Mental and Physical Health: Parity of Esteem

Lord Addington Excerpts

Thursday 10th October 2013 Lords Chamber

[Lord Addington (LD)]

My Lords, this is one of those debates in which, having put down your name to speak, by halfway through you are convinced that you do not have much to contribute. However, the main thing that attracted me to the debate in the first place was that it concerned parity of esteem between mental health and physical health. It has always struck me that the two are absolutely inseparable: you cannot remove one from the other. This is not just about the healthy mind and the healthy body; it is about the fact that you cannot access either one without paying attention to the other.

As has already been said in the debate, we had the problem that mental health was something that happened to other people and thus was something that did not concern us. We removed ourselves from it as a society. It is only over a comparatively recent time that we have started to realise that it is a mainstream problem. The similarities between that and some of the work I have done in other fields—for instance, on hidden disabilities, particularly dyslexia—are many. If what I do is normal or what I perceive to be normal, everything else will not be addressed. There are two things going on: the perception that it is nothing to do with me—I do not understand it, and I do not want to understand it because it is unpleasant—and the idea, as has been referred to in the debate, that we all know exactly what the mentally ill are like. They are basically people running around with meat cleavers and chasing around or shrieking at people on buses; they are not people who are in a state of depression. I almost said “unhappiness”, but it is being depressed, or functioning below par. Perhaps it is making the lives of those around them unpleasant; not fulfilling their greatest function; not interacting with family members. With depression, the field is far too wide to cover everything. That person is more than likely to be the standard person who has a mental health problem; he is not somebody who is in any way dramatic. That person is also going to be very bad at getting over the fact that he is ill and suffering from a long-term condition. As has been mentioned before, the life expectancy of those with mental illness is considerably lower than those without it.

So how do we get into this? Part of the work, clearly, has already been done by the noble Lord, Lord Bragg, who started off by saying that this is not that unusual, please open your minds to the possibility that this could be a very normal part of life. Furthermore, the rest of us will have to work a little harder, first, to take on new ideas and, secondly, to access the potential of those people to get the best out of it for us—the economy and the selfish principle within it. If those people are to have an episode of depression, for example, they will get over it, particularly if we give them the correct help and understanding and do not decide, “Oh, they have had a bout of depression. They will never be able to hold a job again”. If we can get over that, we will do well. We will benefit from that as a society. In my work outside dealing with hidden disabilities, I have found that embracing small changes in attitude and approach benefits the whole of society, not just that person. That process is not easy.

I must make a small confession to the noble Baroness, Lady O’Neill. When I first heard in my work with disabilities that mental health was to be put in with disabilities, I was a little frightened. I thought, “Wait a minute. With illness, you either get better or you die. It is not something that is with you for life”. I was rapidly disabused of that, because the prejudice that goes with it will be with you for life, as with cancer, which has been mentioned. The idea that it marks you out as different and other is incredibly important. I came to the conclusion: “It ain’t a perfect fit, but it—putting them together—is definitely the best show in town”.

We must try to get this across and start to engage with the rest of society about it. On the similarity between physical conditions and mental ones, I discovered many years ago, backed up by my personal experience, that many things that we do to prevent physical ill health work for mental ill health. There is lots of evidence, as Mind has recognised, that physical exercise releases hormones that help with many conditions. If you are physically healthy, you are considerably less likely to suffer from many forms of mental ill health. Encouraging physical activity can help many mental health conditions. The interrelationship between the two types of health is so close that it is ridiculous that we have to go through this process, but we clearly do.

The Government have taken this on board and are moving forward. I hope that we are not merely travelling with the tide but trying to inject some pace ourselves—running up a sail or putting an oar in the water—to go a little faster than general public opinion. There is a time lag within government and certainly in legislation. When Parliament becomes aware of a problem and then has to do something about it, it tends to jump ahead on the problem. I hope that we are seeing the first stage of that here. I am reasonably convinced that we are, but unless the Government now act and use the tide of public opinion, we will always lag behind.

We are dealing with a normal process here, a normal part of society. Unless the Government not only take the administrative steps but add to public awareness, we will be missing an opportunity to deal with a problem that will be with us for a long time. It is not going to go away, and unless we take coherent and sensible action now, we will be dealing with it for ever, normally within our prisons and hospitals.