Mental Health Support

Debate between Luke Evans and Ben Spencer

Thursday 10th October 2024 Westminster Hall

[Dr Ben Spencer (Runnymede and Weybridge) (Con)]

It is a pleasure to serve under your chairmanship, Mr Dowd. I start by declaring that I am a former consultant psychiatrist and that a family member is a consultant psychiatrist.

Listening to this debate has been a mixed experience. It has been great to hear the wealth of talent and expertise that we have in the House, but at times it has been harrowing to hear people speak about their personal experiences or those of their constituents. That is a reminder to us all of just how substantial the impact of mental illness can be on people—our families and friends. The tone in which this very sensitive debate has been conducted is fantastic.

I thank the hon. Member for Ashford (Sojan Joseph) for bringing forward this debate, for the wealth of experience—22 years—that he brings to this place, and for a very balanced speech in which he acknowledged the catchment investments under the previous Government and raised the importance of waiting lists. When I was first elected, I brought up targets for mental health in a private Member’s Bill, which did not end up going anywhere, on waiting times for getting an in-patient bed when one is requested for somebody with a mental disorder. Of course, we all want improvements in mental health care and treatment, and there need to be improvements in mental health care and treatment. I am sure there will be no disagreement across the House about that.

The hon. Member for Ashford was absolutely spot on to mention housing, work and benefits. It is a testament to his experiences in psychiatric nursing that he went on to mention the surrounding holistic care. One of the challenges of debates on improving mental health services is that we must acknowledge that that involves many other areas of public policy, public provision and cultural factors, and try to broaden that as much as possible.

[Dr Evans]

The former Member for Doncaster, who is now sadly not in this House, was a significant champion for men’s and boys’ health—suicide in particular, which has been mentioned here, is such a problem. My hon. Friend stated the case for mental health being a pan-Government policy area—does he believe that strengthens the argument for having a Minister for men and boys to go across Government and think about all these issues, especially as suicide is the leading cause of death for young men under the age of 45?

[Dr Spencer]

My hon. Friend is absolutely right to point out that, sadly, suicide is the No.1 cause of death among young men. My understanding, although the stats change all the time, is that below the age of 45, suicide is the No.1 cause of death among both men and women. It is absolutely right that we look at sex-specific approaches to intervention. Factors affecting health in men will be different from factors affecting health in women.

I want to go back to the social elements of mental health care, which the hon. Member for Ashford mentioned, and a smoke-free society and banning tobacco. Certainly when I was practising, 50% of tobacco was consumed by people with a severe mental illness. That raises a whole host of concerns and issues about what is happening with tobacco consumption and people with a mental disorder.

My hon. Friend the Member for Hinckley and Bosworth (Dr Evans) was absolutely right, given his experience, about something he has mentioned many times in the House: the importance of delineating mental wellbeing and mental illness. I tend to think about it in this way: we all have mental health, but we need to separate mental wellbeing from mental illness. The two are different and need different approaches, as was echoed by my right hon. Friend the Member for Salisbury (John Glen) and the new hon. Member for Stroud (Dr Opher), who gave rise to a very fertile discussion on his views on the area. The hon. Member for Leicester South (Shockat Adam), who is no longer in his place, rightly pointed out inequalities in detention and outcomes for those from minority ethnic backgrounds. That is a very important issue.

That brings me on to our record in Government over the past 14 years; there are a few things I want to pick out. One is that we set parity of esteem in law through the Health and Social Care Act 2012, which was a big step forward. We still need parity of esteem in outcomes, but nevertheless that was a very important step. We expanded access to psychological therapies and I am particularly pleased by the expansion of individual placement and support, which has been shown to help people get into work, particularly those with a chronic and enduring mental illness. We have seen more people take up maternity care, and we also invested in the mental health estate.

In fact, in my own constituency, we have a new mental health hospital. The Abraham Cowley Unit is being rebuilt, which will provide world-class care for people living in my patch. Perhaps most important of all, given the conversation that we have had today, is the decrease in in-patient and out-patient suicide that we have seen over the years. Of course, I recognise that there are a variety of factors driving that but we should be pleased that things are moving in the right direction on suicides, although there is more to be done.

Today is World Mental Health day and it is a very broad topic, but in my time I would like to focus specifically on one area that, as it certainly was in my former career, is often neglected—psychosis. It particularly affects people suffering from schizophrenia or bipolar affective disorder. It can be a very disabling illness and has been responsible for quite a degree of disability and health concern in the UK. Often debates such as these, and debates in the media, do not focus on psychosis and I think a big part of that comes from the stigma attached to it. People who work in the sector, and those with expertise here, will know that it is an area of great need both in terms of community mental health teams and in-patient settings. The hon. Member for Stroud was absolutely right and I am glad he pointed this out: the 10 to 15 years of life lost following a diagnosis of psychosis is something that we have to fix.

I believe that we also need to improve access to treatments such as clozapine, which is an excellent treatment for schizophrenia. I am pleased to have previously worked with Clozapine Support Group UK in its campaign to try to get more access to clozapine for people for whom it is indicated. We have also seen the reform of the Mental Health Act 1983, which the former Prime Minister Theresa May kicked off with the Wessely review. I was part of the working groups on the Wessely review, particularly looking at helping with the tribunal system, and I was on the pre-legislative scrutiny committee as well. How we look after people detained for treatment in the absence of consent is very important, and I am pleased that this Government have committed to take forward the work on reviewing that Act.

I thank everyone who works in the care and treatment of people with mental illness. As we have heard today, that is a very broad sector; it is not only people who work in the NHS but those who work in the third sector in a variety of organisations and institutions. That is very important work.

Supported Housing (Regulatory Oversight) Bill

Debate between Luke Evans and Ben Spencer

Friday 18th November 2022 Commons Chamber

[Dr Luke Evans]

My hon. Friend is making an excellent point. Drawing on his expertise, and looking on a system-wide basis, does he think that the invention of the integrated care boards, pulling together social services, councils and the NHS all in one place, provides the chance to try to join up exactly the care he is talking about?

[Dr Spencer]

I thank my hon. Friend for his intervention. It is a really good question. As the Bill goes through, and hopefully in the Minister’s response, I would like to hear how the regulatory framework it puts forward sits alongside the role of the new integrated care systems, particularly in regard to the duties of organisations that provide healthcare-type treatments to people in exempt settings.

To give a different example of how important general support is, in my career I have looked after many people with complex and severe psychotic illnesses. I recall quite a few cases where people sadly were, despite best treatment and intervention, quite disabled and continued to be quite disabled as a result of their illness, and they were being discharged back into community settings and supported accommodation. Although over the past 30 or 40 years we rightly dismantled the asylum system and brought in care in the community, we then expected the community almost organically to provide general support to people who had severe chronic mental health needs.

However, what I quite often saw was that we had created what I call an asylum of one, where somebody was in a type of supported accommodation on their own with very little social interaction and not much of the sort of stuff coming under general supportive care going in. With many of the people I saw, my conclusion was that they did not have reason to be well, because in the community there was not the outreach, support or ongoing engagement, and that led to destabilisation, worsening mental health problems and admission to hospital.

I want to stress the importance of the general supportive care that is being provided to people in supported exempt accommodation, and how necessary and important it is that there is proper oversight and scrutiny, as well as thought about how and what is delivered and making sure it is badged so that it meets the appropriate criteria. Not giving this the same importance as other regulated activities, such as those regulated by the CQC, is unwise and, as we have discussed and seen today, has the potential to do a disservice to some of the most vulnerable people in society.

I congratulate again my hon. Friend the Member for Harrow East on bringing forward the Bill. I am really pleased that this is being supported to make these very important changes, particularly the national supported housing standards, the advisory panel, which makes a lot of sense, and the licensing framework. To finish, there is a need to collect data, because without data we do not know what the situation is or how many of these organisations operate. With data, we can understand where the problems are and we can scrutinise what is being done to ensure that the most vulnerable in society—this is a group of highly vulnerable people—are getting the support, care and treatment they need. I very much welcome the Bill, and I am very pleased to have had the opportunity to take part in this debate.