Mental Health: Ensuring Equal Access to Mental and Physical Healthcare

Lord Oates Excerpts

Thursday 26th May 2016 Lords Chamber

[Lord Oates (LD)]

My Lords, I welcome the opportunity to take part in this important debate on the Five Year Forward View for Mental Health initiated by my noble friend Lady Brinton. As my noble friend said, mental health is a topic which touches almost everyone in this country, whether through direct personal experience or through families and friends who have suffered from mental ill-health.

For much of the time when I was growing up, it was pretty much a taboo subject. Few people talked openly about mental illness; it was too often a personal burden not to be shared, understood or tackled but to be hidden away even from those closest to one. In recent years there has been a welcome shift in our attitudes, and I pay tribute to the mental health charities and the many activists and campaigners, such as Alastair Campbell, who have helped break down taboos and get mental health on the agenda, but I also pay a real and heartfelt tribute to Norman Lamb in particular who, as a Health Minister in the previous Government, strongly supported by the then Deputy Prime Minister, Nick Clegg, did so much to push the issue of mental health right up the government agenda, placing mental health literally on the front page of the Liberal Democrat manifesto.

I am pleased that the subsequent Conservative Government have reiterated their commitment to tackling the huge inadequacies that exist in mental health care today and which are highlighted in the report we are discussing, but I hope that they will commit themselves to willing the means as well as the ends. Warm words will not be enough when mental health provision remains severely under-resourced and where we need real will to ensure that the services and support that can help prevent mental illness are there and joined up.

Mental ill-health is something I have experience of both personally and through supporting people whom I care for very much who themselves suffered with mental health problems. In my teenage years and my early 20s, I suffered severely with depression and suicidal thoughts. For much of that time, I would go to sleep praying that I would not wake up in the morning, so I would not have to bear any more of the paralysing burden of despair that I felt. It is difficult to describe quite how terrifying it is to be caught in a spiral of depression, how it impacts on your physical health, how it drains all the energy from you. Back then, in the 1980s, you did not generally discuss such things: you bottled it up inside and tried to show a cheerful face to the world. I was lucky because, although I never articulated my despair directly to anyone, I had a supportive and loving family and some of the most amazing friends whose support at the bleakest moment for me saved my life and made living a better prospect than dying. Tragically, as the review sets out, that was not the case for thousands of people last year. Suicide is now the leading cause of death for men aged 15 to 49. What a terrible and tragic waste.

As we know, a wide variety of factors can lead people into mental ill-health. Adolescence in itself is a pretty confusing and difficult experience for most people. For me, it was compounded by trying to come to terms with issues about my sexuality—something I was desperately trying to hide from myself, let alone from anyone else. It was not a great time to be an adolescent coming to terms with being gay because, throughout the 1980s, the drumbeat of homophobia was beating steadily louder, culminating, just as I turned 18, in the passage of the infamous Section 28 of the Local Government Act 1988—the Government of my own country legislating in prejudice against people like me.

Almost a quarter of a century later, I was fortunate to be working in the coalition Government when, at the instigation of my noble friend Lady Featherstone, the coalition legislated for full equality via the equal marriage Act. Nick Clegg reported at the time a conversation that he had with a wonderful mutual friend who, on passing Moss Bros and seeing two grooms in the window, told Nick, “I literally felt myself walk a little taller”.

I make that diversion into that area because I think that we should all recognise that the actions of government, churches and other institutions can have profound impacts on the self-worth and mental health of individuals. I hope that organisations of all faiths, particularly the Anglican Church, of which I am a member, think about that a lot more and show the sort of leadership that it once showed in the days of Archbishop Ramsey.

I was lucky enough to come through my struggle with mental illness with the love and support of friends and family, but many people do not have the support networks that I was lucky enough to have. Too often, as the review sets out, the services that people need are not available. Just half of community mental health teams offer 24/7 crisis care. Only a minority of A&E units have 24/7 cover from mental health liaison teams. As my noble friend Lady Brinton pointed out, too many black and ethnic minority citizens access mental health care first through direct contact with the police. Care for people with eating disorders remains haphazard and often entirely inadequate, and services for young people are unco-ordinated and do not provide anything like what is required.

Over recent years, I have seen the inadequacies of service provision at close hand, in two areas—first, in the services available to those suffering from serious eating disorders, where provision can vary massively across the country and, in many cases, is so inadequate. In the experience I was aware of, there was adequate provision only because the family had the money to buy private provision. The second area is provision for adolescents suffering acute mental health problems. Many areas seem unable to have a properly joined-up approach between schools and mental teams. Children are often no longer in school because of their mental health problems. At the most basic level, there is a lack of provision for those children to continue their education, and if they fall out of education at that point, it can cause more serious problems and compound existing mental health problems.

The provision of services to help young people—in particular, talking therapies—is utterly inadequate, which can have tragic consequences. It is hard to convey the distress and anguish of parents and other family members when they are unable to gain access to services for young people struggling with terrible mental health problems. The adequate provision of mental health services requires much more effective joining up of services, but it also requires extra resources, as the review states. Yesterday, in the debate on the Queen’s Speech, the Minister, the noble Lord, Lord O’Neill, said that the Government are building our economy on low taxes. I am all for lower taxes, particularly for those on the lowest incomes—I was proud of the work of the Liberal Democrats in government in raising the personal allowance—but the taxes we raise and the taxes we levy must be sufficient to provide the services that we require in a civilised society. We have to decide what those services are and then work out how we pay for them, not the other way round. I hope that in his reply the Minister will confirm that the Government will provide the extra resources that the report identified as being required and that, as my noble friend Lady Brinton said, they are additional resources, not an accounting fix.

I hope the Minister will also commit the Government to making a reality of the commitment to provide equality of treatment for mental and physical health. To do that will mean the Government putting a huge amount of energy into this issue. It is so complex and there are so many issues to resolve that they have to champion and drive it the way that our friend Norman Lamb did in the previous Government. If the Government fail to do so, their failure will not just be about never getting round to deciding where an airport will be, or something like that; it will be much more material because it will be measured in millions of lives that are further blighted by the terrible suffering that mental illness can bring.