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.
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 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.
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.
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?
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.
“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.
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?
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.
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.
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.
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.
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.
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.
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?
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 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
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.
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?
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.
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?
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.
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?
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.
I beg to move an amendment, to leave out from “House” to the end of the Question and add:
“notes the increased burden on mental health following the pandemic, including on young people and those with severe mental illness;
recognises the historic levels of investment being delivered by this Government into services, with an increase of £2.3 billion per year in front-line mental health funding over the past four years;
notes that current NHS targets around access to talking therapies and intervention in psychosis are being met due to the efforts of NHS staff;
and acknowledges the investment in mental health teams in schools, as well as the ongoing investment into open access mental health helplines in the 111 service and into the estate, including three new mental health hospitals to be opened in the next two years accompanied by a further £150 million in investment in new mental health ambulances and the development of better alternatives to accident and emergency services, including crisis houses, safe havens and step-down services.”
Improving mental health is a top priority for this Government. We can all agree that in the past it was not given the priority it deserves, and was seen as something to be ashamed of and not spoken about. Thankfully, we are changing that. We are working to achieve parity of esteem between physical health and mental health, with record amounts of investment going into NHS mental health services in England, and the stigma surrounding mental health is being reduced.
“The Five Year Forward View for Mental Health”, which was published in 2016, was a major step forward and secured an additional £1 billion in funding for mental health, so that an additional 1 million people could access high-quality services by 2020-21. It was followed by the NHS long-term plan in 2019, which committed an additional £2.3 billion a year for the expansion and transformation of mental health services in England by 2024, so that an additional 2 million people could get the NHS-funded mental health support that they need. It is also funding the increase in the frontline mental health workforce to meet the plan’s ambition for 27,000 additional mental health staff by 2023-24. There were 138,610 full-time equivalent mental health staff at the end of 2022, an increase of 8,900 on the previous year and of 20,700 on December 2010, so the mental health workforce in the NHS is radically bigger. In total, we spent around £3 billion more on mental health last year compared with four years ago. That is an increase of a quarter.
Backed by this huge investment, we are expanding access to NHS talking therapies for adults to meet the long-term plan’s ambition for an additional 1.9 million people to access National Institute for Health and Care Excellence-approved treatments for conditions such as anxiety and depression. From starting small in 2008, around 1.2 million people are now accessing NHS talking therapies every year, with 98% waiting less than 18 weeks for their treatment and 90% waiting less than six weeks. This means that we are delivering well over our national waiting time targets of 95% and 75% respectively.
Local mental health services are transforming community mental health care to give 370,000 adults and older adults with severe mental illnesses greater choice and control over their care and to support them to live well in their communities. We recognise that poor mental health is a major cause of sickness absence in the workplace and we are providing support to employees and employers on mental health in the workplace. We have announced additional measures to support workplace mental health, including a package to support the long-term sick and disabled to remain in or return to work. This includes £200 million for digital mental health to modernise NHS talking therapies, to provide free access to wellness and clinical mental health apps for the population, and to pilot cutting-edge digital therapeutics. There will be around £75 million to expand individual placement and support services to help more people with severe mental health illnesses into employment.
I will make a little progress first.
We know that the number of children and young people experiencing mental ill health is rising, and that many of them will continue to experience mental health problems later in life. Spending on children and young people’s mental health continues to grow, from £841 million in 2019-20 to £995 million a year later, and now to £1.1 billion in 2022-23. This means that we are helping more children and young people than ever before. In 2021-22, there were over 743,000 new referrals to children’s and young people’s mental health services, which is 41% higher than the year before.
I will make a bit of progress before I give way.
The long-term plan will ensure that 345,000 more children and young people can get the mental health support they need when they need it.
We are committed to ensuring that children and young people can access mental health support in school, so that they can access help with anxiety and depression and other common mental health services before problems become more serious. In that way, we can prevent—in exactly the way we all agree on—the problems from becoming more serious. That includes continuing to roll out mental health support teams to schools and colleges in England.
The picture that the Minister is painting does not quite tally with the experience that I am seeing in families, many of whom are watching with a feeling of helplessness as their children’s mental health deteriorates while they are on long waiting lists. In the NHS South West London ICB area, there are over 10,000 young people on waiting lists, and many have their cases closed without even getting the support they need. That leaves them with deteriorating mental health and it leaves their families in despair. How is it that the money the Minister is talking about does not seem to get through to the young people who need help?
I will come to the point about waiting lists in a moment.
Let me complete my thoughts on prevention, which I think we all agree is important. There are 3.4 million pupils covered by mental health support teams in 2022-23, which equates to about 35% coverage of pupils in schools and learners in further education in England. We expect around 500 teams to be up and running by 2024, covering around 44% of pupils and learners, so it will be up from 35% to 44%. Over 10,000 schools and colleges now have a trained senior mental health lead, including more than six in 10 state-funded secondary schools in England. On prevention, the Government are also providing £150 million of capital investment in NHS mental health urgent and emergency care infrastructure over the next two years.
While the Minister is addressing the issue of young people, can I say that I have yet to hear any news from the Department as to whether there will be a public inquiry into the deaths of the three young women who died under the care of the Tees, Esk and Wear Valleys Foundation NHS Trust. Can he enlighten me on that?
This is an extremely important issue that the hon. Gentleman is quite right to raise. We will be producing the results of the rapid review in the coming weeks, so he will not have to wait very long.
Like other colleagues, I see many children in my constituency waiting well over a year, sometimes two years, to access child and adolescent mental health services, so I was alarmed when NHS England recently told me that, on the latest modelling, the number of NHS-commissioned training posts in London for child and adolescent psychiatry will halve by 2031. I have no idea what is driving this modelling, but given that one in six seven to 16-year-olds have a probable mental health disorder, will the Minister at least look into these figures and undertake to write to me to explain why we are seeing such a drop in the number of training places?
Those are not figures that I am familiar with or recognise, but I will certainly take this up with the London commissioners because it sounds like an important issue. I have talked about the dramatic increase we have already seen in the mental health workforce, and we are setting out further steps in our long-term workforce plan, but I will take that away and look at it closely with other Ministers.
One of the issues here is that the demand for mental health services has gone through the roof, from 3.6 million in 2020-21 to 4.5 million in 2021-22. My hon. Friend Dr Allin-Khan was clear in her view, which I share, that the policies of this Government have been a factor in driving up the mental health demand. Does the Minister accept that? If not, what does he put it down to?
I was just coming to that, but on the point about prevention and the social origins of these things, we are in agreement about tackling the origins of these things. In terms of financial security, that is why we are providing financial help worth £3,300 per household, one of the most dramatically generous packages anywhere in Europe. The question of good housing was raised earlier. We have the Social Housing (Regulation) Bill and we are taking action to extend the decent homes standard to the private rented sector.
Is it not the case that we have to be really careful about what we are talking about? There is a difference between mental wellbeing and mental health. We all suffer with our mental wellbeing but we do not all suffer with our mental health, and we therefore need to have the support that is appropriate. Social prescribing, for example, has a fundamental ability to help people who suffer with their mental wellbeing. Are the Government doing anything more to drive up social prescribing, so that GPs and allied professions can get the support from the third sector and other voluntary organisations that people so desperately need for their mental wellbeing?
My hon. Friend, as an experienced clinician, makes an important and thoughtful point. This is exactly why we have so dramatically increased the number of social prescribers in primary care. An example in Britain is the parkrun practices initiative, which is connecting people to sporting and cultural activities that can improve mental wellbeing as well as mental health. My hon. Friend is completely right, and that is why this is a priority for us.
It is just not true there was an increase in suicides because of the lockdowns. There have been a whole series of careful studies of this and that is just not the case. I am afraid that my hon. Friend is not correct about this.
Eating disorders are a national scandal and have reached epidemic proportions. Anorexia nervosa has the highest mortality rate of any mental health disorder and a third of people with binge eating disorders are at suicide risk. With at least 1.25 million people suffering from eating disorders and with soaring waiting lists, is it not time that the Government appointed something like an eating disorder prevention champion to tackle this incredibly difficult but rising crisis?
I completely agree about its tremendous importance, and I take this opportunity to mention the incredible work on this hugely important issue by brilliant charities such as Beat. I will outline some of the general things we are doing to increase capacity further.
Only a few weeks ago, I met a constituent who endured an awful kidnapping and rape. She had some initial counselling and therapy from specialist services, but she has now been on the waiting list for more than a year and a half. What would the Minister say to my constituent, who desperately needs therapy?
I am terribly sorry to hear about the hon. Lady’s constituent’s case, which I will look at extremely closely. This is why we are putting in extra investment and tackling waiting lists.
I should make a little progress before taking further interventions.
The Government are providing £150 million of capital investment in the NHS’s urgent and emergency care infrastructure for mental health over the next two years. Those interventions include £7 million for 90 new mental health ambulances, with the remaining £143 million going to more than 160 capital projects with a preventive focus. These include new urgent assessment and care centres, crisis cafés and crisis houses, health-based places of safety for people detained by the police and improvements to the NHS 111 and urgent mental health helplines. The hon. Member for Tooting talked about creating such facilities in the community, and we are already doing that. We are also investing £400 million between 2020-21 and 2023-24 to eradicate mental health dormitory accommodation, improving safety and dignity for patients. Twenty-nine projects have already been completed since the programme commenced in 2020-21, eradicating over 500 dormitory beds.
I thank the Minister for giving way, as I appreciate that he is trying to make progress. On the capital programme, one of the issues that my hon. Friend Dr Allin-Khan highlighted is Seni’s law, which will look at the treatment that patients receive in mental health units, where, sadly, restraint has led to deaths. The Minister talks about prevention, and we need to make sure that Seni’s law, which was enacted in November 2018, comes forward now. Does he agree?
The remaining provisions will be commenced as soon as possible.
We are working with the NHS towards implementing new waiting time standards for people requiring urgent and emergency mental healthcare, in both A&E and the community, to ensure timely access to the most appropriate high-quality support. We also recognise that there is much more to be done to improve people’s experience in in-patient mental health facilities. The Minister with responsibility for mental health, my hon. Friend Maria Caulfield, has spoken to many Members following reports of abuse and care failings at a number of NHS and independent providers. We have been clear that anyone receiving treatment in an in-patient mental health facility deserves to receive safe, high-quality care and to be looked after with dignity and respect.
It is vital that, where care falls short, we learn from any mistakes to improve care across the NHS and to protect patients. That is why we have conducted a rapid review of mental health in-patient settings, with a specific focus on how we use data and evidence, including from complaints, feedback and whistleblowing reports, to identify risks to safety.
The Minister wants to talk about data and evidence. We know that, within the mental health crisis, there are huge, long-established racial disparities, with young black men disproportionately being sectioned under the Mental Health Act 1983. The draft mental health Bill is still in train, and I would like to know exactly when the Government will table the Bill, which might stop these racial disparities and stop young black men dispro-portionately being sectioned.
We are currently responding to pre-legislative scrutiny, so we are on the case. We are not just waiting, of course, and we are already doing things on these points, including through the culturally appropriate advocacy pilots for those at risk of detention and on the patient and carer race equality framework to avoid and prevent detention in the first place.
The rapid review’s report will be published very shortly. NHS England has also established a three-year quality transformation programme that seeks to tackle the root causes of unsafe, poor-quality in-patient care, including sexual safety, in mental health, learning disability and autism settings.
Our draft mental health Bill, which has been mentioned a few times in this debate, is intended to modernise the Mental Health Act so that it is fit for the 21st century and works better for people with serious mental illness. The draft Bill has completed its pre-legislative scrutiny, and we will respond to the Joint Committee’s recommendations very shortly.
In a world of increasing rates of multiple morbidity and diseases of increasing complexity, it is crucial that we continue our progress towards more person-centred, holistic care that considers a patient’s physical and mental health needs together. That is why we announced in January that we will be producing a major conditions strategy to tackle the conditions that contribute most to morbidity and mortality across the population of England, including mental health. The call for evidence is now open, and I encourage everyone to make their views known before it closes.
The Minister is talking about the mental health strategy now being part of the major conditions strategy. Is he aware that many mental health organisations see it as a retrograde step that, having conducted an extensive consultation and invited views, the strategy will now be put back even further?
I assure the hon. Lady that all contributions were fed into the major conditions strategy process. The reason why we are making the mental health strategy part of the major conditions strategy, and why we are looking at co-morbidities, is because, as the hon. Member for Tooting mentioned, people with mental health conditions have a shorter lifespan and, in general, the cause is typically a physical co-morbidity. It is essential that we look at these things together if we are to make progress on tackling disparities.
We have committed to publishing a new national suicide prevention strategy later this year, and we are engaging widely across the sector to understand what further action we can take to reduce cases of suicide. The new strategy will reflect new evidence and the national priority for preventing suicide across England, including action to tackle known risk factors and targeted action for groups of concern. We are also providing an extra £10 million over the next two years for a suicide prevention voluntary, community and social enterprise grant fund. This competitive grant fund will help to support the sector to deliver activity that can help to sustain services to help meet increased demand for support and to embed preventive activity that can help to prevent suicide and stem the flow into crisis services.
Of course it is good that we will have a refreshed national suicide prevention strategy, and of course £10 million is welcome, but it is not out there yet. In the meantime, the £57 million that was earmarked for local work on suicide prevention has run out. Will the Minister consider making urgent interim arrangements to ensure that this vital work can continue until the strategy is published?
I am conscious that we need to help the sector to maintain and grow its levels of service.
I finish by paying tribute to all those who do so much to support people’s mental health: frontline NHS staff, those working in the voluntary community and social enterprises, and all those who are quietly supporting a family member or loved one.
I think the whole House agrees that there is a mental health crisis, but the Minister’s presentation simply will not do. It was like a series of numbers read from a brief prepared by somebody who is remote from the reality of life in our country. It sounded complacent and like it was coming from on high, rather than from real experience.
I hope the House will not mind if I illustrate the general points I want to make by referring to my own area, as the experiences I am going to relate have a general significance for the country as a whole. First, let me agree with my Front-Bench colleague, my hon. Friend Dr Allin-Khan, that the seed beds that are creating the great demand for mental health services lie in the social and economic conditions that have been created following 13 years of failed government. My constituency is 529th out of 533 English seats in social mobility—it is one of the most immobile socially. A child who is born today in the local hospital will die younger than those elsewhere in the country if they are in deprivation; there is no chance whatsoever of getting out of the crisis that so many families face, given the absence of social mobility across the country, but especially in areas such as mine. I am talking about deprivation where, in a constituency such as mine, access to a house, green space, healthy living and all the things one should expect to be able to achieve as a human being in one of the richest countries in the world are simply not available. That is the seed bed for the mental health crisis. I speak about my area, but this is a generic problem, as we all know. Even the Minister seemed to concede that in one of his responses, although the idea that the Government will somehow address the problems they have created after 13 years is preposterous.
The Minister talks a good talk on the Government’s intentions, but under his Government NHS staff wages have fallen, and nursing bursaries have been cut, as have mental health beds. In my area of Yorkshire we have lost a quarter of our mental health beds since 2010—since the Conservatives came into power and Labour was last in government. The loss of a bed may not sound much, but if we think about it, we see that dozens and perhaps hundreds of people would use that bed in a year. Every bed lost has a huge impact on a series of individuals, families and even communities. The same applies to the loss of nurses and other qualified staff; these things are in decline. So it is no good the Minister standing there and repeating stuff that has been provided to him by the civil service.
It is scandalous that in my area of West Yorkshire 10,000 people in a single year were released from acute hospital with a recommendation that they receive mental health treatment and all of them failed to get a mental health appointment. They were then removed from the list without any opportunity to receive even the basic courtesy of a single half-hour meeting. Beyond that, in the same year, 60,000 patients in Yorkshire had to be referred to a provider outside their area. Let us just think about this: we are talking about people with mental health problems being sent to an area that is unfamiliar to them, miles away from anywhere they know or feel comfortable and loved in, in order to receive basic treatment. It is not acceptable that that is happening in Yorkshire.
Suicide has been mentioned by a number of colleagues, from all parts of the House. In West Yorkshire, the figure for men committing suicide is over 20 per 100,000, whereas the figure for the country as a whole is 16 per 100,000. Let us just think about that. It is because of the deprivation and the problems we face in our area. Why should we put up with a postcode lottery that fails to address the mental health needs of young people, with the result that we have a quarter more suicides in West Yorkshire than in the rest of the country? That is shocking, but this is the kind of society that the Government have created and they have then cut the services that would provide the basic support that a civilised society should provide.
Let me refer to two profoundly shocking cases, which I am sure are reproduced everywhere in the country. The first involves a family who have an 18-year-old daughter. She has a mental health issue and it has led to her becoming immobilised physically. She was admitted to an acute hospital over the weekend—she is unable to move. The hospital insisted that she left yesterday, but there is no care package and no assistance for her. The doctor said, “My advice to you is to get some treatment, but you won’t get it on the NHS because you’ll wait for years. Your need is urgent. Go to a private practitioner.” That was what he recommended. We looked it up and found it will be £3,000 per month to get the treatment. This is treatment that should be provided by a civilised Government, but we do not have a civilised Government—it is shocking. This morning, that young woman of 18 was left on her own on a sofa—not even with a commode provided—with two glasses of water and a bloomin’ sandwich while the family went off to work to try to earn the money to pay. It is a disgrace that that happens in our society.
Finally, I come to the issue of people with mental health issues in care homes. These care homes are in some ways very good, but in other ways this is a racket. We have a care home in my area that the Care Quality Commission condemned in 2020. Nothing was done by the owners to improve the situation but the CQC did not go back, presumably because of covid, until November. It then said, “This home isn’t working, so you’ve got to move everybody out.” There are people there who are close to the end of life and others who have serious mental health issues. Closing that home is going to kill some people: let us be honest and blunt about it. It appears that its private owners are removing all the people in there with these mental health issues and putting them somewhere else, with no reference whatsoever and no care for people who have basically been commodities for them to use—but they are investing in the home. I have spoken to the CQC and asked: are those fit and proper persons to run such a home to care for people with mental health crises? My argument is that they are not and they have proved the point. They did not even go to appeal and the staff are being left on the scrapheap.
We have had a Government who, through austerity and the particular form of economic society they have created, have developed a major mental health crisis and then cut the required services. There is no prospect of their doing anything else to improve the situation. This is a serious problem. We must imagine ourselves in the situation of the family in the case I illustrated. This is a crisis that echoes throughout the land and it is not acceptable.
I finish on this point. We do need money putting into our mental health services, as everyone would agree. But why do the Government not start by saying that the staff—the carers, cleaners and all the clinical staff—get a proper rise? That would at least be a decent way to try to retain some of those people in house for now.
I ought to have said after the Minister had spoken that the original Question was as on the Order Paper, since when an amendment has been proposed as on the Order Paper, and the Question is that the original words stand part of the Question. I do not think that my putting that to the Chamber after Jon Trickett has spoken will have made any difference to his speech—I do hope not. I prefer to get procedure absolutely correct. It will be obvious that a great many people wish to speak this afternoon and we have limited time. Therefore, we must have an immediate time limit of five minutes, which is quite generous really. We begin with Dean Russell.
Thank you, Madam Deputy Speaker. Before I begin, I will rip up my unwritten 50-minute speech.
I have previously said in this Chamber that, if suicide were a virus, we would be on the hunt for a vaccine; if loneliness were a disease, we would be looking for a cure. I welcome the debate today. I know that it is politically charged, but that is the nature of this Chamber. Any opportunity that we have to talk about mental health and to tackle the stigma around mental health must be welcome.
Of course, we are talking today about the support that is available to people, but one area on which I wish to focus is mental health in the workplace, which is a passion. We spend most of our lives in the workplace; we spend time with colleagues. We are perhaps not always truthful to ourselves about how we feel. Engagement in the workplace is essential to prevent mental ill health. One challenge is to ensure that there is parity across physical and mental health. I have argued about that in this place before, and received support from all parts of the House. I welcome parity around things such as first aid; that is essential.
I have been very pleased with the engagement that I have had with Ministers, especially the Under-Secretary of State for Work and Pensions, my hon. Friend Mims Davies, the Minister for Disabled People, Health and Work, my hon. Friend Tom Pursglove, and the Minister on the Front Bench today. I have also engaged with other Ministers in the Departments of Health and Social Care and for Work and Pensions. They have all been open to looking at how we can get better services and better support for colleagues in the workplace.
One challenge we face is stigma. I say gently and respectfully to Members in the Chamber today that, while of course these issues are politically charged and that we will all have a very strong view on this and on the need to make sure that services are in place, we are careful about the words that we use. When we talk about people not being able to get support, it might put off somebody from seeking and getting support. When we talk about some of the statistics, I ask Members to please be mindful about how they are used. We could deter a person in crisis from seeking help, because they might think that that help is not there, which could be dangerous.
I appreciate that we have a long way to go with mental health, but we have come quite a way. The support over the past few years and the change in stigma around mental health have been transformative, but we still have a way to go for the situation to be transformed. That means that, as politicians, chief executives of businesses and community leaders, we must ask ourselves whether we are doing enough. Are we talking about this enough? Are we looking at those solutions enough?
My hon. Friend is making a powerful speech about raising awareness. Yesterday, I hosted members from the NFU, who candidly said that, a few years ago, they would never have been speaking about these kinds of issues. We know that rural communities and farmers in particular suffer when it comes to asking for help. Is it not exactly those organisations coming forward and speaking about the problem that allows us to have this debate?
I thank my hon. Friend for his important intervention. This morning, I was fortunate to host the Royal College of Psychiatrists. We had a roundtable discussion with different charities, organisations and leaders in this space about what we need to do and what that looks like. It looks like more funding—there is always an argument for that and rightly so; it means ensuring that we support people who have gone through crises, and that we look at that long-term support; but it is also about how we shift the conversation. For me, it must be about parity between physical and mental health. A few years ago, an amendment was tabled that would have introduced more parity of funding. As a Government, we need to look again at that amendment. Other important steps would include a mental health Bill. I appreciate that we need to move forward with that as soon as possible, and I echo the calls for such legislation, but we should not be damning everything that has been done so far, because huge strides have been made, especially in relation to extra funding.
When I was a councillor many years ago, I worked with local schools to look at what support was in place. I wanted to know whether the children as well as the teachers were aware of the support that was available. If we were to do the same survey today, we would find that the situation is far better than it was 10 or 15 years ago, but, as I have said, there is still a way to go.
I want to finish on a few brief points. When we consider the challenges around mental health, we must understand that the problem is not mental health alone. There is always some sort of comorbidity and there is always some impact on physical health. When we talk about parity, we are not just saying, “one person with mental ill health and one person with physical ill health must be seen equally”. That, of course, is important, but we must also be mindful of the fact that if somebody has a mental health condition it may affect their ability to work. On the flipside, a physical health condition may impact a person’s ability to get out of bed in the morning and their ability to do exercise. All those things are essential.
I hope that my words, from the Conservative Back Benches, will echo across the House: we want to get to a position where mental health is a priority across all of society. Both the Government and our communities play a part in that, and how we talk about this matters. I hope that we can talk civilly about the opportunities that are available. I urge colleagues to talk about what support is out there as much as, quite rightly, challenging Government and all of us to do more.
I also wish to speak civilly. For me, this is fundamentally a debate about mum. My mum was diagnosed with schizophrenia before I started primary school, so I have been talking about mental ill health all my life. Growing up, we saw on a weekly basis the inadequacies in support, the rough treatment from mental health services and the results of poor medication. We cannot ignore the fact that there have been some improvements, but some of the worst of the ‘80s appears to be returning after 13 years of Tory Government. Governments have failed to improve the system, which is described as the Cinderella service, since before Cinderella was written, which apparently was as long ago as 1697—I discovered that only today.
This crisis is exposed in that lack of access to support, lack of outreach, lack of choice, lack of control over support being received even where it is received, lack of genuine community care and lack of priority being given to mental healthcare overall. It is also exposed through an overuse of detention. Detention is necessary when people cannot manage their own safety, but it is the most costly end of mental health treatment when all else has failed. It is more expensive than sending people to prison in this country, but it is over-relied on by a failing Government who are unable to see long-term needs and the means of saving funds as well as saving people.
As has been mentioned, this is also a crisis exposed by a rising inability to meet need, as demonstrated by the size of, and time spent on, waiting lists. The shadow Minister mentioned 400,000 children. I bumped into Karen, my constituent, on the bus this morning. She finally has an appointment for counselling after three years of waiting in Southwark. Therefore I speak today from personal experience and as an MP representing a community with a high prevalence of mental health conditions, including some of the highest levels of psychosis anywhere in the country. However, I am privileged to speak as MP of an area where there is greater support for some people.
Southwark’s Labour council has been at the forefront of instigating measures, including online support, the Quality Indicator for Rehabilitative Care, the Nest system for the under-25s and an equivalent wellbeing hub for the over-25s, which helped more than 2,000 people last year. I am talking here about fast access, professional support that does not require a GP referral or a long wait of time. This is vital support on the frontline delivered by a Labour council and an integrated care board, which are prioritising correctly.
We are also a community served by South London and Maudsley NHS Trust. SLAM staff do their best to meet needs, but, sadly, I see people and their families who are not best served. I know that SLAM wants to do more—I speak to the staff and I met the chief executive last week—but it is limited by a Government who lack ambition and intent. The Government are not just ignoring the crisis, but contributing to it through things such as benefit cuts, and allowing food bank dependency and debt in a way that contributes to mental ill health. This is also a Government who are cutting capacity. The Minister made some claims about figures at the Dispatch Box just now, but SLAM told me last week that, despite the level of the crisis, it is cutting £45 million this year. What that means in practice is horrible.
I wish to talk about the human impact. I met Stephen Crawford through the Walworth community council. I have known him since 2010. To be clear from the start, this was a man who was known to the local community and known to council care workers and local mental health services. He had severe anxiety. He was a sweet, gentle soul, but he was a target for those seeking to misuse him and his home with criminal intent. Understandably, he became very agitated about his home following break-in attempts and thefts. He was ultimately sectioned and detained for his own wellbeing, but then discharged to the unsafe home that he had told everyone he was unable to live in. He called the London Ambulance Service daily. He and others called the police. The police told me they had visited and intervened 56 times in recent months due to his behaviour. It was a crisis for him, for his neighbours in the street, including Norma and the Groombridges, who were trying to help him, for the London Ambulance Service, which is already overstretched and struggling, and for the police, who now say they may have to stop responding to mental health call-outs.
Stephen was discharged and did not get sufficient support. On
That is what the mental health crisis means in practice—the loss of life, the human tragedy. Stephen deserved better, and if individuals like him, whole communities such as mine and multiple public services are not to face similar situations, with the avoidable costs and loss of human life, mental health reform must deliver better. I hope we see a serious case review and I look forward to that coming forward.
I very much welcome the opportunity to speak in this debate on a crucial issue. We have heard already about the importance of parity of esteem between physical and mental health, something I have been speaking about since my maiden speech. I am passionate that we achieve that parity.
I welcome the Government’s announcements over many months, the actions and contributions of Ministers and the £3 billion a year increase in funding. The £10 million in the Budget for suicide prevention was especially welcome, as was the £150 million for mental health facilities. I particularly welcome the £3 million for the mental health crisis centre at the Carleton Clinic in Carlisle.
As we have already heard across the House, prevention is important in mental health. We have heard a lot about young people, and we know that, sadly, suicide is the biggest killer of people under 35. I pay tribute again to 3 Dads Walking; I have been privileged and humbled to work with the three dads, Andy, Mike and Tim, who tragically lost their precious daughters Sophie, Beth and Emily to suicide. They have been able to channel their personal tragedy into trying to help people and raise awareness about suicide prevention. We are working hard to get age-appropriate suicide prevention into the school curriculum. The Prime Minister and the Education Secretary have met us and we are making significant progress on that.
I think this is an area that really unites us in humanity across the House. I very much respect the shadow Minister and her clinical expertise in this area, and it is crucial that we talk about prevention. I am grateful to the 41 hon. Members who signed my early-day motion on suicide prevention in the school curriculum and increasing mental health first aid provision.
My hon. Friend Dean Russell has been a passionate champion for mental health first aid training. I have had mental health first aid training during my career in higher education. I have also had ASIST, or applied suicide intervention skills training, and I can tell hon. Members that it is very important. It does not make someone a consultant in mental health, but it helps them to have those discussions and be able to signpost people to the help they need.
I have put that training into practice with people I have worked with, and a great sense of relief has welled up in some of these people, who have said, “Oh my goodness, Neil, you understand.” I could then have discussions with them about seeking the support that they need. I passionately advocate that the Government work to increase mental health first aid training in educational settings and in the workplace. The more people we have on the frontline who can signpost people who need help, the better.
I also want to talk about rural mental health. Two or three weeks ago, our Environment, Food and Rural Affairs Committee published a report on rural mental health. I pay tribute to those who provide so much support to people out in rural communities, including charities such as the Royal Agricultural Benevolent Institution, You Are Not Alone, the Farming Community Network, Farmerados and, more broadly, the Samaritans, Vetlife, Mind, PAPYRUS and Every Life Matters. Rural mental health is a critical issue.
The EFRA Committee has made strong recommendations to the Government. I was pleased to attend the NFU reception yesterday, which had rural mental health at its heart. Our inquiry covered some of the issues around stigma that we have talked about in this debate. People are reluctant to put their hand up and say that they are struggling, including farmers and vets—as a vet, my profession is sadly over-represented in mental health issues and incidents of suicide. It is important that the stigma is broken down and mechanisms put in place so that people can seek out support.
In rural communities there are also acute stress events such as animal disease outbreaks. I witnessed the trauma from foot and mouth disease in 2001, and those ripples still affect rural communities today. The mental health trauma on people when avian influenza comes and their animals or birds are culled out is significant.
Our inquiry has made recommendations and, as we have heard from those on the Opposition Benches, we need cross-Government working on the problem, with the Department for Environment, Food and Rural Affairs working with the Department of Health and Social Care, the Department for Education and the Department for Transport to mitigate issues such rural isolation, connectivity, broadband and transport. It is so important.
This is an area that unites us in humanity across the House. I firmly believe that debates such as this can really help the Government to develop their policies and support people’s mental health.
At 11.33 yesterday morning, this House finished Prayers and the first questions to the Health Secretary began. Disgracefully, two hours and five minutes later, the Government’s business was done and hon. Members were told that, if they had no further meetings, they could go home. This exhausted Government had literally nothing left to say or do.
It is therefore hugely welcome that my hon. Friends the Members for Tooting (Dr Allin-Khan) and for Ilford North (Wes Streeting) have stepped forward on behalf of the Government-in-waiting to ensure that today there is a debate on a matter of considerable importance. Every week in my constituency surgeries I meet parents exasperated that the treatment and support that they know their children need is not available. That can lead to the unchecked exacerbation of problems and children missing school—not the odd day, but months at a time. Whole years of their schooling are lost and family routines decimated as the entire family steps in to provide the support that an earlier intervention could have prevented.
Mental health is not a minority issue. Every year, one in four people will experience a common mental health problem. This Government are guilty of both underfunding mental health services and, through their actions, causing the number of people with mental health problems to rise. We all know that the Government have allowed our country’s economy to end up in a terrible mess and that money is short, but it is welcome and right that the Labour party and my hon. Friend the Member for Ilford North have been able to secure a commitment for additional funding from shadow Treasury colleagues—all of us who sit in Front Bench positions will know that is very difficult—to pursue the plans that are so desperately needed.
I want to talk about access to services locally. Stephen Jones in my constituency had a child with a mental health crisis that required in-patient treatment. The child was moved to Stoke-on-Trent, 70 miles away, because there are no child in-patient beds available in the whole of Derbyshire. The isolation that Stephen’s child experienced exacerbated their problems and made it harder for the family to support them. I stress to my Front-Bench colleagues that, while we realise that specialist staff will not be based in every single village and town, we need to give real consideration to providing those specialist services close enough that families can easily play their part in supporting patients, particularly children, in their treatment and recovery.
I am pleased that my hon. Friend the Member for Tooting focused on some of the causes of the mental health crisis. The Government are quick to talk about the increased amounts they are spending, but they are forced to spend more because there are more and more patients coming forward. If we had a huge expansion in the number of people with cancer, we would have to increase the number of cancer doctors, and yet we have far more people with mental health crises. The Government need to stop for a minute and think about the role they have played in causing that increase.
From the start in 2010, the Government’s pursuit of people on benefits, their targeting of the unemployed and the mentally ill, their approach to work capability assessments and the reduction in housing benefit, leading to record levels of poverty and homelessness, have all played a part in increasing the pressures on people and have in themselves added to the mental health crisis. No one is suggesting that those are the only causes—of course, very successful people can have mental health crises, too—but the Government should take that expansion in the numbers seriously.
The pressures on children in that period have exacerbated the problems. Between 2017 and 2022 alone, the number of children aged between seven and 16 with a probable mental health disorder rose from 12% to 18%. Shockingly, among those aged between 17 and 19, the figure more than doubled, from 10% to 25.7%.
Finally, let me turn to the Government’s disappointing, inadequate and defensive amendment to the motion. It says everything about their complacency and lack of ideas that they should try to convince the House that they have already acted to reduce A&E stays. Last year in Chesterfield alone, people suffering a mental health crisis spent 5,254 hours in A&E. It is clear from the debate that our nation’s mental health patients are being let down and the Government have neither the wit nor the will to fix it. I am pleased that Labour will prioritise this crucial area of health and I endorse the motion.
As you and my hon. Friend the Minister are aware, Madam Deputy Speaker, there has been a tragic, historic issue of in-patient mental health deaths in Essex—it goes back to 2000—over a 20-year period. Roughly 2,000 people have lost their lives. An inquiry has been going on, but, as I said in the House in January, there has been deep concern about the lack of progress and the low level of engagement between Essex Partnership University NHS Foundation Trust and the inquiry. I also pointed out that families who have lost loved ones want to know that lessons have been learned, they want accountability, and, most important, they want to know that patients are not suffering the same today.
“quantum leap in the level of co-operation”—[Official Report,
Vol. 727, c. 51WH.]
with the inquiry, it would move to a statutory basis. I know that the Secretary of State treats the matter seriously—he met Essex MPs recently and is close to making a decision—but it has now been four months since that debate, so may we please have a decision soon?
In the meantime, I recently met EPUT to find out what is happening with its service. I will tell some positive stories. In March, EPUT announced that it was going to launch a mental health urgent care unit in Basildon. We have all heard stories of people in mental health crisis going to A&E, waiting hours and hours, and then not getting the specialist service that they need, but that new specialist 24/7 centre saw 200 people in its first month. Instead of what happened historically in A&E—90% of people waiting a long time before being sent home without a care plan—90% of people see the experts within four hours and leave with a care plan. That is transformational. The unit is also piloting a 24-hour paramedic.
Demand in Essex is settling down. It rushed through the roof during covid but is now increasing in line with population growth. Complexity also rose during the pandemic. Prior to the pandemic, about 30% of those going into in-patient units needed to be detained. At the peak of the pandemic and post pandemic, that figure was 70%. It is now down to 60%. Our waiting time to see a psychologist, which rose to a year, is now down to 29 weeks. Vacancies for all positions have been filled, so the trust will be fully staffed from September and expects the waiting list to drop to zero.
Furthermore, EPUT is trying new technologies such as the new and innovative neuromodulation centre, which opened six months ago in Brentwood and is having great success. The trust is also encouraged by the Government’s announcements on electronic patient records. Enabling hospitals and mental health services to share patient records easily between them will make a huge difference. It is great news that the Government are behind that, but we need the funding for it.
Colleagues have mentioned eating disorders. Some may be aware that I suffered from anorexia when I was a teenager. It is still very difficult to talk about one’s own mental health. I encourage everyone in the Chamber to please be mindful of the language that they use; I have found some of the language used so far in the debate very upsetting. I completely agree with my hon. Friend Dean Russell about being mindful of the tone that we use, because there will be people watching who are suffering with mental ill health, and we must not scare them away from getting treatment.
I am particularly concerned that what is being seen on social media today fuels eating disorders. The speed at which young girls in particular are shown eating-disorder content on social media by platforms such as TikTok is outrageous. I am glad that the Government are tackling that.
My right hon. Friend is absolutely right to mention social media, particularly in relation to teenage girls and eating disorders. I praise her for bringing her own experience to the Chamber. Another major contributor to the rise in mental ill health among young people in the last decade has been the isolation that social media can cause through bullying and so on.
My hon. Friend is completely right about online bullying. It is so important therefore that we get the Online Safety Bill through—it must not be delayed too much, although there are still issues to be looked at in the Lords.
I am very pleased that Ministers have announced that they will criminalise the intentional encouragement of serious self-harm, including eating disorders. I would like them to look again at the toggle on/toggle off issue that I mentioned last time we debated this, and—on another issue that is having an impact on children—to take seriously the need to prevent children from accessing online pornography, which is of an increasingly violent nature. Those matters are all related to the mental health of the nation.
“We should be frank. We have not done enough to end the stigma of mental health. We have focused a lot on physical health and we haven’t as a country focused enough on mental health.”
“intervene much earlier with those suffering from poor mental health…we can stop problems escalating… By breaking the mental health taboo, by working with businesses and charities…I believe we can lead a revolution in mental health treatment in Britain.”
Yes, yes and yes. My question is: why, seven-and-a-half years and four Tory Prime Ministers later, are we still waiting? Mr Cameron has long departed these Benches. This is not the occasion to lament the mess that he left behind, but the experience in my constituency—and, I respectfully suggest, in the constituencies of many, if not all, hon. Members—is that the Government’s approach to mental health remains, all these years later, wholly inadequate.
We have heard a lot of statistics in the debate. The numbers matter, because they show the overwhelming scale of the problem that we are facing. Every one of those numbers is an individual, and around them is a network of family and friends whose lives are impacted day in, day out by the very real challenges of confronting mental illness. I have met many such individuals and families in my constituency. Just last week, I hosted a roundtable at which I heard heartbreaking stories of such daily struggles, many of which involve children and young people.
Amelia is now 16. She was diagnosed with autism at the age of seven. For the past nine years, her mum, Anna, and her family have been trying to get help and support, and they are on their knees with exhaustion. Amelia has attempted to take her own life several times, and has been so let down by the system that she says that she just does not trust it anymore. It feels to her that she only gets any kind of support when there is an absolute crisis. I believe that, if she had got the support that she needed a long time ago, she and her family would be in a much better place today.
Eli is 10. He has been diagnosed with Tourette’s syndrome. He has various tics affecting his eyes, face, neck, back, hands and feet. He is a fantastic young man, but he is regularly in pain, which affects his ability to cope with days at school and has a huge effect on his mental health. Until recently, he was told that he just had conjunctivitis. His mum, Natalie, told me that she has struggled to find the psychiatric support Eli needs, and every time she calls CAMHS she is passed from person to person. She has been told that there are no NICE guidelines on Tourette’s and the best they have been offered to date has been worry management.
Those are just two examples, but they reflect a much bigger problem across society and in all our communities. I have meetings regularly with teachers across Batley and Spen, but we spend far more time discussing the mental health needs of their pupils and their families than we do the many other challenges faced in education—another sector that is underfunded and under-resourced. We cannot keep pushing this issue back on schools. Teachers do an amazing job, but we cannot expect them to take on responsibility for what is a widespread societal health issue because of more than a decade of lack of focus and national leadership on mental health.
It is not just teachers. Because we do not have the mental health experts and provision that we need in the places where we need them, it falls to others in the community to pick up the pieces. In Batley and Spen, I am incredibly proud of the many voluntary organisations, sports clubs and charities that do a magnificent job week in and week out under huge pressure. I pay tribute to groups such as Andy’s Man Club, Game Changerz, Blue Tulips, Team Daniel and Luke’s Lads, but the voluntary sector is propping up the NHS and society as a whole. That is not sustainable and it is simply not right. We would not expect teachers, sports coaches, voluntary groups and others to deal with a burst appendix, a broken leg or an ear infection, so why are we asking them to deal with the mental health crisis? They are, of course, part of a wider, holistic solution, but they should not be the only solution. That is not the parity of esteem between mental health and physical health that David Cameron spoke of. While I am hugely optimistic about the excellent plans Labour has to address the mental health crisis, people such as Natalie, Eli, Anna and Amelia cannot wait any longer, which is why today’s debate is so important.
As a now non-practising former consultant psychiatrist, I have a host of declarations I should make in terms of speaking in this debate. For the sake of brevity, I draw attention to my entry in the Register of Members’ Financial Interests and my declarations as part of my work on the pre-legislative scrutiny Joint Committee, which list them in full.
This is an important debate and I shall focus on two angles. One is the delivery of mental health care and treatment and the other is the framework for that. I want to celebrate today the rebuild of the Abraham Cowley unit in my constituency. It gets rid of the awful dormitories that have plagued mental health care and treatment for some time. They are now gone, and we will have a brand new, rebuilt mental hospital. In fact, tomorrow, I am going to the topping out ceremony on the site to see the progress in delivering that. It will make a huge difference to the delivery of mental health care.
I used to work as an in-patient consultant psychiatrist. When people come into hospital for in-patient psychiatric treatment, it is often at the most difficult times of their lives. It is critically important that our mental health estate is fit for purpose and is a therapeutic environment. For too long, the mental health hospital estate has been the second cousin to acute physical health care and I am delighted that we are driving change forward in my patch. If people need in-patient care and treatment, they will get it in a new hospital that is fit for purpose. I just want to celebrate that and thank everyone who has been involved in getting it over the line, as well as all the people who work in that sector, including those who are looking after the patients who would have been in the old hospital, which is now a building site, and going through a stressful period of transition while the new hospital is set up.
My second point is about the draft Mental Health Bill. A few years ago, my right hon. Friend Mrs May, the former Prime Minister, suggested that we should review the legal framework we use when we treat people who are unable to consent or do not consent to treatment. Around every 20 years or so, we go through this process. We should be proud as a country that we have always been at the forefront of driving forward legislation and legal frameworks for dealing with people who cannot consent to treatment, the law of best interests and capacity. I was fortunate to be a panel member of the Simon Wessely review. I did that as part of my previous academic life, so Members can imagine my pride and delight in being part of the pre-legislative scrutiny Joint Committee on the draft Mental Health Bill.
I am slightly saddened by the debate today, because mental health—especially the frameworks we use to treat people who are severely unwell—needs to be above party politics. We are discussing the most invasive thing we do in medicine—detaining and treating people in hospital, sometimes for a substantial time. We need to think carefully about the right balance between choice, freedom and autonomy and making sure that people get the care that they need at the right time and under the right framework. I am glad that the Government have done pre-legislative scrutiny and we have worked on a cross-party basis to get this issue over the line. I hope that we will see the mental health Bill very soon.
My final point is about psychosis. The Government’s amendment mentions the treatment of psychosis, which I know is often missed out in these debates and when people talk about mental health. Psychosis is one of the most disabling mental disorders and far and away the most costly and impactful, because it can affect people when they are quite young—
It is simply because of advocacy; the conditions debated tend to be mental health conditions for which people can advocate. We talk a lot about dementia, and the children of those suffering tend to advocate for them. For CAMHS, it is the parents who advocate. For common mental disorder, people are able to advocate for themselves, but psychosis can be—I do not want to make a broad generalisation—disabling and isolating, and can limit people’s ability to advocate for themselves. From my research, I know that psychosis can break down family relations and alienate people. I am nervous about broad generalisations, and for the most part people can get better and do very well, but in some cases psychosis can be very disabling and limit advocacy.
I welcome this debate because, like every other Member, my inbox is often full of cries for help from people who are suffering mental ill health or from family and friends trying to help them. Looking through recent cases I have had in St Albans, I see a litany of problems with the system. Many constituents have told me that they have had to wait for more than a year for diagnosis. Some have needed an urgent medication review. One parent told me they feared for their and their child’s safety while the child was on a particular medication. They sought an urgent medication review, had an urgent referral from their GP, but the matter then sat with the psychiatrist for weeks and weeks. They were terrified during that time, waiting for a decision.
Other constituents have told me of their relief when they finally secured a mental health care package, only to find that it takes many weeks or months before the package can be put in place in practice. Those who have mental ill health and are also neurodiverse or have learning difficulties have told me about the hoops that they have to jump through. In some cases they have been told, “We can offer you mental health support, but it is not tailored or suitable for you because of your neurodiversity or your learning difficulties.” I have heard about the frustration that those individuals feel because those services are not tailored to them as a person.
Then we have the emergency A&E admissions. Again, just a couple of weeks ago, I had a parent email me in total desperation from a hospital corridor because one of their children had attempted suicide and had been rushed to A&E. They were not safe to be left unsupervised, but they were supervised by somebody who was inappropriate to supervise them. The family were desperate to get their child to a safe place, but that did not happen for days and days—it was only with my intervention that it happened. As I am sure many Members know, it is really pleasing to be able to make a difference in those cases, but it is worrying to think about all those families who have not got in contact—others out there who are struggling alone.
There are real problems with A&E pathways and with children’s mental health services. I hope that the Government will focus on those areas, but from speaking to my local mental health trust and hearing about the pressures that it is facing, is it really any wonder that we are having these issues? There were warnings at the start of the pandemic of an explosion of mental ill health, and I believe that the Government could have done a lot more to get ahead of that problem. For example, my local mental health trust has told me that there is not only an increased number of people looking for help but higher acuity. Therefore, instead of having a 2:1 staff-patient ratio, it often has to be 3:1. So even with the same staff headcount, there is less staff time for more people seeking help.
Those who work for the trust tell me of their frustration that the waiting lists are getting too long. They accept that medication reviews are often delayed because of staffing and resourcing issues, and there are huge pressures on the trust’s budget. Not only is there the demand; there is the cost of out-of-area placements, having to pay for private beds where none are available in the NHS, and paying for agency staff to cover vacancies that are not filled. Our mental health trust in Hertfordshire is the smallest bedded mental health trust in the country. We have huge ambition to open a new bed unit in the west part of the county, but we need the Government and the NHS to get behind that ambition.
So what do we need to see? We need to see prevention, and we need to see it early. Research from New Zealand, which is often cited here in the UK, indicates that three in four people with mental health problems show symptoms before the age of 25. That reinforces the need for prevention and the need to see it early, so I would like there to be a qualified practitioner in every single school. We need mental health community hubs in every community. We need to empower the charity sector—a sector that has barely been mentioned today. In St Albans, we have Time To Talk, Youth Talk and the OLLIE Foundation, which are all fantastic mental health charities that are working on tiny budgets. In Hertfordshire, we need support for mental health beds and, of course, we need to tackle the workforce problem. Until the Government publish their workforce plan, the lack of a workforce remains the biggest risk to service delivery in mental health in every single part of the country. I urge the Government to take action on those points.
It is well reported that mental health difficulties have become both more prevalent and more talked about in recent years. Lockdown has certainly had a detrimental impact on the mental health of the nation, which is completely unsurprising. Isolation and loneliness are significant contributors to poor mental health. We have also had the economic consequences of inflation putting pressure on people’s personal finances, and the consequences of the NHS backlogs that have been referred to in this debate, but I particularly want to focus on children’s mental health.
As has already been mentioned by other hon. Members, we have had a rise in diagnosable mental health conditions among children since before lockdown. We have gone from about one in nine children having potentially diagnosable mental health conditions to one in six. I am sure we have all had cases in our constituencies—tragic stories of children who no longer leave home because they are too anxious, who are not able to go to school. We have seen a rise in the number of ghost children, many of whom are not turning up at school because of anxiety and mental health issues.
The Opposition have talked a lot about all the money that needs to be spent. The Government are spending money, boosting mental health spending by at least £2.3 billion by 2024. The motion calls for improved outcomes for people with mental health needs. We all want that, but prevention is better than cure, and it is simply not sufficient to call for ever more money to expand remedial capacity without addressing the root cause of the problem. It is a bit like having a leaky roof and calling for ever larger buckets to catch the drips: we need to fix the roof. Many will cite poverty, poor housing and not enough youth services as the causes. All are contributing factors, I have no doubt, but there are two less well understood, less talked about, and potentially more significant factors contributing to poor child mental health.
The first, which has been mentioned already, is the clear correlation between the rise of smartphones and social media and deteriorating mental health in young people. The extent of online harms cannot be overstated. My right hon. Friend Vicky Ford mentioned pornography. Violent pornography is now routinely encountered by children on the internet, with 1.3 million visits a month by UK children to adult sites. There is also eating disorder and suicide content—again, as my right hon. Friend so articulately mentioned —and child sexual abuse material and exploitation. Anxiety issues are compounded by social media platforms. Children stay up all night waiting for likes on their social media profiles. There is clearly a relationship between more time spent on screens and less outdoor activity, which is another good indicator for poor mental health.
There seems to be a relationship between children spending more hours on social media and worse mental health. The Online Safety Bill, which is going through the other place at the moment, will deal with some of those issues, but I urge Ministers to encourage their colleagues in Government to accept some of the amendments that their lordships have tabled to strengthen the age verification provisions, to make it absolutely watertight that children cannot access some of the worst of those harms. However, we urgently need some proper research into whether it is safe for teens to have smartphones or to go on social media at all. Some have said that their smartphones are as addictive as cigarettes—that they are the opiate trade of the 21st century. I applaud the campaign group UsforThem and its “Safe Screens for Teens” campaign, which is calling for proper research into the health impact of smartphones on teens and whether, like tobacco and alcohol, it is necessary for there to be a legal age limit for accessing some of these platforms, or indeed having a smartphone at all.
A second, under-discussed contributing factor to poor child mental health is family breakdown. We are not talking about a small number of children affected: the UK has the highest rate of family breakdown in the OECD and in the western world. Some 44% of our children will not spend their childhood living with both of their biological parents. There is not enough recent data on this issue, but Office for National Statistics studies from 2010 suggest that back then, 3 million children did not live with their father and 1 million had no meaningful contact with their father. Given those figures, a mental health crisis among children and young people is absolutely no surprise.
Of course, family breakdown leads to other factors that contribute to poor mental health, such as poverty and low income. Some 80% of single-parent households are on universal credit, I think. That is no surprise at all, as there is only one adult in the house to fulfil all the roles and responsibilities of a parent. It puts pressure on housing costs, as one adult is supporting the household—of course there are going to be pressures on housing costs. Single parents are absolute heroes, and I take my hat off to them. Being a parent is an incredibly difficult job when there are two adults in the house. Single parents are heroes, but few would say that it is an ideal situation.
Family breakdown is far worse for the poor, which of course is closely linked to marriage rates. Married relationships are statistically less likely to break down than cohabiting ones, and marriage rates have remained very high in high-income groups, but have collapsed in low-income groups.
Can I tell Members on the Government Benches a little bit about the mental health crisis in Newham? We have a rocketing population that is young, with no commitment from this Government that health funding will rise to match it. We have almost 41,000 children living in poverty. We have the highest proportion in the country of people living in damp, mouldy, overcrowded temporary accommodation. All of these people have no sense of security in their home at all: they do not know when their local ties will be shattered yet again by a forced move.
As we know, all of this impacts on mental health, and particularly on the mental health of children. I see that constantly in my casework, and local health leaders tell me exactly the same thing. It can hardly be a surprise to the Government that the number of young people being referred to mental health services is 30% up in Newham alone. Cases are increasingly more complex, more urgent and more in danger of spiralling into deep crisis.
Newham is the most diverse borough in the country, with the second highest rate of GP registrations by migrants. Our diversity has massive benefits, and I love it, but it requires clinicians to adapt their way of caring for people with different cultural backgrounds and languages. Despite all that, Newham’s mental health spend is the lowest in London. With all those challenges, our clinicians and our health leaders are obviously struggling to meet their targets. Average waits in Newham between referral, assessment and treatment were at 12 weeks in 2021. Some patients are waiting for as long as a year, and that is after they have had a referral, which as we know is terribly difficult to access.
Our local mental health unit, which deals with only the most severe needs, is at 98% occupancy—far in excess of the clinical standard. Quality of care and patient care and safety are suffering. There is a dire shortage of specialist mental health beds for our older adults. We have older people waiting for long periods on utterly inappropriate wards and in beds that are no doubt sorely needed for those waiting for other hospital treatments. Many patients with mental health crises are waiting in emergency departments for more than 12 hours, and local health leaders are worried that those numbers will increase. Our mental health services are struggling even to react to some of the most dire situations, let alone being able to offer proactive support that prevents mental illnesses getting worse.
We are creating even more problems—greater problems for the future, greater costs for the Government, greater costs for the NHS, more antisocial behaviour, more homelessness and rough sleeping, and massive wasted economic and social potential. People’s lives are being devastated by treatable ill health and completely avoidable misery. If we are not sitting in this place to avoid that, why are we here?
Labour’s plan to transform mental health treatment is desperately needed in Newham, along with thousands more mental health staff and professionals in every school and accessible mental health hubs in every community. We sorely need a preventive approach so that we can bring this crisis to an end, and we need it now. Can I use my last 30 seconds to look at the Minister and ask whether she will meet me and my health providers and health leaders in Newham to talk about the massive underfunding that our borough and my community face?
It is with some trepidation that I rise to speak in this debate, given the expertise and experience we have heard from all parts of the Chamber so far. I draw particular attention to the speech by my hon. Friend Dr Spencer, who is no longer in his place but who shared his personal expertise as a clinician, and my hon. Friend Dean Russell, who kicked off the Back-Bench speeches from the Government Benches. He made a well-constructed speech that spoke to his expertise in campaigning for mental health so assiduously in this place. I pay tribute to everyone on both sides of the Chamber who has brought forward their own personal experience, their family experiences and their constituency experiences of mental health.
I will not reiterate everything that the Minister and my hon. Friend the Member for Watford said, but the parity of esteem we are working towards in this country is vital, as are the record investment of £2.3 billion that this Government have put into mental health and the extra doctors and nurses who will support people. Most of all, it is about reducing stigma in mental health. It is not unfortunate that we are doing so, but it does create more demand.
The shadow Minister said that the causes of poor mental health were complex, and they are, but she then went on to basically try to lay it all at the door of the Government. That is not remotely fair or accurate, because the statistics are complex too. We should welcome more demand from people who were previously undiagnosed, and we should recognise, as my hon. Friend Miriam Cates did a moment ago, that there have been societal changes, particularly with social media, which I referred to in my intervention.
At the very youngest ages, we are seeing an explosion in autism cases. I speak to the excellent Peter Pan Centre in my constituency, which deals with pre-school children with some of the most severe forms of autism, including those who are non-verbal. Next door is the excellent Merryfields special school, where a number of them end up going. Increasingly, those organisations are saying that the majority of their pupils are those with autism or autism spectrum disorder, and that simply was not the case 10 years ago. Again, that is probably because of better diagnosis—we do not fully understand the explosion in autism—but we must not assume that everything is to do with money being spent on things; it is to do with better understanding of mental health, more awareness and less stigma.
The pandemic affected the mental health of the entire nation, and I recognise that that has put a lot of pressure on young people in schools and universities, which I will talk briefly about as the Member who represents Keele University. On schools, I speak frequently with my heads and with parents who come to me trying to get statements for their kids. As we get a greater understanding of neurodiversity, there is obviously a real interaction between special educational needs and poor mental health. I was speaking to my county council yesterday, and the big issue is the availability of educational psychologists. My county council, Staffordshire, is doing a great job of training more of them itself, but that is a problem across the country, and we need to address it so that we can get children the help that they need with their education and their mental health earlier.
We have heard about the Department for Education funding and the training of senior mental health leads, with 400 already supporting more than 3 million children. There will be up to 500 next year, and more than 60% of state secondaries have a mental health lead. I want to see that get to 100% as soon as possible.
In my final couple of minutes, I will speak a little about universities, as the Member who represents Keele, which has 12,500 students. I am pleased that Keele has, as many universities do, a professional counselling and mental health team to support its students. More generally, the Higher Education Statistics Agency collects data from students on any disability that they have, including mental health conditions. In 2021-22, 416,000 UK students said they had a disability of some kind—that is 19% of UK students—and within that, 119,500 said they had a mental health condition, which is 5.5% of all UK students. That number is three and a half times higher than it was in 2014-15. Higher rates are found among women, undergraduates, full-time students and those in their second or later years. There is an issue here that we have to address, and I am pleased that the Government are doing so.
The covid pandemic fell heavily on students at university, particularly during the lockdowns and associated restrictions. At the height of the pandemic, many students, including those at Keele, struggled with the measures employed to prevent the spread of covid, particularly in university settings. Some had to socially isolate regularly and could not go home to see their parents. They were essentially locked in their room with nobody else there for a long time. Nightline, which co-ordinates student-run listening and information services, reported in November 2022 that it had recorded a 51% increase in calls in 2020-21. Numbers for the next year were 30% higher than that, which indicates that the pandemic has had a continuing effect on universities. I welcome that the Department for Education has asked the Office for Students to distribute £15 million for transition into university.
I am pleased with everything that the Minister said about what we are doing, and I end on the point that there is less stigma, which is a good thing, and if there are more people coming forward, that is a good thing too.
As we have heard from colleagues from all parts of the Chamber, we are in a mental health crisis. Unfortunately, it is becoming increasingly endemic. I pay tribute to the work of our offices, including my own team, who regularly deal with critical cases of mental ill health, including suicide calls, for which we have had to put on special training. That was happening before the pandemic too, and we need to recognise that.
Recent figures show that seven out of 10 secondary school children are expressing mental health distress. That should worry us. It has already been mentioned, but we know that there are risk factors and risk conditions that can contribute to the onset of a mental health problem. I will speak about the importance of early intervention a little later.
Oldham has the 37th highest prevalence of mental health disorders in the country. That puts it in the highest 20% in the UK; for reference, the Prime Minister’s constituency is in the lowest 6%. On the other side of the coin to this higher prevalence is our reduced funding. Research from the Children’s Commissioner found that child and adolescent mental health services in Oldham received over £100 less in spending per child from the Government than those on the Isle of Wight. Similarly, in 2019 The Guardian reported that London had nearly double the number of psychiatrists in the north of England. As I have mentioned, it is true that things have got worse since the pandemic, but that is not just a consequence of the pandemic.
I want to focus on what needs to happen, because we need a serious plan, and I am not from the Minister’s speech that the Government recognise that. The Opposition want to recruit thousands of new mental health professionals, which will go some way to addressing the lack of parity of esteem between mental and physical health services. That needs to be reflected in the Government’s NHS workforce plan. We have waited ages for the Government to produce that and it makes the partygate report look quite prompt. As the Government sit on their hands and fail to produce a plan, the crisis continues to get worse. That is why we will commit to the biggest expansion of the NHS workforce in history. We must also look at the metrics we use. For example, we would guarantee treatment within a month. That would make such a big difference to all those people stuck on what feel like endless waiting lists in Oldham, Saddleworth and across the country.
Finally, I am pleased to see our party committing to a paradigm shift from the medical to the social model of health, focusing on prevention in communities as well as treatment. The Leader of the Opposition has committed himself to that in Labour’s health mission, and we have also pledged that there will be a mental health hub in every community. We will go further than that: our commitment to addressing the rampant health inequalities across our country includes tackling the inequity in mental health. As we develop national policy from education to transport and finance, we will consider the impacts on health and health inequalities, including mental health. This is the difference a Labour Government will make. The next Labour Government have a plan that is both radical and credible, and for my constituency and for our country, it is long overdue.
On a point of order, Madam Deputy Speaker. You will be well aware, because you have chaired many of the debates, that there has been a campaign in this House for over a year to stop SLAPPs—strategic lawsuits against public participation—which are used by very rich men to oppress free speech in this country. Just in the last hour or so, the High Court has ruled one of those SLAPPs cases out of order: the case of Mr Mohamed Amersi against the ex-Member of this House Charlotte Leslie has been struck down. In my view, that is a great victory for free speech. Because it is so important, I give notice that I will be raising the matter on the Adjournment.
I thank the right hon. Gentleman for his point of order. It of course needs no comment from the Chair, except to say that I think the whole House will agree with him that this is a good judgment and an important step forward. I do indeed recall chairing many debates on the matter, and I am sure the whole House will look forward to his raising it on the Adjournment. We will recommence the debate with Danny Kruger.
It is a pleasure to follow the speech of Debbie Abrahams, who is a great champion of this cause. I am very proud to work with her on the all-party parliamentary group for prescribed drug dependence, which, after this debate, I am going to ask her to co-chair with me.
I want to call the House’s attention and that of Hansard to the speech made by Neil Coyle. The distressing and powerful story he told of a constituent of his will remain with me as a terrible example of the state of so many of our constituents and of mental health services that do not work properly.
I welcome this debate, and I am afraid to say that I do recognise many of the descriptions given by Members on both sides. I want to call attention to the excellent services provided in my constituency of Devizes by the Green Lane Hospital, a mental health hospital that has been there for many years. However, even there we have many cases of constituents feeling that they have been let down and of genuine difficulty in accessing the services that are needed in time. Despite the good efforts made from the top of the system to the bottom, we simply are not doing well enough, so I welcome the debate, and I recognise the general point being made.
Of course, I agree with the argument put forward by the Opposition that we need more mental health services. The question is what those services should be, how they are organised and, indeed, whether we should use services as the frame for this whole debate. I wonder whether the term “services and relationships” would be more appropriate, and Members have mentioned the primacy of relationships. The fact is that we do not fully understand all the neurological origins of mental health conditions, but we do know that they are exacerbated by social circumstances, and that while medical treatment can help, what really helps is good relationships.
I know this from my own experience. For many years, I ran a project working in prisons and with ex-offenders, and we saw so clearly that, while of course the official and the essential responsibility for crime and criminality rests with the individual, it is usually relationships and relational skills or the lack of them that lead somebody into crime and into prison, and it is relationships and relational capacity and skills that help people to get out of an offending lifestyle. We also know this very well from all the evidence in studies of addiction, which is very closely correlated to mental health.
What do we do? There is consensus that we need more services and better services, but my concern is that we will end up focusing the system’s efforts on quantifiable measures or quantifiable inputs—most of all, the prescription of pills and pharmaceutical treatments—so we will end up medicalising mental health, just as we medicalise so much physical health. I chair the APPG on prescribed drug dependence, as I have mentioned. The research that the APPG has supported, particularly by Dr James Davies of Oxford University, shows that a fifth of adults are on antidepressants, many of them because they cannot get off these pills, even though they are only supposed to be prescribed for a certain time. We spend £500 million a year on prescriptions for medication that people should not be on, according to the guidance for those pills.
I worry about the trend towards the medicalisation of mental health, and I particularly worry about the Government’s major conditions strategy, which I welcome. We cannot have a focus just on pharmaceuticals; we have to make it much wider. It should not just be about services, but about the relationships that support good mental health. I am pleased there is a strategy on mental health and there does need to be top-down action, but I would like it also to focus on undoing this over-medicalised model. We need more training for GPs to understand the social relationships at the heart of mental health, including how to support people who have acute conditions. We need more funding for social prescribing—that has been mentioned—which is a tremendous initiative. We need support for withdrawal services and a helpline for people who are addicted to prescribed drugs.
Overall, however, we need a bottom-up approach. I respect Labour’s plan for more access hubs for mental health, more school mental health workers and more staff, but really we need system reform. Dr Allin-Khan mentioned the community mental health approach, and I like that phrase, but I think it includes much more than just more hubs and more staff. We need a whole system reform that prioritises the civil society organisations, families and community groups that have such a powerful role to play in supporting people with mental health.
Lastly, I draw attention to the new developing model called outcomes partnerships, whereby the public sector pays for results—not for inputs and not even for outputs, but for actual demonstrable improvement, whether it is in healthcare or mental health. It brings together all the different providers from civil society, the public sector and, indeed, businesses—we have mentioned the importance of workplace training—so that we get all the different players involved in a person’s life, and so that the funding is more local and can be used on the preventive agenda, which is so important. Rather than just trying to pour more money into the top of the NHS and thinking that is going to work, we need to fund it from the bottom up.
Order. I need to reduce the time limit to four minutes with immediate effect.
I want to highlight the crisis faced by families dealing with mental health issues, particularly those with children.
The crisis has been brought to my attention by many constituents over the time I have been an MP, but today I would like to raise the issue of my constituent Stephanie, whose son is autistic, non-verbal, and has complex developmental and communication delays. Stephanie knew that her son needed an attention deficit hyperactivity disorder diagnosis from an early age, but was told that he could not be diagnosed until he was seven. When her son did receive a diagnosis, Stephanie was told by the doctor that it was obvious how much he was struggling to cope with his life due to his ADHD. He is suffering from elevated levels of distress and unable to sleep through the night due to his inability to sit still for long.
Sadly, Stephanie was informed that there would be an 18 to 24-month wait for the community service MindMate to sign off the diagnosis and to be referred to child and adolescent mental health services, along with the medication plan. The CAMHS wait would mean a further 18 to 24 months to receive medication, so if they hit the longest waiting times at both services, her son would have been told that he needed medication at the age of seven and only receive his prescription at 11. Long wait times for diagnosis and medication mean that families across the country are turning for help to charities and support groups such as ZigZag, a Leeds autism support group based in my constituency that offers essential advice and support to thousands of families across Leeds. Stephanie has expressed her concerns and garnered support from other families with similar experiences.
The situation is at crisis point and requires immediate attention from the Government. We cannot ignore the struggles faced by families across the country dealing with the complexities of mental health issues. It is the Government’s responsibility to ensure that our most vulnerable citizens have access to prompt and proper care. Those issues are just the start. For instance, Leeds University reports that it has seen an about 60% increase in demand for mental health services and that the issues are a lot more complex than they were before covid. It says that many students are arriving at university with anxiety and mental health issues as the support they needed in their formative years was simply not available. Huge pressure is being built up, like a dam that is going to burst.
Adult ADHD services in Leeds currently have 3,300 people on their diagnostic waiting list—that does not include all the people who cannot be bothered to see their GP because of the length of the waiting list—and they are receiving more than 170 referrals a month, which far exceeds their capacity. The waiting list is currently upwards of three years, with an added wait for medication after having received a diagnosis. Similarly, the adult autism diagnostic service in Leeds currently receives more than 100 referrals a month, but it has the resources to complete only 40 assessments a month.
The current situation is completely unacceptable. We need the Government to create a more effective and efficient mental health care system that is responsive to the needs of communities. We cannot continue to let down families like Stephanie’s at every turn. It is crucial that we invest in the mental health sector and prioritise the wellbeing of all our young people.
As an officer of the all-party parliamentary group on eating disorders—an issue that I will raise in my speech—I thank Vicky Ford for her bravery in sharing her experience.
The statistics on the crisis in the NHS, as raised by my hon. Friend Dr Allin-Khan and others, speak for themselves. The 5.4 million hours that people with mental health problems are waiting in A&E is a scandal. We know that the longer patients wait for treatment, the worse and more dangerous their conditions can become. While I would love to make this speech about the importance of prevention, unfortunately we see a crisis in the NHS, so I will focus on the issues of acuity mentioned by Daisy Cooper. Many of those who cannot access the mental health care that they need are children. A quarter of 17 to 19-year-olds have a probable mental illness. Nearly one in 10 seven to 16-year-olds and a third of 17 to 24-year-olds have tried to self-harm. My own NHS South Yorkshire integrated care board has a waiting list of 10,015 children.
If those figures were not horrific enough, I want to talk about one further horrifying effect: that of people with eating disorders—often children or young people—having to wait to be given a tier 4 bed in a specialist ward owing to the acuity of their condition and because of the lack of preventive care available. Last year, a parent wrote to tell me that they were struggling to secure a mental health bed for their child, who had been diagnosed with anorexia. They would have gone anywhere in the country to get their child seen given the care they received while they were waiting. They needed urgent in-patient mental healthcare, but no tier 4 beds were available, so they had to be admitted to a general ward instead.
When the parents first contacted me, their child was being restrained most days to be fed. They were worried that, without specialist support, repetitive restraint was only making things worse. I have since spoken to numerous eating disorder specialists, researchers and medical staff who have all told me about the rising number of children with eating disorders being restrained—often unnecessarily —by staff in general medical wards without training, recording or following guidance. I have heard more first-hand stories. I warn hon. Members that these are not nice experiences to relay, but they should be shouted from the rooftops because they are the human consequences of a system that is understaffed, under-resourced and under strain.
One person told me that, as a 17-year-old, they were restrained for feeding via a nasogastric tube three or four times a day by five people; that went on for about 10 months. Another person told me that they were restrained for daily NG feeds by five to six staff at a time for six months. Sometimes, they were held for an hour after the feed and would come out with bruises, despite their screams during the restraint. I have heard stories of 15-year-olds being restrained at 11 o’clock at night for NG feeding. To be clear, it is not just the people I have described who are suffering because they must wait for access to the care they need; it is also causing tension between psychiatric staff and medical staff on wards because these people are getting inappropriate care.
It is shameful that in such settings the use of restraint does not need to be recorded. Its use is heavily regulated in mental health settings for a reason. The use of restraint and restrictive practice is really consequential to the conditions that people go on to develop and their ability to recover. I am disappointed that in a letter and in response to me following a debate, the Minister refused to act and close the loophole. I ask her to think again about closing that loophole so that, no matter where a person is in the system, they have the same rights around restraint and that it gets recorded.
I refer the House to my entry in the Register of Members’ Financial Interests because I am an independent lay manager. Everywhere we look in Britain at the moment, public services are crumbling. Chronic neglect by the Conservative Government means that people across the UK can no longer trust that they will be able to access mental health services when they need them.
As a lay manager in Birmingham and Solihull Mental Health NHS Foundation Trust, I often see the impact that dwindling services and limited resources have on residents across our city. In our local ICB area in December, nearly 3,000 children and almost 50,000 adults were on the mental health waiting list. In my constituency, parents have told me that their children are waiting a number of years for urgent mental health support.
Birmingham and Erdington are not unique cases. Since 2010, the Conservative Government have cut one in four mental health beds across the country as waiting times for treatment have soared. Currently, 400,000 children are waiting for mental health treatment across the UK. They are being denied the help that they need.
I am a mum and a grandmother. Like all parents, I want the next generation to have better opportunities than I did. That is why Labour’s plan to recruit thousands more mental health staff, guarantee treatment within a month and provide access to a mental health professional in every school is so important. It is inconceivable that the Government have failed to put forward their own plan to recruit mental health staff or even reduce the shocking waiting times that our constituents are having to put up with.
I worked in the NHS for 25 years and, like many of my colleagues, I despair at how it has been treated by the Government. This year will mark 75 years of our incredible NHS, but, over the last 13 years, the Conservatives have done all they can to wreck it. People suffering with their mental health cannot afford to wait any longer for the support that they need. We need serious government. We need a Labour Government to tackle the crisis now.
The Metropolitan police recently announced that it would stop attending mental health calls unless there was a risk to life. That has rightly generated much debate about the role of policing. However, it has not generated much debate so far on how, if we all believe in the right care, right person principles, we got into the position where the police are playing such a primary role, and where our mental health services are in that conversation. We know that the police are stretched. For all the Home Secretary’s talk of increased police numbers, the Government are only restoring the officers they have been cutting since 2010. Alongside those cuts, years of austerity have hammered other public services. West Yorkshire police tell me that mental health-related demand increased by 60% between 2012 and 2022. We have allowed policing to become the one-stop-shop that we ask to pick up the pieces when everything else falls apart. Mental health practitioners are also undeniably stretched, but mental health specialists are the right people to provide mental health support, especially when somebody is in crisis.
I am in no doubt that the police will have tried various other ways of encouraging their colleagues in mental health trusts to recognise the leadership role they are required to play in the response to a mental health issue. I know that because I also spend a great deal of time locally in Halifax trying to do the same, and secure specialist support for people who need serious and urgent help. When someone is in real distress with their mental health or approaching a crisis, too often West Yorkshire police, Calderdale Council, charities and other partners—even the hospital trust—work together with my team and I to do what we can. Yet I am afraid that too often it has proved incredibly difficult to bring qualified mental health specialists into the team to even be a part of the conversation. That results in the wrong care for people at their most vulnerable.
As my hon. Friend Jeff Smith said, that is a false economy, because it falls to all the other services and partners to try to provide a degree of care that they are not qualified to provide. We should not criminalise people who are unwell out of necessity. The police are right to take a step back. The question is what will it take for mental health trusts and professionals to be able to step forward?
As our motion sets out, patients suffering with mental health issues waited more than 5.4 million hours in accident and emergency last year and we have nearly 400,000 children currently waiting for treatment. If we are proactive about mental health, it will, as has been outlined, be cost-effective in the long term and we can prevent more people from being in a crisis situation. A Labour Government would recruit thousands of mental health staff to expand access to treatment, provide access to specialist mental health support in every school, establish open access mental health hubs for children and young people, and bring in the first ever long-term, whole-Government plan to improve outcomes for people with mental health needs.
I read the Government’s amendment to our motion. Does any MP who does their casework properly and is truly grounded in their constituency really recognise the picture it paints? The Government pat themselves on the back for hitting the target for interventions in psychosis. I checked what the target was. The standard is that 60% of people experiencing their first episode of psychosis will have access to a NICE-approved care package within two weeks of referral. We have all experienced supporting people in a psychotic episode. How long does it take to even get an assessment for that person to then hope that they are in the 60% of people who should get care within two weeks? It is not good enough. We need a Labour plan to deliver much more.
There has been a narrative about whether it is increasing numbers of people becoming more aware of mental health that has led to more cases being reported, or whether there are actually more people suffering from mental health problems. I spoke to Michele Moran, the head on this issue for the Humber Teaching NHS Foundation Trust. She told me, indisputably, that we have more people suffering from mental health conditions. We only need look at the examples coming into each and every one of our surgeries to see how desperate the situation has become. Like other hon. Members, I would like to thank my staff for the work they do in supporting people with mental health problems. I will give two examples.
One example is a 13-year-old boy who has not been in school for two years. The school funded three counsellor sessions for him, but it cannot continue to give the boy the level of support he needs. This is a crucial point. Schools are very willing to help, but teachers are not mental health professionals. We need the professionals in the system, which is why Labour’s pledge to have professionals in schools matters so much. We all know how desperate the waiting list for CAMHS is and how difficult it is to get the level of support that is needed. We are left with families who are desperately struggling, having to rely on other family members and finding life incredibly difficult.
It is the same for another constituent with a 17-year-old daughter. She did not get the help she needed at the time she needed it. She could not access that primary care. What ended up happening was that she took an overdose, which she survived, but it was clear that her mental health was in such difficulties that she was sectioned. Her parents now find that only one of them is able to work, because the other parent has to be with their daughter at all times because of the difficulties she is facing. That is having a huge impact on their income and their standard of living.
In our area we have tried to do something different with the police. Right Care, Right Person is a joined-up approach from Humberside police, the clinical commissioning group—as it was at the time—local councils, mental health providers and hospitals to decide who is the right person to attend to someone in crisis, and then look at developments. It is not perfect, but it tries to address the difficulties we are having. Many of the cases the police have been sent to are still people actually struggling with their mental health, and the police, like teachers, are not the professionals always best placed to deal with someone in a mental health crisis. We are evaluating that as it goes along, but the demand for services is indisputable.
We need to take a step back a little and think about what is going on. We are talking about citizens advice bureaux providing counselling and support for people with mental health problems. The people that the citizens advice bureaux are supporting are not those who generally have mental health problems; they are people who do not have enough money to live, and their level of debt is causing them to have mental health problems. They are in a situation called negative budgeting, where, quite simply, the amount of money they have coming in is less than the amount of money going out. That is what is driving some mental health problems.
If we are to solve the mental health crisis, we must look at poverty, debt and the cost of living crisis. That is why I am so delighted that my hon. Friend Dr Allin-Khan said that a future Labour Government’s approach to mental health would be focused not just on health, but across the whole of Government. Until we have that joined-up approach, we will never really tackle the crisis our country faces.
West Yorkshire has among the highest rates of mental health issues in the country, with 28,630 children and 63,755 adults on waiting lists alone. The statistics show that Wakefield, specifically, is above average, with one in three people suffering from mental illness. As we all know, some of the primary causes are poverty, debt, poor housing and long-term physical health problems. Indeed, Eastmoor in my constituency has the highest prevalence of mental health illness, as well as those cause factors, too.
I know from my casework that the number of mental health cases coming into my office has been rising steadily over the past year. With mental health provision at breaking point, that is no surprise: more than 5.4 million hours waiting in A&E in 2021-22 for mental health patients; 1.6 million people stuck on long waiting lists for mental health treatment; and nearly 400,000 children currently waiting for treatment. On that last point about children, I am deeply concerned that Wakefield has the seventh-highest rate of under-18s under mental health care, with over 6,000 having contact with mental health services in the past year alone. Parents are left feeling helpless, watching their children’s mental health deteriorating as they linger on waiting lists for months, if not years, to access treatment.
Much of the problem is caused by the number of mental health nurses in the NHS now being lower than when Labour left office. It is unacceptable that people are left turning to A&E because of staff shortages in mental health. I have had cases where patients have been advised that they will have to wait a year for their treatment to start and such delays are becoming more common. Nearly 10,000 people in West Yorkshire had treatment closed without even receiving an appointment. After 13 years of the Tories running down our health services, we need a Labour Government that will guarantee mental health treatment within a month for all who need it, recruit thousands of new mental health staff and ensure that mental health specialists are in every school. The scrapping by the Conservatives of the 10-year mental health plan shows a total lack of long-term focus on those with mental health needs. That is why Labour would bring in the first ever long-term, whole-Government plan to improve outcomes for people with mental health needs.
With mental health services on their knees, I will be voting for Labour’s motion, and I hope the Government will finally give this area the attention it so sorely needs.
The Conservative cost of living crisis is causing a mental health crisis. People living in poverty or, as we are increasingly seeing, under financial stress and in personal debt are more likely to develop mental illness, as so many hon. Friends have already said. Sadly, children from the poorest 20% of households are four times more likely to have serious mental health difficulties by age 11 than the wealthiest 20%, and after 13 years of Conservative Government our mental health services are at breaking point and patients are being failed. It is important that we talk about mental health in this place because it is a key issue. Like many other Members, I have constituents who are struggling to get the support they and their children need; that is their lived experience and it is right that we hold the Government to account on it.
For children, recent research shows the average CAMHS waiting list in February rocketed by two thirds, and the 400,000 children on mental health waiting lists are waiting an average of 21 weeks for a first appointment. Data from December 2022 shows that children in a mental health crisis spent 7,034 hours in A&E in my Bedfordshire Hospitals NHS Foundation Trust area. That is in the context of our Bedfordshire, Luton and Milton Keynes Integrated Care Board area having over 15,000 children on mental health waiting lists. This is distressing for both the children and their families.
Turning to adults, Royal College of Psychiatrists research from last October found that 43% of adults with mental illness said that long waiting times had worsened their mental health: 23% had to wait more than 12 weeks to start treatment and many end up turning to A&E departments. Indeed, data from December 2022 shows that adults in the Bedfordshire Hospitals NHS Foundation Trust area, including the Luton and Dunstable NHS Hospital, spent over 11,000 hours in A&E.
It is right that I mention the many volunteers who operate in the mental health sphere. It is the end of Volunteers’ Week 2023 so I want to make that shout out, particularly to the brilliant volunteers with the Luton, South Beds and Harpenden Samaritans, who are committed to supporting people struggling to cope or struggling with their mental health through the listening service the Samaritans offers 24 hours a day. If anyone listening to this debate needs support, they should call 116 123 for free from any phone 24 hours a day.
Finally, I want to state my support for Labour’s community-focused preventive plan for mental health so that people will be guaranteed to be seen within one month, there will be 8,500 new mental health staff, with open access mental health hubs in each community and a mental health professional in every school. We need this bold plan; we need it now, and we need a Labour Government to deliver it.
There is no doubt that our mental health system is broken. Like many other Members, I receive hundreds of emails from my constituents about the dire state of mental health services, and there is a story for every age and every system failure, but today I want to focus on young people, particularly students.
It will come as no surprise that the Mental Health Foundation found that 40% of students are not coping well with their anxiety. In Oxfordshire, a survey by The Tab in 2022 found a staggering 82% of students at Oxford Brookes University had self-medicated with drugs or alcohol to cope with mental health issues. Where students know that they cannot rely on the NHS, an added burden is put on university staff. Tutors increasingly find themselves acting as therapists or counsellors for their overburdened, ill or anxious students.
Oxford University is working hard to improve services. It has come up with a joint mental health committee and a more common approach across the colleges and departments. It deserves praise for that, but the students I have spoken to have made it clear that
“University wellbeing services are not and cannot be a substitute for adequate mental health care” and those gaps have dire consequences when severe mental health issues are left untreated. My constituents Jacquie and Mark faced every parent’s worst nightmare when their son Rory reached crisis point. Rory was suffering from anxiety and depression and found no support after a year of absence. He tragically committed suicide at university at just 22. His parents told me that
“we can’t bring Rory back, but we can help other young people preparing to go to uni.”
They are calling for a statutory duty of care for universities, which would force them to take proactive steps and intervene where a student is clearly at risk of harm. It is just common sense. It already exists between employers and employees. All we are asking is for the same duty of care to apply to students.
But, as we all know, the problems in young people’s mental health services are not restricted to those at university. So many people tell me the system is broken: parents, teachers, educational psychologists and clinical psychologists all identify the same failings. One parent wrote to me:
“I am breaking my heart listening to my son saying horrible things about himself, threatening to take his life, and struggling with his mental health in general. Next year we would have been on the waiting list for four years and nothing will probably happen.”
That story is not unique.
So it is left to voluntary organisations and local authorities to step in where this Government are clearly failing. Oxfordshire Mind and Restore do incredible work. Last year, I visited The Abingdon Bridge, a fantastic charity that provides specialist support for 13 to 25-year-olds. When I visited, it had 50 young people on its waiting list, who had to wait up to 24 weeks for an assessment and a further 10 weeks for counselling. Shockingly, that is still much shorter than CAMHS, where the waiting list is between two and four years.
We know how to fix this; it is about more funding. A senior healthcare professional in Oxfordshire told me that
“every pound spent on a child’s mental health saves thousands in the future.”
It is this Government who are failing our young people and their parents. The Government are dragging their feet. Young people and their parents deserve so much better than this.
Suicide is a tragedy: it is a tragedy for the person, their loved ones and their community. As we have heard in the debate, suicide affects people of all ages. However, I am going to focus on one group: men. For men under 50, suicide is the biggest killer—not cancer, not other physical illnesses, but suicide. Mental health matters so much and it should be on a par with physical health. The NHS is there to look after and care for us all. That is the basic principle it was founded on. With suicide being such a big killer, it is only right that more effort and resources go into treating poor mental health.
Each suicide cracks an irreparable hole in the lives of loved ones. They often ask themselves, “Could I have done more? How did I not spot any signs?” or even, “Did I contribute towards it?” This would not be the case for physical illness; instead they would rely on professional healthcare. That is why the same resources need to be in place to treat poor mental health. Yet instead this Government have scrapped their 10-year mental health plan, displaying yet again that they are not interested in long-term planning. If it does not give them an instant headline, it seems the Government lose interest.
Of course, society has a role to play. For too long, men struggling or even displaying emotion are told to “man up,” “stop being a wimp,” or even, more cruelly, to “grow a pair.” Those words may seem harmless at the time, but in reality they are dangerous and cause tremendous harm. No one knows what is going on in somebody else’s head. That again reinforces why a national strategy is so important, not only to offer better and more accessible mental health care but to help to shift societal attitudes. We all have a role to play. How we conduct ourselves towards others is very important. In everyday life, we have an impact on every person we come into contact with. Pre-emptive mental health care is a must. That is why Labour’s plan to prioritise mental health care in an open access hub is so important.
Businesses and employers also have a role to play. They have a duty to their employees’ mental health. Modern workplaces should have accessible mental first aid in the way that they have physical first aid. For any strategy to combat suicide to be successful, it needs to be a priority of national Government. We need professional mental health support requirements for employers and a plan to change attitudes in society, not just a plan to swat the flies with. We need a plan that is resourced and put into practice.
We should make it easier for men to talk at work, in the pub and, most importantly, with professionals. Labour’s plan to recruit thousands of mental health staff would put us on the right path of caring for our men. The Government need to and should do more to solve that crisis, and our Labour Government will resolve it.
In Greater Manchester, the number of children on waiting lists under the NHS Greater Manchester Integrated Care Board is 23,510. The number of adults on waiting lists is 89,250, and the number of patients whose treatment was closed without receiving an appointment at all was 31,405. Those statistics represent people facing crisis, who desperately need help.
Like other Members of this House, I have heard many stories from constituents, including those waiting over a year for assessment and treatment for obsessive compulsive disorder, attention deficit hyperactivity disorder, autism or potential learning disabilities. Many have been forced, through desperation, to take out personal loans to pay for private assessments. Then, they have tried to privately fund their own treatment and medication. I have heard from constituents suffering with severe depression, waiting months for therapy and simply being told to ring 999 if it gets serious.
I have heard traumatic cases of teenagers battling serious mental health conditions who needed urgent help, with no bed available for them for hundreds of miles unless they chose to go on an adult ward, which I am sure for most children and young people would be an extremely frightening experience. I also hear the stories of our hard-working NHS mental health staff, who are overworked, overstretched, underpaid and at breaking point. So there is not a mere crisis in mental health; the service has effectively collapsed. Sadly, I fear for what is to come if the Government do not urgently act today.
Salford City Council estimated in 2021 that there would be between 36,537 and 40,902 additional diagnoses of anxiety and depression in Salford alone, equating to a point prevalence of between 14% and 15.8%. That was before the cost of living crisis hit. For those who reach crisis point, the outlook is equally frightening. An overstretched, underfunded ambulance service means that, often, the police are diverted to emergency mental health calls. That is why there was huge concern expressed recently in response to plans by the Metropolitan police to stop attending emergency mental health incidents.
More broadly, in addition to the chronic understaffing of mental health services, funding remains a huge issue. The Centre of Mental Health estimates that mental health conditions make up 28% of all referrals, but services receive only 13% of NHS funding. The Health Foundation found that the lack of funding meant that just four in 10 people seeking help would be able to receive it. The sad fact is that it makes no economic sense not to increase investment in the NHS and funding of NHS mental health services. As the Mental Health Foundation states:
“Poor mental health costs the UK a staggering £118 billion per year, but much of this is preventable.”
I welcome wholeheartedly the motion of my hon. Friend Dr Allin-Khan and I will support it. The Government must recognise this crisis, properly fund our NHS mental health services, and properly recruit those staff and pay them the wages that they deserve.
The Minister spoke earlier about what the Government have done for the mental health service, but we have all known for far too long that people in mental health crisis are not getting the support that they need urgently. They need swift, accessible and effective support and treatment. I am glad that we in Labour have a clear and thought-through plan to address this issue and suicide prevention.
I want to start with some figures. The shadow mental health Minister, my hon. Friend Dr Allin-Khan, has already touched on the national figures. The figures from my local trust in the north-east are also worrying. Just in the 2021-22 financial year, adults in mental health crisis spent more than 1,134 hours in A&E at Gateshead Health NHS Foundation Trust, while children in crisis spent 180 hours there. The North East Ambulance Service received 3,622 emergency 999 calls from people in mental health crisis. NHS Digital figures for 2022 showed that, in the north-east and north Cumbria ICB alone, 31,345 children and 70,770 adults were on waiting lists, and 12,845 patients had treatments closed without even receiving an appointment. Those staggering figures have been reflected nationally.
This morning, I met representatives from the charity YoungMinds, who told me that urgent referrals to CAMHS are the highest on record. Let us make no mistake: many of our young people are in acute crisis. Research by the charity shows that 43% of the young people turned down by CAMHS had experienced suicidal thoughts, psychosis or self-harm. As a result of having to wait so long, 26% had tried to take their own life.
In an intervention, I raised the concerns of mental health charities about the subsuming of the mental health strategy into the major conditions strategy. There is real concern that the voices heard in the mental health consultation will be lost and that a five-year major conditions strategy is too short to bring about the changes needed and to emphasise the cross-governmental work envisaged in the original plan.
As the Mental Health Foundation highlighted,
“public mental health has traditionally received extremely minimal funding”, of an average of about 2% of the public health budget of local authorities. That has been accompanied by a cut of 26% in public health grants in real terms. The Mental Health Foundation notes that we cannot simply “treat our way” out of mental health problems. We know that they are formed by hard socioeconomic factors that the Government need to address, and that the poorest regions, such as mine in the north-east, see the highest number of suicides. The Government need to work on that.
As the chair of the all-party parliamentary group on suicide and self-harm prevention, I have the pleasure of talking with many local organisations that have been formed by people who have personal experience of suicide. To name just one, James’ Place is a charity that offers professional support to men in acute suicidal crisis. It currently has centres in London and Liverpool, but I am delighted to say it will be opening a centre in the north-east, where, sadly, we have the worst suicide figures in the UK. There is so much more I could say, but I wish to emphasise my wholehearted support.
As we have heard today, England is in the midst of a mental health crisis, and that is certainly true in the north-east. I join my hon. Friends the Members for Middlesbrough (Andy McDonald) and for Darlington (Peter Gibson) in calling for an independent inquiry into the Tees, Esk and Wear Valley NHS Trust. The testimonies I have heard have shocked me. I know that I can speak only in broad terms, but they include serious cases of improper care and misdiagnosis, and of putting people on waiting lists despite their feeling suicidal.
The Care Quality Commission reports that we have seen raise concerns about risk assessments, communications and record keeping, and a lack of observation. There have also been concerns raised about the lack of beds for children, as well as poor staffing levels, high staff turnover and a lack of neurodiversity training. Horrifically, young people have even taken their lives while in the care of the trust. We owe it to them, and all those who have been harmed, to investigate what is going on within the trust. Will the Minister commit to an independent, judge-led inquiry into the trust? She can either respond to me now or I can wait for her response in her closing speech. One thing is clear: this cannot go on.
I want to highlight the crisis in children’s mental health. In my region, children spent over 1,000 hours in A&E because they were in a mental health crisis. There are over 30,000 children on waiting lists. Across England, one in six children aged five to 16 are likely to have a mental health issue. Children’s happiness and sense of wellbeing continues to decline. With mental health trusts raising the threshold of how ill under-18s must be, we have seen a quarter of a million children being denied help for their mental health. Poor mental health compounds. Left untreated, it can spiral out of control, as we have heard many times today. No one should be in a mental health crisis, let alone children. The Government must invest in children’s mental health today—no more delays and no more referrals. The Minister must allow children the happiness that they deserve.
Before I call the shadow Minister, I must say that I am very disappointed that seven Opposition Members who spoke in the debate are not back in the Chamber for the wind-ups, as well as about three Government Members. I must emphasise again that it is really important for people to get back to hear what the shadow Minister has to say, as well as the Minister. I hope that message will be conveyed back to those Members who are not here. I will say it again in the hope that they are back by the time the shadow Minister has finished his speech.
It is a pleasure to close the debate on behalf of the shadow health and social care team.
We have had a thorough debate and we have heard some heartbreaking, harrowing and concerning things during its course. The amendment that the Minister has put down in response to the motion is reminiscent of “Alice Through the Looking Glass”, because it does not bear any relationship to people’s lived experiences of the mental health system in England or the contributions made by Members from both sides of the House to the debate.
I pay tribute to all who have spoken today. There have been some incredible speeches. We heard from the hon. Members for Watford (Dean Russell) and for Penrith and The Border (Dr Hudson), from Vicky Ford, and from the hon. Members for Runnymede and Weybridge (Dr Spencer), for Penistone and Stockbridge (Miriam Candidates), for Newcastle-under-Lyme (Aaron Bell), for Devizes (Danny Kruger), for St Albans (Daisy Cooper), and for Oxford West and Abingdon (Layla Moran).
We also heard from my hon. Friend Jon Trickett, my hon. Friend Neil Coyle, who made an extremely powerful contribution, and my hon. Friends the Members for Chesterfield (Mr Perkins), for Batley and Spen (Kim Leadbeater), for West Ham (Ms Brown)—I ask the Minister not to forget her request for a meeting; she is certainly someone to whom it is difficult to say no—for Oldham East and Saddleworth (Debbie Abrahams), for Leeds North West (Alex Sobel), for Sheffield, Hallam (Olivia Blake), for Birmingham, Erdington (Mrs Hamilton), for Halifax (Holly Lynch), for Kingston upon Hull West and Hessle (Emma Hardy), for Wakefield (Simon Lightwood), for Luton South (Rachel Hopkins), for St Helens South and Whiston (Ms Rimmer), for Salford and Eccles (Rebecca Long Bailey) and for Blaydon (Liz Twist). Finally, we heard from my hon. Friend Mary Kelly Foy; I remind the Minister that she would like a response to her request for an inquiry into issues in her local area.
We are facing a mental health emergency in this country—
The hon. Gentleman has said that the Government’s amendment bears no relation to the reality of what people are seeing. In my speech I mentioned the creation of a brand-new facility for patients in mid-Essex, which means that people in crisis are not spending many hours in A&E but are going to a bespoke 24/7 centre. That is the sort of provision that I want to support, and it is mentioned in the Government amendment but not in the Opposition motion.
Of course we need facilities in every part of England, but the fact is that after 13 years, too many parts of England are falling behind. We know that the mental health crisis in this country has become worse on the watch of the right hon. Lady’s Government, and she should have a little contrition about the state of mental health services in England.
As we have heard today, people who require mental health support, no matter where they live—except in the right hon. Lady’s part of England—will be confronted by a system that is buckling under the pressure of 13 years of Tory mismanagement, neglect and incompetence. The right hon. Lady shakes her head, but the figures speak for themselves. Last year, patients suffering with mental health issues waited more than 5.4 million hours in accident and emergency departments. There are 400,000 children currently waiting for mental health treatment, and 1.2 million people are waiting for community mental health care, with some patients being forced to travel more than 300 miles because there are no beds in their local area. My hon. Friend the Member for Hemsworth spoke powerfully about that. The Resolution Foundation has found that, of the 185,000 young people who are unable to work, nearly two thirds cite mental ill health as the reason. Suicide is now the leading cause of death in adults under 34, with about 18 people losing their lives every single day. As the cost of living crisis has worsened, we have also seen a knock-on effect on addiction and rehabilitation. Drug-related deaths are at a record high, and last year there were 9,641 deaths in the UK from alcohol misuse, a 27% increase on the year before.
Make no mistake: the emergency in mental health has become a public health crisis, and we need to see action. Our motion calls on the Government to adopt Labour’s plan to recruit 8,500 mental health staff to expand access to treatment, to provide specialist mental health support in every school, and to establish open-access mental health hubs for children and young people. That would be paid for by the closing of tax loopholes, because politics is about priorities, and Labour’s priority is to ensure that those who need mental health support have access to it in all parts of the country. Our priority is to build a Britain where patients start receiving appropriate treatment within a month of referral. I hope that those on the Government Benches will demonstrate that they share these priorities by voting for Labour’s motion today.
Staffing is just one part of the equation. Like any public health issue, addressing mental health requires a holistic approach that recognises its complex nature. That is why Labour has committed to a whole-Government plan to improve outcomes for people with mental health needs and to address the social determinants that drive mental ill health for many people. Our mental health can be influenced by a multitude of different things. Secure jobs, fair pay and good housing are all building blocks for a healthy life, physically and mentally, and unless we improve people’s lives in the round, positive change will remain out of reach.
It is for this reason that the next Labour Government will focus as much on prevention as we do on treatment. We will pioneer a transformative cross-departmental agenda with a mission delivery board at the heart of the Government ensuring that all Departments work to improve the wider determinants of health. We will boost capacity in mental and public health teams so that people can get the support they need before presenting at A&E or turning to substance abuse. We will also encourage the integrated care systems to identify opportunities to join up services within the community. Our aim will be for more patients to have one point of contact for appointments with a range of professionals and services. This neighbourhood team will include the family doctor, carers, health visitors, social prescribers and mental health specialists.
Our vision is to turn the national health service into a neighbourhood health service with the patient right at the heart of it. The benefits of this kind of work will travel far beyond improving the lives of individuals suffering from mental ill health. For instance, in my own region of the north-west of England there were over 140,000 calls to 999 from people in a mental health crisis last year, and in my own constituency local people spent over 6,500 hours waiting in A&E for mental health treatment. If we were to help people before they reached these crisis points, we would drastically reduce pressure on the wider health system and thereby improve patient outcomes right across the board.
The same is true of wider economic productivity. As we have heard in the debate, the Mental Health Foundation and the London School of Economics have estimated that poor mental health costs the British economy £117 billion a year. That is a phenomenal amount of money and a huge loss to our country’s economic power. Improving mental health outcomes is therefore not just a moral imperative—although it is certainly that—but a practical one, and one that is essential if we want the United Kingdom to prosper, as I hope and believe we all do. That is what we come to this House for. We want to leave our country in a better shape for our children than it has been for ourselves.
That brings me again to the motion. All Members of the House have the opportunity today to support a fully funded plan to improve mental health treatment. Those on the Government Benches can choose to put party politics first, but that will not change the fact that this Government have failed people on mental health. No matter what amendments they put before us, that does not change people’s real, lived experiences or the experiences of Members on both sides of the House who deal with the impact of mental ill health in their constituency casework. The system is crumbling and more of the same will just not cut it, so I am enormously proud to be supporting Labour’s motion today and I would strongly urge Members on both sides of the House to back it. It is time to give those suffering from mental ill health the treatment and support they deserve, and I commend our motion to the House.
I reiterate for those who were not here that it is incredibly important that people get back in good time to hear the Opposition wind-up as well as the Government wind-up—that includes Ministers. I would expect anybody who was not here at the beginning of the Opposition wind-up, some of whom are still not here, to write to Mr Speaker to apologise. I take it that people will do that.
Thank you, Madam Deputy Speaker.
What a shame it is that the Opposition have chosen to play politics with mental health, as we heard from my right hon. Friend Vicky Ford and my hon. Friends the Members for Watford (Dean Russell), for Runnymede and Weybridge (Dr Spencer) and for Penrith and The Border (Dr Hudson), because these are important issues. All countries are facing challenges with rising cases of mental ill health and capacity issues, but we have made progress in the last 10 years. It was in 2016 that David Cameron first talked about changing the stigma on mental health and, as my right hon. Friend the Member for Chelmsford put it so well, we want more people to come forward. The problem in the past was that people did not come forward, instead waiting until they became so acutely unwell that it was more difficult to support them.
A recurrent theme in today’s debate, on both sides of the House, has been the importance of prevention and breaking down stigma. Does my hon. Friend agree that the message should go out from Members on both sides of the House that it is okay not to be okay, that people should reach out and that more people in all walks of life should be first aid-trained to help when people do reach out?
My hon. Friend is absolutely correct. As my hon. Friend Dr Evans said, we had an event with the NFU yesterday, and that is exactly the point we wanted to make. It was my right hon. Friend Mrs May who set about changing the status of mental health, putting it on a level playing field with physical health, not just in the services we provide but in funding and staffing, with parity of esteem across the board.
Let us look at some of the progress that has been made over the last 10 years. The shadow Minister, Dr Allin-Khan, said in her opening remarks that she is bored of this figure, but it is true that £2.3 billion of additional funding is being put into frontline mental health services, supporting another 2 million people to access NHS-funded mental health services.
We are already doing much of what shadow Ministers have set out this afternoon. We are already recruiting 27,000 additional staff into mental health services, with 20,000 of them already in place. My right hon. Friend the Member for Chelmsford highlighted the difference that is making in her local area. We are removing dormitory accommodation across the country through a £400 million capital programme, and 29 schemes have already gone through—that is 500 beds that are no longer in dormitory-style accommodation.
My hon. Friend the Member for Runnymede and Weybridge highlighted the difference that funding is making in his constituency. We are moving to a system of community crisis support and early intervention so that people do not get to a point where they need to be admitted. Our £190 million of capital funding is being used to build community crisis facilities up and down the country. We are investing in mental health ambulances: 20 are already in place, 40 will be in place by the end of the year, and 47 will be in place next year. The shadow Minister laughs about this, but when somebody is going into crisis, it is more appropriate that a mental health specialist team visits them in a mental health ambulance than an ordinary paramedic, who will inevitably take them to A&E.
Suicide is the leading cause of death in new mums, which is completely unacceptable. That is why we are investing in perinatal mental health services in every part of England—these services saw 31,500 women last year.
As we remove the stigma, it is important that we have the services to deal with the rising number of people who come forward and ask for help, as we want them to do. We have introduced three targets, the first of which is on access to talking therapies, where 75% of people should begin treatment within six weeks. Currently, 90% of people are doing so and we are meeting that target. When children and young people are referred for eating disorders, the target is that 95% should be seen within one week. We are currently at 77%, whereas last year’s figure was 61%, so despite the rising numbers we are seeing more children with eating disorders—
I was incredibly upset by the shadow Minister’s suggestion that I do not care about mental health. As someone who has suffered with mental ill health in the past and spoken in the Chamber about how hard it is to speak about that, I found that very upsetting. Mental health suffered greatly during the pandemic, especially that of children and young people—I was the children’s Minister at the time. We all know that we need to do better, which is why it is important that we learn about what is working now and about new innovations. On eating disorders, I particularly thank the Minister for getting the waiting list time down.
I thank my right hon. Friend for that. It is important that we take the politics out of this argument, because no one in this Chamber, on either side, does not care about mental health.
The psychosis target we have introduced is that 60% of people should start treatment within six weeks, and we are currently at 72%. We are overperforming on many of those targets. NHS England has five new targets that we hope to introduce soon—
Unfortunately, given the time I have left, I will not give way any more.
As for the challenges we face, we are seeing rising numbers, but we are seeing that in all parts of the country. The shadow Minister, Andrew Gwynne, talked about not judging Labour on its track record on health in Wales, where Labour has produced smaller funding increases for its health service; its 7.8% increase compares with the 8.6% increase that we have given in England. Mind Cymru has said that hundreds of people across Wales are currently waiting more than a year to access psychological therapies. The target is supposed to be that 80% of people in Wales access therapies within six months, but that target has never been met. It gets worse, because since 2020 the number of people waiting longer than a year in Wales for mental health support has increased by 17%. Labour talks a good game, but its actions speak louder than its words. I urge shadow Ministers to acknowledge that these problems exist in all countries and that we all face these pressures. A grown-up conversation would be about sharing best practice and working together to make that happen.
Many Members talked about preventive and early intervention therapies. My hon. Friends the Members for Bosworth and for Devizes (Danny Kruger) talked about that and about moving away from the medicalisation of mental health. That is why we are investing in talking therapies. For anyone who has not been on the Every Mind Matters website, let me say that it provides practical support for people who are anxious, distressed or not sleeping. It also provides for self-referrals to talking therapies. Since we introduced that, more than 1.2 million patients have accessed NHS talking therapies in the last year, helping them to overcome anxiety and depression. More than 90% of those people have had their treatment completed within six weeks.
Many Members talked about schools, and we are introducing mental health support teams in schools. We have almost 400 now, covering more than 3 million children, and about 35% of schools and colleges. More than 10,000 schools and colleges have trained a senior mental health specialist, including more than six in 10 state schools. That work is happening already and it is making a difference right now. My hon. Friend Aaron Bell highlighted how we need to move that into universities, and I would be happy to talk to him about how we can do that further.
On in-patient services and the quality of care, we have recently conducted a rapid review of mental health in-patient settings. The Secretary of State will announce the results of that soon. We have also introduced a three-year quality transformation programme, which seeks to tackle the root cause of unsafe, poor-quality in-patient care, particularly for those with learning disabilities and autism.
On suicide prevention, our forthcoming strategy will target high-risk groups and locations of concern. We will also provide £10 million of funding for charities that do so much good work in this space. I say to my hon. Friend the Member for Penrith and The Border that I would be very happy to meet the 3 Dads Walking, Andy, Mike and Tim. I know that they have met the Prime Minister.
I am just answering a question on suicide. I would be very happy to meet the 3 Dads Walking to learn the lessons for our suicide prevention strategy.
I will not give way. I only have a few minutes left.
It is disappointing that Labour Members cannot understand the progress that has been made and are determined to make political points, damaging the work that our NHS staff up and down the country do day in, day out, backed by record levels of investment that have never been seen before in mental health services.
It is true that we have tabled an amendment this afternoon, in which the Prime Minister acknowledges how much work we have done in this space. With a rising number of people accessing mental health support, which is a good thing and not something to be criticised, we are investing in those services and in 27,000 extra staff.
Madam Deputy Speaker, I will continue if I may.
Despite the disingenuous motion proposed by the Labour party, it is my privilege to hear about the valuable contributions being made up and down the country. It is so easy to talk down our services, but if Labour Members are serious about improving mental health services, perhaps they should talk to their Welsh counterparts. Action speaks louder than words. Mental health services in England are performing better than those in Wales. We all know that this is not really about improving mental health services; it is about using mental health as a political football, but we on the Government Benches will not play that game.
Question put (
The House divided: Ayes 278, Noes 0.
Question accordingly agreed to.
The Deputy Speaker declared the main Question, as amended, to be agreed to (
That this House notes the increased burden on mental health following the pandemic, including on young people and those with severe mental illness; recognises the historic levels of investment being delivered by this Government into services, with an increase of £2.3 billion per year in front-line mental health funding over the past four years; notes that current NHS targets around access to talking therapies and intervention in psychosis are being met due to the efforts of NHS staff; and acknowledges the investment in mental health teams in schools, as well as the ongoing investment into open access mental health helplines in the 111 service and into the estate, including three new mental health hospitals to be opened in the next two years accompanied by a further £150 million in investment in new mental health ambulances and the development of better alternatives to accident and emergency services, including crisis houses, safe havens and step-down services.
“the asylum initial decision backlog is down by 17,000”.—[Official Report,
Vol. 733, c. 557.]
The asylum initial decision backlog is clearly defined by the Home Office. It is the total backlog of initial decisions before and after June of last year, and Home Office figures show that it has gone up from 132,000 to 137,000 for main applicants since the beginning of December. It has gone up from 160,000 to 172,000 for all applicants in the first quarter of this year. On either measure, that backlog is up, and not down.
I raised this matter as a point of order on Monday, and the Home Secretary refused to correct the record then. I have written to the Home Secretary this morning, but have still heard nothing back. The ministerial code requires
“that Ministers give accurate and truthful information to Parliament, correcting any inadvertent error at the earliest opportunity.”
I know that the Home Secretary has a history of breaching the ministerial code but, Madam Deputy Speaker, would you agree that facts matter and that it is not acceptable for Ministers to fail to correct the record if they have given inaccurate information to Parliament? Have you heard from the Home Secretary about her intention to come and correct the record?
I thank the right hon. Lady for her point of order. As has been said before, and I think this was said when she raised the point of order yesterday, it is obviously not for the Chair to adjudicate in cases of differing interpretations of statistics. That said, if a Minister has made a mistake in the House, I would of course expect them to correct it. The right hon. Lady has put her perspective on the record. Ministers will have heard it, and I am sure the Home Secretary will reflect on whether a correction is required in this case. I see that the Whip, Joy Morrissey, is writing this down and it will be fed back, and I am sure Ministers will do the same. I thank the right hon. Lady, and I think we will leave it at that.