Mental Health of Children and Young Adults

Lord Bragg Excerpts

Thursday 16th May 2019 Lords Chamber

[Lord Bragg (Lab)]

My Lords, I too thank the noble Baroness, Lady Royall, and congratulate her on introducing such an important subject at a particularly apposite time. Her comprehensive speech was compelling. I declare an interest: from 1996 to 2011 I was president of Mind, the leading mental health charity in the UK. In 2011 I handed over to Stephen Fry, but I have continued to work for Mind and its CEO, Paul Farmer.

Although it could not be called an interest, it is also relevant to say that I am rather in the position of my noble friend Lady McIntosh. I had a severe breakdown in my early teens. This lasted about a year and a half and had many unhappy consequences at school, at home and in the town. I raise this to observe that at that time, 1953-54, there was no one I could say a word to about what was happening, neither at home nor at school. There was nothing I could read, and I never dreamed of going to the doctor about such an inexplicable event that I could not articulate. Even now it is impossible to describe. It seems to have been an inescapable condition and the only thing I could do at the time was to hide it. Isolated and imprisoned like so many young people are today, it was a desert.

I can draw the following from that for this debate. First, mental health issues are still largely invisible, which over centuries has resulted in them being dismissed as the devil’s work, mere make-believe, obstinate laziness or the sufferer’s own fault. It has also persistently carried stigma, with the word “mental”, by a vicious irony, being applied to someone whose unimaginable affliction was mentally generated. You can see a fractured arm and sympathise; a fractured mind eludes sight and sympathy.

The example of my childhood, which could have been multiplied 10,000 times or more by people of my age at that time, was likely to have been considered a mark of shame, beyond reach. Sufferers were taunted or ostracised. Remember, this was soon after World War II, when tens of thousands of victims of traumatic stress in this country were totally ignored.

The main point I wish to make in my contribution is to argue how very much has changed for the better since that time. It is perhaps against the flow of this debate but it is important to air it. I am aware of how far there is to go and, thanks to Mind, I have a litany of sad statistics. One in 10, or nearly 850,000, children and young people aged five to 16 are diagnosed with mental health problems and this is increasing. These statistics have been set out by other people. However, the progress over the past 50 years—especially the past dozen or so years—is important to show that these problems are being resolutely tackled at last.

Another personal example I will now give may seem to be on the margins of usefulness but I think it matters. So, if your Lordships will excuse me once again, I will use personal experience. About 20 years ago, when I helped run the Mind annual book award for the best book of the year concerning mental distress, I tried to find a sponsor. Mind’s money came almost wholly from its effective shops throughout Britain. A sponsorship of £5,000 would have been a help. I approached a number of organisations and well-known patrons and, to use a phrase, none of them wanted to know. They did not want the association. The ancient taboo that mentally ill people were destabilising was still rigidly in place. Perhaps they feared contamination by association.

How greatly for the better times have changed. The younger members of the Royal Family, for instance, have just come onside emphatically and openly and with a substantial contribution from their own funds—unthinkable before—and have aligned themselves with the cause we are discussing today. This is a tremendous boost. The great and the good—I say this with gratitude and not irony—have over the past dozen years moved into this area with substantial impact. Tonight, for instance, with Stephen Clarke, the CEO of WHSmith, I will be talking to more than 100 people at the house of the noble Lord, Lord Fink, in London, who will be there because of their interest in helping Mind’s efforts for young people. It is a high-level involvement on their part and it is important for us. Their contributions will be invaluable and fill many a gap in the present struggling system for mental health for the young.

Something in our society has shifted. In this as in some other areas we have become kinder. Perhaps generous people looking for a cause to support have found —who knows, perhaps on their own doorsteps?—that this problem affects the most vulnerable and needs all the help that powerful patronage can bring. They are acting pro bono publico and Mind is grateful to them.

As we have heard, the subject is now referred to much more openly on the television and certain newspapers have come out in support and have, above all, made the issue visible. The formerly unmentionable has now become a problem that can be addressed and, I hope, set on the road to benefit many young people who, at the moment in our country, are locked in a state of mind from which they despair ever to be released. It is part of the good that is happening here as more and more we are uncovering minorities who have been scorned or neglected and trying to bring them home into the larger community that is our country. We are as good as we treat the weakest people among us, and that needs to be singled out for praise.

As I said, I know there is a long way to go but we are now on the road. For instance, Anne Longfield, the Children’s Commissioner, points to the vast number of reports we have had on children’s mental health recently. That is a mark of the some way in which we have gone.

We learn in this debate how far there is to go. Although we are failing, we are trying, and that is important. We are trying better. If we can make as much progress in the next 20 years as we have made in the past 20 years, we could be well on the way to removing the stigma, the centuries-old, deep prejudice, and alleviating the torments attending so many young people. We need to harness the strength of hope for our young people who need help so much, who need to be reached and restored to the full possibilities of the lives they deserve.

Mental and Physical Health: Parity of Esteem

Lord Bragg Excerpts

Thursday 10th October 2013 Lords Chamber

[Lord Bragg (Lab)]

My Lords, I, too, thank my noble friend Lord Layard for securing this important debate and for his comprehensive and definitive speech, one of many erudite and moving contributions. Mental health—or, rather, its opposite—is a subject that impinged on me personally and crucially, some years ago. It was partly for that reason that I joined Mind and eventually became its president for 15 years. I handed over to Stephen Fry a year or so ago. I have talked to my friend, Paul Farmer, Mind’s chief executive, about this debate.

The bleak statistics have been set out clearly by many of your Lordships. The list of lacks is long. Six million adults suffer from different forms of depression; the cost of poor treatment is pain, distress and, we are told, £60 billion. As we have heard eloquently and graphically today, the injustice is intolerable, the neglect is shameful and the effects are often disastrous and on many levels.

The cleverness of this proposal, in my view, lies in the phrase “parity of esteem”. That is key; it opens up several doors, some of which lead to better prospects than others. We all agree that this parity must be based on parity of treatment with physical illness, as has been well said again and again. Progress depends on investment, but it also depends on something just as important, which is a fundamental change of attitude and the will to bring it about. The ancient stigma is dissolving, but very slowly, and is still, I suggest, however unconsciously, the major impediment to the parity that my noble friend Lord Layard seeks.

In terms of investment there is a deep problem; perhaps that is the elephant in the Chamber. We have an outstandingly good health service. I experienced it recently through myself, my family and two of my friends over the past 18 months, in the north-west of England, in Edinburgh and here in London. In every case we met high skills, courtesy and care—and still free, as Bevan intended. It is an amazing asset and a flagship for this country’s decency.

Today, however, this is accompanied in general terms by a rarely and uneasily articulated, yet growing, fear that this noble ideal—this vow in our country to deliver such a service, from however difficult a childbirth to however lingering a death—is now under serious threat, failing, falling and going. The extensive and inclusive nature of our health service is both its greatness and, in some people’s view, is proving to be its weakness. From the latest intricate and expensive surgery to looking after dumb Saturday night drunks; from the increasing flood of the complex ailments of old age to cosmetic surgery; and from dialysis to a small bruise, it serves a multiplying range of complaints and demands. As the needs increase, can we continue to afford it? Do Governments want to afford it? We read about subtraction, but rarely about additions: cutting is the sound of the day.

In that context I suggest that at present, sadly, mental health is low down on the list of priorities. It is a very demanding aspect of national health and of the utmost concern to all of us here, as it should be to everyone in the country. All of us here are trying to improve the position of those afflicted, at whatever level. Although we must keep up the pressure, it seems that we cannot merely reach out to the Treasury. We have to find other ways, if only as interim measures.

The direction to which my noble friend Lord Layard points us is as much in the human as in the economic sphere. Mind’s steady encouragement of people in the public eye to admit to mental health problems is one useful method. I did so myself when I became president of Mind 17 years ago; the public reaction was one of overwhelming relief. “I found that I was not alone”, people said, again and again. Too many people still are alone.

Next to increased investment, one of the best ways to meet this challenge is to find parity in the workplace, which gives people esteem in the eyes of others and of themselves. The knock-on effects are extremely encouraging. This has already been tried and encouraged by Mind. I will give one example. As part of Mind’s employee support programme, EDF offered psychological support—cognitive behavioural therapy—to employees and trained more than a thousand managers to recognise mental health problems among staff and develop support strategies. Job satisfaction has already, over a couple of years, risen from 36% to 68%. There also have been marked savings through increased productivity and increased profits. All this is a reason for some optimism this afternoon.

This programme could be developed further and would benefit from a higher profile. Does the Civil Service, do local authorities and do we here in Parliament take on and help people in the workplace with mental health problems in that way? Could we introduce legislation to move that along? It could help, and would be widely welcomed as a positive move; it could set an example. Could we not find a way to develop that?

In short, we need more money, more understanding and more resources. However, we also need more attempts to integrate people into the workforce and to educate those more privileged in health to understand and throw out a new lifeline. Parity of esteem might come most surely of all from friends at work and the respect gained by working with other people. I believe that many people in this country are ready to support that.