Dual Diagnosis (Hansard, 29 April 2003)

§ 3. Ms Oona King (Bethnal Green and Bow)
If he will make a statement on services provided to patients with dual diagnosis of mental health and addiction problems. [109802]

§ The Minister of State, Department of Health (Jacqui Smith)
As part of the work to modernise mental health services, the "Dual Diagnosis Good Practice Guide" was issued last year. Following the publication of the national service framework for mental health, we have embarked on a radical modernisation of services to improve access to effective treatment and care, to reduce unfair variation, to raise standards and to provide quicker and more convenient services to all people with mental health problems including those with a dual diagnosis of addiction.

§ Ms King
Does the Minister agree that such patients have a particular need for supported accommodation and ongoing social services support? However, because they have the greatest problems, they are often the ones who fall through the safety net. Will she consider increasing resources for programmes such as assertive outreach and ensuring that patients with dual diagnosis problems are taken into account?

§ Jacqui Smith
My hon. Friend raises an important point. Despite the considerable extra investment in our mental health services and staffing increases, we nevertheless need to examine new ways in which to organise the services. I strongly agree with her, as we spelt out in the national service framework, that assertive outreach teams are particularly able to get to some of the people who have fallen out of touch with services in the past, perhaps because they had additional problems such as drug or alcohol addiction, which had knock-on bad effects for their health and for communities as a whole. That is why I am pleased that extra investment for assertive outreach teams is being considered in Tower Hamlets. The existing investment in our mental health system means that 191 additional assertive outreach teams are operating throughout the country to bring people who had lost touch with mental health services back in touch.

§ Tim Loughton (East Worthing and Shoreham)
A lesson from the first Gulf conflict was that many returning service personnel were susceptible to mental health problems, which were often combined with addiction problems, especially alcohol addiction. Given that fewer than 20 per cent. of the Government's required crisis resolution teams are in place, how can the Minister justify her claim on 6 March that there is operational flexibility within the system 136 to enable the NHS to deal with the mental health needs of servicemen and women returning from the Gulf, many of whom are likely to be given a dual diagnosis? Is it not the truth that the Department of Health and the Ministry of Defence are woefully unprepared?

§ Jacqui Smith
No, it is not. As I have spelt out in response to the hon. Gentleman's questions, it is clearly the business of mental health services to deal with any mental health problems that might arise when people return from active service, as is the case with the wide variety of other needs that they address. We have made it clear that people with a dual diagnosis of mental health problems and drug or alcohol addiction are mainstream business for mental health services.
The hon. Gentleman seemed to suggest that we need more investment and an expansion of capacity. As I have said, there are already 191 extra assertive outreach teams. We have 62 more crisis resolution teams, 22 more early intervention teams and there are 25 per cent. more community psychiatric nurses working in the system than in 1997. There are problems and the only way in which to address them is to continue with the investment that the hon. Gentleman and his colleagues have opposed far too often.

§ John Mann (Bassetlaw)
Fewer than 3 per cent. of people with an addiction to heroin are receiving medical treatment. How long will we allow a presumption in favour of dual diagnosis to be a smokescreen for stopping proper medical treatment for such people?

§ Jacqui Smith
The dual diagnosis guidance that we issued made it clear that treatment for the significant number of people who have both a serious mental illness and a drug addiction is part of the mainstream business of mental health services. We need to do work, especially to ensure that we reduce waiting times for people who need specialist treatment services, which also have specialist mental health services alongside. We are making progress on extra capacity and new ways in which to deliver those services. I agree with my hon. Friend that it is unacceptable if people do not receive suitable treatment. We will ensure that we address the problems through the additional investment and new forms of treatment that we are implementing. However, only the investment that we are undertaking will ensure that that happens.