Government Action on Suicide Prevention

Debate between Dan Carden and Kerry McCarthy

Wednesday 8th June 2022 Westminster Hall

[Kerry McCarthy]

I thank my hon. Friend for his intervention. I know there was a very good debate in this Chamber yesterday morning, which unfortunately I could not attend, where such issues were raised. There are some discrete areas where a specific intervention suggests itself, such as gambling addiction, alcohol abuse, post-natal depression, or veterans’ mental health. I certainly feel that such risk factors ought to be reflected in the suicide prevention plan.

A quick win would be to obstruct people from accessing the means to die by suicide, with obstacles placed in their way. A lot of suicides are opportunistic. For example, the British Transport Police is very good in terms of how it polices stations and watches out for signs that somebody might be thinking of jumping in front of a train, and helplines can be flagged up at places such as the Humber bridge and the Clifton suspension bridge, but there are also physical measures that would make suicide more difficult. People might say, “Well, perhaps people will just go somewhere else,” but it does not always happen like that. If the moment is lost, there is a good chance a life will be saved.

Will the Minister tell us a little bit about the plans for the revised suicide prevention plan? Will it have clear priorities, with an evidence-based, tailored plan in each case for how we will bring rates down, and then targets set on that basis? One organisation described the current approach as very much a “throw everything at the wall and hope something sticks” approach. We need a far more tailored approach.

Will the Minister also tell us where the boundary falls between what is in the remit of the Department of Health and Social Care and work that requires action by other Departments? We have already talked about gambling, and the debate yesterday was answered by the Under-Secretary of State for Digital, Culture, Media and Sport, the hon. Member for Mid Worcestershire (Nigel Huddleston). The Online Safety Bill is another example of where another Department is taking the lead, and I am worried that the Government will not fully seize that opportunity to crack down on sites promoting suicide and self-harm. I gather there is a bit of a difference of opinion between the two Departments, which is particularly disappointing given that the current Secretary of State for Digital, Culture, Media and Sport, the right hon. Member for Mid Bedfordshire (Ms Dorries), was the first Minister for Suicide Prevention. Does the Minister agree that we need to strengthen the Bill’s provisions on this issue, or has she lost the battle with the Secretary of State for Health and Social Care? I hope not, and I hope that, if the Bill is not strengthened in Committee, we can improve it on Report.

The review of special educational needs and disability is another potential missed opportunity. It is meant to be a joint effort by the Department for Education and the Department of Health and Social Care—there is a joint foreword—but there is very little in it on child and adolescent mental health services. Given the overlap between children struggling at school who cannot get the right diagnosis and cannot get a timely education, health and care plan and children who end up in the mental health system, joint working is really important.

Obviously, it is not just children with SEND who struggle. One in six children are now said to have a probable mental health condition, up from one in nine in 2017. More than 400,000 under-18s were referred for specialist mental health care between April and October last year. These are children at the more severe end of the spectrum—those who presented with suicidal thoughts, self-harming or eating disorders. The number of attendances at A&E by young people with a diagnosed psychiatric condition has tripled since 2010.

We know that CAMHS is at breaking point. There are huge waiting lists, and severely mentally ill children are being cared for in inappropriate settings or being sent hundreds of miles away from home for treatment. It is said that half of all mental health problems are established by the age of 14, rising to 75% by the age of 24. If we do not want today’s children to be tomorrow’s suicide statistics, we need to do much more, much faster, to help them now, and I just do not see that sense of urgency from the Government. This consultation is all wrapped up in a 10-year plan, but we need a 10-day plan. We need action now.

One issue we discussed at the event in Speaker’s House was how schools could better nurture children’s creativity and give them an outlet for their emotions through music and art. We also talked about whether the current trajectory of education, with schools very focused on grades—someone described them as “exam factories”—places undue pressure on children. I agree with that to a large extent and worry about cuts to things like music education, which mean that creatively inclined children do not have that outlet. It is not plain sailing for the other 50%, the academic ones, either. Just because a child does well in education does not mean that they are set up for success in the wider world, whether that means higher education or the world of work.

I am sad to say, as a Bristol MP, that Bristol University has become known for the number of student suicides in recent years. It is obviously not the only university to have experienced this, but it has come to particular attention. There needs to be a constant process of reflection and review. We have just had the court ruling in the tragic case of Natasha Abrahart. She was a very able student at Bristol University, but she suffered terribly from social anxiety and just could not handle the oral side of her course and having to do presentations. Rather than trying to force all young people into one model of what success and achievement look like, institutions need to adapt to them. I hope that Natasha’s parents will be able to pursue their campaign to ensure that that happens in the future.

I have also spoken to various groups about data sharing, which I appreciate is a complicated area. When should parents of university students, who are adults, after all, be informed? What are the boundaries of patient confidentiality? Some students might be deterred from speaking to mental health services at uni if they think that their parents might be told, particularly if they are grappling with something like their sexuality or if they have become involved with drugs. There are all sorts of things that young people would not want their parents to know about. Some might come from abusive family backgrounds and their parents would not be helpful or supportive, but in many cases the parents would have desperately wanted to know that their child was struggling to the extent that they were.

Steve Mallen from the Zero Suicide Alliance thinks that more could be done within data protection laws to protect students, and I hope that that is under active consideration.

[Dan Carden (Liverpool, Walton) (Lab)]

I was at the Speaker’s House reception, and one of the most shocking things I heard was that two thirds of people who commit suicide have never sought any support for their mental health. What does my hon. Friend think are the consequences of that, and how should we be trying to deal with it? I think that we need to ensure that we have a holistic approach that offers support, because we all have mental health needs; we all need support. What does she think?

[Kerry McCarthy]

I thank my hon. Friend and agree with him, but I have some reservations about going down that path. A lot of the conversation about mental health in recent years has focused on the importance of getting people to open up and talk about their problems, and an obstacle in the way of doing that is that it can be very difficult for people to access GP appointments or to get the help that they need. I very much support Labour’s policy of publicly accessible mental health hubs in every community, as well as mental health support in every school. There needs to be swift and easy access to talking therapies or even to something less formal—just to someone who will sit there and be prepared to talk to the person. There is also campaigning to try to get people just to ask others how they are feeling, and that would help. I am a bit worried because there is a danger that we will focus totally on the softer end of things and talk a lot less about the more difficult areas, where people are well past the point where a nice cup of tea and a friendly chat would make a difference. At the moment, there certainly seems to be a huge problem where people are considered to be past the point where talking therapies would help. It might be that they are too high risk or too unwell to benefit from primary mental health services but not quite ill enough to access secondary services, such as the community mental health teams; they are not totally at crisis point. Often, they are left to fester somewhere in the middle, and when they reach crisis point, they finally get help, but that is too late in many cases to actually turn their mental health around. Too many people fall by the wayside because the right pathway is not available.

Currently, 40% of patients waiting for mental health treatment are forced to contact emergency or crisis services before they receive treatment. One in 10 of them ends up in A&E, and I have real concerns about whether A&E is appropriate, particularly if someone has experienced psychotic episodes. I cannot think of anything worse for them than being in an A&E department, with the sirens, flashing lights and people who have probably turned up there because they have drunk far too much or are off their heads on something or other and have got into fights on a Saturday night. Some hospital trusts are experimenting with trying to triage people very quickly away to mental health provision in A&E, which I think is a very good move.

We have waited a long time for the Government to bring forward the mental health reforms outlined in the Queen’s Speech. We are right to be concerned about the misuse of powers under the Mental Health Act 1983. We have heard terrible stories of people with autism being detained long term against their will, and the disproportionate use of those powers against people from ethnic minority backgrounds, particularly young black men. I hope that, as part of that debate, we can also talk about how the system fails people who do need to be in hospital, whether by voluntary admission or being sectioned, because a lot of people would benefit.

We see people on the streets talking to themselves, heads bowed, and everybody side-steps them. Sitting on public transport next to someone who is clearly unwell can be uncomfortable. If people have physical health problems, the expectation is that the health service is there to treat them. I know there is a question of capacity and whether people consent to treatment, but I feel we write people off when their mental health reaches a certain state, unless it gets so bad that they are a danger to themselves or others. The system needs to gear up to help people who are broken to that extent. It might not be possible to fix them, but their lives could be made better.

The number of beds in NHS mental health hospitals has fallen by a quarter since 2010, with almost 6,000 beds lost in England alone, despite big increases in the number of people needing mental health support, and cases where people are sectioned under the Mental Health Act. Figures obtained through freedom of information requests show that on a single day in February this year, all of England’s high and medium-security hospitals were operating above the Royal College of Psychiatrists’ maximum bed occupancy rate of 85%. The NHS pays £2 billion a year to private hospitals for mental health beds because it does not have enough of its own. Nine out of 10 mental health beds run by private operators are occupied by NHS patients.

It was also revealed last month, again through FOI requests, that over a five-year period from 2016 to 2021, more than half of the 5,403 prisoners in England assessed by prison-based psychiatrists as requiring hospitalisation were not transferred from prison to hospital. Those were not people with what might be called run-of-the-mill mental health concerns; they had major psychotic illnesses or chronic personality disorders. They needed to be in hospital, not in prison, but they did not get those transfers. We can only speculate on the problems that might store up for the future.

Where there are hospital beds, the pressures on the wards and staff are immense. There are way too many tragic stories of patients being discharged too soon, being wrongly assessed as low risk, and not getting the help they needed, with inevitable results. For example, 22-year-old Zoe Wilson died at Callington Road hospital in my constituency in 2019. She was put on a low-risk ward, despite ongoing psychosis. In January this year, the inquest jury returned a narrative conclusion, having found that multiple failings contributed to her death. The prevention of future deaths reports—the regulation 28 reports—published with the latest coroners’ statistics, make very grim reading. So many of the reports point to failings such as those noted in Zoe Wilson’s case.

I am not convinced that lessons will be learned from these reports, because what is required in many cases is not actions by individual hospital trusts. I should explain what happens. The coroner notes that an institution—a university, or any organisation that might have had contact with the person prior to their death—should learn a lesson and do something in future to try to save a life. Those comments are usually directed at a hospital trust or another organisation, but I would like to know what notice the Government take. Patterns showing where there are failings in the system emerge in these reports. I would be reassured if I felt that, rather than just informing the actions of an individual institution, the reports also informed future suicide-prevention strategy. I am sure the Minister will tell us how much more is being devoted to mental health spending, but we need to acknowledge the simple fact that, despite any figures she might produce today, our mental health services are drastically underfunded, under-resourced and under-staffed, which is why they are at crisis point.

I want to finish today by paying tribute to people who have spoken up about their own family experiences, as Mr Speaker did at the event in Parliament. He spoke so powerfully, because he was clearly very upset about what had happened. I, too, lost someone to suicide last year, as many other people will have, including people who are listening today. I started off by talking about how Bernard and Stephen from Joy Division/New Order came to speak about how, even 42 years later, they are still affected by the death of their singer Ian Curtis. Another musical genius and a musical hero of mine, David Berman, took his own life a few years ago. His last album, “Purple Mountains”, was basically a suicide note. He can be very funny at times—he has this real lyrical genius—but listening back to the album now, you can see where he is going. He suffered from depression for a long time, and he has this song, “Nights That Won’t Happen”, which says,

“The dead know what they’re doing when they leave this world behind…

When the dying’s finally done and the suffering subsides

All the suffering gets done by the ones we leave behind.”

I will finish on that note, because that is very true. He felt that he was escaping from something. He escaped from it, but I hope that support services for people who have recently been bereaved by suicide is at the top of the Minister’s agenda, because those are the people who really need it.

Climate Change, the Environment and Global Development

Debate between Dan Carden and Kerry McCarthy

Wednesday 10th July 2019 Commons Chamber

[Dan Carden]

I am happy to say that the Labour party is committed to exactly that. Dealing with the figures honestly is one of the first actions that we can take.

The shadow Chancellor recently spoke at length about the preparations that Labour is making to roll out a climate emergency programme should there be a general election this autumn. We are working on a range of ambitious new policy proposals that we think will turbo-charge our effort. We want to be as ambitious as possible, and we are looking into how we can bring forward the target date for net zero emissions.

Let us examine the Government’s international actions on fossil fuels, climate finance, and global climate justice. Take the Prosperity Fund, set up by this Government, plagued by scandal, and funded to the tune of £1.2 billion from the aid budget. In October 2018, it was found that 29% of its energy spending was on fossil fuel projects, including projects to expand the oil and gas sectors in Brazil and Mexico and support for fracking in China. Or take CDC Group, which is wholly owned by the Department for International Development: it, too, continues to invest directly in fossil fuels. Then—as has been mentioned—there is UK Export Finance, 97% of whose support for energy in developing countries is going to fossil fuels, with less than 1% going to renewable energy. The Minister was keen to give examples of support for renewables, but the statistics are stark and speak for themselves.

Let us take the Foreign Secretary and Conservative leadership contender. He talks a good game on the climate emergency, but in April this year, during his first official visit to Africa, he announced an agreement that will allow money from UK Export Finance to support the building of offshore oil and gas installations in Senegal by British companies BP and Cairn Energy. Or take the UK’s failure to use its influence in the big multilateral development banks, such as the World Bank, to ensure that their investment strategies are aligned to help us hit the Paris agreement’s target.

The Government must do much better on all those fronts. The International Development Committee has called on them to use their influence on the boards of the big multilateral banks to move them away from high carbon investments. Labour is committed to divesting fully our aid budget from the financing of fossil fuel projects, so I ask the Minister whether the Government will back up their warm words with action. They could announce today that they will stop funding fossil fuel expansion overseas, and encourage others to do the same.

[Kerry McCarthy]

I do not know whether my hon. Friend has had a chance to look at the Environmental Audit Committee’s report on UK Export Finance, but does he agree that the Minister’s assertion that we are significantly reducing our investment in fossil fuels through that organisation does not stack up? There does not seem to be any evidence that we have shifted our policy at all.

[Dan Carden]

My hon. Friend is absolutely right and the Government need to report back to Parliament on that.

I want to say a few words about climate finance. The signatories to the Paris agreement have committed to finding at least $100 billion just for mitigation and adaptation in developing countries, but even that number is extremely conservative; UN Environment estimates that the real number for mitigation and adaptation alone could in fact be as high as £500 billion by 2050. So why does the UK not have a serious climate finance strategy? In its most recent report in May the International Development Committee called again for one to be given to Parliament, and I urge the Minister today to set out exactly when that will happen.

I turn now to how the UK can tackle the root causes of climate emergency, rather than just manage the decline of our planet. It must not be the role of the British Government and the British taxpayer to throw money at clearing up the mess left behind by the world’s biggest polluters simply so that they can carry on polluting. The truth is that our global economic model is fundamentally broken; it is a system that is driving us towards disaster in the quest to accumulate ever more wealth and extract ever more profit. Unless there is a UK Government who are serious about transitioning away from our current economic model, however ambitious our international action is it will only tackle the symptoms of climate change, never its root causes.

It is a tragedy that those least responsible for the climate crisis will be the first to suffer its consequences. It is not the world’s billionaires who are suffering the worst effects of planetary breakdown, and we should be under no illusions: they are making plans not to fix our economic model, but to escape, survive and ride out the catastrophe.

I want to bring to the House’s attention the writings of the technology writer Douglas Rushkoff, who last year recounted how he was brought in as an expert adviser to a room of billionaires to talk about climate change. He was flabbergasted when, instead of asking him about how to prevent the climate catastrophe or what role they could play, they asked him about how they could insulate themselves from the danger, including, amazingly, the use of disciplinary collars to maintain the loyalty of their private security forces to protect them when society finally broke down and when wages and money no longer held sway. That is quite remarkable.

The time for tinkering around the edges is over. To avert climate catastrophe we must radically restructure our economy here in the UK and globally so that it works for the many, not the few. We should consider this: if global growth continues at 3% each year the global economy will have doubled in size by 2043, and so too will material consumption unless we can de-link it from economic growth. For too long we have ignored the plain fact that we cannot sustain permanent growth on a planet of finite resources. That is exactly why we need the kind of systemic change that our shadow Chancellor has spoken about, and it is why we must use and harness every policy lever available to us and ensure that the state and the private sector invest in the infrastructure to bring about the next green industrial revolution. And that is why we must work with the City to reform and why we must use our influence on the global stage to promote a more democratic global economy.