Homeless People and Mental Illness (Hansard, 22 June 1988)

§ The Parliamentary Under-Secretary of State, Department of Health and Social Security (Lord Skelmersdale)
My Lords, the Government have no basis on which to make a calculation in the form requested in the noble Lord's Question. However, we know that during the first quarter of 1988, 3 per cent. of the 31,100 households accepted as homeless by local authorities in England were regarded as vulnerable on the grounds of mental illness.

§ Lord Dean of Beswick
My Lords, I am grateful to the Minister for that reply. Is he aware that people dealing with the problem of homelessness recently issued information which shows that in London alone over the past four years homelessness and the number of people sleeping rough have doubled? Is he also aware that it is now calculated that 12,000 people sleep out rough each night in London alone. Is he further aware that the numbers and percentage of people suffering from mental health disorders of various kinds are increasing substantially? Ought we not to be looking for drastic action in order to stop the escalation in the number of those very tragic cases?

§ Lord Skelmersdale
My Lords, I aceept on behalf of the Government that the number of homeless people is indeed greater in London. In the last quarter, 6 per cent. of those accepted as homeless were mentally ill compared with 1 per cent. in the non-metropolitan districts. There has been a slight increase over the first quarter of last year when 2 per cent. of those households accepted as homeless were vulnerable due to mental illness compared with 3 per cent. this year. The figures for London are likely to be double those that I have just mentioned, which are for England as a whole.

§ Lord Murray of Epping Forest
My Lords, is the Minister aware that the National Schizophrenia Fellowship has asserted that 50 per cent. of people staying overnight in St. Mungo's and Salvation Army hostels are mentally ill? Is he further aware that a team of psychiatrists who interviewed a sample of people at the Crisis at Christmas 1986 discovered that 40 per cent. were suffering from psychotic disturbances? If he challenges those figures, will he instruct or at least encourage regional health authorities to institute proper systems for surveying, following up and statistically examining what happens to people who have been discharged from mental hospitals so that we can have the information which the Minister says that he does not have at present?

§ Lord Skelmersdale
My Lords, I think that the noble Lord has asked two questions. One concerns the identification of this most unfortunate group of people. Local government statistics and indeed health authority statistics have to be precise. They cover that group which has been identified as mentally ill. The difficulty with some of the figures from other authoritative sources in this area is that there is no means of telling whether or not they relate to people who are identifiably ill. I shall certainly bring the noble Lord's words to the attention of health authorities.

§ Baroness Seear
My Lords, does the noble Lord agree that this situation emphasises the importance of improved community care? Will he tell us when we are going to get a statement from the Government on the Griffiths Report?

§ Lord Skelmersdale
My Lords, no, I cannot tell the noble Baroness when there will be a government statement on the Griffiths Report for the simple reason that I do not yet know. When I know I shall of course inform not only the noble Baroness but the House as a whole.
As far as concerns community care, in the mental health field the policy is that in every health district there should be a comprehensive range of accessible and easy-to-use services for all mentally ill people. However in many areas the numbers of mentally ill have been growing at a greater pace than that at which the services can be provided. The Government are very conscious of that fact and that is why they are consistently putting more resources into that area.

§ Lord Ennals
My Lords, does the Minister accept that I, like my noble friend Lord Murray, am amazed by the figures he quoted? Is he aware that I have seen a survey which indicated that of 51,000 homeless people 40 per cent. were identified as having psychiatric problems? Does he accept that there seems to be no evidence of an increase in the number of people who are mentally ill, except in the case of the very elderly, and that the problem lies in the increase in the number of psychiatric cases discharged from hospitals and arriving in the community? Is he further aware that in that connection there is an increase in homelessness because there is not a satisfactory response in terms of the community care needs in our local authorities?

§ Lord Skelmersdale
My Lords, the Government have researched this area fairly extensively, as the noble Lord will know from recent experience and also from past experience. From time to time our attention is drawn to the cases of people who have been discharged from long stay hospitals and are—if the noble Lord will pardon the expression—floating in the community. We have always tracked down those cases and found that that is not the case. The problem arises with people who have had short-term treatment in acute psychiatric hospitals from which it is not unnatural to suppose that they should go back to the kind of living standards from which they came.

§ Lord Allen of Abbeydale
My Lords, the Minister gave some figures concerning the mentally ill. Does he have comparable figures for the mentally handicapped?

§ Lord Skelmersdale
My Lords, I do not have those figures with me at the moment but I shall write to the noble Lord if I may.

§ Lord Carter
My Lords, is the Minister aware of the recent report by Shelter which indicates that the increase in the number of disabled people—with all disabilities, not just mental illness—recorded as homeless is increasing at twice the percentage rate for able bodied people? Can he say what are the Government's plans to deal with that very serious situation?

§ Lord Skelmersdale
My Lords, I know of the report but I have to confess that I have not yet read it. I understand that it is very recent. I shall certainly be looking into it. I made the point earlier that there has been an increase and that the Government are aware of that. I said—I believe to the noble Baroness, Lady Seear—that resources have not yet caught up with that increase.

§ Lord Stallard
My Lords, is the Minister aware that one of the main difficulties in collating statistics is the fact that very often single homeless people cannot register with a GP and many of them have to use the hard-pressed emergency provisions in hospitals. As has been said, where they have been an in-patient they would be discharged into the same accommodation, which may even have been a cardboard box, with no after-care facilities at all. May I suggest to the Minister that he issues some 762 guidance to district health authorities and family practitioner committees with a view to their investigating means of improving after-care facilities as well as the registration difficulties of the single homeless?

§ Lord Skelmersdale
Yes, my Lords, I should like to think further about the noble Lord's very valuable suggestion. It is a fact that central government and the health authorities are concentrating many of their resources into funding the voluntary bodies which are working so successfully in this area. Having said that, I shall certainly investigate the noble Lord's suggestion.

§ Baroness Masham of Ilton
My Lords, may I ask the Minister whether his department works closely with the Home Office over the problem of the homeless who are mentally ill and who land up in police cells?

§ Lord Skelmersdale
Yes, my Lords, in recent weeks there have been discussions on this very worrying subject.

§ Lord Dean of Beswick
My Lords, is the Minister aware that the report from which I quoted in my first supplementary question showed that in the foreseeable future the number of people sleeping rough in London could be of the same order as in New York where it is estimated that at present 35,000 people sleep rough, an ever-increasing number of those people being found to be mentally ill in some way? I and those people involved with this problem welcome the recent announcement of increased financial resources from government to deal with it. But the Minister must be aware of the size of the problem with which we are dealing and realise that even those increased measures are only tilting at windmills in an attempt to fight a major war. Will he ask the Secretary of State as quickly as possible substantially further to increase resources—and I am speaking about providing housing for those people—in order to enable the people who are dealing with the problem to produce some improvement before it becomes too bad to deal with at all?

§ Lord Skelmersdale
My Lords, I shall of course pass on the remarks of the noble Lord to my right honourable friend. In so doing I shall have to tell him that from the remarks that the noble Lord has made it is likely that he will be a strong supporter of the Government's current Housing Bill, which has such an end in view.