Mental Health Treatment and Support

Neil Coyle Excerpts

Wednesday 7th June 2023 Commons Chamber

[Neil Coyle (Bermondsey and Old Southwark) (Lab)]

I also wish to speak civilly. For me, this is fundamentally a debate about mum. My mum was diagnosed with schizophrenia before I started primary school, so I have been talking about mental ill health all my life. Growing up, we saw on a weekly basis the inadequacies in support, the rough treatment from mental health services and the results of poor medication. We cannot ignore the fact that there have been some improvements, but some of the worst of the ‘80s appears to be returning after 13 years of Tory Government. Governments have failed to improve the system, which is described as the Cinderella service, since before Cinderella was written, which apparently was as long ago as 1697—I discovered that only today.

This crisis is exposed in that lack of access to support, lack of outreach, lack of choice, lack of control over support being received even where it is received, lack of genuine community care and lack of priority being given to mental healthcare overall. It is also exposed through an overuse of detention. Detention is necessary when people cannot manage their own safety, but it is the most costly end of mental health treatment when all else has failed. It is more expensive than sending people to prison in this country, but it is over-relied on by a failing Government who are unable to see long-term needs and the means of saving funds as well as saving people.

As has been mentioned, this is also a crisis exposed by a rising inability to meet need, as demonstrated by the size of, and time spent on, waiting lists. The shadow Minister mentioned 400,000 children. I bumped into Karen, my constituent, on the bus this morning. She finally has an appointment for counselling after three years of waiting in Southwark. Therefore I speak today from personal experience and as an MP representing a community with a high prevalence of mental health conditions, including some of the highest levels of psychosis anywhere in the country. However, I am privileged to speak as MP of an area where there is greater support for some people.

Southwark’s Labour council has been at the forefront of instigating measures, including online support, the Quality Indicator for Rehabilitative Care, the Nest system for the under-25s and an equivalent wellbeing hub for the over-25s, which helped more than 2,000 people last year. I am talking here about fast access, professional support that does not require a GP referral or a long wait of time. This is vital support on the frontline delivered by a Labour council and an integrated care board, which are prioritising correctly.

We are also a community served by South London and Maudsley NHS Trust. SLAM staff do their best to meet needs, but, sadly, I see people and their families who are not best served. I know that SLAM wants to do more—I speak to the staff and I met the chief executive last week—but it is limited by a Government who lack ambition and intent. The Government are not just ignoring the crisis, but contributing to it through things such as benefit cuts, and allowing food bank dependency and debt in a way that contributes to mental ill health. This is also a Government who are cutting capacity. The Minister made some claims about figures at the Dispatch Box just now, but SLAM told me last week that, despite the level of the crisis, it is cutting £45 million this year. What that means in practice is horrible.

I wish to talk about the human impact. I met Stephen Crawford through the Walworth community council. I have known him since 2010. To be clear from the start, this was a man who was known to the local community and known to council care workers and local mental health services. He had severe anxiety. He was a sweet, gentle soul, but he was a target for those seeking to misuse him and his home with criminal intent. Understandably, he became very agitated about his home following break-in attempts and thefts. He was ultimately sectioned and detained for his own wellbeing, but then discharged to the unsafe home that he had told everyone he was unable to live in. He called the London Ambulance Service daily. He and others called the police. The police told me they had visited and intervened 56 times in recent months due to his behaviour. It was a crisis for him, for his neighbours in the street, including Norma and the Groombridges, who were trying to help him, for the London Ambulance Service, which is already overstretched and struggling, and for the police, who now say they may have to stop responding to mental health call-outs.

Stephen was discharged and did not get sufficient support. On Wednesday 19 April, just three days later, he climbed through the window frame on the top floor of a Browning Street building. He told everyone he would take his own life. The police attended, but he fell and was pronounced dead the following week.

That is what the mental health crisis means in practice—the loss of life, the human tragedy. Stephen deserved better, and if individuals like him, whole communities such as mine and multiple public services are not to face similar situations, with the avoidable costs and loss of human life, mental health reform must deliver better. I hope we see a serious case review and I look forward to that coming forward.

--- Later in debate ---

[Maria Caulfield]

I thank my right hon. Friend for that. It is important that we take the politics out of this argument, because no one in this Chamber, on either side, does not care about mental health.

The psychosis target we have introduced is that 60% of people should start treatment within six weeks, and we are currently at 72%. We are overperforming on many of those targets. NHS England has five new targets that we hope to introduce soon—

[Neil Coyle]

Will the Minister give way?

[Maria Caulfield]

Unfortunately, given the time I have left, I will not give way any more.

As for the challenges we face, we are seeing rising numbers, but we are seeing that in all parts of the country. The shadow Minister, the hon. Member for Denton and Reddish (Andrew Gwynne), talked about not judging Labour on its track record on health in Wales, where Labour has produced smaller funding increases for its health service; its 7.8% increase compares with the 8.6% increase that we have given in England. Mind Cymru has said that hundreds of people across Wales are currently waiting more than a year to access psychological therapies. The target is supposed to be that 80% of people in Wales access therapies within six months, but that target has never been met. It gets worse, because since 2020 the number of people waiting longer than a year in Wales for mental health support has increased by 17%. Labour talks a good game, but its actions speak louder than its words. I urge shadow Ministers to acknowledge that these problems exist in all countries and that we all face these pressures. A grown-up conversation would be about sharing best practice and working together to make that happen.

Many Members talked about preventive and early intervention therapies. My hon. Friends the Members for Bosworth and for Devizes (Danny Kruger) talked about that and about moving away from the medicalisation of mental health. That is why we are investing in talking therapies. For anyone who has not been on the Every Mind Matters website, let me say that it provides practical support for people who are anxious, distressed or not sleeping. It also provides for self-referrals to talking therapies. Since we introduced that, more than 1.2 million patients have accessed NHS talking therapies in the last year, helping them to overcome anxiety and depression. More than 90% of those people have had their treatment completed within six weeks.

Many Members talked about schools, and we are introducing mental health support teams in schools. We have almost 400 now, covering more than 3 million children, and about 35% of schools and colleges. More than 10,000 schools and colleges have trained a senior mental health specialist, including more than six in 10 state schools. That work is happening already and it is making a difference right now. My hon. Friend the Member for Newcastle-under-Lyme (Aaron Bell) highlighted how we need to move that into universities, and I would be happy to talk to him about how we can do that further.

On in-patient services and the quality of care, we have recently conducted a rapid review of mental health in-patient settings. The Secretary of State will announce the results of that soon. We have also introduced a three-year quality transformation programme, which seeks to tackle the root cause of unsafe, poor-quality in-patient care, particularly for those with learning disabilities and autism.

On suicide prevention, our forthcoming strategy will target high-risk groups and locations of concern. We will also provide £10 million of funding for charities that do so much good work in this space. I say to my hon. Friend the Member for Penrith and The Border that I would be very happy to meet the 3 Dads Walking, Andy, Mike and Tim. I know that they have met the Prime Minister.