Mental Health: Access to Work Support Service

Baroness Meacher Excerpts

Monday 18th June 2012 Lords Chamber

[Baroness Meacher]

My Lords, I, too, applaud my noble friend Lady Thomas for tabling this important debate and for her rather pertinent quote from Shakespeare.

The Department for Work and Pensions indeed has an enormous challenge if it is to condense the vast numbers of claimants of employment support allowance. The objective at one stage was to reduce those numbers by 1 million over 10 years; I do not know whether that remains true today. Perhaps the Minister will correct me if that is not right these days. We know that nearly one half of all claimants have some form of mental health problem. If the department is to achieve any sort of target, it clearly has to make a major impact on the number of people who are not in work because of mental health difficulties.

The noble Baroness, Lady Bottomley, referred to my excellent husband. Perhaps I am allowed to refer to the excellent LSE report issued today, entitled, How Mental Illness Loses out in the NHS. It underlines the challenge for Access to Work as regards mental health. For example, the report points out that among under 65s, nearly as much ill-health is mental illness as all physical illness put together. That is a striking fact. We think of one single physical illness, but mental illness equals pretty much the whole of physical illness, and mental illnesses are, in general, more debilitating than long-term, chronic physical disabilities. I do not think that people fully appreciate that.

As others have mentioned, only one quarter of people with mental illness are in treatment, while pretty much everyone with any kind of serious physical problem is in treatment. It is a completely different landscape. To prepare those sick and untreated benefit claimants requires the DWP to work closely with the providers of improved access to psychological therapy services, because those services are evidence-based. At last, we have evidence-based mental health services; we have never before had effective evaluations. The commission has been given £400 million to roll out increased access to psychological therapy and, by next year, 900,000 people should be receiving those services.

In my view, DWP clients should be at the front of the queue for those services if the Government are to achieve what they hope to. May I be so bold as to challenge the Minister to contact his colleagues in the Department of Health to persuade them of the importance of ensuring that that £400 million is in fact devoted to increase access to psychological therapies and is not diverted to other parts of the system, because the money is not ring-fenced? If the DWP is to succeed, it must have that money spent where it is supposed to be. Otherwise Access to Work as regards mental health will have to pick up the pieces.

Of course, effective treatment is only the beginning for many such clients. The people we deal with need volunteering opportunities, help to improve skills, skilled employment support and all sorts of things which, in the secondary sector, we provide, but there are people not in the secondary sector mental health services who will need some of those services—probably not all of them. Many with mental health problems, unlike physical health problems, will need help once they have gone into a job. That is crucial, and employers and bosses will need some help as well as they do not understand these things. The need for special Access to Work as regards mental health is clear. That certainly came out of the Institute for Employment Studies’ evaluation of the main Access to Work programme. I have to say that its results are dismal. Others have mentioned the figure of 580 people receiving help through the Access to Work programme, compared to 27,000 altogether. One of our colleagues referred to 0.2%, I calculated it as 2%; but anyway it is a very small percentage compared with nearly 50% of all people who suffer from mental health problems.

Access to Work as regards mental health is therefore, as I said, so important, but we have only three offices for the entire country—one office for the whole of south-east London, I read in a document circulated by the Library. The only way to get these services is by a postal system so you have to write. Oh dear. As another colleague mentioned, it is the best kept secret. I talked to some employment specialists in east London who work with these issues all the time. They had never heard of Access to Work mental health. They had just about heard of the main programme, but, as they said, it does not deal with our people; they do not understand our clients at all.

So we have a long way to go. Clearly, the three offices will not touch the problem, if that is still the case today and that was the only briefing that we were given. I put one plea to the Minister. If the DWP really wants to achieve something, it needs one really good mental health specialist in each DWP office and a budget that they can allocate specifically to the personal needs of each individual with mental health problems. Many years ago when I went to Stockholm, Sweden had the lowest unemployment levels of any western European country and they had that budget. That was the key, alongside the skills of the individual.

I know the Minister well understands these issues and I respect his ability to come up with practical solutions, so I hope that he will respond positively to the practical proposal that I have just offered.