Mental Health and Wellbeing Plan

Maria Caulfield Excerpts

Wednesday 15th March 2023 Westminster Hall

[The Parliamentary Under-Secretary of State for Health and Social Care (Maria Caulfield)]

It is a pleasure to serve under your chairmanship, Mr Twigg. I thank the right hon. Member for North Durham (Mr Jones) for bringing forward the debate and for all his work in this space. He is absolutely right that mental health affects us all, and for those who have a poor experience with mental health the impacts can be life-changing. He is also right that debates in this place have broken taboos and challenged stigmas around mental health, and have helped with the national conversation about mental health and why it is so important. In one sense, I violently agree with all that he said. The difference is about how we get to that place where we are looking at mental health, rather than just mental illness, and treating people sooner when they need help and support.

I believe that in the last 10 years we have seen a seismic shift in the way that we look at mental health—a shift to parity with physical health, and towards early intervention and community support, rather than waiting for someone to reach a crisis and then intervening. It has been a shift to look at mental health as well as mental illness; the two are very different, but support each other. If we get mental health right, we are much more likely to deal better with mental illness. Parity between mental health and physical health is why the major conditions strategy has mental health in it.

Huge progress is being made. We have committed to funding increases each year, from almost £11 billion in 2015 to £15 billion in the current financial year. Such a level of funding has not been seen in mental health services before, and it is making a difference. The additional £2.3 billion a year to transform mental health services in England has the aim of getting in as early as possible when people need help, and moving to community mental health services as the first port of call for people who need support.

I have seen in practice the difference that the funding and change of emphasis are making. I recently visited Hammersmith and Fulham Mental Health Unit, where community and in-patient mental health teams are working together. If someone is struggling in the community they get input from the in-patient setting, and, when someone is an in-patient, the community team are making sure they are getting the help and support they need for discharge. It is working extremely well.

I have met with police chiefs and talked about the Humberside model, which means that patients are not being taken to A&E or police cells as a first point of refuge, but are instead seen by community support teams. That frees up police time, and is a better experience for patients to quickly receive more appropriate care. That would not have been possible 10 years ago. Of course, there is work to be done, and we get huge numbers of patients who need services and want referrals, but a huge amount of progress has been made.

We recently announced £150 million to support crisis centres in local communities up and down England, so that someone who is not well has easier access to teams and support. Up to 90 mental health ambulances are being rolled out, which means that if someone is going into crisis, it is a mental health support team that responds to them, and not necessarily a paramedic, who would normally be the first responder. That is making a difference, keeping people out of hospital and making sure they are getting the right support as quickly as possible.

[Daniel Kawczynski]

The Minister will recall a conversation we had some time ago, when I was very keen for her to meet a constituent of mine from Shrewsbury who has a daughter experiencing mental health problems. They are not happy with the level of service we receive in Shropshire. I hope the Minister will commit to meet my constituent.

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[Maria Caulfield]

I am happy to meet my hon. Friend’s constituent.

Record numbers of patients are coming forward, both through referrals and via GPs. The consequence of breaking stigmas and taboos and encouraging people to come forward early is that more people want to use the system, so it is taking longer than we would hope for them to be seen. The situation is the same in Scotland, Wales and Northern Ireland; it is not just something that England faces, which is why we are focused on increasing funding and resources. We are recruiting 27,000 additional mental health staff, and we are on track to deliver much of that in terms of support staff that are already in place.

We are also putting mental health support teams in schools. There are 287 mental health teams in place, covering 4,700 schools and colleges. They are not only helping young people who are struggling, but normalising mental health and making it as important as physical health. We teach young people about their physical health in schools—how to look after it and look for signs and symptoms of concern—but we have not done that in the past with mental health. Mental health support teams will normalise the idea that mental health wellbeing is as important as physical health wellbeing.

It is an achievement that in the major conditions strategy, mental health is on a par with other major conditions in the strategy. We cannot see patients just as people who have mental health needs, or who are suffering with a mental health illness. More than one in four patients who have mental health conditions have two or more long-term conditions, and 30% of people with a long-term physical health issue will also have a mental health problem. We cannot treat problems in isolation—seeing the individual as a cancer patient, a heart disease patient or a mental health patient. People are complex and have multiple issues.

By putting mental health in the major conditions strategy, we are matching what NHS England is doing with its Core20PLUS5 strategy. The right hon. Member for North Durham talked about inequalities. That is exactly what Core20PLUS5 does: it looks at the 20% of the population who are the most deprived and struggling the most with all their health needs, both physical and mental, and drills down into the five conditions that drive those inequalities, of which mental health is one. The major conditions strategy will mirror exactly what NHS England is doing.

[Mr Kevan Jones]

Will the Minister comment on the 5,200 responses to the discussion paper and the issue that was raised by my hon. Friend the Member for Blaydon (Liz Twist) about groups that fed into the discussion paper? How will that work, and how will charities and people in the sector be able to feed into the new strategy?

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[Maria Caulfield]

I am not one for reinventing the wheel. Consultation work has been done, and we received a significant response. The hon. Member for Blaydon is right to point out groups such as YoungMinds, who will be in Parliament next week—I hope to meet them to follow up discussions. We will publish the previous call for evidence this spring, because we want to use that work to navigate and develop the mental health part of the major conditions strategy. This is not about undoing the work that was done before; it is about including it with physical illness. Over a third of people with severe symptoms of common mental health disorders also report a chronic physical condition, compared with a quarter of those with no or fewer symptoms of a common mental health disorder. Physical and mental health are very much interlinked, and to address one without the other would be to do a disservice to those patients.

[Rachael Maskell]

I am glad that the Minister has talked about parity of esteem, but only 8.6% of the health budget is spent on mental health. I hope that we will see a real uplift in funding for and investment in people’s mental health. Will the Minister set out the timeline for the publication of the strategy? It feels like the can is being kicked down the road.

[Maria Caulfield]

For the mental health perspective, which is the area that I work on, we will publish the previous consultation responses this spring—in the forthcoming weeks. That will feed into the development of the mental health aspect of the major conditions strategy, which we want to publish very soon. We also have the suicide prevention strategy, which will be a stand-alone strategy that will dovetail into that as well. There are record levels of funding for mental health. I am sure that more will be required, but it is not just about the amount of money; it is about how we spend it. We want to deliver on mental health ambulances, crisis centres and community support. We want to get in as early as possible.

I hope that I have been able to reassure hon. and right hon. Members that, just because this is not a standalone mental health strategy, that does not mean that we are reducing elements of the work that has gone before. It is so important to include it with those other major conditions, which is exactly what NHS England is doing with its Core20PLUS5 strategy to reduce inequalities. We hope to do the same with our strategy.

Question put and agreed to.