Covid-19: Mental Health Services

Lord Bethell Excerpts

Thursday 2nd July 2020 Lords Chamber

[Baroness Barker]

To ask Her Majesty’s Government what steps they are taking to ensure that mental health services are available in (1) acute, and (2) community, care settings (a) during, and (b) after, the COVID-19 pandemic.

[The Parliamentary Under-Secretary of State, Department of Health and Social Care (Lord Bethell) (Con) [V]]

My Lords, the mental health challenge of Covid is a serious matter, and I pay tribute to NHS mental health services in both acute and community care settings, which have remained opened for business throughout this time, including delivering support digitally, over the phone and, where possible, face to face. There are no plans to stand down that support after the peak of the pandemic and we remain committed to our NHS long-term plan ambitions for increasing mental health services in acute and community care settings.

[Baroness Barker (LD) [V]]

In July 2019, the Government committed £2.3 billion for services for 370,000 people with severe mental illness. Will the Minister give an undertaking that if, as expected, Covid-19 causes greater demand for mental health services, that money will be increased?

[Lord Bethell [V]]

My Lords, we are investigating the long-term implications on our services from Covid-19. We are engaging with counterparts across Whitehall and, if necessary, we will invest further money. However, the mental health impact of Covid is not clear yet, and we await the final implications of that.

[The Lord Bishop of Coventry]

My Lords, at least one of the churches in my diocese recently set up a mental well-being centre, providing support groups, a helpline and signposting to professional services. Has the Minister considered inviting churches and other faith communities, with their knowledge of, trust within and connections to the local community, including networks of young people, to participate in the response to the mental health needs caused by Covid-19?

[Lord Bethell [V]]

The right reverend Prelate makes a good point, and I thank very much indeed those from all faith groups who have provided important pastoral support during this difficult time. On a practical matter, the funding for the mental health projects from our £5 million fund has gone to 130 different charities through the coronavirus mental health response fund. We are assessing the impact of those and we look forward to the recommendations of the Mind and mental health consortia which are behind that fund.

[Baroness Redfern (Con) [V]]

Mental health community projects are supporting people during coronavirus, and the Government’s announcement in May of £5 million of additional funding marked the first round of funding to be allocated to the sector. When will the second wave of projects receive funding, and will that include extra training for staff and to recruit more to service the 24/7 helplines?

[Lord Bethell [V]]

I pay tribute to charities and other community projects which have contributed to a wide range of projects across mental health, learning disabilities, dementia, isolation, befriending, domestic abuse, women’s issues and BAME groups. As I mentioned earlier, the Mind and mental health consortia are making recommendations about the progress of the fund. I look forward to their recommendations and we will act on them wherever we can.

[Baroness Greengross (CB) [V]]

My Lords, one consequence of the pandemic has been increased rates of violence or harm against old, young and other vulnerable people. Increased pressure on people’s mental health during the lockdown will likely have contributed to that. Should the Government make it obligatory for threats of violence, which could be bravado but which could also be dangerous, to be reported to the police as well as to social services, and would such measures help reduce domestic and other forms of abuse and ensure early intervention when someone is having a serious mental health episode?

[Lord Bethell [V]]

My Lords, threats of violence under any circumstances are reprehensible, and those aimed at the old and the vulnerable are in a category of their own. It is up to the clinical judgment of those involved in social care to decide whether the involvement of the police is of benefit and worth. I would not want to apply a blanket ruling on that, but the noble Baroness makes an extremely important point, which we are constantly reviewing.

[Baroness Blackstone (Ind Lab) [V]]

My Lords, there is increasing evidence that the mental health of children and young people has been badly affected by the Covid-19 lockdown. Given that the provision of mental health services to this age group was already inadequate, why has progress in implementing plans in the Green Paper on child mental health been so poor, particularly in the rollout of child mental health teams? What steps will the Government now take to rectify that?

[Lord Bethell [V]]

The noble Baroness is likely correct that the epidemic has had a particular effect on children and young people. The evidence on this is not crystal clear, but that is the strong instinct of all those in the field. I personally welcome the reopening of schools, which will have a particularly beneficial effect on those children who at present are stuck at home and do not have the support of the school system. Mental health services for young people are part of our long-term plan, with the additional £2.3 billion of spending on mental health. Our ambitions in that area remain enormous.

[Baroness Jolly (LD)]

My Lords, the Mental Health Act is no longer fit for purpose. With outdated legislation, both children and adults are at risk while either at home or in a care setting. In the aftermath of the Covid epidemic, there is no time for delay. When should we expect a Bill here in Parliament? If that is not in the Minister’s brief today, would he write to me?

[Lord Bethell [V]]

My Lords, we remain committed to publishing a White Paper that will set out the Government’s response to Sir Simon Wessely’s independent review of the Mental Health Act 1983 and pave the way for reform of that Act. We will publish it as soon as possible. The Covid epidemic does nothing but incentivise us to move as quickly as possible on this.

[The Earl of Sandwich (CB) [V]]

My Lords, does the Minister share my concern that the data he kindly supplied in Written Answer HL5619 on 22 June shows an 11% increase in March in prescriptions for anti-depressants over the same month last year? Is he therefore considering urgent measures to increase the funding and availability of psychological therapies instead?

[Lord Bethell [V]]

My Lords, I am as concerned about the over-prescription of anti-depressants as the noble Earl and would much prefer people to take cognitive therapies than drugs wherever possible. As I mentioned earlier, we have invested in two major rounds of support for community groups to help those struggling with their mental health, and we are reviewing additional funding for those schemes. We will keep a careful eye on the prescription of anti-depressants, which we are all concerned about.

[Baroness Thornton (Lab)]

My Lords, health and social care workers battling through the coronavirus pandemic are paying a heavy mental and emotional toll and will continue to do so. Yet the current mental health support available is not adequate. Will the Government commit to appointing a new independent national well-being guardian to co-ordinate and oversee a proper mental health support package for all NHS and care staff?

--- Later in debate ---

[Lord Bethell [V]]

My Lords, the work on the NHS people plan continues during the epidemic and we look forward to making the first announcement on that shortly, which will cover many of the concerns of the noble Baroness. I also remind the House that, on 15 June, Public Health England unveiled its psychological first-aid training course, developed by PHE, which has proved extremely helpful, as has the confidential helpline that was unveiled on 8 April, which we continue to support.

[Lord Rennard (LD) [V]]

My Lords, people with diabetes are twice as likely to experience depression as those without, and a third of Covid-19 deaths in England are linked to people with diabetes. A survey by Diabetes UK shows that three-quarters of people with diabetes who have felt that they needed specialist mental health support cannot access it. How can the Government help to ensure that more people are tested for diabetes and that those with the condition receive comprehensive check-ups, including screening and support for mental health issues?

[Lord Bethell [V]]

My Lords, we are investing in new and additional diabetes testing arrangements. Testing is essential for the diagnosis and management of this affliction. The noble Lord is entirely right that the connection between Covid deaths and diabetes appears profound. It is a wake-up call for the whole country and puts a spotlight on the large amount of diabetes in the UK. We will unveil plans in the future for refocusing on this important public health issue.

[The Deputy Speaker (Lord Russell of Liverpool) (CB)]

My Lords, all supplementary questions have been asked, so we now move to the next Question.