Mental Health

Debate between Lord Beamish and Baroness Morgan of Cotes

Thursday 14th June 2012 Commons Chamber

[Nicky Morgan (Loughborough) (Con)]

I beg to move,

That this House has considered the matter of mental health.

I am particularly grateful to all members, old and new, of the Backbench Business Committee for allocating time for this debate in the Chamber. The effort to secure the debate has been done jointly with my hon. Friend the Member for Broxbourne (Mr Walker), the chairman of the all-party group on mental health, which he has led so well, and with my hon. Friends the Members for Worthing West (Sir Peter Bottomley), for New Forest East (Dr Lewis) and for Halesowen and Rowley Regis (James Morris)—I hope I have pronounced that one correctly—and the hon. Members for Dagenham and Rainham (Jon Cruddas) and for Foyle (Mark Durkan).

We were quite clear when we put in our bid that we wanted a full debate on the Floor of the House. Why? It is at least four years, and probably slightly longer, since the general topic of mental health was debated in the Chamber. That is a long time, given that 25% of the population—one in four people—will experience a mental health problem at some point in their lives. Just imagine if this were a physical health condition and it had not been talked about by Members in the House of Commons other than in very specific ways such as Adjournment debates for a very long time.

Mental health comes at an economic and social cost to the UK economy of £105 billion a year, yet mental health has been a Cinderella service—poorly funded compared with other conditions and not spoken about nearly enough either inside or outside this House. It is the largest single cause of disability, with 23% of the disease burden of the NHS, yet the NHS spends only l1% of its budget on mental health problems.

[Mr Kevan Jones (North Durham) (Lab)]

Does the hon. Lady agree that it is not only a matter of the effects on individual mental health because mental health issues can lead to physical disabilities, leading to extra costs to the NHS on top?

[Nicky Morgan]

I entirely agree with the hon. Gentleman. The Centre for Mental Health has shown that for a person who has a physical and a mental health condition, the costs of treatment are increased by 45%. Those are additional costs around mental health problems, which are often untreated initially and then have to be treated at a later stage, so the hon. Gentleman is absolutely right.

According to the Centre for Mental Health, only a quarter of people with mental health conditions—children as well as adults—receive any treatment. I have no reason to doubt that statistic, and I find it shocking that three quarters of people with mental health conditions are not being treated. We should ask ourselves why that is.

Recent figures have shown that depression alone is costing the economy £10 billion a year. As we all know, we do not have a lot of money to spend, so we should be working as hard as we can on preventive measures. One in every eight pounds spent on dealing with long-term conditions is linked to poor mental health, which equates to between £8 billion and £13 billion of NHS spending each year.

I welcome the Health and Social Care Act 2012. I hope that today’s debate will be conducted on pretty non-partisan terms, but I realise that that may strike Opposition Members as a controversial comment. I welcome the opportunities that the Act offers for the commissioning of mental health services. I spoke in the Third Reading debate, and I especially welcomed the Government’s acceptance of an amendment tabled in the other place to ensure parity between physical and mental health. Although those are only words in a Bill, they are very important words, and they send a very clear signal not only to sufferers from mental health conditions and their families, but to those working in the NHS. I hope that, in his annual mandate to the national commissioning board, the Secretary of State will insist that the board prioritise mental health.

How are we to achieve parity between physical and mental health conditions? The question is about money, certainly, but it is also about awareness. Confessing to having a mental health condition carries far too much stigma. That is part of the reason for our wish to hold a debate on the Floor of the House. If we do not start to talk about mental health in this place, and encourage others to talk about it, how can we expect to de-stigmatise mental health conditions and enable people to confront their problems?

I find it interesting that, when I was preparing for the debate, a few people who had initially said to me “Yes, go ahead, mention my name” came back after thinking about it for a couple of days and said “Actually, I would rather you didn’t, because I have not told my employer,” or “I have not told all my friends and my family.” It is clear that mental health conditions still carry a considerable stigma. Admitting to having been sectioned is traumatic, especially when the information appears on Criminal Records Bureau checks connected with job applications.

I welcome the work of Time to Change, which has been funded partly by the Department of Health as well as by Comic Relief. I also welcome the Sunday Express campaign on mental health. However, the de-stigmatisation of mental health conditions is down to all of us, and it is especially important for those of us who are employers not to discriminate against people who may be working for us and who tell us that they have a mental health condition. I hope that today’s debate will constitute another firm step on the path to ensuring that mental health conditions are de-stigmatised, because I think that without that de-stigmatisation, successful treatment will be very hard for a person to achieve.

We asked for today’s debate to be kept deliberately general, so that Members in all parts of the House could raise many different issues on behalf of their constituents and, perhaps, themselves or their families as well as looking at the mental health policy landscape. Mental ill health is no respecter of age or background. It can strike anyone, often very unexpectedly. That includes people in senior positions such as Members of Parliament, company directors and school governors. I am sure that my hon. Friend the Member for Croydon Central (Gavin Barwell) will refer to the private Member’s Bill that he will be presenting, which would end discrimination against people in such positions who have mental health conditions.

I expect that during today’s debate we shall hear about new mums with post-natal depression. For them, a time of life that should be one of the happiest is often one of the most difficult. I welcome the recent Government announcement that health visitors will be properly trained to recognise signs of post-natal depression, which I think was long overdue. I expect that we shall also hear about veterans from our armed forces who suffer from mental health conditions, and about older people who suffer from dementia. Particular issues affect our black and ethnic minority communities, as well as those who find themselves in the criminal justice system. I am sure that we shall hear from the Minister abut the Government’s widely welcomed framework document “No health without mental health”, which was published last year. We now await the detailed implementation plan on which the Department of Health is working alongside leading mental health charities.

I want to talk, very briefly—I have noted Mr Speaker’s strictures about time limits—about three specific matters: listening to patients, integrated care, and the wider mental health well-being landscape. We made it clear during the passage of the Health and Social Care Act that one of the developments that we wanted to see, as a Government, was “No decision about me without me.” That means patients having a voice in their care. It seems to me from my discussions with those in the mental health system who have been sufferers that once the initial crisis has been dealt with, they tend to want choice and involvement in their treatment. They are facing a lifetime condition. They will have to self-medicate, look after themselves and identify the point at which they may be deteriorating or potentially reaching crisis point for years and years to come. They want a voice. They want to be heard by the health care professionals, and I think that it is up to us as a Government to help them to achieve that.

--- Later in debate ---

[Mr Jones]

I totally agree and I shall give some examples of that in a minute.

We must try to get a system in which employers, even in these tight economic circumstances, understand the mental health issues and can make adaptations. Whether we support employers who take people with mental health issues on for a certain period or whether we do other things, we need to think it out a bit more than it is at the moment.

[Nicky Morgan]

One statistic that I did not use in my speech was that only 1% of the access to work funding, which employers can use to help to smooth someone’s path back into employment, is used for mental health facilities. It could be used for counselling or support workers, but only 1% is spent on such provision in the context of the prevalence of mental health issues in the general population.

[Mr Jones]

The hon. Lady makes an important point that should be considered. That is where we need to join up the two relevant Departments.

Mental Health North East has carried out a survey and I thank that organisation and Derwentside citizen’s advice bureau for the examples I am going to use. Like the hon. Member for Loughborough, I asked whether I could use names. One person said that I could, but late last night she rang me to say no. I am sure that people will understand why I use letters to refer to these individuals rather than their names.

The first case is that of Mr A, a 50-year-old man who lives alone and received ESA. He suffers from depression, anxiety, agoraphobia and anger issues. Despite the support he is getting and the drugs that he is taking, he was called by Atos to a work-related interview. He got no points at all even though he finds it very strange to go outside the house, let alone to interact with people. He decided to appeal and attended the appeal. There is a huge backlog in the appeals system that is adding to people’s anxiety as they are having to wait a long time, and the pressure on citizen’s advice bureaux and local welfare rights organisations to support those appeals is creating a crisis in some of them. When I give some of these examples, Mr Speaker, you will see that they should never have gone to appeal in the first place.

This case was very interesting. Mr A turned up at the appeal, which, as my hon. Friend the Member for Islington North mentioned earlier, caused him huge stress as he thought he was going to lose. He turned up in the afternoon, and his appeal had been heard that morning without his being present and his award had been granted on the basis of the medical evidence. If the appeal hearing could do that, why could Atos not do so? The reason is that Atos is not taking medical evidence into account at all.

The second individual is from Stanley in my constituency and I have known this young lady since she was in her early 20s.