Mental Health Services

Part of Opposition Day — [10th Allotted Day] – in the House of Commons at 7:17 pm on 8th May 2007.

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Photo of Norman Lamb Norman Lamb Shadow Secretary of State for Health 7:17 pm, 8th May 2007

I appreciate the hon. Gentleman's intervention, and he makes a valid point. Our case is simply that a great deal of priority needs to be given to expanding capacity, because—I shall come to this later—the National Institute for Health and Clinical Excellence itself concluded that we can make a real difference if we can increase capacity.

I want to focus on not just the cost to individuals but the cost to the economy. Layard estimates that the total loss of output as a result of depression and chronic anxiety is £12 billion a year or 1 per cent. of national income. Despite that, however, people are not receiving the help that they need. What is missing? As I said in response to Chris Bryant, NICE has issued guidelines stating that psychological therapies should be available to all people with depression and anxiety disorders or schizophrenia, unless the problem is very mild or recent. However, there are not enough therapists, as the hon. Gentleman highlighted. As a result of the inadequate number of therapists, waiting times are often very long—nine months is common—and often there is no therapy available at all, so GPs in those circumstances have no option but to prescribe drugs or to offer no help at all. GPs themselves acknowledge that they over-prescribe drugs in circumstances in which they would prefer to refer their patient for therapy which, however, is not available. Only one in four people suffering from depression or chronic anxiety receive any kind of treatment. That is a scandal in this day and age, and it needs to be addressed.

The Government make much of their commitment to choice in health care, yet for those people there is no choice at all, unless they can afford to opt out. If they can afford to do so, they can gain access to the therapies that we are discussing. We are spending a fortune on benefits, and the economy is suffering a loss of billions of pounds in lost output. Therapies are available that have a proven track record and which are recommended by NICE, yet most people who could benefit and who could be helped back to work cannot get the help that they need. Lord Layard estimates that an effective course of therapy costs about £750, which is about what it costs in benefits and lost taxes every month that someone remains out of work.

I acknowledge that the Government are pursuing pilots—the Minister referred to that in a recent Westminster Hall debate—and that the number of those pilots is expanding, but progress is too slow. Imagine the outcry that there would be if there were NICE guidelines on, for example, cancer treatment that were being ignored across much of the country. There would be an enormous outcry—rightly so—and it would achieve a response. We owe it to people with mental health problems to demand exactly the same response that people who suffer from cancer and other physical conditions can get from their politicians. This demonstrates yet again the extent to which this is a Cinderella service. Implementing the guidelines requires a significant increase in the number of therapists—Layard estimates a figure of about 10,000. It will take time—he reckoned seven years—but he argues that the cost would be totally offset by savings in benefits and increases in tax revenues.

Another area that the Government need to deal with relates to stigma associated with mental health. In New Zealand, a Government programme to tackle stigma appears to have been very successful. They have invested in the job of reducing the stigma of mental illness. Persuading employers to take on people who have had mental health problems is sometimes a significant challenge, but it has had some effect in New Zealand. I urge the Government to look closely at what they have done and to pursue a similar route in this country.

Annotations

Alix Cull
Posted on 10 May 2007 6:46 pm (Report this annotation)

With regard to employment I would suggest that there are many people with mental illness who can work from home, but are unable to work at the speed required to enable them to earn sufficient to increase their income from benefits. May though not all, have difficulty in socialising with other people. It is not always their fault, it is the stigma which attaches to them, and work mates feel they are carrying a burden. Not all people without mental illness are kind and considerate enough to asist disabled people, especially those with mental health probems, to merge into the work scheme, which may have a time limit.The amount that disabled people including those with mental health problems are allowed to earn (£20 p.w.) is a disincentive to someone who has difficulties anyway.

Karen Molyneux
Posted on 18 May 2007 9:14 pm (Report this annotation)

There has been an outcry across the country in the form of a petition signed by more than 10,000 people asking for other therapies to be considered (other than CBT). There is ample evidence that other therapies such as the Person-Centred approach work as well as CBT and may have longer lasting effect. Imagine if cancer sufferers were only offered radiation treatment and denied chemotherapy.

Karen Molyneux
Posted on 18 May 2007 9:15 pm (Report this annotation)

There has been an outcry across the country in the form of a petition signed by more than 10,000 people asking for other therapies to be considered (other than CBT). There is ample evidence that other therapies such as the Person-Centred approach work as well as CBT and may have longer lasting effect. Imagine if cancer sufferers were only offered radiation treatment and denied chemotherapy.