Women’s Mental Health

Paula Sherriff Excerpts

Thursday 3rd October 2019 Commons Chamber

[Paula Sherriff (Dewsbury) (Lab)]

I congratulate the hon. Member for Bath (Wera Hobhouse) on securing this important debate and thank all Members who have spoken in it. I also welcome the Under-Secretary of State for Health and Social Care, the hon. Member for Mid Bedfordshire (Ms Dorries), to her new role. I look forward to having some robust debates with her across the Dispatch Box in the weeks and months to come.

We have heard some excellent contributions this afternoon. The hon. Member for Bath discussed how important it is to consider trauma-informed services. She also talked about eating disorders, and I thank her for the excellent work that she has done in that area. My hon. Friend the Member for Southend West (Sir David Amess)—may I call him my hon. Friend?—spoke passionately about his constituents, Carla and Kelly. I have had the pleasure of meeting them, and I would like to applaud them for the wonderful work they do on endometriosis, which, as he knows, is a subject close to my heart. He also talked about prisons. I had the pleasure of visiting a local women’s prison on the edge of my constituency a few weeks ago, and it was incredibly interesting to talk to the women about their experiences there. It was striking to learn just how many of them had a history of mental health problems.

My hon. Friend the Member for Manchester, Withington (Jeff Smith) discussed how crucial it was that post-natal women were offered a six-week standard maternal check. My hon. Friend the Member for Lewisham West and Penge (Ellie Reeves) talked movingly about her own experience of pre-natal depression and how important it is that the mum’s mental health is considered at the post-natal check. We also heard from the hon. Member for East Worthing and Shoreham (Tim Loughton) about the importance of maternal mental health and about how crucial it is that early intervention is offered as soon as possible. That is something that the whole House can get behind, and I thank him for his contribution.

My right hon. Friend the Member for North Durham (Mr Jones) mentioned something that really resonated. He said that we must hard-wire mental health information into every public policy. Once again, I am sure that all of us in the House would agree with that. It is really good to see the former Minister, the hon. Member for Thurrock (Jackie Doyle-Price), here. I thank her for the excellent work that she did and for her collegiate and collaborative approach. She also made some excellent points today, particularly about the impact that sexual violence can have on people’s mental health.

Last but not least is the hon. Member for North Ayrshire and Arran (Patricia Gibson). Like others, she began by saying that mental health problems are nothing to be ashamed of. We cannot repeat that enough; it is incredibly important. Stigma does still exist, although some excellent work is being done to reduce it. Still, we must keep repeating this until people believe it.

We know that we face a mental health crisis, and women are certainly not exempt from it. Women are more likely than men to have a common mental health problem and twice as likely as men to be diagnosed with an anxiety disorder. That feeds through to service delivery. Women account for around two thirds of referrals to the improving access to psychological therapies programme. While some of this might come from different attitudes towards sharing mental health problems, it still speaks to an undeniable truth that we must prioritise women’s mental health. In particular, we must pay attention to the mental health of young women: while 20% of women overall have a common mental health problem, that figure rises to 28% of women aged between 16 and 24.

Mental health conditions do not arise in isolation. They are not inherent to a person and are not always unavoidable. Instead, they are bound up with the circumstances in which a person lives their life. They are also closely linked to the way we are treated by others. That is something that all of us in this place should consider carefully at a time when many of us in this Chamber, women in particular, have received death threats and other horrendous abuse.

Before I go on to mention two situations that might have a particular impact on the mental health of women, I want to mention the broader issues that affect our mental health. One of the consistently recognised causes of mental health problems is financial stress: whether it is struggling to find work or being trapped in a job that does not pay enough to make ends meet, this can be a source of enormous stress. As we have heard from a number of hon. Members, there is clearly a link between poverty, austerity, deprivation and mental health. That in turn leads to people developing mental health problems: 35% of women who are unemployed have a common mental health problem, compared with only 20% of women in full-time employment. We know that women are more likely to be unemployed or in lower-paid roles than men. Industries that rely largely on minimum wage workers on zero-hours contracts, such as social care, overwhelmingly employ women.

As well as being a cause of mental health problems, economic instability can open women up to abuse by others, whether that is their employer or a controlling partner. One woman in four will experience domestic violence. As well as the physical trauma of that abuse, survivors can be left with long-lasting mental health problems. Women who suffer domestic abuse are three times more likely to develop a mental illness, including severe mental illnesses such as schizophrenia and bipolar disorder.

Addressing that serious issue works two ways. We need to ensure that services for the survivor of domestic violence, whether the police, shelters or other organisations, are better at recognising mental health problems. Our mental health services need to get better at recognising the signs of domestic abuse. One way they can do that is to be more aware of the reasons a woman might not attend a follow-up appointment. Controlling and coercive partners can easily stop someone going out to attend a medical appointment. Mental health services should be awake to that possibility, and not simply move straight to discharging people.

We have an opportunity to address that through the Domestic Abuse Bill. This is a crucial Bill that, thankfully, has not been lost due to Prorogation. We should use the Bill to bring domestic violence and mental health services closer together so that fewer people are lost between the two. Like many colleagues, I pay tribute to the emotive speeches that were made yesterday from both sides of the House—in particular, the contribution from my hon. Friend the Member for Canterbury (Rosie Duffield). We can all agree that she was incredibly brave when she made her extraordinary contribution. We thank her for that. Will the Minister say what conversations she has had with her colleagues about joining up mental health and domestic violence services?

Unpaid family carers in the UK are more likely to be women, and therefore more likely to be providing round-the-clock care for the people they care for. Caring for a friend or family member can have a significant impact on a person’s own mental health. That is particularly true for women carers, who are more likely to be sandwich carers, caring for young children and elderly relatives at the same time.

A survey from Carers UK found that more than two thirds of carers have suffered poor mental health as a result of caring. Carers looking after children and young people, and those who have been caring for 15 years or more, are also more likely to have poorer mental health. Carers are being let down by this Government, and this is taking its toll on their mental health. One carer told the Carers UK survey:

“I was admitted to hospital after a breakdown due to exhaustion and chronic pain. If I had had more breaks from my caring role or adequate mental health support, I might not have had the breakdown at all.”

Access to adequate support and carers’ breaks are crucial to ensuring carers do not reach crisis point. Carers’ breaks are particularly important for mental health, as nearly half of carers have used their breaks to attend their own medical appointments. The Government’s failure to set out plans to support carers properly, or address the crisis in social care, is taking its toll on the mental health of unpaid carers. We have had a watered-down action plan that promises very little action to support carers. It is time for a full national carers strategy that sets out plans to ensure carers have adequate support, including with their mental health. So will the Minister outline how her Department intends to ensure that carers have access to the support they need? Furthermore, will she commit to increasing access to carers’ breaks?

All of this has caused a mental health crisis among women. As I have mentioned, women are far more likely to be referred for basic therapy than men, reflecting both the prevalence of mental health conditions and a willingness to seek help. But a referral to these services is not a guarantee that someone will get the help they need. Talking therapies through IAPT still have a noticeably higher recovery rate for white women than they do for black and minority ethnic women. They also are not working for young women. A 16 or 17-year-old woman accessing IAPT services has a lower chance of recovery than a woman of any other age—or than a man in any age group. We have to do better than this. It simply is not acceptable that someone’s chances of recovering on the primary NHS care pathway for mental health is so dependent on their age, gender and ethnicity.

I wish to take this brief opportunity to thank some of the peer support groups in my constituency, which work so incredibly hard, particularly for those who struggle to access traditional NHS services. Stevie Morley from Take Ten offers the most phenomenal service for those who are suffering from mental health problems, and I wish to use this opportunity today to thank her. I also wish to thank Auntie Pam’s, which is based in Dewsbury and supports young mums, expectant mums and those who are just having problems, perhaps even problems conceiving. Auntie Pam’s is made up of local young mums and they are just wonderful.

The current situation is why Labour will ask the National Institute for Health and Care Excellence to carry out a full review of the psychological therapies available on the NHS, to ensure that everyone is able to access therapies that are appropriate and work for them. For some people with a mental health condition, it may be necessary to go beyond talking therapies or community support. When that is the case, we should be working to ensure they receive the best treatment possible. But too many women are still being mistreated in mental health units. Last year, more than 4,000 women held under the Mental Health Act were subject to restriction. Each woman was subject to an average of 12 restrictive interventions, which is far more than for the average man.

One example of how this excessive restriction can look in practice is seen in the case of a woman called Alexis Quinn. Alexis is an autistic woman who has spent years of her life trapped in a mental health unit. Since she escaped this unit she has shared her experience, and it is truly harrowing. After she tried to leave the unit, which she was on as a voluntary patient, she was held down and forcibly sedated. When she complained, she was locked in seclusion for more than a week. Alexis was restrained 97 times and secluded 17 times, although there were numerous seclusions which went unrecorded. When somebody seeks support from mental health services, they deserve better than that. It can never be right that we fall back on violent restraint and seclusion.

There is a crisis in mental health support for women. Today’s debate has called for more mental health support tailored specifically to women. Members have called for greater access to mental health support for domestic abuse victims, and greater support for young women and girls and for carers.

In conclusion, we need urgent investment in mental health. Our mental health services should be comprehensive and universal, and we need to invest in early intervention as a priority. Women should be able to access specialist, gender-specific, in-patient and community services that recognise the traumatic nature of domestic violence or abuse. Women experiencing a mental health crisis must be treated with dignity and respect, but too often this is not the case. On all these areas, the Government are simply not doing enough. Women deserve better than being ignored or fobbed off with services that do not work. It is time to act and deliver a mental health system that truly delivers for everyone.