Psychosis: Early Intervention

Helen Whately Excerpts

Thursday 15th March 2018 Westminster Hall

[Helen Whately (Faversham and Mid Kent) (Con)]

I have been trying to think about how to put the experience of psychosis into words. Having observed it rather than experienced it personally, I suspect that I will not do it justice. From my observation, however, it is a devastating thing to experience: it is debilitating, frightening, bewildering and enormously destructive to someone’s life, aims and prospects. Its impact on people’s lives is severe, as other hon. Members have described.

In the past, a diagnosis of psychosis was essentially a life sentence, but now early intervention and treatment can lead to recovery. People can get their lives back on track—we are not in the dark old days when if someone had a mental illness, that was it. People can and should recover, but getting early treatment is crucial.

I will be brief, not only because you said that the winding-up speeches would begin at half-past 2, Mrs Moon, but because the issue has been covered comprehensively by the right hon. Member for North Norfolk (Norman Lamb), who has such huge knowledge and has clearly done an enormous amount of groundwork; by the hon. Member for Stockton South (Dr Williams), who brings to the debate his expertise as a doctor; and by the hon. Member for Liverpool, Wavertree (Luciana Berger), who does a huge amount of work in the area. I will therefore make only three points.

First, I express my appreciation to the Government, and to the Minister, for their enormous commitment to mental health and their huge focus on improving mental healthcare, achieving parity of esteem and ensuring that far more people have access to treatment, starting from a really low base. They set out that commitment in the “Five Year Forward View”, the most comprehensive strategy for mental health, and have demonstrated it with an increase in mental healthcare funding and with greater transparency. The fact that we can even have this debate, and that there are targets for waiting times and access to mental health, represents great progress from the time described by the right hon. Member for North Norfolk, when targets and transparency were making a huge difference to the quality of physical healthcare but there was no information about the quality of mental healthcare or access to it. We now have a developing, albeit early, set of data about access to mental healthcare. There is a long way to go, and that includes getting much more data about progress through treatment and outcomes, but the access data has at least given us a start. I welcome the fact that we are in a better place with mental healthcare, and that there is a great commitment to improvement.

My second point, however, is about the worrying trend in the treatment of people with psychosis. The direction of travel seems to be towards a decline in early access to treatment—not just in percentage terms, which could be explained by rising demand, but as an absolute number. The data cited by the right hon. Member for North Norfolk shows the gap between the treatment that some patients receive and the full recommended amount. A large number receive only some treatment, so we cannot hope for the recovery and outcomes that the full NICE-recommended package would offer.

My third point is that we need to know the reason for this worrying trend, which goes against our ambition to treat more people and help them to recover, and against the Government’s commitment to mental health. What is going on? Why do we appear to be going in the wrong direction? We have heard some possible reasons this afternoon, including lack of governance and accountability; lack of focus in many parts of the country, although there is clearly huge variation; underfunding of treatment packages, despite the overall backdrop of more money going into mental health; and shortage of workforce. Under the “Five Year Forward View”, there were meant to be 60 extra psychiatrists to provide early intervention in psychosis, but it is not clear—perhaps the Minister will tell us—whether those posts have been filled. It is clear to all hon. Members who work on mental health issues that the workforce is facing a huge challenge in recruitment and retention.

Is there a lack of ambition to provide early access to treatment for psychosis? Even achieving the 2020-21 target of 60% would leave 40% of people without much-needed treatment; we could argue that that is too low an ambition, especially as we know how effective treatment can be. I welcome the Government’s commitment, but it is worrying that the direction of travel seems not to be positive, so it would be extremely helpful if the Minister gave us some insight into what is going on and what steps are being taken to ensure that people get treatment that works.