloth?
Secondly, when does he expect the Mental Health Bill to have its
First Reading in this place? All Members are going to want to
extensively debate and scrutinise that Bill. When does he expect
it to come forward? What is his appraisal of the challenges that
the Bill needs to answer when it comes to the interaction between
the Mental Health Act 1983 and the Mental Capacity Act 2005 and
the deprivation of liberty safeguards? What about the MM case on
deprivation of liberty in the context of a restricted patient in
the community, and the interaction with the Children's Act 1989
on when children can choose a nominated representative? I realise
he may not have the answers to that immediately, but I would be
grateful if he could write to me. Community mental health teams
are the core of psychiatric teams in the community and our
psychiatric care and treatment service. What is his plan to
support them?
Finally, what is his appraisal of integrated care systems and
their commissioning of mental health services? The hon. Member
for Hastings and Rye () mentioned the challenges
with her ICS. What is the Minister's appraisal of that
commissioning and how integrated care systems can be held to
account to make sure that is being delivered?
(in the Chair)
I want to give the sponsor an opportunity to wind up at the end.
I call the Minister.2.43pm
The Parliamentary Under-Secretary of State for Health and Social
Care ()
It is a pleasure to serve under your chairmanship, Mr Dowd, and
it is also a pleasure to respond to this debate on World Mental
Health Day. I am grateful to my hon. Friend the Member for
Ashford () for securing the debate and
for drawing on his long-standing experience of working in mental
health care to raise so many important points in the debate. As
several others have, including the shadow Minister, I thank
everybody who works in the field of mental health, whether as a
mental health practitioner or as one of the very many volunteers
who give up their time freely to help people who are facing
particular difficulties in their lives.
I am responding to this debate on behalf of , the Minister with
responsibility for mental health, so apologies if I do not answer
everybody's questions. I have taken copious notes and am sure
that the powers that be sitting behind me have taken even more.
If I do not answer all the points raised, Members can expect to
receive something from the relevant Minister in due course.
It has been a great debate. I thank my hon. Friend the Member for
Folkestone and Hythe () and the hon. Members for
Epsom and Ewell () and for Hinckley and
Bosworth (Dr Evans). The latter made a really important point
about the interrelationship between education and health in the
whole sphere of special educational needs, autism and so on. I
reassure him and others who made that point that the beauty of
being part of a mission-led Government that has five missions—one
is the health mission and another is the opportunities mission—is
that it allows Ministers the opportunity to look at things in the
round and break out of departmental silos. I assure him that on
these issues I am having bilateral meetings with counterparts in
the Department for Education about how we drive forward key
elements of the health mission, and also about the role that the
Department of Health and Social Care can play in achieving the
Government's opportunities mission. That work is taking place at
departmental level.
I thank my hon. Friend the Member for Gateshead Central and
Whickham () for his contribution, and
the hon. Member for Leicester South (), who is not in his place but
made some really important points, particularly about the impact
of the Mental Health Act on black and minority ethnic groups. I,
and the Government, think it is shameful that under the existing
Mental Health Act black people are three and a half times more
likely to be detained than white people and eight times more
likely to be placed on a community treatment order. Our mental
health Bill will give patients greater choice and autonomy and
enhanced rights and support, and we will ensure that it is
designed to be respectful in terms of treatment with the aim of
eradicating inequalities. I put that on the record because the
hon. Member for Leicester South made an important point.
I thank my hon. Friends the Members for Gravesham (Dr Sullivan)
and for York Central (). My hon. Friend the
Member for Hastings and Rye () made a powerful
contribution about Phoebe and about her ICB—I hope the ICB has
listened. My hon. Friend the Member for Chatham and Aylesford
() made a contribution, as
did my hon. Friend the Member for Stroud (Dr Opher). I reiterate
to him that of course the arts have a powerful role to play in
the health and wellbeing of the individual. I was fortunate last
Friday to see the Manchester Camerata, one of the great
orchestras in my home city, at the Gorton Monastery in my
constituency, which is now a health and wellbeing hub. As well as
understanding the work that it does, I also learned a lot more
about social prescribing and about its powerful listening
service.
(Dudley) (Lab)
As an NHS physiotherapist working in Dudley, I know very well
that mental health is multifaceted. It affects not just one part
of a person's life, but everything: sleep deprivation, diet,
overeating, undereating and building relationships. Does the
Minister agree that we need more care in the community, including
first contact practitioners, social prescribers and councillors
in the community as the first line of treatment?
My hon. Friend is absolutely right. At the heart of the health
mission that the Labour Government want to see is the shift from
hospital to community, from analogue to digital and from sickness
to prevention. What we do in the community really matters. Our
ambition for the future of mental health services is wrapped up
in those shifts, particularly the shift from hospital to
community.
Could I share my experience as a Minister? When we looked at
social prescribing when I was in the Treasury, it was always
difficult to establish an evidence base to justify the allocation
of resources. I urge the Minister to continue that battle to make
the case, because I am sure that the instinct of all Members
throughout the House is that there is something in that ambition,
and we must find a way of unlocking it so that we can get social
prescription out into the community where a variety of provision
is available.
The right hon. Gentleman is absolutely right. That will be one of
the big challenges with the prevention agenda more generally,
because often the investment we have to make today does not pay
dividends immediately and there is a bit of a punt. Having been a
Treasury Minister, he will know the challenges that that can
present to the Treasury orthodoxy, but we have to push on this
agenda.
I always say that being an MP and a GP is only one letter apart.
We are often dealing with the same people who present with the
same problems but from a different angle. We go away as Members
of Parliament trying to fix the issue as they have presented it
to us, and the GP will write a prescription and send them off
having sorted out the issue as it was presented to them. However,
the beauty of social prescribing is that there is an opportunity
to deal with the whole issue in the round. The argument has been
won with almost everybody, and any tips from the right hon.
Member for Salisbury () so we can get this over the line
with the Treasury will be welcome.
I should mention my hon. Friend the Member for Darlington (), and welcome the hon. Members
for Winchester (Dr Chambers) and for Runnymede and Weybridge (Dr
Spencer) to their Front-Bench positions.
In the minutes I have left, I want to say to the House that many
of the issues raised by Members during the debate are symptomatic
of a struggling NHS. If we look at the figures, the challenges
facing the NHS are sobering. In 2023, one in five children and
young people aged eight to 25 had a mental health problem, which
is a rise from one in eight in 2017. The covid-19 pandemic has
exacerbated need, with analysis showing that 1.5 million children
and young people under the age of 18 could need new or increased
mental health support following the pandemic.
Dr
I want to raise an issue as the Minister is the Minister
responsible for prevention. One of the biggest and most shocking
things we saw during the pandemic was the increase in eating
disorders, which is a very difficult topic for any Government
around the world to try to break down. We know that the impact of
eating disorders lives with people for the rest of their life and
can cause them to lose their life, so will the Minister ensure
that they are looked at as a priority? There was previously a
roundtable; will he look into doing something similar again to
bring experts together?
I am reluctant to commit Ministers to roundtables when I am
covering another portfolio, because then they will do the same
when they cover me in Westminster Hall debates, but I will say
that we take this agenda incredibly seriously. When we were in
opposition we gave support to the then Government, and I assure
the hon. Gentleman that we will do everything we can to support
people who have eating disorders and to get the right provision
and support at the right time to the people who need it.
As I was saying, the covid-19 pandemic has exacerbated the need
for mental health support. Around 345,000 children and young
people were on a mental health waiting list at the end of July
this year, with more than 10% of them having waited for more than
two years. Some groups of children and young people are
disproportionately impacted by mental health problems largely
driven by a complex interplay of social and environmental
determinants of poor mental health, as we heard in the
debate.
We are committed to reforming the NHS to ensure that we give
mental health the same attention and focus as physical health. It
is unacceptable that too many children, young people and adults
do not receive the mental health- care that they need, and we
know that waits for mental health services are far too long. We
are determined to change that, which is why we will recruit 8,500
additional mental health workers across child and adolescent
mental health services. We will also introduce a specialist
mental health professional in every school and roll out Young
Futures hubs. We are working with our colleagues at NHS England
and in the Department for Education as we plan the delivery of
those commitments.
Early intervention on mental health issues is vital if we want to
prevent young people from reaching crisis point. Schools and
colleges play an important role in early support, which is why we
have committed to providing a mental health professional in every
school. However, it is not enough to provide access to a mental
health professional when young people are struggling; we want the
education system to set young people up to thrive, and we know
that schools and colleges can have a profound impact on the
promotion of good mental health and wellbeing. Doing this will
require a holistic approach, drawing in many aspects of the
school or college's provision. I know there are many schools that
already do this work, and my Department is working alongside the
DFE to understand how we can support best practice across the
sector.
As I have said, our manifesto commits us to rolling out Young
Futures hubs. This national network will bring local services
together and deliver support for teenagers who are at risk of
being drawn into crime or who face mental health challenges. The
hubs will provide open-access mental health support for children
and young people in every community.
On other aspects of our plans, the mental health Bill announced
in the King's Speech will deliver the Government's manifesto
commitment to modernise the Mental Health Act 1983. It will give
patients greater choice, autonomy, enhanced rights and support,
and it will ensure that everyone is treated with dignity and
respect throughout their medical treatment. It is important that
we get the balance right to ensure that people receive the
support and treatment they need when necessary for their own
protection and that of others. The Bill will make the Mental
Health Act 1983 fit for the 21st century, redressing the balance
of power from the system to the patient and ensuring that people
with the most severe mental health conditions get better and more
personalised care. It will also limit the scope to detain people
with a learning disability and autistic people under the 1983
Act.
Finally, Lord Darzi's report identified circumstances in which
mental health patients are being accommodated in Victorian-era
cells that are infested with vermin, with 17 men sharing two
showers. We will ensure that everyone is treated with dignity and
respect throughout their treatment in a mental health hospital,
and we will fix the broken system to ensure that we give mental
health the same attention as physical health.
If I have not answered Members' questions, those Members will be
written to by the relevant Minister. I again congratulate my hon.
Friend the Member for Ashford on securing the debate.
(in the Chair)
I call to wind up very briefly.
2.58pm
I thank the Minister for his brief answer, and I thank the shadow
Minister and the Liberal Democrat spokesperson for their
responses to the debate. I also thank the other Members who took
time out of their busy schedule to be here.
I thank all the organisations that contacted me in advance of the
debate. There are too many to mention them all, but they include
the Education Policy Institute, the Royal College of Paediatrics
and Child Health, the Royal College of Psychiatrists, the Royal
College of Nurses, the Children and Young People's Mental Health
Coalition, the British Association for Counselling and
Psychotherapy, the Maternal Mental Health Alliance, YoungMinds,
the King's Fund and, finally, Flourish, which is based in my
Ashford constituency. I hope that the Department of Health and
Social Care will actively engage with these organisations from
across the sector to draw on their knowledge and experience.
Question put and agreed to.
Resolved,
That this House has considered improving support for mental
health.
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