My Lords, I will speak to Amendment 148, which is in my name and that of my noble friend Lady Hollins. I also support all the amendments in this group. Indeed, on the ones introduced by the noble Earl, Lord Howe, I very much support the stories that we have heard and which he spoke about at Second Reading. I also note the points made by the noble Baroness, Lady Tyler, about non-drug therapies, which relate very much to what I will talk about.

I will make one general point: a generational change in the whole field of mental health is happening globally, with a shift towards more social interventions and preventions. This wider context needs to be recognised a bit more in the Bill. Amendment 148, which is about withdrawal from dependency-building drugs, is part of that context. I also agree very much with the point that the noble Baroness, Lady Tyler, just made that drugs are needed, and with the powerful points raised by the noble Baroness, Lady Fox, in the last day in Committee on the real pressures and problems that people within the NHS and beyond face in working with some of the people they end up having to work with, and on the conditions that they are working in. This emphasis on social interventions, therefore, is not at the expense of other aspects of mental health.

Some of these interventions do harm. I will come on to the point about withdrawing from drugs. On reducing prescribing and supporting withdrawal, I do not understand why this Government, through the Bill or otherwise, are not making changes that could help to reduce costs and improve services, which would take pressure off all services and, indeed, improve people’s economic position by enabling them to be fit to work.

The highest-profile issue here is antidepressants because, very sadly, of recent tragedies that have been very much in the news. I shall talk about antidepressants, where it seems the best evidence is available. Over the past 12 years, antidepressant prescriptions alone have almost doubled in England, from 47 million to 89 million last year. Nearly one in five people over 18—adults—in England is now prescribed them annually and, sadly, nearly 450,000 children and young people, almost 4,000 of them under 10, were prescribed antidepressants in 2022-23.

I am going to talk not about unnecessary prescribing and the tragic deaths associated with some of these prescriptions but withdrawal. The figures that we have managed to obtain show that up to one-quarter of adults on these drugs report their withdrawal, their coming off the drug, as being severe, and a significant proportion—while there are no particularly accurate figures here, the best estimates are about 10% of them—will experience withdrawal that is both severe and protracted. If one takes that as a minimum, we are talking about something like half a million people. What we mean by protracted withdrawal is withdrawal that lasts many weeks or months or longer as they try to come off these drugs. They are often in mental and physical pain and unable to work. Of course, this is a largely hidden crisis affecting patients one by one in the privacy of the home and often known only to relatives, close friends and service providers.

Focusing not just on antidepressants, reviews by the previous Chief Pharmaceutical Officer and others show that possible reductions in the use of dependency-forming drugs, not just antidepressants, could save £500 million in drugs alone, without taking any account of other savings to the NHS and the contribution that people could make to the economy.

This is a very practical amendment. Its purpose is what I have described so far. There is evidence now of what works in helping people to withdraw from these services. The amendment calls for four things. First, integrated care boards should provide local withdrawal services based on this evidence. Secondly, they should ensure that relevant professionals know about and are trained in these services. A number of GPs have talked to me about how individuals have had to try to manage without support, and the GPs feel without support as well. Thirdly, there needs to be reporting to Parliament on progress with this. Fourthly, at the national level, there needs to be a 24-hour helpline to provide support to patients.

I suspect that the Minister and the Government understand and support the intention behind this amendment but, in the language of your Lordships’ House, will be minded to resist it. I do not think this issue is going to go away. The prescription of antidepressants, as I have already said, has become far more high-profile in recent weeks, and the Government may yet find themselves forced to act. This amendment provides the opportunity to do precisely that. This is a story of both human tragedy and an unnecessary financial drain on the country.

A final point I shall make is that it is strange that there is no requirement on the NHS to deal with problems that have been caused by drugs that have been, with the best intentions and often successfully, administered to patients, but have led to harm thereafter. With cytotoxic drugs in cancers, I believe the NHS does a lot to support people with their impact. Why is it that in this particular case, in mental health, when we know that these drugs cause a significant problem for a significant number of people, we do not recognise that there is a responsibility for the NHS to help people to come off them in the appropriate way?

If the Minister is minded to resist the amendment, can she tell the House how the Government propose to deal with these massive problems of withdrawal? I am very happy to receive a letter or to have a meeting to discuss this. I commend the amendment to the House.