Mindfulness-based Therapy

Debate between Mark Hoban and Chris Ruane

Tuesday 4th December 2012 Commons Chamber

[The Minister of State, Department for Work and Pensions (Mr Mark Hoban)]

I congratulate the hon. Member for Vale of Clwyd (Chris Ruane) on securing this debate. He commented on the effectiveness of the lobbying by pharmaceutical companies, but I think he has done a rather effective job himself in lobbying for mindfulness. He said that he was missing the Irish ambassador’s party tonight. In my research for the debate, I discovered that mindfulness was of growing interest in Ireland, so I expect that the Irish ambassador will be mindful of his explanation for not being there tonight.

The Department recognises the role that a wide range of interventions can play in supporting people to move into work. Mindfulness therapy is a psychological approach to well-being that people report as helpful in the workplace. The principles behind mindfulness therapy are extremely interesting and, by many accounts, can be helpful in alleviating distress. As I understand it, mindfulness encourages people to focus on their present experiences in the here and now, without making judgments about the experiences. It is rooted in Buddhism, but has been westernised through medicine and psychology.

Mindfulness can be delivered in a wide range of ways—the hon. Gentleman referred to the Durham pilot, which I will return to later. People can be taught it through meditation and other techniques, in group sessions delivered every week for eight weeks, with follow-up sessions over the course of the next year. Some advocates believe it has the potential to be used in a range of circumstances, such as for stress at work, for personal problems, and for managing chronic pain, substance abuse and unemployment.

As with all medical and therapeutic interventions, however, the National Institute for Health and Clinical Excellence should be the key deciding body for reviewing the evidence for which interventions should be used and when. Mindfulness is one of several therapy services approved by NICE, which has indicated its benefits in preventing the relapse of depression. In particular, NICE proposes the use of mindfulness for people who are currently well but who have experienced three or more previous episodes of depression. The value of mindfulness as approved by NICE, therefore, is as a useful health intervention to prevent relapse among people who have experienced depression.

As the hon. Gentleman made clear, mindfulness therapy is an emerging and important field. We will watch with interest the outcome of the randomised controlled trials that are under way—not only in preventing relapse, but for treatment of long-term conditions. As he said, a number of organisations are involved in research into mindfulness. Bangor university and the Oxford Mindfulness Centre are examples. In answer to one of his many questions, I can say we will remain open-minded about mindfulness-based therapy; the challenge is to demonstrate how it will work.

The hon. Gentleman referred to the programme in County Durham, in Derwentside. My understanding is that it is a pilot that the Department for Work and Pensions oversaw. He is right that we need to look at the evaluation of it. The point I would make to him—we make this point in connection with all evaluations of pilots that the Department undertakes—is that we tend to benchmark pilots against what would happen in the absence of intervention. We will look at how the rate at which people sign off benefit having gone through the mindfulness pilot compares with the rate of people coming off benefit in other areas, so that we can judge its effectiveness and report back.

Let me respond to the detailed questions that the hon. Gentleman asked. He asked about the Work programme. It is designed so that it is for providers to determine which approaches are best at helping to get people back into sustainable employment, and they clearly need to understand which approaches and therapies are most effective. In order to embed mindfulness, the centres in Bangor or Oxford might want to work with some providers to see how mindfulness could be used more widely.

[Chris Ruane]

That is an excellent suggestion, but all I am asking of the Minister is that he write to those private sector providers to tip them the wink and say, “There are established British centres of excellence; please could you make an assessment of them?” because I do not think they even know about mindfulness therapy.

[Mr Hoban]

The model was set up so that providers have the initiative to make innovations and that it should not be Ministers telling them what to do. There is a role that the centres can play. Perhaps the hon. Gentleman might engage with the two Work programme providers in Wales—Working Links and Rehab JobFit—to see whether they might want to work with Bangor university on this issue.

I know from talking to the Minister of State at the Department of Health just this afternoon that the Department is aware of the issues around mindfulness therapy—the fact that the hon. Gentleman asked about it at Health questions last week has ensured that it is certainly on the ministerial radar.

The hon. Gentleman asked about the evaluation of best practice. Let us see what it says, what lessons should be drawn from it and, if it is successful, how it might be scaled up for use. He suggested that I should visit Durham.

[Chris Ruane]

It’s a long way.

[Mr Hoban]

It is not a long way and it is not difficult to visit. I was in Durham last month and I will be there later this month, as my family happen to live there, so I might visit Jobcentre Plus to understand just how that evaluation worked and what the evidence is.

I am delighted to be invited to Rhyl—it would not be my first visit. I will bear it in mind, because one of the issues we face is ensuring that we find new ways to help and support people with a range of mental health conditions, and there may be some value to be seen in the pilot there.

The hon. Gentleman encouraged me to meet mindfulness therapy practitioners. I have many strengths, but an understanding of psychological therapy is not one of them; but I will ensure that contact is made with either Bangor university or the Oxford centre, and that officials from my Department engage with them in order to understand it.

We take mental health conditions seriously. We need to ensure that support is put in place through Jobcentre Plus to help people to get into work; that, too, is something that we take seriously. Throughout the Jobcentre Plus network, work psychologists and mental health and well-being partnership managers are available to support advisers and to work with their counterparts and providers in the mental health service. That support is there for Jobcentre Plus advisers. All jobcentre staff with a claimant-facing role go through mandatory training modules to help them to support claimants with mental health problems and to refer them to specialist support if appropriate.

Last week, my noble Friend Lord Freud launched the mental well-being and employment toolkit for employment advisers. It has been produced and designed by Work programme and specialist mental health and employment providers. It is a free-to-use product that will help advisers to use employment discussions to identify mental health and well-being needs and to support people to access appropriate therapy services. One of the challenges is to identify those needs and to effect the appropriate referral. Debates such as these are important, because they raise the profile of these issues and ensure that they are on people’s radar screens.

The hon. Gentleman will know from his contacts in the Jobcentre Plus office in his constituency that each Jobcentre Plus has a disability employment adviser. They work with claimants facing complex employment situations resulting from a disability or health condition. Notwithstanding the debate on mindfulness, those resources exist within Jobcentre Plus to support claimants with such conditions. Those advisers can also act as an advocate with prospective employers on behalf of the customer, and they aim to identify work solutions that will minimise or overcome any difficulties related to an individual’s disability in the workplace.

I thank the hon. Gentleman for highlighting this issue. It is something that we need to look at carefully. We need to find every possible way to help people to get back into the labour market and to support them in getting there. I hope that, as people develop their understanding of mindfulness therapy, it might become a tool that could have a wider application.

Question put and agreed to.