Mental Health Treatment and Support

Rosena Allin-Khan Excerpts

Wednesday 7th June 2023 Commons Chamber

[Dr Rosena Allin-Khan (Tooting) (Lab)]

I beg to move,

That this House notes with concern the scale of the mental health crisis facing the country with patients suffering with mental health issues waiting more than 5.4 million hours in accident and emergency last year; further notes with concern the mental health crisis facing young people with nearly 400,000 children currently waiting for treatment; recognises the health inequalities within the use of the Mental Health Act 1983; and calls on the Government to adopt Labour’s plan to recruit thousands of mental health staff to expand access to treatment, to provide access to specialist mental health support in every school, to establish open access mental health hubs for children and young people and to bring in the first ever long-term, whole-Government plan to improve outcomes for people with mental health needs.

After 13 years in office, this Government have delivered the worst mental health crisis in our history. We are becoming a brittle, anxious, fractious society, the very bonds of which are frayed and torn. The causes of mental ill health are complex: poverty, homelessness, neglect, loneliness, debt, bereavement, domestic violence and child and adult trauma. Our understanding of mental health is developing all the time. We have moved on in the years since I trained as a doctor. We can now see how interlinked and enmeshed the range of factors is: warm and safe homes, fulfilling work, strong relationships, safe streets, opportunities to learn, fresh air and green spaces are policies for good mental health.

Nye Bevan talked about the serenity in knowing that medical care is free at the point of need. After 13 years of Conservatives, we are far from serene. For many of the families I meet, the future is filled with dark clouds, fear of displacement and debt, and a sense that society is going to hell in a handcart—a Britain where nothing works, where everything is broken and where everything costs more than six months ago. Zero-hours contracts, boarded up high streets, rapacious landlords, rising lawlessness and antisocial behaviour and the long-term effects of covid—no wonder we are in the grip of a mental health crisis.

[Mr Toby Perkins (Chesterfield) (Lab)]

I am very pleased with the way my hon. Friend has started her speech, because she is absolutely right. Alongside the additional healthcare staff needed and the many measures that my hon. Friend the Member for Ilford North (Wes Streeting) and I have been spelling out for the health service, the society that has been created over the past 13 years of austerity has had massive impact on the mental health crisis. I am glad that my hon. Friend has focused on that. It will be the job of the entire future Labour Government to support her and her colleagues to reduce the mental health crisis.

[Dr Allin-Khan]

I thank my hon. Friend for his intervention; he is right. I will talk about the need for mental health not to exist in a silo later in my remarks. Frankly, it is the problem of every single Government Department.

One in four people experiences a problem with their mental health each year in England. One in six people experiences a mental health condition, such as anxiety or depression, each week. Three in four people with mental ill health in England receive little or no treatment for their condition. And people with the most severe mental illnesses die up to 20 years sooner than the general population. I ask the House to reflect on that for a moment. Tragically, in 2021, over 5,000 suicides were registered, up by 300 on the previous year. The Government should wear these statistics like a badge of shame.

[Andrew Bridgen (North West Leicestershire) (Reclaim)]

The shadow Minister makes an accurate assessment of the size of the mental health crisis facing our nation, but her words would have more resonance if she and her party had not voted in lockstep with the Government for the disastrous lockdowns that damaged mental health, especially that of our young people. Will she apologise?

[Dr Allin-Khan]

I will take no lectures from the hon. Member, because he proudly sat as a Member of a Government who oversaw hundreds of thousands of unnecessary deaths. Families are still feeling the ongoing mental effects of losing loved ones because of the mishandling of the pandemic by his then Government.

My right hon. and learned Friend the Member for Holborn and St Pancras (Keir Starmer), the Leader of the Opposition, launched Labour’s mission for health in May. He said:

“Suicide is the biggest killer of young lives in this country, the biggest killer. That statistic should haunt us, and the rate is going up. Our mission—must be and will be—to get it down.”

He is right. Across the House, we are increasingly hearing brave, moving and revealing testimonies about our own experiences and struggles. It is vital that we challenge the stigma and talk openly about mental health.

[Dan Carden (Liverpool, Walton) (Lab)]

My hon. Friend and I have worked on these issues over the last couple of years. She knows that 70% of people who enter treatment for alcohol issues also experience trouble with their mental health. The Public Accounts Committee recently released a report on alcohol treatment services, and recommendation 4 called on the Government to set out, without delay

“what it is doing to help improve integrated care for people with co-occurring alcohol and mental health problems.”

Will she use her position today to encourage the Government to act on that recommendation?

[Dr Allin-Khan]

I could not be more proud to work with my hon. Friend in this space. He is a powerful advocate and I wholeheartedly support all his efforts, and those of Members across the House, to support people who are living with alcoholism, and their families. I thank him; we will continue to support his work.

[Jim Shannon (Strangford) (DUP)]

I commend the shadow Minister and the Labour party for bringing this issue forward. Support for mental health across this great United Kingdom of Great Britain and Northern Ireland is a massive issue, including in my constituency. For example, one of my constituents told me they finally found the courage to seek help for their mental health, only to be told by health professionals, “We can’t do anything for you just now as your condition is not severe enough yet—you have no thoughts of suicide.” Does the hon. Lady agree that supporting those with mental health issues at the earliest stage—right away—is more beneficial, instead of forcing them to wait until it may be too late? At that stage, the situation cannot be turned back.

[Dr Allin-Khan]

I thank the hon. Member; it has been a pleasure to work with him in every single debate about mental health that I have held in the past three years, since I started my role. He speaks to the important point that prevention is the watchword that counts when it comes to mental health.

[Janet Daby (Lewisham East) (Lab)]

My hon. Friend is making a powerful speech. Does she agree that the Government are failing people who are experiencing mental ill health, or even a mental health crisis? Psychiatrists are leaving the country because they are finding jobs overseas more accessible. People experiencing mental health crises are having to wait in A&E departments for too long; they waited for a total of 5.4 million hours during 2021, which is entirely unacceptable. Things need to change.

[Dr Allin-Khan]

I thank my hon. Friend for assisting me in writing my speech; she has pre-empted much of what is to come. She is a powerful advocate for her community and I am proud to share the Opposition Benches with her.

[Laura Farris (Newbury) (Con)]

On that point, will the shadow Minister give way?

[Dr Allin-Khan]

I will make some progress, but I would be happy to take further interventions after that.

Amid all the anguish and pain, one thing comes through: people cannot access the mental health services they need. The stark fact is that the way the UK’s mental health services are funded and distributed can exacerbate the problem, so instead of making people better, they are making them worse.

The current reality is that 1.6 million people are waiting for treatment. More than 1 million people had their referral closed without receiving any help in the last year alone. Last year, children in mental health crisis spent more than 900,000 hours in A&E and almost 400,000 children are on waiting lists. In the same period, adults experiencing a mental health crisis spent over 5.4 million hours in A&E. Black people are five times more likely to be detained under the Mental Health Act 1983 than white people. People with eating disorders are being put on a palliative care pathway.

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

Will the shadow Minister join me in welcoming the work the Government have done to bring forward the draft Mental Health Bill? We both sat on the pre-legislative scrutiny Committee. Hopefully, the Bill will right some of those wrongs.

[Dr Allin-Khan]

It has been a pleasure to work with the hon. Member on the draft Mental Health Bill. However, as I will say later in my speech, I have little confidence that the draft Mental Health Bill will move beyond the draft stage. We need to debate the issues in the House, to ensure that what we know needs to be fixed is actually fixed, so that we can help people in our communities, including black people, who are more likely to be detained under the Mental Health Act, and people with autism and neurodiversity, who are mistreated simply as a result of having that diagnosis, so that their lives can be better lived. We need these issues to come before the House, so that we can debate them and move forward.

[Jeff Smith (Manchester, Withington) (Lab)]

My hon. Friend is making an important point about the demand on A&E, but there is demand on other public services as well. When I have been out with the police in south Manchester, I have been shocked by the sheer amount of time they spend dealing with people in mental health crisis. I am sure we all know the amount of time our staff spend dealing with people in mental health crisis. Does she agree that it is a false economy not to invest properly in mental health services, because of the impact on other public services?

[Dr Allin-Khan]

My hon. Friend makes a powerful point; he is right. It is also a false economy because of the impact mental ill health has on families. Not investing in one person’s mental ill health not only has an impact on their working and earning potential, but has a knock-on impact on that of their parents, siblings and other family members. People are currently sitting at home on suicide watch for their children because they cannot get access to the timely help and treatment they need. This is Tory Britain.

What has been the response from the Government to these alarming facts? Ministers have junked the 10-year mental health plan and binned thousands of responses to the consultation. Seni’s law, set out in a private Member’s Bill introduced by my hon. Friend the Member for Croydon North (Steve Reed), passed unanimously, but it has not been fully implemented. It was passed almost five years ago and there have been three subsequent Ministers, and yet we are in the highly unusual situation where it has not been commenced in full. Who exactly is against the monitoring of the disproportionate use of force? The House certainly was not against it when the Bill was passed.

The Government have announced plans for new mental health hospitals, but those new hospitals are not new. The hospitals announced on 25 May—Surrey and Borders, Derbyshire and Merseycare—were already in the pipeline.

Let us talk about the Minister’s own patch, to really see the scale of the issue. At his closest hospital, adults experiencing a mental health crisis waited 11,000 hours in A&E last year. There are over 5,000 children and 40,000 adults stuck on mental health waiting lists across his integrated care board. Thousands of local people were turned away from services before treatment; I am sure the Minister will agree that that is unacceptable. As ever, we have smoke and mirrors when we need bricks and mortar. If this seems bleak, that is because it is.

[Margaret Greenwood (Wirral West) (Lab)]

My hon. Friend is making an excellent speech about a very important issue. One of my constituents who works in psychiatric care has talked of staff having to deal with violence, verbal abuse, being swilled with boiling water and more. He says that they are under extreme pressure, which is causing some to leave and putting more pressure on those who remain. Does my hon. Friend agree that that is a shocking and unsustainable state of affairs, and that we need a Labour Government who will invest in mental health services?

[Dr Allin-Khan]

I entirely agree with my hon. Friend, who works tirelessly on this issue.

After more than a decade of Tory Governments, if people need help, all too often no one is there. Last year, emergency service workers took more than a million sick days because of stress. NHS staff are at the sharp end of this mental health crisis. I know them, I work with them, and I see what they are coping with daily. They are heroes, but they simply do not have the resources, the staff or the leadership from Ministers that would enable them to do their jobs. They themselves suffer exhaustion, depression, stress and anxiety. About 17,000 staff—12% of the mental health workforce—left last year.

You will be pleased to know that I have had a look at the Government’s amendment, Mr Speaker—I do my homework. There is the tired old £2.3 billion figure. How many times have we heard that trotted out? Actually, I can tell the House that it has been used more than 90 times over five years, and it has been spent in myriad different ways. Then there is the £150 million for mental health crisis units. But the amendment fails to mention the serious patient safety concerns that doctors have raised, and it is clear that the pressure on A&E remains as fierce as ever. There is also nothing about the recent announcement from the Metropolitan police that they will not help people in a mental health crisis.

Ministers need to get out of Whitehall and see what is really happening in our mental health service. If they did so, they would see what I have seen in recent months. They would see the junior psychiatrists whom I met recently—junior doctors who have devoted all their training to this profession, and half of whom plan to leave the NHS at the end of their training. They would see the doctor who told me of an incident in which six police officers were in A&E for 18 hours with a patient detained under section 136 of the Mental Health Act 1983. They would see a child arriving at A&E after self-harming, having been referred by the GP a long time ago but not been seen for weeks, which led to an escalation point and a crisis in A&E. We are seeing a system in crisis, people in pain and families in distress.

[Munira Wilson (Twickenham) (LD)]

The shadow Minister has referred several times to children’s mental health and the crisis that often occurs when they present at A&E departments. Does she agree that schools have an important role to play when children have moderate mental health conditions, before those conditions escalate? The role of mental health support teams in schools is critical, but their funding is due to end abruptly next year, with only about half the programme complete. Will she join me in asking the Minister to commit himself to funding the full roll-out of mental health support teams or, better still, to back the Liberal Democrats’ plan to provide a qualified mental health practitioner in every school?

[Dr Allin-Khan]

I invite the hon. Member to have a look at the plans we already have in place. She will be pleased to learn that one of our pledges is the provision of a mental health specialist in every school. I invite her to support those Labour plans—and to come and join us over here if she feels like it.

[Luke Pollard (Plymouth, Sutton and Devonport) (Lab/Co-op)]

Young people are bearing the brunt of the mental health crisis, and parents are worried sick. I see evidence of that every day in my inbox, and it is getting worse. When so little money is being spent on young people’s mental health, even though we know that the vast majority of mental health conditions appear in people under the age of 18, is the balance right between the money spent on adult mental health and that spent on young people’s mental health? If we want a preventive system that helps to cut costs for the taxpayer and helps people as well, is not investing early in young people the best way to achieve that?

[Dr Allin-Khan]

My hon. Friend is spot on in making the point, very articulately, that prevention is our watchword. It is vital that we have mental health access hubs in every community to give people the support that they need; it is essential that we have mental health specialist support in every school; and it is essential that mental health does not operate in a Health silo, because when it comes to improving adverse childhood experiences that can lead to poor mental health in later life, that is every Department’s issue.

I have asked Ministers six times to tell us of their meetings with mental health trusts where there are reported abuse scandals, but they have failed to respond. In-patient services across England must be reviewed, with patients’ voices at the centre. After a series of allegations in different settings, the Government have dragged their feet, and we are still waiting for the findings of their data exercise, in which no one even spoke to families or patients. They could start by giving statutory powers to the inquiry into deaths in Essex mental health units.

What else needs to change? First, we need to speed up diagnosis and treatment. The longer we leave a mental health disorder untreated, the worse it gets—just like cancer, sepsis and heart conditions. Delays cost patients their wellbeing and their families their peace of mind, and of course it costs the taxpayer more to treat a patient who is more acutely unwell after months and years of delay. The argument for prevention, early intervention, speedy diagnosis and timely treatment is clear. Labour will guarantee treatment within a month for all who need it, which will be better for patients and better for the NHS.

Secondly, we need a tough new target for delivery—something for the whole system to drive for, and something for the voters to judge us on. Labour will recruit 8,500 new staff, so that 1 million more people can access treatment every year by the end of Labour’s first term in office.

Thirdly, we will reach out to our young people, and give the next generation the support that they desperately need. This is the generation who have known little or no security: children who have gone through the great financial crash, austerity and covid, robbed of their future and dismissed as snowflakes. We will open a mental health access hub for children and young people in every community, providing early intervention and drop-in services, and we will provide access to a mental health professional in every school. This is a true community, preventive approach in action.

Fourthly, we will stop mental health policy being placed in a silo. As I said at the beginning of my speech, mental health policy cannot be disentangled from social and economic policy. A decision on Bank of England interest rates takes its toll on the mental health of a family in Tooting. We are all interconnected. The economy is not an abstract concept; it is people. The next Labour Government will present a long-term, whole-Government plan to improve mental health outcomes—mental health in all policies.

Fifthly, Labour Ministers will allocate to mental health its fair share of funding, as the economy grows and as resources allow. For starters, we will close tax loopholes, putting the country’s mental health first. That is our plan and, crucially, it will not be solely the responsibility of the incoming new mental health Minister; it will be the responsibility of the whole Cabinet and the whole Government.

We have seen enough plans, we have heard enough announcements, and we have watched enough Ministers pass in and out of the revolving doors of 39 Victoria Street. Let us have no more Tory sticking plasters. Labour’s health mission, guided by prevention and anchored in community, gives children the best start and boosts the economy, with more people in better health. With a clear plan, with clear costings and with resolute leadership, we will deliver the world-class health system that our society truly deserves.