Asked by
To ask Her Majesty’s Government what steps they are taking (1) to
protect, and (2) to support, mental health services (a) during,
and (b) after, the COVID-19 pandemic.
The Question was considered in a Virtual Proceeding via video
call.
The Parliamentary Under-Secretary of State, Department of Health
and Social Care ()
(Con)
My Lords, the NHS has issued guidance to services to support them
in managing demand and capacity across in-patient and community
mental health services. Services have remained open for business
as usual as a result. We remain committed to the additional
investment in mental health services set out in the NHS long-term
plan. We have provided an additional £5 million to mental health
charities to support their work during the pandemic.
(LD)
My Lords, the Royal College of Psychiatrists warned last week
that the nation faces a mental illness “tsunami”. Those on the
front lines of our health and social care services have gone
above and beyond to tackle this dreadful virus, but now may
themselves face significant mental health problems. Thousands
have lost colleagues, endured serious illness or experienced
major trauma. Will the Government commit to investing in a
world-class mental health response to Covid-19, including by
setting up specialist support services for those on the front
line of our NHS and care services, mirroring the services
available to our armed services personnel?
I join the noble Baroness in paying tribute to those working in
mental health in the NHS. They have kept services running in
extremely difficult circumstances and their impact has been
extremely powerful. Although we are aware of the deep threat of a
mental health tsunami, as was warned, the evidence to date is
that these people have done an amazing job of addressing the
concerns of those who are suffering under coronavirus and the
lockdown.
(Lab)
My Lords, does the Minister accept that the implications of the
Covid-19 pandemic include loneliness, a sense of entrapment,
income and employment insecurity, substance abuse, relationship
problems, bereavement and other factors that are liable to be
severe? Resources will be needed for many interventions. Is he
aware of the growing evidence base on the important benefits of
the arts and creativity for mental health? What plans do
Ministers and NHS England have to accelerate the spread of social
prescribing, supporting people with mental health conditions to
engage creatively with the arts, culture and nature?
My Lords, I completely recognise the noble Lord’s warnings. He
rightly warns about the huge pressure of lockdown on people, and
rightly mentions the benefits of the arts—particularly social
prescribing, of which I am particularly supportive. I pay tribute
to the Permanent Secretary of the Department of Health and Social
Care, who has allowed me to bring Tilly, my working cocker
spaniel, into the office to provide me and my fellow workers with
some kind of support from an animal. I know that canine support
is valuable. We are working hard to support the kind of social
prescribing of which the noble Lord speaks.
(Con)
My Lords, this is an interesting area which I was concerned with
both in my former role as Victims’ Commissioner for England and
Wales, and personally. As well as viewing mental health services
through Covid, we must recognise the risks to pre-existing
services, which were an underfunded postcode lottery with not
enough qualified professionals. Our front-line workers are now
dealing with a pandemic that none of us could envisage. Will the
Minister speak to the Secretary of State for Health to ensure
sustainable funding for access to mental health services, and
that support is given to mental health workers, who will be the
front-line workers again? We must ensure that people’s ability to
access the services does not just become a tick-box system
governed by an algorithm within an app. There has to be
sustainable funding for a least five years to invest in the care
and support needs of the most vulnerable in society.
I recognise the insight of my noble friend Lady Newlove, who
speaks from experience of these matters. I reassure her that the
funding in place from the long-term plan for mental health has
been substantial and will support a dramatic change in mental
health services. We will be supporting mental health workers who,
as my noble friend says, have delivered under difficult
circumstances. Their creativity is demonstrated by the
introduction of video and other technical facilities to keep
mental health services going during the lockdown. I pay tribute
to their inventiveness and creativity at this time.
(LD)
My Lords, is data on mental health support, A&E
presentations, referrals to community mental health services,
crisis resolution callouts and detentions under the Mental Health
Act being collected during this period—yes or no?
My Lords, I understand that it is a firm “yes”, but I will check
that answer and revert to the noble Baroness if there is any
different information.
(CB)
My Lords, yesterday the Guardian reported a study by Public
Health England which showed that agency staff working between
multiple care homes in London were unwittingly spreading Covid-19
during the surge of the pandemic. Given the evidence of the
vulnerability of those receiving care, which includes working-age
adults with mental health needs, is there really a commitment to
parity of esteem between physical and mental healthcare? Why has
the testing strategy not been amended properly to cover these
groups?
The noble Baroness rightly points to one of the most difficult
aspects of the Covid epidemic—the itinerant staff who pass from
one vulnerable person to the next. We recognised this issue at
the beginning and put money in to try to ameliorate it. When
testing was expanded weeks ago to key workers, it was
deliberately targeted at these staff and this continues to be
prioritised.
(Lab)
My Lords, children’s lives have been disrupted, not only
educationally but socially and emotionally, as friendship
patterns have changed. The Minister will know that these
relationships can be fragile but are essential to good mental
health and well-being. What are the Government planning to do to
provide additional support to schools to help with the problems
they will inevitably encounter when children return?
The noble Baroness is entirely right. I am living with four
children who are greatly distressed at losing their friends and
not being able to stay in touch in the way they would like. We
will undoubtedly need to provide support to schools to cover a
list of mental health issues. The Secretary of State for
Education is working on plans for that.
(Lab)
My Lords, as a nation, a vast number of us have seen our mental
health deteriorate during the coronavirus crisis, so the
challenges facing our mental health services are even greater
than they were before. Surely we need a strategy to take us
through the Covid-19 pandemic that takes account of the most
welcome promises in the NHS long-term plan and addresses and
scrutinises the impact of the pandemic on mental health and
learning disability settings, including the impact of the
temporary measures in the emergency legislation. Such a strategy
must address how and when the DoLS legislation will be rolled
out, and when and how the Government will bring forward reforms
arising out of the review of the Mental Health Act. Does the
Minister agree that these are the key ingredients of such a
strategy? When will we see progress in this area?
The noble Baroness is right: the Covid epidemic will throw a
spotlight on our mental health provision. That provision is
already benefiting from an extra £2.3 billion a year by 2023-24.
We have already brought forward the 24/7 crisis lines that were
due to be delivered in 2023-24, and I think there is a good case
for bringing forward other parts of our mental health strategy to
address mental health issues during the Covid epidemic.
Undoubtedly, we will focus very shortly on ways of doing that.
(GP)
The Stevenson-Farmer review of 2017, which was set up by the then
Prime Minister, recommended strengthening the 1981 health and
safety regulations on mental health first aid. Will the
Government commit to picking up those recommendations and
implementing them?
The noble Baroness raises an important point. I will confess that
I am not, and will not pretend to be, completely across the
matter she raises, but I will write to her with a clear answer.
(Con)
My Lords, I declare an interest: my daughter Natasha is an art
therapist and co-founded the charity Arts Therapies for Children,
which works in 19 schools. The impact on the mental health of
children brought up where domestic abuse is the norm is sadly
clear; it is all they know, and often they think that the
problems encountered are their own fault. It is during these
years that they develop and learn how to value themselves and
others. Therefore, the impact of domestic abuse can lead to a
skewed view of who they are, which can be taken into adulthood.
Will my noble friend the Minister ensure that resources are
targeted at supporting charities and mental health services that
work with these vulnerable children?
I pay tribute to exactly the sort of charity that my noble
friend’s daughter works in. They provide invaluable and often
unseen benefits to society. We have already made available
considerable financial support for similar such charities. If my
noble friend would like to write to me with the details of the
one he described, I would be glad to consider it. Undoubtedly,
these charities will play an important role in dealing with
mental health issues of the kind he describes during the mop-up
after Covid.
(CB)
My Lords—
The Senior Deputy Speaker ()
I am sorry, but I think we have lost the connection. I will call
the noble Baroness, , and then come back to
the noble Lord.
(Con)
Will my noble friend assure me that all communities will be able
to access appropriate mental health services? What work is being
done to speak to local women’s and girls’ groups in the
ethnic-minority communities, where language and access to online
services may often be a barrier?
One thing that Covid has thrown a light on is that digital
communications have been greatly improved; the use of video
conferencing in mental health services is one of the things that
have helped. Groups that do not have access to video conferencing
need to be reached in other ways. We are working on using
telephones and community outreach to do that. My noble friend is
entirely right that this needs to be a focus of our work.
The Senior Deputy Speaker
I return to the noble Lord, .
My Lords, does what the Minister has said apply to prisons and
probation?
I pay tribute to the Prison Service, which in extremely difficult
circumstances has managed to provide pastoral care and clinical
segregation in our prisons in a way that has completely
outperformed expectations. The effect in prisons has been
profound and the mental health of prisoners is concerning. The
degree of lockdown in prison cells is an awful aspect of this
disease, and undoubtedly we will have to work very hard to manage
and deal with the mental pressures on prisoners, which are
extremely unfortunate.
