Mental Health First Aid in the Workplace

Jackie Doyle-Price Excerpts

Thursday 17th January 2019 Commons Chamber

[The Parliamentary Under-Secretary of State for Health and Social Care (Jackie Doyle-Price)]

I should like to thank all the contributors to the debate. It has been marked by a lot of enthusiasm and passionate advocacy in support of improved mental health. In particular, I would like to pay tribute to the hon. Member for Liverpool, Wavertree (Luciana Berger), the right hon. Member for North Norfolk (Norman Lamb) and my hon. Friend the Member for Plymouth, Moor View (Johnny Mercer) for securing the debate and for bringing their characteristic ambitious agendas into play, alongside their well-informed and passionate advocacy on behalf of them. It can often be challenging to respond to all three of those Members, but on this occasion I have really enjoyed listening to their contributions and I agreed with much of what they said.

We all share the same objective, which is to secure support as early as possible for people who are suffering mental ill health and, more specifically, to enable more people with mental ill health to stay in work. That is good for their health—as long as it is good work and they are well supported—but it is also good for the economy when more people are encouraged to work. That was clearly illustrated by the figures cited by the hon. Member for Liverpool, Wavertree for those receiving care from Mersey Care, which bring into stark relief the size of the challenge. They show that only 3% of those patients are in work, which is something we should all reflect on. It underlines the importance of ensuring that we get better at supporting people who are suffering mental health challenges and at encouraging them into work.

I am pleased to be joined on the Front Bench by the Minister for Disabled People, Health and Work, my hon. Friend the Member for Truro and Falmouth (Sarah Newton). She is also responsible for the Health and Safety Executive, which obviously has a big role to play in this agenda. She has been listening carefully to all Members’ contributions today. She and I are united in an objective to ensure that we keep more people with all kinds of disability in work, and that we get those who are currently excluded from the workforce into it. We have a wide package of measures that we are taking forward in that regard, some of which have been referred to today.

The Government are committed to building a country that works for everyone, and that must include ensuring that disabled people and people with mental health conditions can go as far as their talents can take them. Too many people with a mental health condition are unable to do that, and that is a burning injustice that must be tackled. As the right hon. Member for North Norfolk pointed out, people who are unemployed for more than 12 weeks are between four and 10 times more likely to suffer from depression and anxiety. That statistic illustrates why it is good for society, as well as for the individual, that we tackle this issue. The good news is that staying in or returning to work after a period of mental ill health really does aid mental health recovery. It really does make perfect sense.

[Norman Lamb]

The Minister will be aware of the objective in the five year forward view to double the number of people who get access to individual placement and support. Can she indicate how that programme is going? If she cannot do so now, will she write to me?

[Jackie Doyle-Price]

I can say that we are making progress, but I would prefer to write to the right hon. Gentleman with more details, if I may. I have seen some of that individual placement and support in operation, and it is hugely inspiring. In those mental health trusts that are giving one-to-one support, people are finding that the reward and discipline of going to work really does aid their recovery, even in some of the most challenging cases. I will write to the right hon. Gentleman with more information on that.

[Mr Kevan Jones]

Will the Minister liaise with colleagues in the Department for Work and Pensions? As I said to the right hon. Member for North Norfolk (Norman Lamb), voluntary work is a helpful access point for people who want to get back into work, and the current limitations on people being allowed to do certain voluntary work hinder some who want to take that route into work.

--- Later in debate ---

[Jackie Doyle-Price]

I completely agree with the right hon. Gentleman, and my hon. Friend the Minister for Disabled People, Health and Work agrees too. Employers are often risk-averse about using voluntary work, and we in government need to ensure that we are making it easy for people to apply for those routes. My hon. Friend says she will write to the right hon. Gentleman on that matter.

A number of points have been raised in this debate. On the issue of mental health first aid in schools, I can advise the hon. Member for Wakefield (Mary Creagh), who is not in her place, that the Government have a commitment to ensuring that at least one member of staff in each primary and secondary school receives mental health first aid training. We have currently reached 1,537 schools with that training.

I am delighted to hear from my constituency neighbour, the hon. Member for Dagenham and Rainham (Jon Cruddas). Like him, I am well aware of much of Ford’s activity, and it is good to hear what it has been doing in this regard.

My hon. Friend the Member for Waveney (Peter Aldous) highlighted the work of St John Ambulance in promoting mental health first aid and, again, I commend its work. The right hon. Member for North Durham (Mr Jones) made the excellent point that this is a cross-governmental issue. I have mentioned DWP, but the five year forward view carries the message that this issue must be tackled across Government, and we remain focused on delivering exactly that.

The Prime Minister has set out an ambitious set of reforms to improve mental health. We have heard references to parity of esteem, and I reiterate to all hon. Members that the fact that parity of esteem is written into legislation is not the end; it is just the start. The truth is that, in delivering true parity of esteem, we have to manage a programme of behavioural change throughout our services and, indeed, throughout society. Frankly, none of us should ever be complacent about whether we have achieved it. Parity of esteem will take a lot of time, and it is great to see just how much energy is being applied to it.

We have heard a number of references to Time to Change, and it is clear that the cultural transformation in society has been massively aided by Time to Change and that destigmatisation is really helping with delivery. None the less, we have a big role to play in service provision. We are creating 21,000 new posts in the mental health workforce. We are implementing the first waiting time ambitions for mental health so that people have faster access to the care they need. We have recently published the first review of mental health legislation in a number of years. And, of course, we are massively improving early intervention by investing in more services in schools.

We are investing more through the 10-year plan, and the Prime Minister has announced that the NHS budget will grow by over £20 billion. In turn, in the long-term plan published last week, the NHS confirmed that there will be a comprehensive expansion of mental health services, with an additional £2.3 billion in real terms by 2023-24. The ambition is that that will give 380,000 more adults access to psychological therapies and 345,000 more children and young people greater support in the next five years.

We are ambitious, although I do not pretend that, by putting it into law, we have suddenly achieved parity of esteem. We are on a journey in how we commission and deliver services and, of course, in how we behave across society. There is still much to do, not least in the workforce. Destigmatising mental ill health is contributing to understanding and challenging the prejudice and stigma, but we still need to do more.

We have heard much reference to the Farmer-Stevenson review. The Prime Minister appointed them to advise us on how employers can better support all employees to remain and thrive in work. We set out a broad-ranging strategy further to support disabled people and people with health conditions, including mental health ones, to enter into and thrive in work. We did that through our response, where we accepted all those recommendations; indeed, the leadership council to deliver that met only this morning. The work and health unit, which I lead jointly with the Minister for Disabled People, Health and Work, will be overseeing progress on those recommendations, which range from short-term deliverables to longer-term reform. That will include looking at potential legislation in due course.

The key Thriving at Work recommendation is that all employers, regardless of size or industry, should adopt six core standards that lay the basic foundations for an approach to workplace mental health. The review also recommended that all public sector employers, and private sector companies with more than 500 employees, deliver mental health enhanced standards. Those include increasing transparency and accountability through internal and external reporting of their performance against those standards. The Prime Minister accepted those recommendations that apply across the civil service and NHS England. The civil service, as an employer of 420,000 employees, really should be leading by example on this. Equally, the NHS, as both the provider of services and as a large employer, should be leading the way.

The Government have also taken action to work with partners to develop a framework to support organisations to record and report their performance on disability and mental health in the workplace. Last November, we published that voluntary framework, which highlights transparency and reporting as the effective levers in driving the cultural change we need to develop. But we know that every line manager, supervisor and leader has a crucial role to play in supporting employees to stay well and stay in work, which is why the work and health unit is also working with partners to identify the support and skills that line managers need, across all sizes of organisation, to create inclusive and supportive workplace environments. So we are exploring how we in government can share those examples of best practice, so that all employers get better at this. Many of them will recognise that they need the tools to do the job, because no one knows what they do not know, and we in government have a role to play in spreading that good practice.

We recognise that mental health first aid has a role to play in the Government’s ambitious strategy to transform workplace mental health. Mental health first aid is a helpful training resource to educate people to care not only for others, but for themselves. It also helps to improve understanding about mental health and mental illness; to build that culture and better understanding within organisations; and to encourage people to stay well and get the support they need to manage any mental health symptoms and problems. I was also struck by what the right hon. Member for North Norfolk said: on its own, it is not enough. We would not want to have legislation that became a floor of service in mental health.

A number of references have been made to Thames Water and its success in delivering mental health first aid, all of which is true, but mental health first aid is just part of its embedding a supportive workplace culture for those with mental ill health; it is not the only tool that the company uses. It has introduced mental health first aiders across the business, but it has also expanded its internal clinical occupational health team to support the business in case management, health screening, health surveillance and well-being. The occupational health team now processes an average of 100 referrals a month, 98% of which are for non-work-related issues. Up to 80% of the cases referred every month are for those still in work, which shows that people are accessing longer-term care; this is about keeping them in work, rather than just their getting mental health first aid. We need to be careful about honing in on one simple measure of supporting mental health in the workplace, rather than encouraging a more holistic culture of supporting wellbeing.

I can also advise the House that the Health and Safety Executive, working together with Mental Health First Aid England, has recently published revised guidance for employers on their compliance with the Health and Safety (First-Aid) Regulations 1981. The guidance clarifies for employers the existing requirement to consider mental health alongside physical health when undertaking a first aid needs assessment. The findings from the needs assessment will help direct employers to decide what measures they need to put in place.

The advice of the Health and Safety Executive is that the Stevenson and Farmer review recommendations go way beyond the provision of mental health first aid. The Government’s view is that the best way to secure employer action, to enable those experiencing mental ill health to remain and thrive in work, is to engage with employers to adopt a comprehensive approach based on the Thriving at Work mental health standards. Mental health first aid is not an exclusive way of delivering employer action, but it can form part of it.

To improve information and advice for employers, we are supporting Mind and the Royal Foundation to continue developing their mental health at work online gateway, which we launched on 11 September 2018. The online platform is aimed at employers, senior management and line managers but is accessible to anyone, and it helps them to find help and support for colleagues, to challenge stigma and to learn more about mental health in the workplace. The guided search tool helps with the development of toolkits, blogs and case studies to help everyone in their journey to improve the workplace. Mental Health at Work is a UK-wide initiative that supports people across all workplaces, in all sectors, of all backgrounds, and in all regions.

In conclusion, by working with our partners, including health professionals and employers, this Government are working to change culture and professional practice fundamentally, to tackle poor mental health and to ensure that disabled people and people with health conditions can reach their full potential, not only in the workplace but across society as a whole.

I thank all Members for their contributions and for their interest in the subject. We need to continue to discuss the issues and to encourage good practice. We have heard many good examples today, but we need to consider debating the issues so that we genuinely foster a culture at work that supports people with disabilities and with mental ill health to get jobs and to stay in work.