Mental Health Treatment and Support

Danny Kruger Excerpts

Wednesday 7th June 2023 Commons Chamber

[Danny Kruger (Devizes) (Con)]

It is a pleasure to follow the speech of the hon. Member for Oldham East and Saddleworth (Debbie Abrahams), who is a great champion of this cause. I am very proud to work with her on the all-party parliamentary group for prescribed drug dependence, which, after this debate, I am going to ask her to co-chair with me.

I want to call the House’s attention and that of Hansard to the speech made by the hon. Member for Bermondsey and Old Southwark (Neil Coyle). The distressing and powerful story he told of a constituent of his will remain with me as a terrible example of the state of so many of our constituents and of mental health services that do not work properly.

I welcome this debate, and I am afraid to say that I do recognise many of the descriptions given by Members on both sides. I want to call attention to the excellent services provided in my constituency of Devizes by the Green Lane Hospital, a mental health hospital that has been there for many years. However, even there we have many cases of constituents feeling that they have been let down and of genuine difficulty in accessing the services that are needed in time. Despite the good efforts made from the top of the system to the bottom, we simply are not doing well enough, so I welcome the debate, and I recognise the general point being made.

Of course, I agree with the argument put forward by the Opposition that we need more mental health services. The question is what those services should be, how they are organised and, indeed, whether we should use services as the frame for this whole debate. I wonder whether the term “services and relationships” would be more appropriate, and Members have mentioned the primacy of relationships. The fact is that we do not fully understand all the neurological origins of mental health conditions, but we do know that they are exacerbated by social circumstances, and that while medical treatment can help, what really helps is good relationships.

I know this from my own experience. For many years, I ran a project working in prisons and with ex-offenders, and we saw so clearly that, while of course the official and the essential responsibility for crime and criminality rests with the individual, it is usually relationships and relational skills or the lack of them that lead somebody into crime and into prison, and it is relationships and relational capacity and skills that help people to get out of an offending lifestyle. We also know this very well from all the evidence in studies of addiction, which is very closely correlated to mental health.

What do we do? There is consensus that we need more services and better services, but my concern is that we will end up focusing the system’s efforts on quantifiable measures or quantifiable inputs—most of all, the prescription of pills and pharmaceutical treatments—so we will end up medicalising mental health, just as we medicalise so much physical health. I chair the APPG on prescribed drug dependence, as I have mentioned. The research that the APPG has supported, particularly by Dr James Davies of Oxford University, shows that a fifth of adults are on antidepressants, many of them because they cannot get off these pills, even though they are only supposed to be prescribed for a certain time. We spend £500 million a year on prescriptions for medication that people should not be on, according to the guidance for those pills.

I worry about the trend towards the medicalisation of mental health, and I particularly worry about the Government’s major conditions strategy, which I welcome. We cannot have a focus just on pharmaceuticals; we have to make it much wider. It should not just be about services, but about the relationships that support good mental health. I am pleased there is a strategy on mental health and there does need to be top-down action, but I would like it also to focus on undoing this over-medicalised model. We need more training for GPs to understand the social relationships at the heart of mental health, including how to support people who have acute conditions. We need more funding for social prescribing—that has been mentioned—which is a tremendous initiative. We need support for withdrawal services and a helpline for people who are addicted to prescribed drugs.

Overall, however, we need a bottom-up approach. I respect Labour’s plan for more access hubs for mental health, more school mental health workers and more staff, but really we need system reform. The hon. Member for Tooting (Dr Allin-Khan) mentioned the community mental health approach, and I like that phrase, but I think it includes much more than just more hubs and more staff. We need a whole system reform that prioritises the civil society organisations, families and community groups that have such a powerful role to play in supporting people with mental health.

Lastly, I draw attention to the new developing model called outcomes partnerships, whereby the public sector pays for results—not for inputs and not even for outputs, but for actual demonstrable improvement, whether it is in healthcare or mental health. It brings together all the different providers from civil society, the public sector and, indeed, businesses—we have mentioned the importance of workplace training—so that we get all the different players involved in a person’s life, and so that the funding is more local and can be used on the preventive agenda, which is so important. Rather than just trying to pour more money into the top of the NHS and thinking that is going to work, we need to fund it from the bottom up.

[Several hon. Members rose—]