[Mr. Bill Olner in the Chair] — Mental Health

Part of the debate – in Westminster Hall at 10:30 am on 17th April 2007.

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Photo of Tim Loughton Tim Loughton Shadow Minister (Children) 10:30 am, 17th April 2007

We have had a very interesting debate. I add my congratulations to Dr. Cable. The timing of the debate is fortuitous. We shall be mental healthed-out by the end of the week: debate on the Mental Health Bill started yesterday, and as he mentioned, this is national depression awareness week, which is an initiative of SANE and the Depression Alliance.

The hon. Gentleman raised some good points and introduced a wide-ranging debate on the subject, unlike the limited one that we had yesterday on the Mental Health Bill. I am pleased that this debate is part of a profile-raising exercise for mental health, which is not a fashionable subject. As he rightly said, many people who suffer from mental illness will not be the first to admit their own problems, let alone demonstrate in the street, so it is incumbent on us as legislators and the representatives of those most vulnerable people to speak up for them. This debate is another good opportunity to do that.

All hon. Members in this Chamber and, I am sure, across the House know from their surgeries and constituency post of distressing cases of people who suffer from mental illness but are unable to access services. I refer to two cases in my constituency. One constituent recently had a psychotic incident that involved the police. He was arrested and kept in the cells for five days before he was assessed by a mental health professional and then able to be sectioned to the Maudsley hospital. That is no way to deal with somebody with a disturbing illness.

Secondly, I had a very distressing case a couple of years ago of a father who had killed his own daughter. She had asked him to kill her because of her mental illnesses. She had just been thrown out of a local mental hospital. The help that she needed was not there, and the system failed her. That was a deeply tragic case, and the trouble is that there are too many such cases all over the country.

Whatever the Minister and the Government may say, mental health services remain the Cinderella service of the NHS. I was pleased that the hon. Member for Twickenham gave the figures. We know that extra money has gone into the NHS across the board in large portions, quite rightly, and that extra money has gone into mental health services, but the percentage of NHS funding going to mental health services has fallen during the past 10 years—it has not increased. That can only help to compound the stigma that is attached to mental illness.

I believe that every Member mentioned problems with deficits. Mental health was last in the queue to benefit from the Chancellor's largesse, and now it is first in the queue when services are being asked to hand money back to pay for deficits in other parts of the health service. Mental health is suffering a double whammy: mental health trusts had to tighten their belts because of the present funding crisis, and they have to tighten them a second time to bail out other parts of the NHS. That really is not fair. Louis Appleby, the mental health tsar, said that acute trusts should be ashamed for taking money from underfunded mental health services. The Government have admitted that that is happening, but they must do something to ensure that it does not happen even more in the future.

As I said earlier, vacancy rates among mental health professionals are much higher than for the rest of the NHS, and there is a postcode lottery for services, particularly in talking therapies. Several Members mentioned the lack of availability of talking therapies such as cognitive behavioural therapy. The hon. Member for Twickenham was absolutely right to mention the depression report and the excellent work of Lord Layard. From an economic perspective, funding such services makes sense—the numbers add up. More than 1 million people are on incapacity benefit for a mental illness-related problem. A relatively short course of treatment, which would involve a relatively small amount of money, would have a success rate of around 50 per cent., as calculated by Lord Layard. We could get those people back into the economy and into employment, at great personal benefit to themselves and to the state and the NHS budget, so it has to make enormous economic sense.

We heard some interesting contributions in addition to those made by the hon. Member for Twickenham, who opened the debate. Susan Kramer, who is no longer in the Chamber, spoke in an intervention about the Cassel hospital. It is unfortunate that she did not elaborate on that. I visited the Cassel hospital a little while ago. It is worrying that that excellent institution is facing a funding squeeze at the moment, particularly for the work that it does with mothers facing mental health problems—often being able to keep them with their babies. One in six women will suffer from depression around the time of a pregnancy. That is a largely unseen mental health problem, but it has enormous consequences. Four out of five women with babies are admitted to psychiatric hospitals without them. That can only engender greater distress in those women. The Cassel hospital has made great strides in being able to keep families together.

I reiterate the praise that Mr. Smith gave to staff and volunteers. There are enormous challenges and pressures for the staff working in mental health trusts around the country. We have some excellent mental health voluntary organisations, such as Rethink, SANE and MIND, which do fantastic work for the sufferers of mental illness.

Hon. Members were right to say that there is a continuing stigma attached to mental illness. I was interested in a local project in Oxford that the right hon. Member for Oxford, East mentioned, particularly as it deals with treating personality disorders, with therapeutic benefit, on, I would guess, a voluntary admission basis in many cases. However, the proposals in the Mental Health Bill for people with personality disorders would regard those people as largely untreatable. It is for that class of patients that the Government are now introducing community treatment orders, with no empirical evidence to underline their efficacy. There is no research internationally to suggest that such things work. The right hon. Gentleman's constituents who are benefiting at the moment from the great advances and innovation in mental health treatment, particularly for personality disorder, could be subject to those community treatment orders. Nothing would deter them more from presenting in the first place for therapeutic treatment than the fear that they may be subject to some degree of compulsion. After last night's debate, we face the bizarre prospect of Ministers saying, "We must have more compulsory treatment to guarantee treatment for those patients". However, the compulsion is on the patient to receive the treatment, not on the mental health trust or the providing authority to provide it. The Government have got their priorities wrong.

I am worried about the sort of projects that the right hon. Member for Oxford, East mentioned, which are doing great work on a pilot basis, although funding is not guaranteed. For those projects, the prospect of people turning up in future could be greatly imperilled by coercive measures, which this Government seem hellbent on pushing through the House, that are having great ramifications outside.

Mr. Clegg mentioned problems in his constituency with the deficit crisis. I know Sheffield well and I know the problems with the health service there. Too much is being done in the name of reconfiguration. In Sheffield there is a rather vague reconfiguration to save money, which is really what it is all about. The hon. Gentleman mentioned prisons and he was right to do so, because the state of mental health in our prisons is an absolute scandal and is highly counter-productive. There are large numbers of prisoners suffering from mental health problems and there is a lack of integration to get them sorted out mentally before they can be properly rehabilitated and not reoffend. It is worse in young offenders institutions. I visited the young offenders institution in Feltham just a couple of months ago, where a lot of impressive work is going on. Again, though, it is a deeply depressing place. A lot of work is being done to try to address the mental health needs of young offenders there. The recidivism rate for young offenders who are sentenced to jail terms of less than 12 months is 92 per cent. A lot of that is due to not dealing with the underlying problems that may have led them to get into crime in the first place.

The hon. Member for Twickenham mentioned the problems of dual diagnosis. It is ridiculous that we do not have better inter-agency working, so that while we may be able to deal with a person's mental illness we cannot deal contemporaneously with their alcohol or drug misuse problem. The two things are closely linked and we need far better progress on dual diagnosis. Whether the hybrid prisons will do anything about that I do not know; it sounds to me like another soundbite from No. 10, which the Prime Minister may hope will form part of his legacy, but which will not amount to much.

Mr. Olner, you are right to say that hon. Members have raised many questions about mental illness, which the Minister needs to answer. I ask her in particular to give detailed indications of what will happen to the CBT pilot projects in Newham, which I visited recently, and in Doncaster. There are fears that those will not carry on, despite the fact that they do great work. I should like her also to comment on the lack of progress in dealing with the black and minority ethnic community given that Matilda MacAttram, director of Black Mental Health UK, said recently:

"Absolutely nothing has changed for black people over the last 12 months".

She also commented:

"The 2006 Bill as it is currently drafted will make this situation a lot worse. This calls into question the Government's commitment to address race issues within mental health services."

Many people in the black and minority ethnic community suffer disproportionately from mental illness. They suffer particularly from being disproportionately subject to sectioning and other coercive treatment, and the Government need to take that far more seriously.

There are many other things that we could say in a mental illness debate. I am glad of the opportunity to air problems within the mental health community and I shall not recount again the problems affecting young people and children, one in 10 of whom will now suffer some form of mental illness, with one a day in the past few years being admitted to highly inappropriate and intimidating adult mental health wards. As the Children's Commissioner for England said recently:

"It wouldn't surprise me if children leave adult wards worse than when they went in. Putting children in an age-appropriate and developmentally appropriate environment can only be better for them."

Mental health needs to be a far greater priority than it currently is in the NHS and the Department of Health. It is a false economy not to make it a greater priority. It is one of the most challenging ticking health timebombs that we face in westernised countries. It is a particularly false economy not to take the subject of young people with mental illness more seriously. I hope that at last the Minister will treat that as a priority. She might start by guaranteeing that the Government will restore mental health funding in the NHS to the level that she inherited in 1997, which was much higher, in percentage terms, than it is now.

Annotations

molijana
Posted on 18 Apr 2007 5:26 pm (Report this annotation)

With regards to the Draft Mental Health Bill, I see the Police Federation, did not give oral evidence to the Scrutiny Committee.

Surely it is vital that we hear from the Police, this Bill will have huge repercussions on them, and the Public.

An increase in the use of 136 sections will be inevitable. (This is of great concern to me having been 136 sectioned. My first and thankfully only encounter to an incredibly frightening system.)

Should this Bill go through far more resources are required. For instance I am aware that cadets In West Kent are only given an hour and a half of diversity training. This is nowhere nearly sufficient, if this Bill goes through we must have an intensive training for not only cadets but for all our bobby's on the beat.

Are the Police preparing for the rise in 136 sectioning, and is it possible to track down the figures for these sort of detentions. I believe that they are held by the Home Office. This must have been researched, so could we get the prediction figures for the next few years? As we should be prepared for the true impact of this Bill.

What is the opinion of the Police?

Are they getting adequate Mental Health training across the country?

A place of safety is not a Police cell....