Health: Mental Health Strategy

Baroness Thornton Excerpts

Monday 14th February 2011 Lords Chamber

[Baroness Thornton]

My Lords, the noble Baroness, Lady Murphy, has provided us with an opportunity to discuss this important issue, for which we should all be grateful. The Government published their new mental health strategy, No Health without Mental Health: A cross-government mental health outcomes strategy for people of all ages, on 2 February. It is designed to set the framework for the policy and development of mental health services for at least the next five years. It is accompanied by a call for action to set out the principles of change and urge co-ordinated action in delivering the strategy. I join other noble Lords in saying that this is an aspirational document and there is no doubt that it makes a powerful case. However, as is this Government’s habit, it does not contain goals and target-setting as a means to reach its objectives.

I welcome the strategy’s acknowledgement that mental health problems cost England £105 billion every year and that this burden spreads beyond health services to education, employers, the social security benefits system, housing, the criminal justice system, and families and communities. I also welcome its demonstrating how effective interventions and initiatives can reduce that burden and prevent needless suffering to individuals and their families.

I think that we are all familiar with policy documents that are excellent and long on analysis of the problem in question but unfortunately bring to bear solutions that lack the same passion, drive and specificity. I think that I am not alone in expressing this concern—the noble Lord, Lord Newton, and my noble friend Lord Patel are but two of the others who have done so. In the same week that the Government launched their mental health strategy, the Commons debated the revolution in the NHS that is the Health and Social Care Bill and the uncertainties that it may bring. At the same time, hundreds and thousands of people with a mental health problem will face a test of their incapacity evidence which is already suggesting great unfairness and causing great distress. If one adds to this the local cuts which threaten services that are vital to many, one concludes that the Government must expect a level of anxiety about the deliverability of the strategy.

I commend the work of the voluntary sector in this area. I did a trawl through the websites of Mind, SANE and Rethink to see what they had to say about the Government’s plans. I also had a look at their blogs to gauge their members’ reactions. Like most noble Lords and me, they give a general welcome to the strategy. However, I shall quote what someone on the Mind website said:

“The county council will cease to provide funding for our local branches of Mind, or indeed for any services for people will mental health problems. We, (mental health service users who attend any of the pitifully few groups or agencies available) were told that this is so we can all have more ‘choice’ by opting to fund organisations ourselves with personal budgets. In reality, people with life-long mental health problems are being weeded out at every stage of trying to access these budgets and will therefore be unable to attend anything. Centres such as those provided by local Mind charities may well have to close if there are no longer people who can afford to attend them. So much for ‘choice’. The future health and stability of those now left unsupported does not appear to concern the council. At a time when council budgets are being slashed, social care is under a great threat. Any talk of a ‘strategy for mental health’ is somewhat meaningless in the circumstances, particularly for anyone with long term problems”.

That is a point of view that the Government need to take very seriously.

Will the Government’s strategy work? For people who experience mental health problems, I suggest that it has to work. It is legitimate to ask questions about how it might be delivered. I agree with the noble Baroness, Lady Hollins, on the lack of mention of funding for research in the document. I make two points. First, multidisciplinary commissioning is vital for pathways of care. Some of the matters will fall within the remit of the public health authorities, some with the NHS Commissioning Board and some with GP consortia. This may risk fragmentation of provision. If co-ordination and co-operation are so important, why are the Government abolishing the National Mental Health Development Unit as part of their rationalisation of the arm’s-length bodies?

The second point is the greater societal challenge. We have to recognise that cuts will bring restrictions to education opportunities, unemployment and debt. The impact on people’s lives and their mental health cannot be underestimated. Debt and the risk of homelessness and family breakdown will have a huge, spiralling effect on stress and anxiety levels. There will be an even greater need for these services to be got right.

In recent times under the Labour Government, we saw the start of a positive change in public attitudes. Evidence clearly showed that we need to support people in the workplace and the wider community. I will be very interested to learn from the Minister the answer to the questions that the noble Baroness, Lady Murphy, and others have posed in this debate.