Mental Health

Diane Abbott Excerpts

Thursday 16th May 2013 Commons Chamber

[Ms Diane Abbott (Hackney North and Stoke Newington) (Lab)]

I apologise to the House for not being present for the debate’s opening speeches, which was due to circumstances beyond my control. I certainly meant no lack of respect for this debate; I think these Backbench Business Committee debates have been one of the more important and successful innovations of this Parliament, and mental health is a particularly important subject.

I congratulate the right hon. Member for Sutton and Cheam (Paul Burstow) on leading the debate in a detailed and informative fashion, and my hon. Friend the Member for Bridgend (Mrs Moon), who raised a number of important points, including alcohol abuse and its impact on mental health—those two issues are inextricably linked. I follow the hon. Member for Totnes (Dr Wollaston) in saying that if we are concerned about addressing alcohol abuse, one issue—although not the only issue—must be to do something about the flood of cheap alcohol that is overwhelming some of our communities, and put in place a minimum price for alcohol. I am glad to say that that is the Labour party’s policy.

I congratulate the hon. Member for Broxbourne (Mr Walker) on his speech. I remember a similar debate last year in which he made a moving speech about his experience, which resonated country-wide. Since then, he has shown great leadership in the mental health all-party group. He made a number of important points, including the fact that although the NHS can be good at managing symptoms, it is not necessarily so good at addressing their underlying causes. I will return to that issue when I mention Atos later in my remarks.

I am sorry to have missed the remarks of my hon. Friend the Member for North Durham (Mr Jones). He is always well worth listening to, and he too received country-wide respect for his contribution to last year’s debate on mental health when he spoke about his personal circumstances for the first time on the Floor of the House. He made a number of important points, including that mental illness and depression are equal opportunity conditions. They do not discriminate; they affect all social classes and backgrounds.

The hon. Member for Romsey and Southampton North (Caroline Nokes) spoke about a number of issues, including borderline personality disorders and the way that eating disorders affect women and girls. She made the important point that, although we sometimes associate mental disorders with socially marginalised communities and persons, eating disorders can affect the most high-achieving, educationally focused girls. That issue should not be trivialised because it is harming the life chances, health and well-being of many young women up and down the country.

My good Friend the hon. Member for Islington North (Jeremy Corbyn) made an important speech about mentally ill people in prison. When getting caught up with the “prison works” narrative, it is worth remembering how many people in prison are either illiterate or simply mentally ill, and if we want to contain the number of people in the prison estate, we must address the mentally ill. My hon. Friend also mentioned black and minority ethnic communities and mental health, and I will return to that point later.

The hon. Member for Totnes made an important speech and mentioned social exclusion and BME mental health. My hon. Friend the Member for Croydon North (Mr Reed) made an important speech about Olaseni Lewis and the issue of black and minority ethnic persons detained under the Mental Health Act 1983. I am glad that the Minister has agreed to meet my hon. Friend and engage with him and the family on that issue. The hon. Member for Harrogate and Knaresborough (Andrew Jones) also made an important speech.

My hon. Friend the Member for Bolton South East (Yasmin Qureshi) made a speech about—among other things—the importance of a holistic treatment for mental health issues and taking account of people’s different cultural backgrounds, which I thought was important. There was, as always, an interesting and provocative speech from the hon. Member for Southport (John Pugh), and I was interested to listen to the hon. Member for Battersea (Jane Ellison) who spoke about mental health and female genital mutilation—if it had been my choice, her speech could have gone on longer. I thought she raised important issues, and the House should respect the lead that she has shown in addressing the issue, which is difficult for people outside the affected communities to address. If in future some young girls are not subjected to that child abuse because of her work, she will deserve the congratulations of this House. The hon. Member for Finchley and Golders Green (Mike Freer) also made an important contribution.

We have heard figures for the incidence and prevalence of mental health problems, and because it is a Cinderella service and a Cinderella issue it is always worth reminding people that one in six people in Britain is affected by mental illness at any one time. In other words, almost every family will have experience of mental health. It is not something that happens to other people, but something that happens in our own families. One in four of us will suffer from mental illness at some point, and by 2030 depression will be the leading cause of disease around the world, costing the NHS a further £10 billion a year. The criminal justice system will also pick up the bill because 70% of those in our prisons have a mental illness. Mental health problems cost British business almost £26 billion a year.

The subject has been addressed by my right hon. Friend the Member for Doncaster North (Edward Miliband) who made an important speech to the Royal College of Psychiatrists in October last year. The key points he made are worth reporting and concern the importance of breaking down stigma—something that the House dwelt on at length in last year’s debate—and the importance of parity of esteem for mental health within the NHS. My mother was a mental health nurse in Huddersfield, and her hospital was a former Victorian workhouse on the fringes of Huddersfield. Having an old workhouse outside the city for mental health issues, and mainstream health services in the centre, illustrates the lack of parity of esteem for mental health in relation to the services we offer, and also to practitioners at every level within mental health services.

Finally, my right hon. Friend the Member for Doncaster North mentioned the importance of mental health in our society, and argued that good mental health does not start in hospitals but in workplaces, schools and communities. He took the opportunity last October to announce the formation of a taskforce on mental health in society, which will look in particular at employers and the role they play.

[Jeremy Corbyn]

Perhaps my hon. Friend can help me. I hope that the taskforce will also look at issues surrounding the voluntary sector and its excellent work within the mental health service, as well as the dangerous tendency of franchising out mental health services to the private sector by some mental health trusts that do it for profit rather than care.

[Ms Abbott]

My hon. Friend’s points are well made.

Let me consider the future for mental health and set out for the House how important the role of local authorities can be in addressing the social determinants of mental ill health. Public health has become the responsibility of local authorities. They have a ring-fenced public health budget, and despite all their pressures and difficulties—which I do not seek to minimise—there is an opportunity for local authorities to do important and interesting work, bringing together education and housing with health care to address mental health problems and intervene in them early.

I was shocked to hear of a social housing project near King’s Cross that, presumably to make its tenants more manageable, did not want to give tenancies either to people who had a history of rent arrears or to people who had a history of mental health problems. Such things need to be highlighted and addressed. Sitting responsibility for public health with local authorities could address mental health, particularly in respect of early intervention and preventive work with children in schools.

I gave a speech this morning on the crisis in masculinity. We need to focus on the mental health challenges that face men. Whether it is because they are unwilling to come forward or because of stress in society, we know that, during a recession or economic downturn, suicide rates among men increase. Suicide is currently the biggest cause of death among under 35s. In planning services nationally and locally, we need to pay particular attention to that issue among others.

The hon. Member for Totnes made an important point. She said that, in our desire to reduce health tourism—a desire supported by the Opposition—there is a notion that people will need their passport when they turn up to see their GP. That runs the risk of making it harder for the socially excluded to access health care—many simply do not have a passport or such documentation.

I will not speak at this point about the merits or otherwise of the welfare reforms, but there is a lot of anecdotal evidence that they are having an effect on the mental health of some who are caught up in the system. There is a lot of anecdotal evidence that Atos, as it is currently configured and as it currently operates, does not meet the needs or seem to understand the problems of people with mental health challenges.

[Mark Hendrick]

I am sure that my hon. Friend, like many other hon. Members, has come across many constituents attending surgeries who are developing serious mental health problems purely and simply because of the pressures caused by the reforms to the benefits system. I am finding that people who are mentally ill and do not know it are getting worse—they are under pressure from the benefit changes that have been made and those that will take place in future.

[Ms Abbott]

I am afraid that there is increasing evidence that worry about the changes and about the threat of the changes is causing a lot of stress for people with mental health issues. Social services and health authorities must be mindful of that.

[Mr Charles Walker]

I apologise to the hon. Lady because I am about to leave the Chamber—I am chairing a debate in Westminster Hall in a moment. I agree entirely that Atos should not be a blunt instrument used to beat those who have mental illness. We need a system that empowers people with mental illness to re-enter the labour market, and not one that terrifies them.

I endorse the hon. Lady’s views on young men. Young men need to feel part of something and they need to feel wanted by their community. They need to have a job and a role. If they do not have those things, they join gangs. Her point about young men was beautifully and perfectly made.

[Ms Abbott]

I entirely agree with hon. Gentleman. Changes in society and economic changes such as the collapse of manufacturing and of de-industrialisation have left many young men unclear about their role, which puts tremendous pressure on their health and well-being.

Before concluding, I want to say a few words on black and minority ethnic persons and mental health. It has been known for at least 25 years that BME persons are disproportionately present in the mental health system. We are more likely to be diagnosed as schizophrenic, less likely to be offered talking therapy, and more likely to be offered drugs and electro-convulsive treatment—the hon. Member for Totnes touched on that important point. There is therefore a great deal of fear and anxiety about approaching the mental health system on the part of some of our BME communities. Very often, mothers will be trapped at home with sons who have serious mental challenges. I have dealt with cases in which they are assaulted in their own homes, but are so frightened of the system that they will stay trapped rather than take their sons for treatment. That is a real problem. We must monitor what is happening and use the voluntary sector. We need to ensure that minority groups do not hold back from presenting with mental health problems. The later people present, the more severe the problems.

Mental health is the biggest financial burden on the health service. It will affect the families of all hon. Members in the Chamber in our lifetimes. There is much to be concerned about in mental health trends. For instance, there is a rise in mental health issues among young people. Fully half of lesbian, gay, bisexual and transgender youngsters are self-harming.

As I have said, there is a relationship between an economic downturn and a rise in suicides of men under the age of 35. None the less, there is the possibility of progress. I believe that there is now less stigma about mental health than there was a generation ago, and the debate we had last year on the Floor of the House played its part in helping to lessen it. I think there is more understanding about some of the contributory issues than there was a generation ago, and I believe that public health going to local authorities opens up the possibility of innovation in mental health, working together with the voluntary sector.

I am grateful to the right hon. Member for Sutton and Cheam for securing the debate. I hope that it is part of a process of parity of esteem that will improve the outcomes for so many of our men, women, family members and communities.

--- Later in debate ---

[Norman Lamb]

My right hon. Friend makes a very good point and I completely agree.

The hon. Member for Romsey and Southampton North (Caroline Nokes) spoke again about eating disorders—I took part in a debate that she secured in Westminster Hall. She talked about the role of parents, the nightmare of a child—I will call them a child—over the age of 16 deciding to refuse treatment and the horror that parents sometimes go through when they are not listened to sufficiently by clinicians dealing with their loved one’s condition. She also mentioned type 1 diabetes sufferers, and I would be interested to hear more about that.

My hon. Friend the Member for Harrogate and Knaresborough (Andrew Jones) is no longer here. Oh, yes he is! He has moved to a different place, just to confuse me. He talked about the low diagnosis rate for Alzheimer’s and dementia in his area. He also stressed the importance of the recognition of mental health by the Government, which I think he welcomed.

The hon. Member for Bolton South East (Yasmin Qureshi) talked about the importance of accessing appropriate and culturally sensitive care and treatment. That is incredibly important, as is getting the approach right for each individual and giving them the power to determine their priorities. She made those points well. She also stressed that the picture round the country was very variable. That is more the case in mental health than in physical health. Some areas have great services, some of which I have witnessed, but in others they are simply not good enough.

[Ms Abbott]

On the question of culturally appropriate care, does the Minister agree that it can extend to quite mundane matters? There are mental health wards in this country with large numbers of BME people in them. Those people sometimes do not have the right hair care or the right music, or they might not have their culinary needs addressed. Those things can be really disturbing for someone who is already in a mentally fragile condition.

[Norman Lamb]

Yes, I completely agree. This is about treating people as individuals, and with dignity and respect. Those things are important to people and they should be treated as such.