Mental Health

Lord Addington Excerpts

Thursday 15th January 2015 Lords Chamber

[Lord Addington (LD)]

My Lords, the first and very pleasant duty that falls to me today is to welcome from these Benches—from this part of the coalition—the noble Lord, Lord Suri. A good start has been made and we look forward to what is to follow.

When I put my name down to speak in this debate, it was because of something which is blindingly obvious to somebody such as me who has dealt with disabilities for many years. Somebody who is disabled is likely to undergo slightly more stress than somebody who is not. Stress seems to be one of the key factors, whether it comes from family, or social background. With disability—that is, not being able to function—there is going to be more stress and there are probably going to be slightly more mental health problems there. It is a little bit of a no-brainer.

However, many of the speeches today have touched upon that. I always regard people as being a cocktail of a series of events, circumstances and chance and all these things come together in individual people, making them slightly more likely to go in certain directions or react in certain ways. If you are a person with a disability, who struggles to access certain parts of society or to communicate, or to achieve as your peers would, it is an almost dead cert that you will be slightly more vulnerable and there is a slightly higher probability that mental health problems will occur in your life. Virtually all the reading I have done backs this up, and everyone who has spoken to me has said so.

On the issue of dyslexia—the noble Lord, Lord Farmer, might have said that he always talks about family breakdown; I am trying to find a subject where I cannot find an aspect on dyslexia and my connection to it and I have failed so far—it is well known that dyslexics get slightly more stressed in the classroom and that mental health problems will be that little bit more common among them. However, they are not the only group. When it comes to autism, 70% of young autistics are reckoned to have a mental health problem. That 70% equates to 1% of the population. The on-costs of not dealing with this in the best way are massive. To deal with just those two groups at first, most of those have economic capacity and the capacity to work, but that will be greatly reduced by not giving them support and help throughout. By not taking action, we are effectively creating that little bit more of a burden or drag on society and making people’s lives more unpleasant.

All those whom I have spoken to in this field say that there is one problem that the medical world—and, indeed, the rest of the world—has in dealing with this. When they see a person who has a disability, whether obvious or hidden, they tend to see the disability first rather than think about what might be going on behind it. I remember that we had a long debate in this Chamber about how the deaf, or British Sign Language users, access the health service. How much more difficult is it for a doctor or a professional to establish that mental health provision is required when they cannot understand the person, who has to be translated through somebody else? There are sometimes difficulties there, so how do we address this?

If we are serious about taking this very sensible and good step forward of giving parity to those with mental and physical health problems, the first thing we must do is surely to ensure that all those in the health service are at least aware that this possibility is there. I am talking about everybody not becoming expert and trained but being aware that there might be a problem, which they should assess and move on from. A degree of awareness can be achieved fairly easily, simply by stating, “By the way, in certain groups certain types of conditions are more frequently occurring”. Once again, that is a no-brainer, but what is required to move you on?

Regarding the education sector, my noble friend Lord Storey mentioned how the Department for Education deals with mental health. In education, we have for a long time dealt with special educational needs, but most of the problem that we have is in identifying them and getting the system to recognise them. I do not say that the Department of Health is going to become any worse but without training, without pushing to make sure that it is kept under surveillance to do so, it will not be any better. That is because it will think—and it may be right—that it has enough to do as it is in dealing with the duties in front of it. That will be so unless you place a duty on that department to become aware or find out and make sure that, when it does not, it must report back the reason why. That is both to reinforce the fact that it is a duty and so that the systems are in place to make sure that it does not happen again. If we do not undertake this type of activity, we will reinforce this cycle of people who are underachieving.

We will not address the selfish interest of society properly unless we become aware of this. We will have a whole section of our society who we are encouraging by saying, “You should go out to work and become fully active”. Indeed, we are making that a legal duty; all Governments in the last few years have done this, saying, “You should get out and earn. We don’t want you sitting at home”. But unless we make sure that they are supported the whole way round they are going to fail in this, effectively because they have no option.

If we look at other areas where bad mental health is prevalent and disabilities, often hidden, are common, we could look at prisons. I thought that I might say a few things on that, but I looked at the speakers list, and then across the Chamber, and saw the noble Lord, Lord Ramsbotham. Whether or not he chooses to take a bite out of this particular apple today, I will always defer to him on that issue, but we should look to the examples of how we get such “co-morbidity”, which I think is the correct term here—personally, I think the word means that you are dying twice and quickly, so perhaps we should say “co-occurrence”. For an example of where co-occurrence leads to failure and expense, you need look no further than prisons. This is particularly true of conditions such as autism and other hidden disabilities. In all the cases at which I have looked, not looking at the whole person or beyond the initial aspect will lead you into trouble.

I am in grave danger of reciting all the facts that I have about the problems in these areas, such as that people with a learning disability were traditionally seen as not being worth indulging with a talking cure —because it would not do them any good because you cannot help them anyway. However, they can become more independent and they can get out there. Unless we address the idea that we give all groups in this sector as much help as we can, we will fail. In failing, we pass on costs to society and to those in families who end up looking after these people.

Carers have a high occurrence of mental health problems. They are under stress. We must start to cut this Gordian knot or break the circle—the clichés roll on—and address this by saying that you must look for this problem, think of a strategy and get into the system some awareness of those who are using it. We must also make sure that the medical profession is prepared to take advice on this subject from outside. Unless we do these things we will not ultimately get the full benefits of a very sensible strategy. We must exercise our peripheral vision and think laterally on this, because it will touch every aspect of society. If we do not, the strategy will not work.