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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 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—
Peter Dowd (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.
Helen Maguire (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 (Sojan Joseph) 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—
Peter Dowd (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.
Tony Vaughan (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 (Sojan Joseph) 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.
Dr Luke Evans (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 (Sojan Joseph) 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.
John Glen (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.
Jack Abbott (Ipswich) (Lab/Co-op)
It is a privilege to serve under your chairmanship, Mr Dowd. I thank my hon. Friend the Member for Ashford (Sojan Joseph) 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 (Clive Lewis) 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.
Mark Ferguson (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 (Sojan Joseph) 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.
Dr Lauren Sullivan (Gravesham) (Lab)
It is a pleasure to serve under your chairmanship, Mr Dowd. I thank my hon. Friend the Member for Ashford (Sojan Joseph) 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.
Shockat Adam (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 (Sojan Joseph) 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?
Rachael Maskell (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 (Sojan Joseph) 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.
Helena Dollimore (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 (Sojan Joseph) 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.
Mark Ferguson
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?
Helena Dollimore
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.
Tristan Osborne (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 (Helena Dollimore), 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.
Dr Simon Opher (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.
John Glen
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 (Rachael Maskell) 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.
Peter Dowd (in the Chair)
Can I just remind Members about modes of expression? I will be diplomatic about it.
Lola McEvoy (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.
Dr Danny Chambers (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 (Helena Dollimore) 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 (Sojan Joseph) has already mentioned that the Darzi report acknowledged that 20% of the NHS disease burden is due to mental health issues.
Lola McEvoy
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?
Dr Ben Spencer (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 (Sojan Joseph) 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 (John Glen) 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 (Shockat Adam), 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 Theresa May 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.
Lee Pitcher (Doncaster East and the Isle of Axholme) (Lab)
Will the hon. Member give way?
Lee Pitcher
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 (Helena Dollimore) 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?
Peter Dowd (in the Chair)
I want to give the sponsor an opportunity to wind up at the end. I call the Minister.
The Parliamentary Under-Secretary of State for Health and Social Care (Andrew Gwynne)
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 (Sojan Joseph) 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 Baroness Merron, 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 (Tony Vaughan) and the hon. Members for Epsom and Ewell (Helen Maguire) 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 (Mark Ferguson) for his contribution, and the hon. Member for Leicester South (Shockat Adam), 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 (Rachael Maskell). My hon. Friend the Member for Hastings and Rye (Helena Dollimore) 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 (Tristan Osborne) 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.
Sonia Kumar (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?
Andrew Gwynne
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.
John Glen
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.
Andrew Gwynne
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 (John Glen) so we can get this over the line with the Treasury will be welcome.
I should mention my hon. Friend the Member for Darlington (Lola McEvoy), 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 Luke Evans
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?
Andrew Gwynne
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.
Sojan Joseph
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.