Written Statements

Monday 20th January 2014 Written Statements

Monday 20 January 2014

“Closing the Gap: Priorities for Essential Change in Mental Health”

Monday 20th January 2014 Written Statements

[The Minister of State, Department of Health (Norman Lamb)]

We are today publishing “Closing the Gap: Priorities for Essential Change in Mental Health”.

At least one in four people will experience a mental health problem at some point in their life; one in 10 will do so before they are 18. An estimated one in six adults has a mental health problem at any one time; there are also many who experience poor mental well-being but do not have a diagnosable mental disorder.

Mental ill-health can mean people are out of work. It can lead to family breakdown and homelessness. It can mean leaving school with poor qualifications, or none at all. It can directly impact on parenting, and in particular on the relationship between children and their parents in those critical early years. It also has a direct impact on physical health. Life expectancy for those with severe mental illness is on average 20 years less for men and 15 years less for women.

All of this places an enormous strain on the health service, and on other public services: mental illness is now the cause of over 40% of sickness benefit claims. Businesses feel the impact: the average cost of poor mental health to business is just over £1,000 per employee per year, or almost £26 billion across the UK economy.

The time is long overdue for us to take a bolder, broader approach to tackling mental ill-health and promoting well-being. In 2011, we published our mental health strategy, “No health without mental health”. This set out a long-term ambition for the transformation of mental health care—and more importantly, for a broad change in the way people with mental health problems are supported in society as a whole. This was reinforced by the mental health strategy implementation plan in 2012 which provided detailed recommendations for action to deliver the objectives.

Two years on from the publication of our strategy, important progress has been made. Crucially, we have taken firm steps to narrow the gap between the way in which physical and mental illnesses are viewed and responded to. The Health and Social Care Act 2012 sets out, in law, that mental health should be on a par with physical health. And we have put mental health at the core of our mandate to the NHS, setting out what the NHS is tasked to deliver—and the NHS constitution. This means that improving mental health, and treating mental illness are key priorities for NHS England. These are also central to our mandates to Health Education England and Public Health England.

We can see that in many areas, real change is already happening to deliver the strategy objectives.

Change is also visible beyond the health and care sector. Many areas of Government policy and public service delivery, from education to employment, the justice sector to housing, are addressing mental health. There is strong cross-Government support for, and actions to deliver, the objectives in the strategy as demonstrated by the children and young people’s health outcomes forum, and the forthcoming crisis care concordat.

Crucially too, there is already a clear change in society. The time to change campaign, set up to tackle discrimination and remove the stigma associated with mental illness, has made real impacts. Research has shown that, since the launch of the campaign, people with mental health problems already experience less discrimination from friends (14% less than in 2008), family (9% less) and in social life (11% less).

All of this amounts to important progress towards achieving the long-term objectives set in our strategy. But we recognise too that for many people with mental health problems, this progress has not yet translated into significant change in the care and support they receive. Much of the work to date has been around laying foundations for further change which means the impact of what has been done is not always clear and relevant.

Our goal is that progress will accelerate and outcomes become more tangible. This document aims to bridge the gap between our long-term ambition, and shorter-term action. It therefore sets out 25 areas where people can expect to see, and experience, the fastest changes. These are our priorities for action; issues that current programmes are beginning to address and where our strategy is coming to life.

While we are highlighting these priorities, it is important to underline that they are only part of a much bigger picture—and a much broader ambition for improved mental well-being. We are determined that achieving these priorities serves not as a distraction from the greater ambition, but instead as a catalyst for further and faster change.

It is right to assert that mental health must have equal priority with physical health, that discrimination must end and that everyone who needs mental health care should have the right support at the right time. These are issues which demand our collective response. I am confident by focusing on the priorities identified in this document we can achieve real and lasting benefits both for mental health services and, more importantly for the people who use those services.

“Closing the Gap: Priorities for Essential Change in Mental Health” has been placed in the Library. Copies are available to hon. Members from the Vote Office and to noble Lords from the Printed Paper Office.

Transforming Rehabilitation

Monday 20th January 2014 Written Statements

[The Lord Chancellor and Secretary of State for Justice (Chris Grayling)]

All probation trusts have now received formal notification of the termination of the probation trust service contract as part of the transforming rehabilitation programme.

Trusts are now completing the allocation of staff to their new roles, and every trust is on track to do so by 1 April. We will then test key aspects of the new model so that those who will be in both the community rehabilitation companies (CRCs) and in the National Probation Service (NPS) can trial the new ways of working before we formally complete the transfer to the new governance arrangements. Over a two-month period from April we will prepare for the full transition to new IT and support systems in areas like HR.

We will also start new interim account management arrangements from 1 April, to allow the account management team to start to work closely with emerging CRC and NPS teams right away and prepare for contract mobilisation from the end of May. Full commercial contract management will follow at the conclusion of the competition process.

A copy of the letter terminating the probation trust service contracts has been placed in the Libraries of both Houses.

Psychological Wellbeing at Work

Monday 20th January 2014 Written Statements

[The Minister of State, Department for Work and Pensions (Esther McVey)]

Poor mental health is a major issue for Government, society and for the many individuals either directly or indirectly affected by it. At any one time, around one in six people have a common mental health problem like anxiety or depression, and a further two in a hundred are affected by severe mental illnesses like schizophrenia. Additionally, we know many people suffer from both physical health and mental health problems at the same time.

The sheer number of people with mental health problems in work, and out of work, across all working-age benefits, makes this a mainstream issue for the Government. It represents an enormous challenge to both health and employment services, not just in the UK but across industrialised nations.

While none have yet established the best way to increase the effective support for people with mental health problems to work, the mental health benefits associated with good work are well known. We are working towards a solution and, if we get it right, the benefits for society will be substantial.

It is clear that health and work services need to work together, for example with flagship programmes like improving access to psychological therapies (IAPT) working more closely with local employment services. We are also developing the health and work service in order to support employees to return to work from sickness absence.

This need for collaboration between health and work services is precisely why my colleague the Minister of State, my hon. Friend the Member for North Norfolk (Norman Lamb), who is responsible for care and support, and I are vigorously pursuing solutions to this issue. Through the Cabinet Office’s Contestable Policy Fund, the Department for Work and Pensions and the Department of Health jointly commissioned RAND Europe to explore the most promising approaches on how to improve employment outcomes for people with common mental health problems, with a focus on better alignment of employment and health services.

Today we are launching RAND Europe’s report, “Psychological Wellbeing and Work: Improving Service Provision and Outcomes”. The report sets out key findings and advocates:

enhanced employment support in primary care including IAPT services, building on the employment advice currently offered in these services, with fully-specified support models like individual placement and support (IPS);

activities for benefit claimants with, or at risk of developing depression or anxiety to build belief in capability for work and increase emotional resilience to the setbacks people face when job seeking; and

different modes of specialist work and well-being assessments and support, including online, telephone and face-to-face.

The project report and its proposals will contribute to a better evidence base for action. It will enable both Departments to take forward our exploration into better mental health and employment provision—providing better approaches to help people with mental health problems to work.

The report will be published later today on the gov.uk website, and I will place a copy in the House Library.