Women’s Mental Health

Debate between Lord Beamish and Wera Hobhouse

Thursday 3rd October 2019 Commons Chamber

[Mr Kevan Jones (North Durham) (Lab)]

I congratulate the hon. Member for Bath (Wera Hobhouse) on introducing the debate and welcome the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries), to her new position.

I welcome this debate because it is another opportunity to talk about mental health. As was said earlier, at one time it would not have been spoken about, but our debates, which have in large part been cross-party and consensual, have changed people’s attitudes. That is the real difference that we have made. The hon. Members for Southend West (Sir David Amess) and for East Worthing and Shoreham (Tim Loughton) were right that this is the House at its best—disagreeing politely, but ensuring that issues that frankly are not very popular are debated consensually. I welcome that. These debates have made a real difference in changing people’s attitudes to mental health. I pay tribute to the charities that have recently been involved in various campaigns, because eradicating stigma is a big issue that we still need to work on in our discussions about mental health.

The hon. Member for Bath pointed out in her introduction to the debate that one in five women can at some stage experience a common mental health issue, whether depression or anxiety. Often, they are the ones at greatest risk, especially young women. Although all the evidence suggests that men are more likely to take their own lives, there is an increasing danger among young women of taking their own lives. The statistics have not really budged since 2012, and I think the same is true for the suicide rate among women generally, which at the moment I think is 5.4 per 100,000 of the population. Those rates have remained static for the past 10 years. Some great work has been done on suicide prevention, which led to a slight drop—although I notice that the figures recently went up again—but we need to put more effort into looking in detail at the underlying reason why the suicide rate among women remains static.

The other issue is that women are more likely to suffer from mental illness because of trauma, such as domestic violence and sexual abuse, and issues around body image, which the hon. Member for East Worthing and Shoreham spoke about and which I will come on to.

I welcome the work of the women’s mental health taskforce, which reported in 2018. Let me put on record my thanks to the hon. Member for Thurrock (Jackie Doyle-Price) for the work she did. She was a great champion not only for women’s mental health but for the entire mental health agenda. Not only was she always available to speak to Members, but I know from speaking to charities and others working in the field that her door was always opened. She listened; she made sure she got change; and she can be proud of the work she did.

The taskforce’s report touched on something that is quite self-evident, but which we sometimes forget—namely, the clear link between poverty and socioeconomic conditions and women’s mental health. It found that 29% of women in poverty experience poor mental health. Another issue touched on, which was raised by the hon. Member for Southend West, was prisons. The report highlighted the depressing statistics for women self-harming in prison, which are obviously linked to other issues such as poverty, which has already been mentioned, and substance abuse.

I agree totally with the report’s conclusion that we need to link those issues up and take an holistic approach, but I would go one step further. I have spoken about this before, but we also need to hard-wire mental health and wellbeing into all public policy, whether nationally or locally. We need a system whereby any policy being developed should be tested against a matrix of mental health indicators before implementation, and I would include spending decisions in that. The hon. Member for East Worthing and Shoreham talked about spending cuts, and although we might disagree about their effects on Sure Start centres for instance, making what the Treasury might see as easy cuts leads not only to problems locally but to more expense for the taxpayer in the long term. We should certainly look at that when we are spending money, because while the call is often for more money—which we do need in mental health—we also need to ensure that it is spent correctly and joined up. We could achieve a lot more if we took a joined-up approach.

Let me give two examples of where not having that prerequisite for testing is leading to problems and costing the taxpayer and society more. One is the Department for Work and Pensions and its employment and support allowance assessment. I am clear that people should be encouraged to work, and we all—let us be honest—know that the right type of work is good for people’s mental health. However, we should not have a system that is very blunt in terms of assessment and that takes little account of those living in our communities with long-term mental health problems.

A constituent in her late 50s came to see me a few months ago, having lived with long-term mental health issues in the community. She went for her ESA assessment and got no points. She was then virtually suicidal. I intervened, although, frankly, it should not have taken me to intervene. She then had a mandatory reconsideration, and her payment was reinstated. If we look at that woman’s history, it is clear that she is not going to work, but the process did not take that into account. If that person had then been sectioned, had gone into hospital or had—let us be blunt—taken her life, that would have been a huge cost to society.

[Wera Hobhouse]

I have been an MP for a relatively short time, and I find increasingly that trying to access services or get universal credit throws perfectly healthy people into mental health problems, because it creates anxieties and delays. I am not surprised that a lot of people are being thrown into mental health problems, because our public services are increasingly not responding in a humane way to people’s needs.

[Mr Jones]

I agree, and I will come on to the other example I have in a minute. Those problems then result in a cost to the taxpayer. If we had road-tested the ESA policy in terms of mental wellbeing and assessment when we were developing it, that would have helped the situation.

The other example, which the hon. Lady has just referred to, is universal credit, which is creating huge problems for many of my constituents. They are going up to six weeks without any money. That is having a huge effect on women’s mental health, because the main carers in most of these households are women, who have to juggle budgets. Again, we should have thought beforehand about the cost to society and the taxpayer of the added mental health problems generated through this policy.

On women in prison, it saddens me a little that the Government have now taken up the “lock them up and throw the key away” agenda in the criminal system. We need to reduce the number of people who are actually in prison, and especially women. If we look at the evidence and at the reason why women are in prison, we see that it is linked to domestic violence, mental health problems and substance abuse.

In County Durham, I pay tribute to Durham police and the crime commissioner Ron Hogg, who introduced Checkpoint in 2011. He did that because he was sick and tired of putting women shoplifters through the criminal justice system when what they really needed was help. If we look at the statistics and at the changes that the programme has made, we see that it is cutting reoffending rates. It is addressing the real issue, which, in most cases, is domestic abuse and mental health issues.

In addition, we need clear pathways. The report says we need joined-up local services. That is not just about the acute sector and GPs; it is about the voluntary sector as well, and we need to ensure that it is part of that joined-up local system. Certainly, in my experience, it is delivering local services and good value for money very effectively for local communities. In my constituency, I have a fantastic project called Just for Women, which deals with women who have faced domestic violence and mental health problems and who have been in probation. The project staff do one simple thing: they allow time, and they talk to people. They use crafts and other things to get women’s confidence back. If we sit and talk to the women in that project, we find that most of them have been through every programme possible—they have gone through systems and systems. We need to ensure that we put in place a system that works.

Finally, I want to touch on body image. I welcome this year’s report by the Mental Health Foundation, which focused on the link between body image and the nation’s mental health. In the report, one in five UK adults said they felt ashamed of their body image and 43% of women had low self-esteem when it came to their body image. That does lead to psychological effects.

I agreed with the hon. Member for East Worthing and Shoreham when he talked about the internet companies. They have a huge responsibility in ensuring that the messages they put out do not perpetuate the myth of the perfect body image. That is leading not only to psychological problems but to people having unnecessary cosmetic surgery and interventions, which are harmful to them.

I have challenged Facebook, for example, to ask why it continues to carry adverts for Botox, which is a prescription drug. Just try to take one down; my constituent Dawn Knight, who has been campaigning on this, tried to take one down, but it cannot be done. These companies should take a proactive approach to blocking these adverts, because they are not only perpetuating the image of the perfect body, but are, in some cases, I think, actually breaking the law. If social media companies such as Facebook will not change, there needs to be legislation.

In conclusion, I welcome the debate, because we are talking again about mental health. Is this about money? Yes, it is. We do need investment in mental health services. However, we also need to ensure that we have that joined-up approach to not only services but methods and processes. That can reduce people’s mental illness and ensure not only that we have a society that is content with itself but that, when people do get into crisis, there is a service and support there for them.

Body Image and Mental Health

Debate between Lord Beamish and Wera Hobhouse

Tuesday 23rd July 2019 Commons Chamber

[Wera Hobhouse (Bath) (LD)]

It is a real honour to speak in this debate, and I regret that not many people are here to participate in it, but as we know, today is today. Even though I have only recently become a Member of Parliament, I echo the comments about what a pleasure it has been to work with the Under-Secretary of State for Health and Social Care, the hon. Member for Thurrock (Jackie Doyle-Price), and I hope that she will continue in her post.

We have talked about many issues, and I want to pick up on what has been said about the cynicism with which advertising exploits vulnerable people. I will be speaking mostly on eating disorders, and many victims of eating disorders already have a massive problem, even before they go online. If they then order slimming pills online, for example, they will be bombarded by adverts persuading them to buy even more, which they then do. That is nothing short of exploitation, and we need to be alert to that.

We are all ultimately affected by our body image. People might say to me, “Well, you look all right”, but we all think, “Well, this could be better and that could be better.” We all want to please the people around us and ourselves when it comes to what we look like, and that is nothing new. It is only unusual or harmful when it so negatively affects us that it is the only thing that guides our lives. There is a certain intolerance surrounding having to have a particular look, and that is where the real danger lies. People feel they have to look a particular way rather than feeling that it would be fun to look this way or that way and to be playful with what they look like. Instead, they are being shoehorned into a particular image, and anyone who does not fit that image can be badly affected and develop serious mental health problems, including eating disorders. I have been campaigning on the particular issue of eating disorders and mental health.

This debate is important for millions of people across the country, and I hope that we can set an example today by honestly exploring the issues. In fact, I think we already have. In a culture that is obsessed with image, we must talk more openly about the impact that body image scrutiny has on our mental health. It has been said before that we are focusing too much on how we look, rather than on who we actually are as people and what we can bring to the table, whether we are short or tall, male or female. That is one of the obsessions of our society: we are always thinking about what we look like, rather than about who we actually are.

For the past year, I have been campaigning for better treatment for eating disorders. Speaking openly about such conditions is more important than ever, because early identification and intervention are key. Mental health conditions thrive in the shadows and are protected by our ideas about what is and is not appropriate to talk about. Eating disorders have a reputation, and sufferers who do not fit cultural stereotypes are often afraid to speak out or, worse still, are refused help.

[Mr Kevan Jones]

The popular image of eating disorders is that they mainly affect young women, but does the hon. Lady agree that young men and people of all ages are increasingly likely to be affected?

[Wera Hobhouse]

The right hon. Gentleman is absolutely right, and that has been explored in several debates on eating disorders. We are somewhat hemmed in by stereotypes, and I wonder whether our age is particularly prone to that. We think eating disorders are a particular thing, so for a long time they have been a problem for young girls, but they affect people of all ages, and men increasingly. As we have explored today, body image and mental health are not gender-specific, but men suffer in silence more, because they are much less likely to talk about things, and subsequently they seek help a lot later, which can be dangerous. In fact, it is well known that the highest number of suicides is among men between the ages of 18 and 25, because men—this is a cultural stereotype that we can hopefully overcome—just do not talk about their body image, anxieties and mental health as much as women.

Research by the Mental Health Foundation published last March shows how common it is to have body image concerns, and we have heard many other statistics today. One in five UK adults have felt anxious or depressed about their bodies in the past year, and that anxiety can turn into long-term mental health problems, such as eating disorders. Across the country, eating disorders affect 1.25 million people, which is probably a conservative estimate. My work in this area supports that suggestion, and the sufferers I have met come from a range of different backgrounds, but they are united by their dissatisfaction with, and need to control, their body image. The hon. Member for East Kilbride, Strathaven and Lesmahagow (Dr Cameron) has already talked powerfully about that.

Of course, eating disorders are far more complex than stress over body image. They are serious conditions that ruin, define and, all too often, end lives. However, the seeds of emergent eating disorders can often be spotted in stress or anxiety about body image. For the more than 1 million people who were identified as having an eating disorder, the outlook is not good. On average, it takes 85 weeks between someone realising they have an eating disorder and that individual receiving treatment. That lost time can be the difference between full recovery and living with a permanent disability or disorder. The Government targets introduced to limit child waiting times for eating disorder treatments were a positive step, but thousands of adults across the UK need the same measures. We need to consider the waiting times for adult sufferers of eating disorders, and I know that the Minister has already looked into that.

Understanding eating disorders better is key to improving treatment. Many sufferers still report being turned away and refused referral, because doctors have told them that they are not thin enough to be treated for an eating disorder—I know that the Minister has talked to Hope Virgo, who has been running the “Dump the Scales” campaign—but an eating disorder is not just about someone’s body mass index. By talking about eating disorders, especially in the context of body image, we can start to grasp how damaging that can be. We must educate everyone, from sufferers’ families to doctors, about the many different forms that such conditions can take and how best to treat them. Eating disorders have the highest mortality rate of any mental health condition, and our mental health policy must reflect that. This is a crisis, but we are not treating it as such.

Early intervention is key. Schools, doctors and support workers must be equipped with the tools to identify when body image concerns are becoming dangerous. Furthermore, we must change the cultural conversation around body image, which can be done on many levels. As we have already heard today, social media companies have a responsibility to police the content on their websites, ensuring that anything that actively incites self-harm is taken down. Eating disorders are on the rise, and many adult sufferers are failing to receive the early intervention they so desperately need. We must do better for those suffering in silence and start having a conversation about body image, mental health and the awful reality of life with an eating disorder.