Mental Health Treatment and Support

Ben Spencer Excerpts

Wednesday 7th June 2023 Commons Chamber

[Dr Allin-Khan]

I will make some progress, but I would be happy to take further interventions after that.

Amid all the anguish and pain, one thing comes through: people cannot access the mental health services they need. The stark fact is that the way the UK’s mental health services are funded and distributed can exacerbate the problem, so instead of making people better, they are making them worse.

The current reality is that 1.6 million people are waiting for treatment. More than 1 million people had their referral closed without receiving any help in the last year alone. Last year, children in mental health crisis spent more than 900,000 hours in A&E and almost 400,000 children are on waiting lists. In the same period, adults experiencing a mental health crisis spent over 5.4 million hours in A&E. Black people are five times more likely to be detained under the Mental Health Act 1983 than white people. People with eating disorders are being put on a palliative care pathway.

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

Will the shadow Minister join me in welcoming the work the Government have done to bring forward the draft Mental Health Bill? We both sat on the pre-legislative scrutiny Committee. Hopefully, the Bill will right some of those wrongs.

[Dr Allin-Khan]

It has been a pleasure to work with the hon. Member on the draft Mental Health Bill. However, as I will say later in my speech, I have little confidence that the draft Mental Health Bill will move beyond the draft stage. We need to debate the issues in the House, to ensure that what we know needs to be fixed is actually fixed, so that we can help people in our communities, including black people, who are more likely to be detained under the Mental Health Act, and people with autism and neurodiversity, who are mistreated simply as a result of having that diagnosis, so that their lives can be better lived. We need these issues to come before the House, so that we can debate them and move forward.

--- Later in debate ---

[Neil O’Brien]

I should make a little progress before taking further interventions.

The Government are providing £150 million of capital investment in the NHS’s urgent and emergency care infrastructure for mental health over the next two years. Those interventions include £7 million for 90 new mental health ambulances, with the remaining £143 million going to more than 160 capital projects with a preventive focus. These include new urgent assessment and care centres, crisis cafés and crisis houses, health-based places of safety for people detained by the police and improvements to the NHS 111 and urgent mental health helplines. The hon. Member for Tooting talked about creating such facilities in the community, and we are already doing that. We are also investing £400 million between 2020-21 and 2023-24 to eradicate mental health dormitory accommodation, improving safety and dignity for patients. Twenty-nine projects have already been completed since the programme commenced in 2020-21, eradicating over 500 dormitory beds.

[Dr Ben Spencer]

Will the Minister join me in welcoming the construction of the new Abraham Cowley unit, which will eradicate the dormitories that were in my constituency?

[Neil O’Brien]

I join my hon. Friend in celebrating that unit and his advocacy for people affected by mental health.

--- Later in debate ---

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

As a now non-practising former consultant psychiatrist, I have a host of declarations I should make in terms of speaking in this debate. For the sake of brevity, I draw attention to my entry in the Register of Members’ Financial Interests and my declarations as part of my work on the pre-legislative scrutiny Joint Committee, which list them in full.

This is an important debate and I shall focus on two angles. One is the delivery of mental health care and treatment and the other is the framework for that. I want to celebrate today the rebuild of the Abraham Cowley unit in my constituency. It gets rid of the awful dormitories that have plagued mental health care and treatment for some time. They are now gone, and we will have a brand new, rebuilt mental hospital. In fact, tomorrow, I am going to the topping out ceremony on the site to see the progress in delivering that. It will make a huge difference to the delivery of mental health care.

I used to work as an in-patient consultant psychiatrist. When people come into hospital for in-patient psychiatric treatment, it is often at the most difficult times of their lives. It is critically important that our mental health estate is fit for purpose and is a therapeutic environment. For too long, the mental health hospital estate has been the second cousin to acute physical health care and I am delighted that we are driving change forward in my patch. If people need in-patient care and treatment, they will get it in a new hospital that is fit for purpose. I just want to celebrate that and thank everyone who has been involved in getting it over the line, as well as all the people who work in that sector, including those who are looking after the patients who would have been in the old hospital, which is now a building site, and going through a stressful period of transition while the new hospital is set up.

My second point is about the draft Mental Health Bill. A few years ago, my right hon. Friend the Member for Maidenhead (Mrs May), the former Prime Minister, suggested that we should review the legal framework we use when we treat people who are unable to consent or do not consent to treatment. Around every 20 years or so, we go through this process. We should be proud as a country that we have always been at the forefront of driving forward legislation and legal frameworks for dealing with people who cannot consent to treatment, the law of best interests and capacity. I was fortunate to be a panel member of the Simon Wessely review. I did that as part of my previous academic life, so Members can imagine my pride and delight in being part of the pre-legislative scrutiny Joint Committee on the draft Mental Health Bill.

I am slightly saddened by the debate today, because mental health—especially the frameworks we use to treat people who are severely unwell—needs to be above party politics. We are discussing the most invasive thing we do in medicine—detaining and treating people in hospital, sometimes for a substantial time. We need to think carefully about the right balance between choice, freedom and autonomy and making sure that people get the care that they need at the right time and under the right framework. I am glad that the Government have done pre-legislative scrutiny and we have worked on a cross-party basis to get this issue over the line. I hope that we will see the mental health Bill very soon.

My final point is about psychosis. The Government’s amendment mentions the treatment of psychosis, which I know is often missed out in these debates and when people talk about mental health. Psychosis is one of the most disabling mental disorders and far and away the most costly and impactful, because it can affect people when they are quite young—

[Vicky Ford]

It is incredibly helpful to have my hon. Friend’s detailed experience in this debate. Why does psychosis get missed out?

[Dr Spencer]

It is simply because of advocacy; the conditions debated tend to be mental health conditions for which people can advocate. We talk a lot about dementia, and the children of those suffering tend to advocate for them. For CAMHS, it is the parents who advocate. For common mental disorder, people are able to advocate for themselves, but psychosis can be—I do not want to make a broad generalisation—disabling and isolating, and can limit people’s ability to advocate for themselves. From my research, I know that psychosis can break down family relations and alienate people. I am nervous about broad generalisations, and for the most part people can get better and do very well, but in some cases psychosis can be very disabling and limit advocacy.