HC Deb 13 February 2004 vol 418 cc285-9W
Keith Vaz

To ask the Secretary of State for Health what steps he has taken to ensure fair treatment of ethnic minorities in NHS mental institutions. [155603]

Ms Rosie Winterton

The specific and general duties of the Race Relations (Amendment) Act 2000 places an onus on statutory bodies to identify and tackle racial discrimination faced by the black and minority ethnic community.

In support of this for mental health services we have issued for consultation "Delivering Race Equality—A Framework for Action" which sets out what those planning, delivering and monitoring local primary care and mental health services need to do to improve services for users, relatives and carers from black and minority ethnic communities. This is backed up by a programme of work by the National Institute for Mental Health in England (NIMHE).

NIMHE has also issued "Engaging & Changing—Developing effective policy for the care and treatment of Black and minority ethnic detained patients". The document provides guidance in relation to the development of policies concerning the care and treatment of black and minority ethnic communities in the areas of ethnic monitoring, racial harassment, the use of interpreters and the provision of culturally appropriate care and staff training.

Keith Vaz

To ask the Secretary of State for Health whether NHS mental health services have a written policy banning racial abuse. [155604]

Ms Rosie Winterton

The NHS Plan introduced an improving working lives standard in 2000 which makes it clear that every member of staff in the national health service is entitled to work in an organisation which can prove that it is investing in improving diversity and tackling discrimination and harassment. All NHS organisations including mental health trusts have to achieve the standard, which is a key performance indicator, part of the star rating system.

In relation to tackling racial harassment an improving working lives toolkit "Improving Working Lives: Tackling Racial Harassment in the NHS—Good Practice Guidance" was issued in 2001. This guidance sets out key principles on tackling racial harassment in NHS employment.

The need for local policies to deal with staff/patient and patient/patient racial harassment where patients have been detained under the Mental Health Act is highlighted in the National Institute for Mental Health document "Delivering Race Equality—A Framework for Action and Engaging and Changing—Developing effective policy for the care and treatment of Black and minority ethnic detained patients".

Mr. Rosindell

To ask the Secretary of State for Health how many people in mental health institutions died in each of the last five years through(a) hanging, (b) hanging with the use of a non-collapsible curtain track and (c) hanging with the use of a collapsible curtain track. [154418]

Ms Rosie Winterton

The total numbers of people who died in mental health institutions from hanging in each of the last five years for which figures are available (1997–2001) are shown in the table.

Deaths from hanging
1997 57
1998 44
1999 51
2000 36
2001 36
Note:
Figures for hangings using non-collapsible and collapsible curtain tracks are not available.

Tim Loughton

To ask the Secretary of State for Health which professionals make up an assertive outreach team. [154406]

Ms Rosie Winterton

A detailed service specification for assertive outreach teams, which includes information on staffing requirements, is contained in the "Mental Health Policy Implementation Guide" (2001), which is available from the Department's website at http://www.publications.doh.gov.uk/mentalhealth/implementationguide.htm and is also available in the Library.

Tim Loughton

To ask the Secretary of State for Health what percentage of the assertive outreach teams that are operational are multi-disciplinary. [154407]

Ms Rosie Winterton

According to the Durham mental health service mapping database www.dur.ac.uk/service.mapping/amh), over 95 per cent. of assertive outreach teams, which are operational, are multidisciplinary.

Tim Loughton

To ask the Secretary of State for Health if he will list which trusts depend on home treatment teams for additional cover to their assertive outreach teams. [154409]

Ms Rosie Winterton

Information about the arrangements for clinical cover in teams is not captured centrally.

The inter-relationship of teams and services and their working arrangements are local matters in the context of national guidance on standards of care, the evidence concerning best practice, and the targets set within the NHS Plan.

Guidance on the configuration of teams and services is provided in the Mental Health Policy Implementation Guide, which is available from the Department's website at http://www.publications.doh.gov.uk/mentalhealth/implementationguide.htm and is also available in the Library.

Tim Loughton

To ask the Secretary of State for Health how many early intervention teams the National Service Framework for Mental Health recommends establishing. [154423]

Ms Rosie Winterton

The "National Service Framework for Mental Health" (1999) set out standards for treatment and care for people with mental health problems, including two standards specifically concerned to ensure that each person with severe mental illness receives the range of mental health services they need. The NSF also set out evidence concerning the importance of early intervention for young people with the first sign of a psychosis.

The "NHS Plan" (2000) provided extra investment by 2003–04 to fast-forward the NSF and set a target of 50 early intervention teams to be established by 2004 to ensure all young people who experience a first episode of psychosis receive the early and intensive support they need.

Further details were set out in the "Mental Health Policy Implementation Guide" (2001) which is available from the Department's website at http://www.dh.gov.uk, a copy of which has also been placed in the Library.

Mr. Burstow

To ask the Secretary of State for Health what the total funding for mental health services was in the NHS in England in each year since 1997. [154005]

Ms Rosie Winterton

I refer the hon. Member to the reply given to him on 15 January 2004,Official Report, columns 857–58W.

Mr. Burstow

To ask the Secretary of State for Health pursuant to his answer of 2 February 2004,Official Report, column 687W, on mental health, how many carer support workers are employed in the NHS. [154010]

Ms Rosie Winterton

This information is not centrally available. Arrangements are being made to centrally capture data on carer support workers in post by the end of the year.

Tim Loughton

To ask the Secretary of State for Health when he expects the full complement of(a) early intervention, (b) assertive outreach and (c) crisis resolution teams to be established, as set out in the National Service Framework for Mental Health. [154424]

Ms Rosie Winterton

The full complement of assertive outreach teams has been delivered.

We expect local services to have plans in place to deliver the full complement of early intervention and crisis resolution teams by the end of the year as set out in the NHS Plan (2000).

Mrs. Gillan

To ask the Secretary of State for Health how many prisoners have been(a) diagnosed with and (b) treated for mental health disorders in each year since 1997, broken down by prison establishment. [155900]

Dr. Ladyman

The information is not available in the form requested. A survey of psychiatric morbidity among prisoners in England and Wales in 1997, by the Office for National Statistics, showed that 90 per cent. of prisoners have at least one significant mental health problem, including personality disorder, psychosis, neurosis, alcohol misuse and drug dependence. Around 5,000 people in prison at any one time have a severe mental illness though they will not all be acutely ill.

Prisons and their national health service primary care trust partners are responsible for assessing the health needs of their populations and developing services, including mental health services to meet those needs. NHS funded prison mental health in reach teams will be providing services in 90 prisons by March 2004.

Mrs. Gillan

To ask the Secretary of State for Health if he will make a statement on incidence of mental health disorders among ethnic minority prisoners. [155901]

Dr. Ladyman

In 1997 the Office for National Statistics (ONS) undertook a survey of "Psychiatric morbidity amongst prisoners in England and Wales". The report included a range of information on the prevalence of specific mental health problems in black and minority ethnic prisoners. A copy of the ONS study is available in the Library.

Mrs. Gillan

To ask the Secretary of State for Health if he will make a statement on the effectiveness of mental health service(a) provision and (b) interventions in prisons. [155902]

Dr. Ladyman

The provision of national health service community-style mental health services will be in around 90 establishments by March 2004. An evaluation of the in-reach programme has been commissioned through the NHS forensic research and development programme and is expected to start shortly.

Mrs. Gillan

To ask the Secretary of State for Health what programmes are in place to ensure swift identification of prisoners with mental health disorders upon arrival at prison establishments; and which prison establishments operate such programmes. [155903]

Dr. Ladyman

Her Majesty's Prison Service and the Department of Health are working together to implement a revised reception health screening process by March 2004. The new process focuses explicitly on ensuring prompt and effective identification of individuals with mental health problems.

The new reception screening arrangements are being introduced into the following establishments in England by March 2004: Durham, Eastwood Park, Feltham, Glen Parva, Holme House, Leeds, Liverpool, Manchester, New Hall, Wandsworth, Brixton, Bedford, Lewes, Preston, Styal, Wormwood Scrubbs, Woodhill, Dorchester, Exeter, Highpoint North, Lincoln, Norwich, Pentonville, Hull, Chelmsford, Nottingham, Hindley, Altcourse, Ashfield, Blakenhurst, Bristol, Brinsford, Castington, Gloucester, Leicester, Highdown, Birmingham, Forest Bank, Onley, Parkhurst, Shewsbury, Stoke Heath, Winchester, Elmley, Brockhill, Bullingtdon, Doncaster, Long Lartin, Lancaster Farms, Wetherby, Wakefield, Holloway, Belmarsh, Full Sutton, Huntercombe, Reading, Warren Hill, Werrington, Low Newton, Kirkham and Morton Hall.

Mrs. Gillan

To ask the Secretary of State for Health which prisons operate permanent community mental health teams. [155904]

Dr. Ladyman

The specialist care of severely mentally ill prisoners is provided by mental health teams, which are staffed by national health service employees and broadly correspond to local community mental health teams. There are currently 90 such teams operating in the following establishments in England:

Phase 1: (introduced during 2001–02): Belmarsh, Birmingham, Brixton, Bullwood Hall, Chelmsford. Durham, Eastwood Park, Feltham, Frankland, Holloway, Leeds, Leicester, Pentonville, Wandsworth, Winchester, Whitemoor, Woodhill and Wormwood Scrubs.

Phase 2: (introduced during 2002–03): Ashfield, Bedford, Blakenhurst, Bristol, Brockhill, Dorchester, Exeter, Glen Parva, Holme House, Hull, Lewes, Lincoln, Liverpool, Long Lartin, Manchester, Moorland, New Hall, Norwich, Nottingham, Onley, Parkhurst, Portland, Preston, Rochester, Styal and Wakefield.

Phase 3: (introduced during 2003–[...]4): Albany/Camp Hill, Altcourse, Aylesbury, Blantyre House, Brinsford, Buckley Hall, Bullingdon, Canterbury, Castington, Coldingly, Cookham Wood, Dartmoor, Deerbolt, Doncaster, Dovegate, Drake Hall, Elmley, Forest Bank, Foston Hall, Full Sutton, Garth, Gartree, Gloucester, Haverigg, Highdown, Highpoint North/Highpoint South, Hindley, Hollesley Bay/Warren Hill, Huntercombe, Kingston, Lancester Farms, Littlehay, Low Newton, Maidstone, Northallerton, Reading, Risley, Shrewsbury, Stafford, Stoke Heath, Swaleside, Swifen Hall, Thorn Cross, Werrington, Wetherby and Wolds.

Mrs. Gillan

To ask the Secretary of State for Health how many people are employed to treat mental health disorders in each prison establishment. [155905]

Dr. Ladyman

This information is not available. Most healthcare staff working in prisons will be involved in some way in caring for individuals with mental health problems. By March 2004 we expect to meet the NHS Plan commitment for 300 additional staff to provide specialist community type mental health services to over 5,000 prisoners.

Mrs. Gillan

To ask the Secretary of State for Health what the total cost of mental health programmes in UK prisons was in each year since 1997, broken down by prison establishment. [155906]

Dr. Ladyman

In England the total amount allocated specifically to primary care trusts for national health service mental health services in prisons was £1,719,000 in 2[...]01–02; £3,685,000 in 2002–03 and £9,400,000 in 2003–04. A breakdown of this information, by prison, has been placed in the Library. We expect total expenditure on these services to double to around £20 million by 2[...]05–06.

Mental health services for prisoners are also provided through Her Majesty's Prison Service, but the funding for these is not separately identified.

Mrs. Gillan

To ask the Secretary of State for Health what mental health programmes are available to prisoners upon release from prison. [155907]

Ms Rosie Winterton

Released prisoners can access the full range of mental health services available to the population in which they become resident. An important function of national health service mental health in-reach teams working in prisons is to ensure effective through-care for prisoners with serious mental health problems, to be followed up by support from appropriate mental health services on release.