National Marriage and Mental Health Awareness Weeks — [Sir David Amess in the Chair]

Backbench Business – in Westminster Hall at 1:30 pm on 16th May 2019.

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Photo of Fiona Bruce Fiona Bruce Conservative, Congleton 1:30 pm, 16th May 2019

I beg to move,

That this House
has considered National Marriage and Mental Health Awareness Weeks.

It is a pleasure to serve under your chairmanship, Sir David. This year, National Marriage Week and Mental Health Awareness Week fall at the same time—this week. I am grateful to the Backbench Business Committee for allowing debate time to explore the connection between these two issues.

Increasingly, evidence is showing that mental health challenges are exacerbated when we experience relationship difficulties. There is a link between emotional health and wellbeing and mental health and wellbeing. As our most important and closest relationships are within our families, it is not surprising that when they are broken or dysfunctional, there is an increased likelihood of our mental health being affected. Evidence from a variety of sources, which I shall turn to shortly, increasingly demonstrates that.

However, the point of this debate is not just to draw the findings together, but to ask what the Government can do to address the matter through public policy decisions. We are suggesting not that the Government should tell people how to run their lives, but that a little bit of support—often it does not take much if it is provided early enough, whether that means early enough in life or early enough when relationship challenges occur—would help people to build stronger and more enduring relationships and, in turn, help to address the distressingly high level of mental health challenges in our country today, particularly among young people, reaping potentially lifelong benefits for them and benefits for wider society. That, of course, is a key thrust of “A Manifesto to Strengthen Families”, which was launched a year and a half ago here in the House of Commons and which has the support of more than 60 Conservative MPs as well as colleagues from other parties. Some are here today, and I thank them for attending.

At this point, I want to thank the Government, because they increasingly recognise the importance of addressing these issues. They are, for example, addressing poorly functioning relationships through the troubled families programme. The Department for Work and Pensions publication from a couple of years ago entitled “Improving Lives: Helping Workless Families” resulted in £39 million of funding for the reducing parental conflict programme, which focuses specifically on the couple relationship and on conflict that falls below the domestic violence and abuse threshold, but which means that parents need help to communicate and relate to each other. There is increasing recognition of the need to improve inter-parental relationships, as a primary influence on children’s long-term mental health and future life chances. I therefore welcome what is being done. Of course, it is geographically limited and, in terms of funding, will not reach all those who need the help and need it now.

It is also encouraging that the Government have committed some £90 million to addressing mental health problems in young people—probably, my right hon. Friend the Minister for School Standards tells me, with a particular view to providing mental health nurses in schools. However, the impact of that investment, as I have said to the Minister, will never be as it could be if those professionals worked not only with the children involved, but with their families. So often, the relationship issues within the home mean that families are the source of the mental health challenges that children bring into school. Unless the whole family are worked with, helping the child in school and then sending them back to the source of the challenges will never resolve the problem.

I want to divert for a few moments and commend a charity called Visyon, which it has been my privilege to be patron of for many years. A mental health charity based in my constituency of Congleton, it supports children and young people from the age of four when they have mental health challenges and it provides help right across Cheshire East and into north Staffordshire.

I am grateful to the chief executive for providing me with some pointers for today’s debate, which I shall summarise. The document states:

“The Government’s Green Paper, Transforming Children and Young People’s Mental Health Provision, recognises the important role that the voluntary and charities sector will play in the formation and delivery of support to schools and colleges. With an ever increasing demand for specialist NHS mental health services for children and young people, it will be vital that schools are able to identify the most appropriate interventions or services to prevent the escalation into costly specialist provision, where possible.”

I shall refer to one area of intervention where the charity works as a priority, which is with parents, but first I shall give a few statistics from Visyon. It says that three in four mental illnesses start in childhood, 75% of young people with a mental health problem are not receiving treatment, and the average wait for effective treatment is 10 years. It also says that UK funding for mental illness research equates to just £8 per person, compared with £178 for cancer and £110 for dementia.

The document that I have from the charity states:

“Visyon’s approach is to look at mental health holistically and provide interventions that involve and impact on all aspects of the…young person’s life…When a young person is struggling with their mental health it has a huge impact on the whole family. Parents are often desperate to support their children but…end up feeling lost, isolated and under skilled…At Visyon we approach our mission to improve a child’s mental health in a holistic way…parents can be a child’s biggest resource.”

Visyon runs a “Parent Empower Hour” programme and states that in a recent evaluation of it,

“parents were asked how family dynamics had changed since taking part in the group. Comments included ‘Our house is so much calmer. I feel less angry and overwhelmed’
and ‘I have found even ground now. I feel more in control and I know this is what my daughter needs’.

There is a conscious focus in Parent Empower Hour to encourage parents to look after their own wellbeing. This serves two purposes—it is important to model to children the importance of self-care and it recognises the emotional toil of caring for children who are struggling with their mental health. One parent commented ‘I have learned to look after myself more and not feel guilty about it. This makes it easier to cope when difficult situations arise.’”

It is encouraging that the Government recently launched their new relationships and sex education in schools curriculum, which requires an emphasis on building healthy relationships. The regulations recently passed by both Houses require that pupils learn about the nature of marriage and civil partnerships and their importance for family life and the bringing up of children; safety and forming and maintaining relationships; the characteristics of healthy relationships; and how relationships can affect physical and mental health and wellbeing.

I am delighted that my right hon. Friend the Secretary of State for Education has made the points for me in his foreword to the documentation that launched this. In his foreword to the guidance, he says:

“In primary schools, we want the subjects to put in place the key building blocks of healthy, respectful relationships, focusing on family and friendships, in all contexts, including online. This will sit alongside the essential understanding of how to be healthy. At secondary, teaching will build on the knowledge acquired at primary and develop further pupils’
understanding of health …Teaching about mental wellbeing is central to these subjects, especially as a priority for parents is their children’s happiness.”

I welcome all that the Government are doing, because that work is crucial, but much more needs to be done. We need to recognise that, just as fractured family relationships can affect the emotional wellbeing and, in turn, the mental health of us all, the impact on the mental health of children growing up and experiencing poor or broken family relationships from an early age can be lifelong.

How can Government help people in the earliest stages of life? I will review a number of recent studies on this issue, not all of which come from organisations that have what might be called a vested interest in the subject. Relate—the relationship people—cites the Early Intervention Foundation’s statement that the inter-parental relationship is a “primary influence” on children’s life chances. In particular, frequent and intense unresolved inter-parental conflict is highlighted as a key factor affecting children’s long-term health and wellbeing.

A 2017 Office for National Statistics survey, no less, showed that children aged between two and 16 who are living in families that struggle to function well are more likely to have mental health challenges than are children from healthy, functioning families.

Interestingly, just today The Times has published details of the latest 2019 ONS survey, under the headline:

“The key to happiness? Eat, drink—and be married”.

The article says that according to research published by the ONS just yesterday on relationships, married people gave the highest score when asked to rate their life satisfaction out of 10, as compared with those who are not married. Researchers looking at data from 2017-18 found that marital status has overtaken economic activity—for example, whether someone is in work—as the most important factor contributing to happiness after good health. That is good news in National Marriage Week, and from an unlikely source.

I will turn to other sources. The National Childbirth Trust says that new mothers may experience multiple mental health problems during pregnancy or after giving birth, including post-natal depression, as we know, as well as anxiety, eating disorders, obsessive compulsive disorder and post-traumatic stress disorder, with suicide the leading cause of direct maternal death after the first year following pregnancy. However, the NCT says that there is no requirement in the six-week maternal check, which mainly focuses on the baby, to include a check on the emotional health or wellbeing of the mother. NCT research shows that nearly half of new mothers’ mental health problems are not picked up by a health professional.

Also, as the National Society for the Prevention of Cruelty to Children says in “All Babies Count: The Dad project”, the role of fathers in supporting mothers can have a significant influence on improving the mental health outcomes of mothers after they give birth. Such early support is critical because parental mental health is a key factor in understanding the mental health of children.

Research by the Marriage Foundation found that family breakdown also has a major impact on teenagers’ mental health. Although its statistics showed that one in five 14-year-olds with a mental health problem live in an intact married family, just under double that number—two in five of teenagers with mental health problems—were the children of parents who live apart and had never married.

The Marriage Foundation also recently conducted an evaluation of factors affecting teen mental health, using data from the millennium cohort study of young people who are now aged about 14 or a little older, who were born around the millennium. The Marriage Foundation report suggests that family breakdown is the biggest factor behind the UK’s child mental health crisis. Its analysis of almost 11,000 families found that having parents who split up was the strongest influence on girls’ mental health in their teenage years, with strong links to emotional problems. It was also the joint strongest factor, alongside relationship happiness, in teenage boys’ mental health, with strong links to behavioural problems.

ChildLine’s latest annual review cites family relationships as the second leading reason why children contacted the service to talk. The Samaritans says that divorce increases the risk of suicide, because the individual becomes disconnected from their domestic relationships and social norms, and that those who divorce may experience a deep sense of “emotional hurt”.

The Mental Health Foundation kindly provided me with a briefing for this debate, entitled, “Relationships in the 21st century: the forgotten foundation of mental health and wellbeing”. The Mental Health Foundation says that people who are more socially connected to family, friends or community have fewer mental health problems than people who are less well connected. It also states that, as I have said, conflict within the family environment impacts negatively on the mental health of children within the family, and the negative effects can be felt across the whole of life’s course.

The Mental Health Foundation’s briefing says:

“The family relationship environment in pregnancy, infancy and childhood is of fundamental importance to future mental health. This is only now starting to be fully appreciated as the neuroscience of brain development is becoming known and being seen to support understanding gained through observational studies of human beings and their mental health.”

In this respect, I commend the Leader of the House, because she has set up a working party of Ministers to look at helping families with children in their very earliest years—the first 1,001 days of life. This subject needs to be focused on more closely by Government, so I am very pleased that my right hon. Friend has done that and I look forward to reading her report, which will come out soon, about what Government can do to support those early days, although of course there is a lot more that needs to be done in later childhood, and indeed in adulthood.

The Relationships Alliance concludes that relationships are a vital public health concern, stating:

“Evidence shows that the quality of our couple and family relationships is linked directly to specific areas of public health concern. Such areas include cardiovascular disease, child poverty, alcohol/substance misuse, depression and mental health, obesity/child obesity, children’s mental health/cognitive development, and infant attachment.”

Of course, the first attachment that we make with others is with our parents; that relationship is one of the most important in all our lives. Positive and secure attachment is important for positive emotional and social development, with children being able to adjust better to adversity and change; to use a favoured word now, they are more “resilient”. By contrast, insecure and disordered attachment relationships in early childhood are associated with depression, anxiety, self-harm, suicidal tendencies and post-traumatic stress disorder, among other mental health problems.

Living with parents who divorce before their child is 18 has now been assessed as an adverse childhood experience, or ACE, for that child. Having one or more ACE increases the risk of a child experiencing depression, poor academic achievement, time in prison or sexual violence, among other negative outcomes. As the Mental Health Foundation says, toxic relationships and negative experiences can have a serious impact on a young person’s mental health.

We should bear it in mind that our children are growing up in a country that has one of the highest levels of family breakdown in the world; indeed, the UK now has the highest divorce rate in Europe, such that nearly half of all our teenagers do not live with both their parents. This is a massive issue, as we also know from those who work in schools, colleges and universities, where supporting young people with mental health challenges is now a major concern.

Why am I referring to all this during National Marriage Week? Because it is not just the quality of the parents’ relationship that matters; it is also being increasingly recognised that the stability of the parents’ relationship matters, if that relationship endures through a child’s childhood. That is important not only for the children, but for the adults within that relationship. As the Centre for Social Justice says:

“Family environment is crucial to children’s outcomes. It is the instability and disruption caused by family breakdown, coupled with poor parenting, that is so damaging to their outcomes.”

Therefore, one of the factors that promotes wellbeing is stability in family relationships, and all the evidence shows— we cannot avoid it—that marriage, as opposed to cohabitation, is much more likely to endure and to promote stability. Just one married couple in 11 splits up before a child’s fifth birthday, compared with one unmarried couple in three.

The CSJ produced a substantial new report just last month, entitled “Why Family Matters—A comprehensive analysis of the consequences of family breakdown”. Before I give Members the statistics, and people reject the comments made in that report as the mere opinions of those who have an interest in promoting such arguments, I will clarify the methodology that has been used. These statistics have been calculated using a sophisticated methodology known as logistic regression. I know; I had never heard of it before, either. That means that the influence of other demographic attributes such as gender, age, socioeconomic grade and ethnicity, as well as experience of social issues, are controlled for. The result is that the statistics arrived at are a true reflection, in this case, of the impact that family breakdown has on the life of a young person.

Here are some of the statistics that the report has produced: those who experience family breakdown when aged 18 or younger are over twice as likely to experience homelessness; twice as likely to be in trouble with the police or spend time in prison; almost twice as likely to experience educational under-achievement, not being with the other parent of their children, alcoholism, teenage pregnancy or mental health issues; and more likely to experience debt and living on benefits. Surely those statistics alone should persuade us that Government should be doing much more to address family breakdown. The cost of not doing so is too great, not just in financial terms—although that cost is huge, far more than the £51 billion often quoted for tackling these issues, which are the consequences of family breakdown—but, tragically, in terms of the lost life potential of the millions involved.

The CSJ states that one adult in 10 who experiences mental health issues says that family breakdown was a contributing factor. Put simply, the CSJ says:

“Marriage leads to the better mental health of children. Children of married parents are more likely to achieve at school, less likely to use drink and drugs and less likely to get involved in offending behaviour.”

Marriage reduces the risk of violence and abuse, and the CSJ states that marriage is more enduring and stable than just living together:

“Marriage is directly linked to better mental and physical health amongst adults, the same benefits are not found amongst co-habiting couples. It is specifically a marriage effect.”

This is very much a social justice issue. Better-off people get this; they get married in far greater numbers than poorer people. Poorer people do not marry as much, and therefore are the ones who sadly experience the consequences of breakdown that I have described. That is not social justice, and it is a key reason that we need to address this issue.

Those tragic, heartrending consequences for millions of young people surely cry out for Government to prioritise supporting all of us to build healthy, close personal relationships, just as no one now blinks when Government recommend that we should eat healthier so that our physical wellbeing is maintained and improved. The steps that we can learn for improving our close personal relationships are not that complicated—I will mention a few shortly—but the benefits we can all glean are unquantifiable. If we can strengthen our emotional wellbeing, we can help to protect our mental health. Not just children in school who are learning through relationships and sex education, but all of us who are learning about relationships capability, would benefit.

The term “relationships capability” has been given to me, and very well promoted, by the organisation Soulmates Academy. About two weeks ago, its founders came to speak at a meeting of the all-party parliamentary group for strengthening couple relationships and reducing inter-parental conflict. That organisation says that we have ignored investing in relationships at our peril. It provides courses and helpful advice on relationships capability to individuals and groups, as well as corporate organisations, which increasingly understand the beneficial effect of relationships capacity on productivity. As Soul- mates Academy says, building a stronger relationship need not be complicated; its relationship tips can be summarised as follows:

BE CURIOUS, not critical…BE CAREFUL, not crushing... ASK, don’t assume…CONNECT, before you correct”.

I recommend its website for more information.

The Mental Health Foundation also provides tips for building and maintaining stronger relationships, which again can be summarised. It says that there are five things we can do: make more time to connect with our family; try to be present with them, not always on our phone; actively listen in a non-judgmental way; concentrate on the needs others are expressing; and express our own feelings honestly. It says:

“As a society and as individuals, we must urgently prioritise investing in building and maintaining good relationships and tackling the barriers to forming them. Failing to do so is equivalent to turning a blind eye to the impact of smoking and obesity on our health and wellbeing.”

People are with us. In a recent YouGov poll carried out for Relate, the relationships charity, no fewer than 99% of people agreed that strong and healthy couple relationships are important to a person’s physical and mental wellbeing—I am sure that any colleague in the House would love a poll that was 99% in their favour. That is why Government need to invest much more in helping all of us to develop our relationship capability. Supporting organisations such as Soulmates Academy to do so would be a good start during National Marriage Week. As that organisation says:

“If we agree that our committed, long-term personal relationships &
marriages are actually what anchor us in life and allow us to go on to achieve our potential, what are we doing to invest in them and build skills to develop them?”

We need a national strategic approach to strengthening families. We have a dedicated Minister for loneliness; why not one for relationships? A coherent strategy across Departments, led by a dedicated Minister at Cabinet level, would be very helpful in ensuring that relationships and families were supported at all stages and ages in life, not just when they run into trouble.

Such a Cabinet Minister could promote all the other policies in the manifesto to strengthen families, including the development of family hubs in local communities where that kind of relationship help could be made available. I am pleased to say that those hubs are springing up in different areas across the country, and the launch of the family hubs network to connect the growing number of hubs in local authorities will happen in Parliament’s Jubilee Room on 5 June. I hope the Minister, all colleagues and all those who have come to listen to today’s debate will attend.

Photo of Jim Shannon Jim Shannon Shadow DUP Spokesperson (Human Rights), Shadow DUP Spokesperson (Health) 1:58 pm, 16th May 2019

First, I will say a big thank you to Fiona Bruce for having set the scene. She is always a strong supporter of marriage, and I wholeheartedly support the issues that she brings before this House, whether here in the Westminster Hall Chamber or in the main Chamber. Furthermore, without speaking for the hon. Lady, whenever I bring issues to either Chamber, she is always there to add her support. I thank her for that. She has been very much at the forefront of ensuring that National Marriage Week and the issues of family life and family values are heard about in this House whenever the occasion arises. It is a real pleasure to speak in this debate.

Marriage is a wonderful thing but, like all things of worth, it is not easy. In all honesty—I speak as someone who, on 6 June, will have been married for 32 years—I have a very long-suffering wife. The truth of the matter is that she has suffered long and hard, but she is still there, and that is one of the good things about married life. If my dad had lived another two weeks—he has been dead for four years—he and my mum would have been married for 61 years. They were a long time together, and that is not counting the time they were going together way back in the early ’50s. I have no idea how and why my wife Sandra has stuck me for so long, but I thank God every day that she has.

A strong marriage requires two people who choose to love each other even when there are times they do not particularly like each other. That is the fact of it. If Sandra was here, she would say, “Amen to that.” She would wholeheartedly know what I mean when I say that, because we have some exchanges of opinion now and again. I think it is good to have those release valves. It does not mean we have fallen out; it means we can have differences of opinion. My wife is not politically motivated at all; she only became interested in politics when she married me. The fact of the matter is that whenever I bring up issues to do with politics, truthfully she is perhaps not that interested, but she supports me well and she has an opinion on political matters. She is quick to tell me about those things.

Marriage is tough, and my heart goes out to those who are unable to make things work despite the hard work put in. The reality is that relationships break down. That is a fact, even with the best relationships. No one gets married to get divorced; people get married to spend the rest of their lives together. That is how it happens, but sometimes things happen along the way. As elected representatives—we are all here speaking in this debate as elected representatives—we are probably confronted every day in our advice centres with people who have had marital breakdowns. If they are churchgoers, I genuinely usually say, “Have you spoken to your minister?” If not, I say, “Have you had a chance to talk things through with someone in Relate to see whether it is possible to pull things together?” Sometimes that works. I am not a Relate councillor with great skills, but I try to point people in the direction where some things can be brought together. That sometimes works, but it does not always work. Sometimes when they come to me as the MP, or when they did in my past life as a Member of the Legislative Assembly, things have broken irretrievably. Those are difficult times.

I read an incredibly interesting report by the Marriage Foundation, which had some noteworthy analysis and statistical presentations. Analysis carried out on the millennium cohort study data on 10,929 mothers with 14-year-old children reveals that mental health problems are especially prevalent among children whose parents split up. We have just finished the main inquiry on education in the Northern Ireland Affairs Committee. Some of the figures on education in Northern Ireland are truly scary and worrying. We have the highest levels of anxiety and depression among children of primary school and secondary school age for the whole United Kingdom. That is very worrying. This debate is so important—the hon. Member for Congleton has referred to it—because it shows the importance of having a normal home life. I say that honestly, because having that does in some way help things.

It is incredibly difficult for a child to watch a break-up, and all too often they are in the middle. It happens so often. I thank every parent who makes the determination that, regardless of the relationship status, they will not allow their child to be a pawn or used as a weapon. A story came to my memory when I was sitting here. There was a sad, sad story last weekend in one of the papers. A mother and father were breaking up and they had two children from that relationship. The really sad thing was that neither the mother nor the father wanted custody of the children. I said to myself, “How sad is that?” Neither the mother nor the father felt that the children could be with them and they wanted the other one to have them. I do not know what the outcome of that will be. Sir David, you and I have talks about many things. You are chairing this sitting, so you are independent, but I know that you and I very much agree on the importance of married life and what it does for a relationship and the children that come out of it.

I have three sons from my relationship with Sandra. Two of them are married. The big fella, Jamie, has been married 11 years, and the second married just last year, and out of that comes the grandchildren. We could never get a wee girl—it was always wee boys—but Sandra always wanted a wee girl. She now has two wee granddaughters, Katie and Mia, and just before Christmas a third grandchild was born to my second son, who was married just last year—the product of that is a wee boy called Austin. How much do we as grandparents enjoy the grandchildren, ever mindful that at 7 o’clock at night we can give them back? That is a big, big thing. We get all the enjoyment, smiles and laughter, but when they get tantrum-y and want to go or argue, we can phone up to say, “They’re ready for going home.” That is always something to remember, but I say it because of the enjoyment they give to us as parents.

The findings show that the influence of family behaviour on teenage mental health extends far beyond parental conflict. Family breakdown is the single biggest factor for girls and equal top influence for boys, along with parental relationship happiness. Whether parents are married and happy, and stay together and remain close to their child all make a unique contribution. I believe that parents have a strong responsibility; they need to be reminded that children watch and note their every word, action and deed. Therefore, the role of the parent is critical in setting an example for children in how the family gets on together.

The positive effect of marriage on mental health is clear and there for all to see. It is particularly interesting that the Marriage Foundation study showed that the effect of marriage extends well beyond stability and selection effects. For boys, whether their parents were married when they were born remains one of the two biggest influences on their subsequent overall mental health, even after taking into account their mother’s age, education, ethnicity and relationship happiness when the child was born, and whether the parents stay together. We cannot ignore—and nor can parents—the influence that parents have on their children.

The 2016 report by the Marriage Foundation found evidence that marriage boosts self-esteem for boys and girls. It is good that that happens. The report relied on the data of 3,822 children from the British household panel survey. It revealed that teenage boys living with continuously married parents have the highest self-esteem, while teenage girls living with continuously cohabiting parents have the lowest. The data outlines that the mother’s education has a smaller effect on self-esteem, while the child’s age and the mother’s income have no effect at all. Some of those stats are particularly illuminating because they give an idea of how what happens in the family home can affect children. Although those differences are all relatively small, they are highly significant and provide robust evidence that the wellbeing of teenagers and their future life chances are influenced by whether or not their parents are married. I am not making it up—the stats come from organisations, and they cannot be ignored.

Teens of either sex who live with continuously married parents have higher self-esteem and acceptance than those who live with continuously cohabiting parents or other family types. In outlining all this, I must be very clear: I do not believe that if a family is not united by marriage, a bad outcome is predetermined—it is not; far from it—but I am referring to the findings and how the information was collated. Data shows that children from married families show a higher level of wellbeing and mental health. That should be noted and highlighted.

The institution of marriage, to which I happily subscribe, has stood the test of time, and its benefits to society are clear. I believe that the House must acknowledge that, which is why I am so happy to support my friend, the hon. Member for Congleton, and I thank her for allowing us to highlight that wonderful institution once more. I am someone who is convinced of the benefits of marriage, and in June, my 32 years of marriage will be an example of just that.

Photo of Andrew Selous Andrew Selous Conservative, South West Bedfordshire 2:09 pm, 16th May 2019

It is a pleasure to serve under your chairmanship, Sir David. I congratulate my hon. Friends—they are my friends—the Members for Congleton (Fiona Bruce) and for Strangford (Jim Shannon) on two excellent speeches. It is very good to see the Minister, who I know takes this area seriously. She has responded to other debates of this nature in Westminster Hall, and is a deep and serious thinker on these issues. We are lucky to have her responding to today’s debate.

The debate quite properly has marriage in its title, because it is National Marriage Week, and mental health, but every single Member in the Chamber, myself included, is here for every type of family. We are here for every one of our constituents, whether they are married, single, cohabiting, widowed or divorced—whatever their state. It is important to put that on the record, because occasionally such debates, and this issue, can end up in an unnecessary culture war. We have moved on. As MPs, we are for absolutely everyone. However, it is also right that at least once a year we come to the important issue of marriage.

On the cross-party consensus, I was really encouraged, as the vice-chair of the all-party parliamentary group for the prevention of adverse childhood experiences, that I, as a Conservative, could sit down recently with a Labour Front-Bencher and a Liberal Democrat MP. The three of us, from different parties and traditions, were united in wanting to do more to promote couple stability, because we understand the links with inequality and poverty. I think all three of us would describe ourselves as true social justice warriors, as the hon. Member for Strangford mentioned. It is really important to put that on the record.

In 2016, 47% of all children in single-parent families were living in poverty. Frighteningly, the Resolution Foundation recently predicted that children in single-parent families will make up two thirds of all children living in poverty. Like every Member in the Chamber, I came into this House to eradicate poverty. That is the heart of what our politics are about. If children grow up in poverty, they do not have the life chances that we all want for them. They cannot make the most of their God-given gifts in terms of their education, career and contribution to their community.

I will focus on why this issue matters to Members in every party—the Scottish National party, the Democratic Unionist party, the Liberal Democrats, Labour and the Conservatives. I want us all to be united on this. We need to get behind the family/relationship aspect of poverty if we are serious about engaging with social justice issues and tackling poverty.

Given the fairly terrifying figures—currently, 47% of children in single-parent families are in poverty, which is predicted by the Resolution Foundation to rise to two thirds—we know that we want to try to keep mum and dad together in order to keep children out of poverty. Why, however, does marriage matter, and why have a debate on it? Is it not just another structure among many?

It matters for this reason: sadly, unmarried couples are six times more likely to break up before their child’s fifth birthday. If we are all on the same page in wanting to tackle poverty and reach a serious, evidence-based recognition of the fact that family breakdown, and the increasing numbers of children in single-parent families, is a major contributor to child poverty, we need to look at the type of relationships that will give our children the best chance of not growing up in poverty.

At this point, the argument is always challenged. “Okay, those are the facts,” people say, “but is that correlation or causation?” In other words, do a particular type of people decide to marry, which is why fewer of them are in poverty? I agree with my hon. Friend the Member for Congleton that we should dig into the data and compare like for like—people living in the same circumstances. I am absolutely assured by the researchers I have spoken to over the years that marriage still has a protective effect against child poverty in low-income communities, which many single-parent families live alongside.

That, in essence, is why marriage matters. If people accept my argument as I have laid it out so far, we need to be concerned about a number of facts. First, the marriage rate itself is in free fall; the figures show that it is really declining. As I said, I am genuinely delighted that today’s Minister will respond, because I know that she cares about this issue. I suspect that she was asked to reply to the debate because of the mental health part of the title. Had the debate been just on marriage, I wonder which Minister the Government would have put forward. I hope that it would have been her; perhaps it would have been someone else.

We might have had the new Under-Secretary of State for Work and Pensions, my hon. Friend Will Quince, as family policy is currently centred in that Department. However, if we are a Government and a Parliament that is four-square behind bearing down on child poverty, this issue needs to be at the heart of Government policy, not tucked away in one or two Departments. To my mind, it should be in the Cabinet Office, and there should be regular accountability through the Cabinet Office of all Government Departments on what they are doing in this area.

Statistics from the Office for National Statistics show that the marriage rate is in free fall. However, it is even worse than that because, as my hon. Friend the Member for Congleton said, marriage rates among the better off are holding up quite well. A company director or university lecturer is 48% more likely to be married than a building worker or office cleaner, and that gap is growing. In 2000, the gap was only 22%. Basically, marriage is almost completely disappearing from low-income communities. We have to call a spade a spade and recognise that fact.

I am really pleased that there are Labour Front Benchers who understand that fact and are concerned about it, because if we are to bear down on child poverty, we have to use every tool in the kitbag. Certainly, the Government, the welfare system, schools, youth clubs, community groups, the voluntary sector, the health service and all manner of different central Government and local government institutions have a role. However, we cannot ignore what is happening in our families up and down the country if we are really serious about this issue. The Marriage Foundation tells us, in a similar statistic put another way, that 87% of mothers from high-income groups get married, as opposed to only 24% from the lowest-income groups. We have to do something about that.

I am grateful to Tavistock Relationships for the briefing that they gave me for the debate. Its representatives sent me some research from Paul Amato, who they say is generally recognised as one of

“the world’s leading researcher on marital quality, divorce, and other family related issues”.

His research has shown that common mental health problems are much

“more prevalent in people who are experiencing relationship distress than those who are happier in their relationships”.

He warned against viewing marriage and cohabitation as interchangeable, stating that

“we should consider the fact that cohabitations are less stable than marriages”,

as I pointed out a moment ago.

Tavistock Relationships has a particular ask of the Department of Health and Social Care, because it believes that the huge overlap between relationship distress and depression is being largely ignored by the NHS. It points out that within the excellent IAPT— improving access to psychological therapies—programme, only 49% of the relevant NHS services provide couples therapy for depression. It is calling for that figure to be increased to at least 90%, although it would be best if couples therapy were universally available. I ask the Minister to take that point back to her Department.

Like my hon. Friend the Member for Congleton and the hon. Member for Strangford, I pay tribute to the many organisations up and down the country that are working hard to strengthen relationship quality and provide relationship support and education. They should be much more prominent in our national life and much better known in Whitehall and Westminster.

In no particular order, let me mention the four organisations that make up the Relationships Alliance: Relate, which is perhaps the best known and the largest, Tavistock Relationships, which I have already mentioned, Marriage Care and OnePlusOne. They are fantastic organisations and are at the front and centre of dealing with these issues and providing support day in, day out. In my view, they need to play a more prominent role in our national life in the fight against child poverty, because they are absolutely part of the solution.

I would like to mention the work of Nicky and Sila Lee, who run the marriage preparation course and the marriage course. I will also namecheck Jonathan and Andrea Taylor-Cummings of Soulmates Academy, which my hon. Friend the Member for Congleton mentioned. I commend them for their recent TED talk on this important subject and for their excellent work, particularly with employers. Many employers are beginning to realise that there is not a watertight seal between what happens at home and at work. Relationship distress and emotional distress at home have an unquestionable impact on performance and productivity at work.

We need the private sector to get a bit more engaged in the issue, because it is not just about the Government. Everyone always asks the Government to do everything, and while the Government have a role, employers and those in the private sector need to get with the programme and realise that they have a role to play too, alongside the community and the voluntary sector.

I will make a silly analogy that some colleagues will have heard before. I would guess that most of us in this Chamber own a car. It is the law that every year we have to give that car an MOT. We spend time and money taking it to the garage and having someone check under the bonnet so that the car is serviceable to go back on the road for another safe year’s motoring, which is the object of the exercise—and quite right, too. Should not our relationships and marriages have the same treatment? Are they not just as important?

I use the phrase “marriage MOT” or “relationship MOT”. Some people may have done a little preparation before getting married, but will that last a lifetime? In my own marriage, I have got into bad habits and have had to be corrected by my wife or by good friends. I have gone on marriage MOTs from time to time with my wife and with other couples, and have found them helpful. We should try to make that more normal and mainstream. It is not just about therapy, but about something that all of us need: a little advice and assistance to get out of bad habits and maintain good ones. I am grateful to my hon. Friend the Member for Congleton for mentioning some of the practical things that are involved.

Research shows that the No. 1 reason why children present at child and adolescent mental health services is family relationship issues at home. The hon. Member for Strangford spoke about the huge growth—the epidemic—in children’s mental health issues, which can extend until they are university students. Recent studies have shown that a quarter of all young women at university and in their early 20s experience some form of mental health issue. Very often, family relationships are at the core of those issues.

I will conclude with a quotation from an excellent article by Ed West that appeared in The Spectator in December 2017. The Spectator is not a magazine that I read very regularly, but I commend the article to anyone who is interested. I will read out his final paragraph, because I found it so striking. On the subject of marriage, he writes:

“How much does the government care? The answer is not very much. About a decade ago, David Cameron said he’d be the most pro-marriage leader the Tories have had in his lifetime, but his enthusiasm cooled quickly.”

Actually, I think that the last Prime Minister did some good things in the area. I would have liked him to do more, but I think that that criticism is a little harsh. The article continues:

Jeremy Corbyn is unlikely to be talking about family values, which is a shame because a true social justice warrior would be obsessed with this issue. Marriage is becoming a luxury item, a trend that is likely to cause ever-increasing inequality down the generations. Any government that is genuinely concerned about helping those at the bottom should think about what it could do to make marriage for the many, not the few”— a phrase that perhaps the Labour party could think about. I think that those are powerful words on which to conclude my speech.

Photo of Patrick Grady Patrick Grady SNP Chief Whip 2:26 pm, 16th May 2019

In some respects, it is nice to have a slightly relaxed atmosphere in Westminster Hall, because that gives us the opportunity to consider issues in detail. I congratulate Fiona Bruce on securing the debate. It is a happy coincidence of the calendar that Marriage Week and Mental Health Awareness Week have fallen on the same dates, because that allows us to consider how marriage and mental health relate to each other. We should also note the general importance of awareness weeks and the work of the organisations that support them, because they give us an opportunity to raise issues in the House and press the Government on their commitments.

I congratulate the Marriage Foundation on promoting Marriage Week, which I believe has been marked for the past 22 years—not quite as long as Jim Shannon has been married, but not far off. I also congratulate the Mental Health Foundation, which has worked on mental health issues for more than 70 years. I am actually wearing a tie with the mental health tartan, which was developed by Support in Mind Scotland as a colourful way to promote mental health awareness and understanding.

As we have heard, Marriage Week is all about the ingredients of positive and healthy relationships, which are at the heart of a successful and vibrant society. Families and relationships bring meaning and purpose to people’s lives, and they come in all shapes and sizes, as Andrew Selous said. Governments have a responsibility to support them by providing good-quality public services and fair work practices to ensure that people can live healthy and fruitful lives. When people feel supported by such services and by a positive sense of community, relationships can flourish. That is an ambition of all Governments, no matter what their political character may be or in which part of the United Kingdom they may operate.

It is right to stress that not all marriages are happy or end as happily as they began. It is important to have services and support in place to help those partnerships to move forward as positively as possible. In Scotland, a lot of support is provided to national family support organisations, such as Relationships Scotland and The Spark. As the hon. Gentleman also said, that importance is particularly true in making sure that the support is there for children, whether mental health support or mediation.

As the hon. Member for Strangford said, people present at our surgeries and we, as Members of Parliament, have an individual responsibility to signpost people to the right organisations and to be aware of the range of support services available nationally and in our communities.

Marriages come in all shapes and sizes, and Scotland was of course the first country in the United Kingdom to consult on same-sex marriage and subsequently to legalise it, through the Marriage and Civil Partnerships (Scotland) Act 2014. That has been a cause of great celebration, including among close friends of mine.

Not every marriage, however, is made through free choice. That is why we must also recognise the importance of having robust legislation in place to protect against the appalling practice of forced marriage and to ensure that marriage is not a misery or a trap. The Scottish Government introduced forced marriage protection orders to protect people from being forced to marry, or who were already in a forced marriage. In September 2014, that protection was extended to protect those at risk and to make forcing someone into a marriage a criminal offence in Scotland.

By coincidence, there was a particularly high-profile exponent of marriage in the news last week. The First Minister of Scotland, Nicola Sturgeon, gave an interview to her local station, Sunny Govan Radio. She was asked what had surprised her in recent years, and she said her marriage had surprised her:

“I had always been a bit of a feminist and never really considered marriage as an option. When Peter and I decided to get married, it was immediate how much more strong and stable I felt knowing that I had him at my back. His support and the support of my mum and dad give me the resilience and strength to keep going every day and doing my best.”

I hope those are words of encouragement to everyone who is considering marriage. Nobody is an island. None of us politicians is an island. We all have colleagues who have experienced difficulties and intimidation. When you are the one person in a room standing up speaking, that is difficult for any one of us. For most of us, it is the knowledge of the strong relationships in the background, whether marriage or other forms of partnership, or friends and family, that provides that support network that we rely on.

That point links to the importance of Mental Health Awareness Week. The First Minister went on to speak about some of the challenges and stresses that come with life in the public eye, particularly her experience of imposter syndrome. When asked if she ever feels like an imposter, she said:

“Like many women in senior positions, yes I absolutely do. However, I think it gives women a bit of humility too and reminds you that you have to work hard for what you need to achieve. It keeps you grounded. Do I deserve this? Could I do better? It makes you more accountable for your own work.”

That level of self-awareness and her willingness to speak out should be an encouragement for everyone in public life and beyond. It is important to use such opportunities to raise awareness of the issues.

The main focus for Mental Health Awareness Week this year is body image—a subject that has become topical in the last few days with the issues that led to the cancellation of “The Jeremy Kyle Show” and questions about “Love Island” and other reality TV programmes. Sometimes, frankly, this job can feel like a bit of a reality TV programme, though it is less likely to be slated for immediate cancellation. Using the opportunity of awareness weeks to turn the debate on social media around and to try to detoxify online culture is hugely important. We must support people who champion body positivity online and make sure that people who are struggling with those kinds of issue, especially young people, interact with social media content in a healthy way and avoid falling into mental spirals.

The Scottish Government have made several announcements to try to support that this week. They are setting up an advisory group on healthy body image, which will include members from youth, third sector and equalities groups, to identify steps that can improve support for young people and advice for relevant professionals. That will build on a package of measures to improve young people’s mental health, including £90,000 in funding to provide advice on the healthy use of social media and screen time, and a review of evidence on the effects of screen use on sleep and its implications for mental health.

We will continue to drive that forward and, again, I hope there will be lessons that the Governments can learn from each other. The hon. Member for South West Bedfordshire spoke about how such issues can be championed in Government. The Scottish Government have a dedicated ministerial post for mental health. The occupant, Clare Haughey, was herself a mental health nurse and brings significant personal experience to the post. The desire to see mental health issues mainstreamed across the NHS and other support organisations runs right across the national strategy.

Like other hon. Members, I see fantastic examples in my own constituency. The members at Flourish House, part of the global Clubhouse Network, presented me with this tie the last time I met them. They wanted to engage with me on different aspects of how Government and public policy affect people with mental health issues, particularly on questions around welfare reform, but also other aspects of social care and the health services. Flourish House does a fantastic job in reducing social isolation and providing different kinds of activity and engagement for its members. Similarly, the Coach House Trust provides a particular focus on employability and skills. It has been doing so for more than 20 years and has an annual open day that is a highlight of the summer calendar. We are always spoilt for choice with the arts and crafts available for sale that have been produced by their members over the years.

I also pay tribute to a group called Differabled, which was founded by parents in my constituency to provide support for other parents and carers of children and young adults with a range of additional support and mental health needs. I met them during the 2017 election campaign and it was an incredibly powerful experience. The way that organisation has developed is incredibly impressive, and I continue to support it.

The Glasgow Riding for the Disabled Association helps to promote the mental health benefits of physical activity and physical exercise in different ways. It was the beneficiary of the Christmas card competition that I ran in my constituency last year. Last year and the year before, the winners of the competition came from two of the schools that provide support to children with additional needs and mental health issues. East Park in Maryhill has been supporting young people since 1874, and Alexander Houston was a worthy winner of last year’s competition. Abercorn Secondary School, which is supported by the local authority, provides a fantastic supportive environment, and Jack Slavin’s Christmas castle featured on my card in 2017. Kelbourne Park Primary School, in North Kelvinside in my constituency, supports younger age groups in a wonderfully nurturing environment. I use this opportunity to offer them my full support.

There has been a fair degree of consensus in this debate, particularly on the importance of stability in relationships for good mental health, and the benefits that that has for wider society in promoting social justice and tackling poverty, and the many different things that, in our different capacities, we all came into politics to try to achieve. There is a challenge to the Governments in the United Kingdom and the devolved nations to ensure that adequate funding is in place for the different services and that the appropriate legislative frameworks are in place to support families and the various organisations that work with them.

I hope the Chamber will indulge me, because on 1 June, during the recess, I will be attending a wedding of two very good friends of mine, Emma and Adam. I have known Adam Sutherland since we were very young. Of course, people are a bit older when they get married these days, so their chances of being married for quite as long as the parents of the hon. Member for Strangford probably depend on a variety of factors, but the strength of their relationship will be a solid foundation for many long years of happiness, and I hope the Chamber will join me in wishing them all the best.

Photo of Barbara Keeley Barbara Keeley Shadow Minister (Mental Health and Social Care) 2:40 pm, 16th May 2019

It is a pleasure to speak in this debate with you in the chair, Sir David. I congratulate Fiona Bruce on securing the debate, and I thank hon. Members who have contributed to mark this unusual mix of Mental Health Awareness and National Marriage weeks.

Many points have been made on the value of marriage and family life, including in the excellent opening speech by Jim Shannon—I think I beat him by two years in how long I have been married. Happy anniversary for each of our relationships. Andrew Selous focused on family relationship issues and poverty, and the role of family breakdown.

In line with my brief, I want to bring this debate back to mental health, because it is Mental Health Awareness week and we could explore some issues there, too. I feel that, no matter how strong a family are, there will be times when they need support from outside—when they need the services that the state can provide to help them to cope. If those services are not there when they need them, it can cause immense strain for everyone involved. This is every bit as true for mental health as it is for physical health services.

We do not expect families to cope with a broken leg or a cardiac problem on their own, so we should not expect them to cope with depression or an eating disorder without professional support. I want to question whether we really are doing all we can for families where one child is living with a mental health condition and they need help. Whatever our best intentions, the fact is that we are not yet doing the best we can for children and families.

According to the British Medical Association, spending on mental health care equates to only 11% of our UK NHS budget, despite accounting for 23% of the burden of disease in the UK. As we know, there is increasing demand for mental health care, with patient numbers increasing across a range of conditions. It might be time to look at that number and decide whether it should be greater, particularly for children and young people. We know that one in eight five to 19-year-olds has a least one mental disorder, but that only 6% of the mental health budget is spent on services for children and young people. I believe it is time we questioned that, because such a gap has serious consequences for children and young people with mental health conditions.

Some 400,000 children and young people who have a mental health condition do not get to see a professional at all. Instead, they have to cope with informal support. More than one in four of the children and young people referred to specialist child and adolescent mental health services in 2016-17 did not have their referral accepted. As the Children’s Society analysis showed us last year—it is a very disturbing statistic—a quarter of 14-year-old girls and nearly one in 10 boys had self-harmed in a year.

I commend Sky News and their reporter Paul Kelso for a great piece of investigative work that sheds light on the experiences of children and young people in private mental health units, many of which take young people hundreds of miles from their homes and families. The report of this work was shown yesterday. One such young person is Natasha, who is now rebuilding her life after a lost decade spent in such units. Natasha has anorexia and escalating self-harm, and she hit crisis point when she was only 12. She then spent 10 years in private mental health units dotted around the country. She says she reached her lowest point in a mental health unit in a privately run hospital in Maidenhead. In that unit, she experienced brutal restraint, which she describes as follows:

“They would pin you up against the wall, smack your head against the wall, drag you across floors, wrap you round doorframes...People sat on your head and on your legs…this would be big men, not women.”

That was the unit where she said she did

“the worst amounts of self harm” that she had ever done in her life. Despite Natasha’s history of self-harm, she was left unattended with razors and cut herself 26 times. She needed 200 stitches.

The constant threat of self-harm is a massive strain and worry for parents when their daughter is hundreds of miles away. A mother with a daughter in one of the units that was shown in the Sky News film described how when she wakes up she thinks, “Is she all right? Will she manage to achieve her self-harm aim today?” She added, “You are hundreds of miles away. If anything happened, you would not get there on time.” As the Sky News report showed, the toll of self-harm and suicide in these units is too high. Natasha explained how she lost 24 of her friends to suicide in such mental health units, including three or four in one unit alone.

Hon. Members here today will know how it feels when a desperate constituent tells us about their child’s mental health condition and the struggle they face being unable to get their child access to the services they need. This is intolerable. We have seen mental health services being underfunded—I know the Minister will tell me about the future funding that is coming in, but we have to think about where we are today—and we know that mental health budgets fell by nearly 8% between 2010 and 2015. Sadly, we are still seeing one in 10 commissioning groups unable to meet the investment standard expected of them by the Government, which means they are failing to give mental health services the funding priority they need. We must do better than that.

In 2017, Labour set out a clear plan for how we would do better than that. I want to touch on those points. Over the past decade, mental health spending has been a part of broader NHS budgets, but as budget pressures emerged, NHS trusts and commissioning groups raided their mental health budgets to prop up services elsewhere. To that end—I know the Government have not been keen on this—Labour would ring-fence mental health budgets, which is important to ensure that the money that those services need is not siphoned off to fill gaps elsewhere.

As we think about children, young people and their families, it is important that we question why only 6% of mental health spending goes to services targeted at children and young people, despite them making up some 22% of the population. Labour would dramatically increase the proportion of the mental health budget spent on children and young people.

Following on from what I said about yesterday’s Sky News programme, we would end the disgraceful practice of sending people hundreds of miles for mental health treatment when there is no good reason to do so. In the past year, sadly we have seen the number of inappropriate out-of-area placements rise from 640 to 720, despite a Government pledge to reduce their use. I see these out-of-area placements as a tragedy for families. They jeopardise the recovery of people receiving treatment and force parents and other family members to travel long distances to support the young person. With Mental Health Awareness Week, let us not persist in treating mental health as the Cinderella service of the NHS, and children and young people’s services as the Cinderella service inside that Cinderella service.

My plea is this. Let us help children and young people in need at the time of their need, rather than making them wait 18 months to get specialist support or letting them end up in very long-term placements in locked mental health units far from home. Let us do something about the fact that the number of autistic people detained in inappropriate in-patient facilities on dubious mental health grounds remains stubbornly high, and includes a rise in the number of children in what have been seen as modern-day asylums. Let us do better. We can do better than this for our children and young people and their families.

Photo of Sir David Amess Sir David Amess Conservative, Southend West

Just before the Minister responds, I should have announced at the start that, because the second debate was cancelled, this debate could actually continue until 4.30 pm. I will leave it with hon. Members.

Photo of Jackie Doyle-Price Jackie Doyle-Price The Parliamentary Under-Secretary for Health and Social Care 2:48 pm, 16th May 2019

Thank you, Sir David. I am sure you do not want to listen to me until 4.30 pm; in fact, I know very well that you do not. It is a pleasure to be here with you this afternoon.

I have really enjoyed listening to this debate. There have been some compelling arguments on a subject that we do not really discuss very often, yet it is the foundation of our society. This debate is a welcome opportunity to do that. Certainly, listening to all hon. Members’ remarks, I was given considerable food for thought, so I shall do my best to address the points that were made. I congratulate my hon. Friend Fiona Bruce on securing the debate and on having the imagination to bring together National Marriage and Mental Health Awareness Weeks.

My hon. Friend Andrew Selous talked about who might have responded to the debate were it not for the reference to mental health, which is an interesting question. Various Departments have an interest, including the Department for Work and Pensions, the Department for Education where the issue affects children, my Department where it impacts on mental health, the Ministry of Justice where it might lead to offending behaviour and the Ministry of Housing, Communities and Local Government in so far as it might lead to addiction.

This all comes back to the state delivery of services and how it tends to rely on a uniform process, yet we are dealing with human beings. If they require support, a one-size-fits-all, tick-box approach will not necessarily be effective in all cases. To be honest, when we see people whose adverse childhood experiences have led them to harm either themselves or others, I view that as a state failure. Perhaps we ought to look at the drivers of child poverty and see whether we can ensure a more effective Government response. When I sit on various cross-departmental working parties looking at domestic violence, mental health or knife crime, I often think they could all be brought together to look more holistically at the children who need early intervention. We need to get much better at that.

Obviously, how we raise our children and family relationships are crucial to how they turn out. We know that for some people, particularly those living in poverty or with an addiction or those who suffer stress, life can be hard. It ought to be available to us to give people extra help. My hon. Friend the Member for Congleton referred to the troubled families programme in her opening remarks. The ethos behind the programme was to support the families that needed extra help. We need to learn from that programme to see what works best so that we can do things better. That is very much in our thinking.

My hon. Friend also talked about some of the initiatives that we are already taking with respect to mental health and highlighted the new mental health teams that we are creating. She suggested that the teams need to work not only in schools but in families. Sir David, you heard me speak about the Charles Dickens primary school in Southwark in another meeting. I visited it as we were developing our thinking on the new support teams, and it had taken a very imaginative approach to embedding mental wellbeing throughout the school and the curriculum. Instead of having teaching assistants in the classroom assisting, the teaching assistants were doing one-to-one interventions with children. As well as one-to-one tuition, some of them were involved in reaching out and building relationships with the parents. Our school network is exactly where we ought to be able to identify the people who need a little more help.

Photo of Fiona Bruce Fiona Bruce Conservative, Congleton

I am delighted to hear that. I do not know whether the Minister has heard of a similar approach taken by Middlewich High School in my constituency, but what is excellent about that is that the school is now reporting improved GCSE results because it works not only with the pupil, but with the whole family.

Photo of Jackie Doyle-Price Jackie Doyle-Price The Parliamentary Under-Secretary for Health and Social Care

As my hon. Friend says, it is not rocket science. If someone is physically, mentally and socially fit, they will have a feeling of wellbeing overall. If any of those pillars falls down, it drags down the rest. If people have a happy environment at home, they will be happier in school and more disciplined and focused. If they live in a dysfunctional environment, they will want to escape, and that will not be good for their GCSEs or anything to do with their long-term development.

Photo of Fiona Bruce Fiona Bruce Conservative, Congleton

Will the Minister allow me to intervene again? I do not want to interrupt too many times.

Photo of Fiona Bruce Fiona Bruce Conservative, Congleton

Yes, so we have heard from Sir David. Corporates are also realising how important this is to the bottom line: productivity. If people arrive at work having left a happier home, they will be more productive, which is an interesting factor to consider if we multiply it across the nation. It is fascinating that we have one of the highest levels of family breakdown in the world, but also low productivity compared with many of our competitor countries. The Minister touches on that when she talks about the flourishing of a human being in terms of relationships and productivity, which are not disconnected.

Photo of Jackie Doyle-Price Jackie Doyle-Price The Parliamentary Under-Secretary for Health and Social Care

That is a very good point. We can expect employers to start doing things when they can see a return for themselves. It is interesting also that, as we reach higher levels of employment and as an appropriately skilled workforce is harder to come by, employers see the advantage of giving more help and support to their staff in order to retain them and keep them productive. We look forward to seeing more of that. Certainly our work through “Thriving at Work” with Mind, Paul Farmer and Lord Stevenson is designed to share best practice and encourage more.

My hon. Friend also talked about the long waits for children’s mental health services, which Barbara Keeley also talked about. We have to concede that, historically, children’s mental health services have been very poorly funded and supplied, and we are dealing with the aftermath of that now. Everyone knows the extent of our ambition to deliver much improved mental health services to children and young people. However, we still have to properly address the situation that we have inherited. We are playing catch-up, but we will push forward and make sure that children have access to services. The mental health support teams are the first point of contact for children, helping them look after their own wellbeing.

Photo of Barbara Keeley Barbara Keeley Shadow Minister (Mental Health and Social Care)

One interesting point, which I did not make, from the piece of work that I referred to from yesterday is that placements for children and young people in private units of the type that I talked about are more expensive. They can be £500,000, £600,000 or £700,000 a year, whereas support in the community would doubtless not be as much as that. They would not be 200 miles away from the families, and they would have the support that they need.

Photo of Jackie Doyle-Price Jackie Doyle-Price The Parliamentary Under-Secretary for Health and Social Care

I agree completely. The reason why we have so many children in out-of-area placements—which, as the hon. Lady says, are expensive—is that there has not been sufficient support in the community. Nor has it been available early enough to give the children support. They have been badly failed. It has done them harm and made them more ill. The issue of out-of-area placements is of massive concern to me. I am making it a personal priority to fix it. I am concerned that, because it is seen as a specialised area of commissioning for NHS England, it commissions a quantum of beds, but that is what leads to them being out of area, and children are referred to them. We all know that their recovery will be much better if they are in their support networks near their friends and families.

When the system works well, it is absolutely inspirational. I visited an intensive care unit in east London last year. A young lady had come out the other side, having gone in for treatment for self-harm and anorexia. She was very clear that being able to undergo treatment while still being able to attend school was crucial to her recovery. To me, that seems compelling. I am deeply unhappy at the extent to which out-of-area placements are still being used. I am afraid there will probably be a need for them until we can be properly confident in our community services to work more effectively, but I am sure we all agree that we need to tackle it as soon as we can.

I enjoyed listening to the observations of Jim Shannon about what makes a happy marriage. He is right that hard work is a big part of it.

The hon. Gentleman also shared the length of marriage in his family. This year, my parents are celebrating 50 years of marriage. Having lived with them for 21 of those, I have to say that that is quite an achievement. Obviously, it takes real work. As he says, quite often we do not like our partners, but clearly, notwithstanding the difficulties, they give us comfort and security. Not having a support network to rely on, whether that is a partner, wider family or friends, makes life a lot more difficult. I recognise that some relationships will be rollercoasters. Pressures, such as financial debts, can cause untold difficulties in relationships. There will be times when people need support and we need to make it easy for them to ask for it. We have heard several references to organisations that try to give support to couples, such as Relate. A problem shared is a problem halved—we need to encourage more of that.

I was horrified by the story that the hon. Gentleman shared of the couple neither of whom wanted custody of their children. That suggests that they were the product of dysfunctional families, which is another thing to consider. If we leave children to grow up in dysfunctional families, they will repeat that experience. We need to try to do better to improve the quality of family relationships, because that would be good for society. When we look at the back stories of people who end up in prison, we see that there were no end of opportunities where they came into contact with the state, either at school or in other ways. That is a failure for us and we need to tackle it.

It is always a pleasure to listen to my hon. Friend the Member for South West Bedfordshire, who really is a social justice warrior. Again, he brought home clearly the effect of the state applying process to everything and forgetting the humanity of people. We need to be more sensitive about how we intervene supportively. The institutions and the way we organise society can be excessively intimidating and formal, which is not the way to deal with people who need more emotional support. We need to think carefully about what sort of agencies should do that. The beauty of schools, and directing support via schools, is that they are not intimidating or formal institutions. Parents and children have peer support there, over and above their actual attendance, from friends and other people attending and taking their children.

We need to look at the avenues for engagement with people and make sure that they are fit for purpose, and to recognise that all Departments have a role in that. We siloise that contact. Mrs Bloggs takes little Jimmy to school, has a nice relationship and feels that they are being supported, but when she goes to the Department for Work and Pensions, she is treated as an operational performance and it is dehumanising. That is where we need to be more joined-up in the support that we are giving to families. There is a lot to learn. State institutions rely on process to ensure uniformity and fairness, but that does not always lead to good outcomes.

As my hon. Friend said, Governments are expected to do everything, but for the reasons I have outlined they are not always best placed to do that. Sometimes, rather than inventing processes and grand programmes, we should look more actively at letting 1,000 flowers bloom. Where third-sector organisations bring value, we should look at directly commissioning more services from them. That is the case in respect of mental health, because not all support for people suffering mental ill-health is clinical. Quite often, they will benefit from support that just helps them to get through life. That is something that third-sector organisations can do well. I have challenged clinical commissioning groups to look more actively at what they can do, because they will be able to deliver more care by not always relying on clinical staff.

I greatly enjoyed listening to Patrick Grady. He is wearing a fetching tartan and I am jealous that we have only the green ribbons. I will think about how we can outdo the Scottish tartan for Mental Health Awareness Week next year. He reminded us that it has been quite a week for mental health and mentioned the axing of “The Jeremy Kyle Show”. The incident that preceded that axing is a wake-up call; it shows that dysfunctional families have become entertainment. What does that say about how we operate as a society? I hope this gives everybody an opportunity for some self-reflection; it is not something that we should use for entertainment.

Photo of Barbara Keeley Barbara Keeley Shadow Minister (Mental Health and Social Care)

I wanted to refer to what Patrick Grady said about detoxifying issues, which is important. The worst thing that I have read about “The Jeremy Kyle Show” is not that it focused on dysfunctional families, but that it set people against each other in an aggressive way, so it needed bouncers and security staff on hand to part people. The programme seems to have used a toxic formula, which is something that the House could look at through an inquiry, because that could persist in other types of filming. Clearly, it has had a tragic outcome, which, given the Minister’s brief, we have to take seriously.

Photo of Jackie Doyle-Price Jackie Doyle-Price The Parliamentary Under-Secretary for Health and Social Care

I share that view. By definition, if people are making TV that is designed to be entertaining, it will be manipulative and exploitative. A good friend of mine went on “I’m a Celebrity…Get Me Out of Here!”—not the person who was an hon. Member, but someone else. He told me in great detail about how situations were manipulated to generate conflict. Because he is already a celebrity, he is resilient and well equipped for that, but we can imagine that for people who are not, and for whom being in the public eye is new, the risk of harm is significant. I understand that the Digital, Culture, Media and Sport Committee will be looking at the issue, and I welcome that inquiry. If someone switches on the TV, there will be any number of reality TV shows on—often because, in truth, they are cheap to make. Given their proliferation, perhaps we ought to have some standards that producers should respect.

Another example—this shows how much rubbish I watch on TV—is the axing of “Celebrity Big Brother” earlier this year, or perhaps last year, because of an incident between two celebrities on it. I think the public showed such revulsion because they were celebrities whom the public perceived they knew. If it had been the non-celebrity version and they were two strangers, I doubt that there would have been the same reaction. That tells us that, actually, we have all been manipulated by it. It is only when something terrible happens that we stand back and think, “Hang on a minute, we shouldn’t be doing this.” But here we are.

The hon. Member for Worsley and Eccles South made some very fair criticisms about the challenges to children and young people’s mental health. I agree that one of the reasons that we are where we are is that, historically, child and adolescent mental health services have been far less effective than they ought to have been. I watched the Sky film that the hon. Lady referred to, and I have to say that some of the practices that were referred to in it are utterly unacceptable.

I have been very clear with the CQC that institutions that apply restraint to the extent that the hon. Lady described are totally unacceptable, and it is now being much more aggressive in implementing inspections. We will hold organisations to account. In that respect, the Bill in the name of Mr Reed will be a great help. We are in the process of agreeing guidance to deliver that. It will require a real cultural change, but I often say that sunlight is the best disinfectant. The best led institutions are open about when they have to use restraint and fully document it; the worst do not report it at all, and that really has to change. That is something that the CQC challenges now when it visits organisations. I want the number not only out-of-area placements, but of in-patient placements more generally, to come down. That will be a mark of success and a sign that we really are investing in improved community services for our children and young people.

The hon. Lady also referred to the appalling extent to which the young lady in the film had come across people who had engaged in suicide and self-harm. I am pleased that we now have the Zero Suicide Alliance, which is led by the fabulous Joe Rafferty, the chief executive of Mersey Care. Our ambition is to have zero suicides as a consequence of any NHS-funded care. That was launched at the end of last year, and we need to use it as a tool to drive improvements in this area.

As the hon. Lady said, we have the mental health investment standards, whereby we expect local trusts and CCGs to spend more of their budgets on mental health. She suggested that funding should be ring-fenced. I have always felt that ring-fences can be seen as ceilings. However, we are committed, through the long-term plan, to ensuring that all local commissioners abide by those standards, which are a ring-fence in all but name. We are closer than we have been on that issue.

I again remind hon. Members about the troubled families programme, which has been dealing with 400,000 families. It will be revisited next year, and we would welcome any representations from hon. Members about how we can learn from it and improve how we help families with complex needs. Obviously, we need to develop better outcomes for all family members.

Coming back to Marriage Week, we know that good quality relationships are critical for all of us, as they add to our overall happiness. As my hon. Friend the Member for South West Bedfordshire said, some people do not necessarily want their relationship to be recognised as a marriage. None the less, we all benefit from stable, loving and supportive relationships. With my suicide prevention hat on, I will say that relationship breakdown is the biggest driver of suicide. That is another reason why we should always enable people to find help when they need it.

As far as the impact on children and their life chances is concerned, we know that by the age of five, almost half of children in low-income households have seen their families break apart, compared with only 16% of children in higher-income households. As my hon. Friend said, we must address that social injustice because when relationships break down, there is a risk of poor outcomes in the long run.

I see health visitors as very important partners—I always refer to them as my army. They are on the frontline, and their contact with people is less formalised. They are the one group of people who can engage with the entirety of the family. They look not just at the baby and mum, but at dad and the siblings, too. We need to take advantage of those interventions to do better for families in general.

We are spending £39 million on the reducing parental conflict programme, which is designed to reduce conflict between parents who are still together, and work with them to strengthen their relationship, exactly as my hon. Friend the Member for Congleton wants, to help them to stay together if that is what they want. We should also recognise that separation can sometimes be the best option, particularly if there are other factors involved that can cause distress for the children. Even in the event of a separation, continued co-operation and communication between parents and their children will give advantage to the child.

Although the Government will continue to support and champion marriage, we will not discriminate against other types of families who require our support. We will ensure that parents can access help when they need it, whether they are already married and need help to sustain their partnership, are not married and wish to improve the health of their relationship, or have chosen to separate.

I turn to what we are delivering through the NHS long-term plan. The improvement in perinatal mental health services will help us to engage people when they are at risk, assess people’s circumstances, give peer support and perhaps just make a decisive intervention at a time of real stress for families, where either the mother or the father becomes ill.

The theme of this year’s Mental Health Awareness Week is not marriage but body image. The two are not entirely unconnected, because how we think and feel about our bodies obviously affects how we engage with other people. Just as we need to get real and think about working harder, not everything will be ideal. We are not all going to have a marriage that is like a fairy tale 100% of the time, and we are not all going to look like Claudia Schiffer. That is okay—that is normal—and we just need to be aware of that.

It is worrying that, according to the Mental Health Foundation, 39% of children feel shame in relation to body image. We ought to think about the causes of that stark statistic. People are bombarded with images via social media, and so on, so we need to encourage parents to spend time with their children and make sure that children know what they can realistically expect. They cannot expect to look like the doctored images that they are being shown.

That comes back to the issue of quality time. Smartphones have been absolutely revolutionary for our society. Is it not fantastic that we can find information about anything we want and contact people at any time? However, face-to-face engagement, especially between parents and their kids, is really important. I pay tribute to Frankie & Benny’s, the restaurant chain, which has said that to encourage parents to speak to their children while they are having a meal, it will give them a discount if they hand their phone over.

We are so easily distracted by time spent on a phone. The first thing I do in the morning when I wake up, and the last thing I do at night, is to look at my phone. It is not very healthy, to be honest. We need to encourage our children to have a healthy relationship with their smartphones, and the same is true for ourselves. There is no substitute for some good parent-child conversation, and that does not need to take place via WhatsApp or text.

Broader mental health support is available to people who suffer from mental health problems. IAPT provides couples therapy for depression, which is available through the NHS. That directly helps relationships.

This debate has been interesting and thought provoking, and it has highlighted many issues that, although we may agree about them, we perhaps need to be more proactive about properly addressing. They are not the easiest things to deal with, because they are about human failings, but it is good to hear that so many colleagues are bothered about them and actively think about them.

Mental health problems can affect anyone, any day of the year. Those problems have a bearing not only on the wellbeing of the individual, but on marriages, relationships and children. We must continue to work together, across Government and with our partners, to address some of those issues. As a society, we all need to be more sensitive about the stresses of particular times, such as when people experience job loss, debt or relationship breakdown, to ensure that we give people appropriate support.

I am sure we can all agree that Marriage Week and Mental Health Awareness Week provide us with excellent opportunities to bring those subjects together. I am very grateful to my hon. Friend the Member for Congleton for bringing those subjects forward for debate.

Photo of Fiona Bruce Fiona Bruce Conservative, Congleton 3:21 pm, 16th May 2019

I am sure, Sir David, that colleagues were relieved and impressed by your astute wisdom in announcing after I had spoken that the debate could continue for longer. I thank all hon. Members who spoke, and I particularly thank Jim Shannon and my hon. Friend Andrew Selous for their thoughtful contributions. I was very pleased to hear the Minister respond in such a constructive way. Her tone, as well as her words, said a lot when she recognised both the impact of family relationships on mental health and the fact that more needs to be done.

I thank the Minister for not sticking to her notes, but instead responding so thoughtfully to so many of the comments that were made. As we have heard—it is a matter of social justice—there is a real need to put strengthening relationships at the heart of Government policy, nationally and locally, to provide joined-up support for families. As the Minister said, the troubled families initiative has started to do that.

As the Minister also said, we need to better support the many excellent voluntary organisations engaged in this area. Crucially, today we have also recognised the importance of marriage in helping to address the country’s major mental health problem. As Members have said, that is not in any way to criticise or condemn those whose home circumstances are different—far from it. We are saying that building relationship capability is for all of us, because we all aspire to have beneficial and flourishing relationships in our lives. We know their benefits.

I was particularly interested to hear the Minister say that because these issues straddle so many Government Departments, and because of the processes and the way that Departments work in silos, addressing them is quite a challenge. That is exactly why the proposal of a Cabinet Minister for the family, to draw together the work on such issues across Departments and support people more effectively, is so important. I close by saying that after the authoritative and compassionate speech that he gave today—it represented the tip of the iceberg of many years’ work on this issue—I cannot think of any hon. Member who would better fill that role than my hon. Friend the Member for South West Bedfordshire; I hope the Minister will forgive me for saying so.

Question put and agreed to.

Resolved,

That this House
has considered National Marriage and Mental Health Awareness Weeks.

Sitting adjourned.