Skin Conditions and Mental Health

Gillian Keegan Excerpts

Tuesday 25th January 2022 Westminster Hall

[The Minister for Care and Mental Health (Gillian Keegan)]

It is a great pleasure to serve under your chairmanship, Mr Gray.

I add my thanks to my right hon. Friend the Member for Gainsborough (Sir Edward Leigh) for securing the debate. The subject is clearly important to many people in the House and to many people across the country who have skin conditions and are concerned about their mental health. I also thank my right hon. Friend for championing this cause for so many years. I am relatively new to my role, but I look forward to working with him. I thank him for sharing his story, which I am sure will have given a great deal of comfort, as well as having resonance in this debate. It is real that people suffer bullying. I was very interested to hear about Changing Faces, the visible signs and the pledge, and I am happy to hear more from the hon. Member for Swansea East (Carolyn Harris).

Skin conditions, such as acne, psoriasis—we heard the personal story about psoriasis of the hon. Member for Coatbridge, Chryston and Bellshill (Steven Bonnar)—the rosacea we heard about from my right hon. Friend the Member for Gainsborough and eczema can be complex and affect people of all ages. Many young people are affected by acne and one in 50 of us will develop psoriasis. Eczema is also very common, affecting one in five children, including me when I was younger. It can also start later in life.

Some of those conditions can be relatively minor, as in my case, and will clear up over time, but others are much more serious, causing pain and scarring and being for the long term, perhaps lifelong. Clearly, that can and will have a negative impact on a person’s life, often causing stigma, discrimination and bullying. It can seriously affect their self-confidence, self-esteem and overall mental health. I understand that. I assure the Chamber that the Government are committed to supporting people with all dermatological conditions.

I note the report on “Mental Health and Skin Disease” by the all-party parliamentary group. I will be happy to attend the group on occasion. I acknowledge that the need for specialist mental health support for people suffering with often debilitating long-term skin conditions was raised as a particular issue, as has been discussed. As my right hon. Friend the Member for Gainsborough stated, the mental health issues faced by people living with skin conditions can be severe, in particular when people are not getting the treatment they need—or waiting for more than a year, as he outlined. Obviously, the longer someone waits, the worse the condition often gets. I reassure my right hon. Friend that mental health and ensuring that people get the treatment that they need will continue to be a priority for the Government.

We are committed to achieving parity between mental and physical health services, and to reducing mental health disparities. We know that we are not there yet, but we are committed to that. We are making good progress, however, with investment in NHS mental health services continuing to increase each year from almost £11 billion in 2015-18 to more than £14 billion in 2020-21. We are investing at least £2.3 billion of extra funding a year in expanding and transforming our mental health services by 2023-24.

Some people with dermatological conditions will be on a long-term condition pathway, due to the nature of their illness, such as cancer, including skin cancer. In these cases, the team responsible for the patient’s physical health should discuss and review the patient’s emotional and psychological status regularly and support them, through access to information and services for their mental health if needed.

Commissioners are encouraged to ensure that local pathways include assessment and ongoing support of patients’ mental and psychological wellbeing and cognitive status. They should also ensure that health practitioners have ongoing training—a number of Members mentioned that—to understand the emotional, cognitive and psychological needs of patients. We have continued to expand our flagship talking therapies programme—a number of hon. Members welcomed that. The improving access to psychological therapies—IAPT—programme for all adults with common mental health problems has been accessed by more than 1 million people in 2020 and 2021. We have expanded the programme to help people with their mental health and long-term conditions, including dermatological conditions.

A person’s mental and physical health are intrinsically linked—they are in one place, in one person. People with long-term physical health conditions, such as dermatological ones, may also need emotional and psychological support. Conversely, two thirds of people with anxiety and depression have a long-term physical health problem—the two go hand in hand. Integrating psychological therapies with physical health services can provide better support to this group of people and achieve better outcomes. That is something we discuss regularly when talking about integration and the new integrated care systems, as one of the benefits of taking that approach. It is also why we have expanded our IAPT programme to include an integrated approach for people with mental health as well as long-term conditions.

All clinical commissioning groups are expected to commission IAPT services, integrated into physical care pathways, as part of their IAPT expansion plans locally. That should bring together mental and physical health providers so they can work in a co-ordinated way to achieve the best outcomes for all people irrespective of their diagnosis. While there is some excellent practice of services offering talking therapies for people with dermatological conditions, such as those in Southampton mentioned by my right hon. Friend the Member for Romsey and Southampton North (Caroline Nokes), I acknowledge that that may not be the case in every area, but IAPT services are continuing to grow and develop all over the country.

I would like to take the opportunity to remind people that IAPT services are accessible to all adults in England. I fear there is low awareness of the understanding that people can self-refer to IAPT. They do not have to wait for a GP, although that is one route, and can self-refer to IAPT. We have also launched a “Help!” campaign, accompanied by The Beatles music, which is raising awareness so people know they can access those services. They can be referred by a range of practitioners in the community or by primary care, but they can also refer themselves. They will receive a person-centred assessment that covers the person’s mental health problems and acknowledges the impact of their long-term condition. Clear pathways and processes should be in place to enable a person to progress between those services and existing pathways.

As mentioned by my hon. Friend the Member for Bracknell (James Sunderland), I acknowledge the impact of the covid pandemic and the excellent work going on in mental health services to respond to the pandemic. The past two years have been really tough. There has been a lot of innovation, as the hon. Member for Bristol South (Karin Smyth) said. We need to take that innovation and embed it in the services. There has been unprecedented demand on mental health; it was growing anyway, but the pandemic has accelerated demand. They are doing their utmost to make sure that services are there for everyone who needs them—for patients and our NHS colleagues who have been on the frontline— but services have been strained and it is harder for people to get an appointment at times. That is why, in addition to our long-term plan commitments, as part of the Government’s commitment to build back better, we have published our mental health recovery action plan, backed by an additional £500 million for this financial year, to ensure we have the right support in place and that we embed that innovation to access more people.

The plan aims to respond to the impact of the pandemic on the mental health of the public, specifically targeting groups who have most been affected—young people and children, clearly, are in that group. That investment and expansion of mental health services will help to address the needs of those people with long-term conditions, as well as other people in need of support. To deliver on our commitments, we need to ensure we have the workforce available. That is important but it takes time to deliver and that impedes our progress. It is vital that we have the right skilled workforce in place; we have improved that and we will continue to improve it.

Question put and agreed to.

Resolved,

That this House has considered skin conditions and mental health.