Mental Health Services (Hansard, 1 April 2003)

§ Baroness Andrews
My Lords, we have embarked upon a long-term programme of modernisation to increase the capacity of the mental health service, provide better access to effective treatment and care, reduce unfair variation and raise standards. This includes action to implement the national service framework for mental health. Our strategy, as always, will be informed by research and development.

§ Lord Ashley of Stoke
My Lords, I thank my noble friend for that reply. Can she confirm or dispute a report that mental illness is the cause of 50 per cent of all measured disability, yet only 12 per cent of NHS funding and 6 per cent of the medical research budget is spent on it? If those figures are broadly correct—and I believe that the research went up to 2001—will my noble friend tell the House what the Government intend to do to change this very sorry picture?

§ Baroness Andrews
My Lords, I suspect that no one knows better than the noble Lord just how long a history of neglect mental health has in this country and the extent of the under-funding that we inherited in 1997. We have made mental health a priority in several ways, primarily through the first national service framework that we established, with seven standards aimed at raising standards across mental health services. Those standards are generating improvement in community development services and in many different ways. We have made £300 million extra available for three years to 2003–04 to develop prevention and care services. We have invested in finding out what is needed, primarily by establishing a new institute, the National Institute of Mental Health, which will play a key role in research and development and good local practice. I think that we can look forward to a better future in mental health.

Lord Campbell of Croy
My Lords, are the Government satisfied with the availability of the latest forms of medication which can help some of the mentally ill to lead reasonably normal lives safely, outside institutions?

§ Baroness Andrews
Yes, my Lords, there is a new range of atypical antipsychotic drugs which seem to be helping people significantly. We understand there have been some concerns about delays, but all PCTs are required to follow the NICE guidance after three months and make those drugs available. We believe that they are making a difference.

§ Lord Clement-Jones
My Lords, the Minister referred to the national service framework. Can she confirm that money will be adequate to implement the national service framework and that it is being received by those trusts to which it has been allocated. Can she also confirm whether the Mind Out mental health campaign, which is an excellent government initiative, will carry on beyond this year, whether it will be funded and whether it will be evaluated by the Government?

§ Baroness Andrews
My Lords, on the first part of the question, we believe that the funds allocated are sufficient. We are beginning to see growth across the service—for example, 22 new early intervention teams are in place in local communities. These are particularly intended to pick up young people who display psychotic attitudes and episodes. We have 63 new crisis resolution teams for people in acute need; we have 191 assertive outreach services. We are already noticing the difference now that we have these community developments in place. For example, where the crisis resolution teams are in place, we have seen a 30 per cent drop in admissions to hospital.
On the second part of the noble Lord's question, I shall have to write to him.

§ Baroness Masham of Ilton
My Lords, is the Minister aware that the National Health Service is now working more closely with the Prison Service? Will there be any new initiatives to help those prisoners who are mentally ill, of whom there are far too many?

§ Baroness Andrews
My Lords, that is a very important question when one considers that 90 per cent of people in prison have some sort of mental disorder. Again, the health service has been working much more closely with the Prison Service for over a year; the PCTs will be driving the funding for the Prison Service as of this April. We are seeing a much more integrated service, which is very helpful.
We already have 48 teams working in 48 prisons to develop inreach services and more psychiatric services. We hope that there will be 70 of those by next April. Although it was not exactly a target, we hope that by 2006 every prison will have these additional and very important services.

§ Lord Avebury
My Lords, I welcome the development of inreach services for mental patients in 1168 our prisons. What is being done to make places available for the 500 people in our prisons who still need residential psychiatric care? How will those places be provided?

§ Baroness Andrews
My Lords, I am not entirely sure which population the noble Lord is talking about, but I can tell him that because of the development of the range of community services as a whole and the development of specialised mental health trusts, there should be increased capacity across the service.

§ Lord Roberts of Conwy
My Lords, further to the Minister's answer to my noble friend Lord Campbell of Croy, is she satisfied with the availability of the latest drug to help schizophrenics?

§ Baroness Andrews
My Lords, as I said, there have been concerns that the new atypical antipsychotic drugs, which were the subject of NICE guidance last summer, have not been reaching patients quickly enough. However, we have seen the rates of prescription going up, so we think that they are reaching more of the people who need them.

§ Lord Addington
My Lords, does the Minister think that, given the complications caused by mental illness and its diversity, there should be at least some form of legislation to ensure that people who have one episode of mental illness are not discriminated against in employment and so on for the rest of their lives?

§ Baroness Andrews
My Lords, that is an extremely important matter. We are considering ways of ensuring that people with mental health problems are not excluded from employment. For example, the Social Exclusion Unit is about to start work on a report examining social exclusion of people with mental illness. It will examine particularly the employment prospects of such people.

§ Lord Rea
My Lords, speaking of legislation, can my noble friend give us a progress report on the redrafting of the expected mental health Bill?

§ Baroness Andrews
My Lords, there was an extremely large response to the consultation on the draft Bill. Over 2,000 responses were received. They are still being evaluated. A report will be published but the Bill itself will have to wait for parliamentary time.

§ The Earl of Listowel
My Lords, does the Minister agree that research suggests that a healthy relationship between an infant and his or her parents is likely to reduce susceptibility to certain kinds of mental disorder in adulthood? Does she further agree that the work of my noble friend Lord Northbourne—who I see is present—in championing support for parents, that of the noble Baroness, Lady Brigstocke, with Home Start and that of the Government's own Sure Start programme are likely to prevent many children developing certain kinds of mental disorder in 1169 adulthood and may indeed have an impact on those 90 per cent of adults in prison with personality or similar disorders?

§ Baroness Andrews
My Lords, I entirely agree. There is no doubt that loving family relationships are absolutely essential for people to develop into sound adults. We are investing in parenting schemes such as Home Start, through which homes are accessed that would otherwise be very difficult to reach, and Sure Start, which helps many families who are not entirely confident about bringing up their children and want advice and support. Those are fundamental building blocks to a better and healthier society in terms of mental health.

§ Earl Howe
My Lords, is the Minister aware that in the five years from August 1997 the number of people claiming state benefit on grounds of mental illness has dramatically increased? There has been an increase of 78 per cent in those claiming Disability Living Allowance and an increase of 25 per cent in those claiming incapacity benefit. What do those figures say about the state of mental health services in Britain? Do they not underline the priority that the Government should be giving to this area of healthcare?

§ Baroness Andrews
My Lords, the reasons for those figures may be complex and diverse. For example, they may reflect an ageing population and the forms of dependence that come with it. As I said, one of the matters that the Social Exclusion Unit will examine is how to increase employment opportunities for people with mental health problems. I imagine that many people on incapacity benefit could be helped with extra support resulting from the changes in incapacity benefit. The figures say a lot about the health of the nation but we are putting new remedies in place.

§ Baroness Howells of St Davids
My Lords, one of the most worrying considerations for the Caribbean community is the number of black males in mental institutions and the treatment they receive. Can the Minister tell the House whether there has been any advance in the type of treatment that they now receive, or whether there is any on offer?

§ Baroness Andrews
My Lords, we are certainly aware that black and ethnic minority people are disproportionately represented in the part of the population with mental health problems. A report was published in March on how to improve mental health services for black and ethnic minority people which explores some of the reasons services fail. After consultation we shall publish implementation guidance in the summer which will address the question of how we get the black and ethnic minority workers we want; how we deal with language issues; how we build capacity; and how we clear pathways for people in need to get the help they want. We hope that by making that a priority—certainly the National Institute of Mental Health will help us do that—we shall he able to make a significant difference to that population.