House of Commons Mental Health Debate, 25 June 2002

"One of the great innovations of the Government has been the reform of the NHS through the introduction of primary care trusts. We have to make sure that the variety of preventive health and social services, designed as dynamic, supportive local networks, work in practice and that each primary care trust gets an adequate budget to follow plans through at a local level. We can get agreement on priorities and objectives, and we can assess the needs. But if we assess that the local surgeries need eight mental health staff, it is not enough to provide funding for two, as has happened in Leeds, West. There are recruitment problems, but that is not all. We need to ensure that resources get to the front line locally. I hope that Ministers and the Department will continue to monitor in detail the reform processes that they have set in train to ensure that that happens."

Mr. John Battle (Leeds, West): I welcome the subject of the debate, because we should all work harder to ensure that the issue of mental health is brought out of the shadows and on to the Floor of the House more regularly. In past years, we heard statements on mental health in December 2000 and December 1998, and I welcome today's draft Bill.

I cannot help but recall that, in February 1996, when the Conservative Government made a statement, we were in opposition, pressing the then Secretary of State to halt further psychiatric bed closures until community services were in place. We were pressing for the implementation of a full care programme. We asked that Government to address staff shortages and to change the mental health funding allocation formula to ensure that cash ended up where it was needed. That went unheard at the time, which is why-despite the tone of the remarks from the hon. Member for Woodspring (Dr. Fox)-I have to say that the new so-called "compassionate conservatism" is a rather shallow plant that lacks historic roots.

Let us consider the future. There is still a deep fear of addressing the taboo of mental health and there is still a stigma attached to it. There is still a sense that although the brain is a wonderful organ, it is still not sufficiently understood, despite all our brilliant neuro-scientists. We know little about its complex workings and connections as it integrates, at its best, the mind and the body.

We neglect mental health, and yet how often do we, as Members of Parliament, see people in our advice surgeries who are suffering from mental illness? People come to see us who literally may not have spoken to another person in the two weeks since they had previously been at our surgeries. People come to see us who are confused, worried about their medication or concerned about their treatment and records. With respect to the doctors in the House, none of us can deal with such problems, but we see that there is a real need in terms of mental health care, and it is increasing. In policy terms, we must not steer clear of the issue but, instead, move closer to it.

For centuries, people with mental health were locked away in Bedlam, in asylums and in institutions, and were forgotten. Now, according to Sane, the mental health charity, one in four of us will suffer some form of mental illness in our lifetimes. We should reflect on that.

We should welcome the more open interest in mental health issues in our society. There is an acceptance of the reality of mental handicap and mental illness that perhaps was not there 10 or 20 years ago. There is an increasing refusal to accept the traditional mind-body split, as if both could be treated separately. There is a greater contemporary emphasis on holistic approaches to mental and physical health.
The mental institutions to which my hon. Friend the Member for Wakefield (Mr. Hinchliffe) referred were closed in an attempt to provide care in the community. I worked in one such institution, in Meanwood Park, and I concur with my hon. Friend; they were not the right places for most of the people who were there. The problem was that when care in the community was introduced, there was neither care, in terms of back-up support services, nor community, in the sense of welcoming someone or offering local neighbourhood support. That left sufferers more isolated, neglected and unsupported than anyone else in society. The funding did not follow the mental health patient, as we were told it would at the time.

I welcome what has happened since then, for example, the Government's plan to increase the priority and significance of mental health, and the increase in investment. I welcome the work to tackle the problem of homelessness. We have a public information campaign and we have heard the announcement of a draft Bill, which deserves full consideration and wider public debate.

In my constituency, the health authority informs me that the rate of mental illness in our inner-city area is significantly higher than in other communities in Leeds. That will include post-natal depression, elderly people with dementia and Alzheimer's, people with phobias and people with eating disorders. However, people suffering from mental illness tend to end up at the bottom end, in privately rented terraced housing, small single bedrooms, low-quality council housing and miscellaneous properties. They get the worst deal of all and they are up against it in trying to survive from day to day.

I spent a day with the Leeds community mental health trust, visiting day centres and talking to mental health workers and specialists working with those suffering as a result of alcohol and drug abuse. I also talked to patients. I would recommend such a visit to other colleagues, as it was worth while. I recall a young mother at one of the centres who told me that the centre was the only place that she could go where nobody judged her. That was important. We have heard the word "sanctuary" used earlier. Sanctuary is not only a place, but an attitude of mind towards others who feel that they are often accused, blamed, marginalised, dismissed and then written off.

One of the great innovations of the Government has been the reform of the NHS through the introduction of primary care trusts. We have to make sure that the variety of preventive health and social services, designed as dynamic, supportive local network, work in practice and that each primary care trust gets an adequate budget to follow plans through at a local level. We can get agreement on priorities and objectives, and we can assess the needs. But if we assess that the local surgeries need eight mental health staff, it is not enough to provide funding for two, as has happened in Leeds, West. There are recruitment problems, but that is not all. We need to ensure that resources get to the front line locally. I hope that Ministers and the Department will continue to monitor in detail the reform processes that they have set in train to ensure that that happens.

I want to refer to three policy matters that we must take much more seriously. Colleagues have referred to prisons, and Armley prison is in my constituency. Some 80 per cent. of people in that prison suffer from mental illness and/or drug dependency and alcohol problems. Ten prisoners there today out of 1,247 have been sectioned under the Mental Health Act. Care in the community has come to mean, for many, care in custody.

I welcome the fact that Armley prison is one of the 10 prisons piloting the Government's new mental health in-reach approach. However, the scheme has been going for three months and has a team of seven; it should be nine. We need to follow this through so that the work of the Home Office and the Department of Health are linked. I also wish to refer to outreach, because we must ensure that when a prisoner leaves prison with mental health needs, he is followed through and receives support within the community.

I was involved in the establishment of the all-party group on epilepsy, which is well supported across the House. Some 450,000 people in Britain suffer from epilepsy. There was a report recently into people who have suffered sudden and unexpected death as a result of epilepsy, and it revealed that they were usually young adults. I thank the Minister for the reply that I received to my parliamentary questions of 20 June, in which she welcomed the national central audit of epilepsy-related deaths. The Department has promised to consider the recommendations and to develop a strategy and plan by September of this year. It is important that we treat epilepsy in the same way as diabetes, for example, and not leave it as a Cinderella illness. In the past, people with epilepsy were locked away in mental institutions.

May I make a plea for more attention to be paid to a real crisis area-that of suicides among young men? I have recently come across three such cases-in two cases suicide was attempted, in the third, tragically, the suicide was carried through. Will the Department of Health use its research resources to look at that policy and take it forward? The mental health needs of young men in an increasingly pressured and high-speed world are paramount.

Finally, proper support, assistance and treatment needs to be followed through to help people help themselves. That implies that the wider community assists as well, which means that the care plans referred to in the draft Bill will be vital. With proper back-up and the involvement of patients, they could be the focus and centre of the Bill. As a result, we might not fear mental illness as we have in the past but, as a society and through our institutions, we could properly care for sufferers and at last treat them as equal citizens in our society, as we treat anyone else with health needs.