Mental Health Services

Part of the debate – in the House of Commons at 3:40 pm on 7th February 2006.

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Photo of Andrew Lansley Andrew Lansley Shadow Secretary of State for Health 3:40 pm, 7th February 2006

I beg to move,

That this House
notes that one in four people will suffer mental health problems;
is aware that mental health trusts are facing some of the largest cuts in planned budgets whilst already having to cope with worryingly high recruitment shortages;
further notes that patients with mental illness are often denied real choice in their treatments due to long waiting times for referrals and an acute shortage of non-drug therapies such as cognitive behavioural therapy;
is alarmed at the particular problems experienced by black and minority ethnic patients in accessing services;
is concerned at the continued absence of a Mental Health Bill almost four years after the first draft Bill was published;
and calls on the Government to raise the relative importance of mental health within the NHS, making early intervention a priority in order to enable access to a range of appropriate services and urgently to publish a revised Mental Health Bill which recognises the rights and dignity of people with mental illness.

May I say at the outset that I am sorry to hear that the Secretary of State is indisposed? We send her our best wishes. We are sure that it will be only a temporary indisposition and that she will be back performing her duties very soon. However, we are happy that the Minister of State, Ms Winterton, is here to speak for the Government on this subject, for which she is directly responsible in the Department.

The purpose of this debate is threefold. First, given that there has been no debate in Government time on the Floor of the House on mental health services since 1997, this debate will permit hon. Members not only to assess the future of those services, but to express their appreciation of the staff who work in them and their understanding of the needs of patients with mental health problems. Secondly, we want to express what I hope will be the view of the whole House, namely, that mental health services must not be the Cinderella services of the NHS that many people have often perceived them to be. The services deserve, and must have, priority, and that priority must be reflected in the delivery of the services. Furthermore, that delivery must not be compromised—and patients must not suffer—as a result of present or prospective NHS deficits. Thirdly, we want a reformed Mental Health Bill that people across the range of mental health interests can support to be brought before the House. Such a Bill was promised in the Gracious Speech, but there have been long delays. We want it to contain provisions that will provide dignity and a positive framework for those whom it is intended to serve.

Annotations

Alix Cull
Posted on 8 Feb 2006 4:05 pm (Report this annotation)

I am pleased that the Rt.Hon Andrew Lansley amongs others is taking up the question of the poor provision for people with mental health problems and their carers. My particular interest is in people who suffer from schizophrenia. The media so often give the wrong impression that these people commit violent offences. Sometimes they do, but it is usually when they have not had a diagnosis, have not complied with their necessary medication possibly because of their lack of insight into their condition, or possibly because of memory impairment.
Schizophrenia is a severe and enduring mental illness and very disabling. I agree that occupation is beneficial to these patints when they recover from a severe relapse, and the effect on families is severe inasmuch as many have shown great promise in making a good life for themselves before their initial breakdown occurred. This illness cuts through all levels of society, although mental illness in general is greater in areas of overpopulation, high unemployment and poverty. The Benefits system is a nightmare, and for people who suffer from the disability of severe and ednring mental illness an impossible hurdle race. Little advice is given to them as to how to negotiate this maze. It may fall to relatives to take this responsibility and take power of Attorney. The "cut off" age of 18 when relatives can be invovled for people with mental illness, or indeed mental handicap, does not assist them to greater independence, and the confidentiality which surrounds the professionals in being able to give relatives information is conta-indicative to the patient's best interest. This may at time be advice that the sick family member should move away from the family home, at least for a period, until their condition has been stabilised.
With regard to an emergency condition arising, why should it be considered less urgent than a perforated appendix, which might well lead to death. In fact a mental emergency could have a similar result in some form of self harm or harm to others, and on occasions to suicide.
The Reform of the Mental health Act (to which I have as a long-term carer contributed) demonstrates the need for more emergency beds for psychiatric breakdown, and better communications, including communication with carers.
The incapacity Benefit may not be the suitable one for people with mental health problems, but disability, or severe disability benefits most certainly are. However this should be decided by the professionals, G.P., C.P.N and Psychiatrist.
I agree that the eight minute pidgeonhole alllowed by Government for G.P.examination of a patient is insufficient, and certainly inappropriate for people who are mentally ill.
Access to services is in many cases, even if available, not used by these patients as they lack insight into their condition.
With regard to the number of people from ethnic minorities being Sectioned more frequently than the indigenous population, Has the genetic factor been considered? Have the new scanning techniques developed in the U.S. been considered as a new and better diaagnostic process?
Thank you for your attention. Pat Cull.

Paul Tovey
Posted on 9 Feb 2006 8:50 am (Report this annotation)

I must partly reflect a previous poster Alix Hull and the Rt.Hon Andrew Lansley for I am very concerned too about the lack of alternative psychological therapies. The supply side in the NHS is poor and the quality is sometimes poor or patchy . Patients cannot easily get adjunctive therapies (CBT or Psychotherapies) to support their lives and the so called CHOICE agenda in mental health terms does not exist and it absolutely should . As I recall the Tories implemented an "internal market" and this at least gave rise to mechanisms whereby it was possible to do price comparison on therapies supplied inside the NHS and outside i.e. privately ...

The mechanism for purchase was called an "Extra contractual referal " and guess what ? I tried it in the 1990's in psychotherapy terms and it was cheaper than the local NHS.

CHOICE and all that it means , is being relegated in mental health for often the assumption of "Service User" representativeness by groups that are given ascendancy in this regard , like the National Institute For Mental Health In England NIMHE..

NIMHE has become a Dept of Work and Pensions almost purely "work-ethos" driven vehicle and whilst there is nothing wrong with the idea of recovery and work there is everything wrong with this approach covering up poor longer term provision of the right therapeutic treatments being governed more by patient choices using the market where supply by the NHS is poor. Paradoxically NHS Trust Boards are busy administering "savings" for a government intent on mental health care on the cheap with a poor stock on the NHS supermarket shelf. Some patients appear to be living inside a virtually serviceless service with Day Centres being closed on the back of new mental health "Social Inclusion" initiatives rather than those assets of Day Centres being used more dynamically. The idea of "asylum" has increasingly gone for those who are more fragile . Their own homes become a "community corner" of "care" . The benefits system does not reflect trying to recognise the need for mentally fragile people trying to be creative whilst not being able to actually work because of their irregularity. Woe betide them if they do anything even on a irregular voluntary basis . The benefit systems punitive policing atmosphere is actually traumatic . The insistence on benefit reviews after reviews does not help those with longer term severer conditions. It provokes fearful responses and less faith in a system that is increasingly experienced as without asylum . Lets see the democracy of the patient exercising more direct CHOICE through market mechanisms rather than the creation of new "Service User" bureaucracies which benefit the few and not the many ..

Sarah May
Posted on 9 Feb 2006 6:11 pm (Report this annotation)

I've been backwards and forwards to a consultant for nearly two years for Obsessive Compulsive Disorder and they've done nothing at all to help me. I had to go private in the end and, even though it's costing several hundred a month, if it had been left up to the NHS I wouldn't be here now. They are that useless. And it's not just the system, some of the Doctors I've come across give the word 'incompetent' new meaning!!! Its about time the government starting spending money tackling mental health issues, because they are failing so many people.

Alix Cull
Posted on 19 Jul 2006 4:34 pm (Report this annotation)

The Mental health Servicces have been neglected, with funding in some areas diverted to other means. This is shameful when vulnerable people.with little voince for themselves cannot get the treatment and support they need. I refer you to www.mica.org.uk for reference to a variety of mental illnesses which are well explained there, and may be of educaational value to M.Ps and others responsible for the care of these ujfortunate people.

Alix Cull
Posted on 31 Oct 2006 12:22 pm (Report this annotation)

I hope that the play (purported to be a real case history) on ITV on Sunday evening showed the unbearable position of parents of a 33 year old lady who suffered from Asperger's syndrome. The lack of provision of care, other than that given by the parents showed the stress which carers face. The father committed suicide successfully, the mother was rescued from this fate twice. The Solicitor was on the side of the patient, and the parents were not informed when the patient came before a Mental Health Tribunal. There was no aftercare or accommodation arranged at this point. It was said that she did not come under the scope of the Mental Health Act, as she did not pose a danger to herself or others. But what of the danger to carers - psychological danger which drove them to suicide and attempted suicide through desperation at having no relief from caring from an impossible situation.
The title was I feel derogatory - "StrangeCreatures".
They are not creatures any more than the rest of us. They are human beings who require care - as do we all. None the less the play did display the plight of families so inflicted.
When is the Government going to increase the provision of care, both in the Community, and where necessary in DECENT supervised sheltered accommodation.
We now have the added problems of our troups who are being returned from the battle zones with PTSD and left ot fend for themselves. Wake up Mr.Blair, and your Ministers. Mental Illness can affect all, Whose turn next?