I would like to update the House following today’s announcement made by the Prime Minister, The Right Honourable Theresa May MP about this Government’s plans to reform mental health services in this country.
For too long those suffering mental illness in England have experienced a hidden injustice. Mental illness has been shrouded in stigma and the needs of those with mental health problems have been neglected compared to those with physical illness. An estimated one in four people in the UK will experience a mental health problem at any one time and the economic and social cost of mental illness is estimated to be £105 billion a year. Left unaddressed, mental illness can destroy lives, cause untold pain to families and prevent people from fulfilling their potential at work, school or in society.
This Government is determined to address the historic failure - over successive generations and governments - to tackle mental illness. We are grateful to the Independent Mental Health Taskforce for publishing the Five Year Forward View for Mental Health last year, which set out a clear roadmap for the NHS, our Arm’s Length Bodies and Government. In February, the Department for Health supported their recommendations with an additional investment of £1 billion per year by 2020. NHS England accepted the recommendations for the National Health Service in full and have published an Implementation Plan. Today the Prime Minister announced that the Government accepts all the recommendations made to it by the Independent Task Force on Mental Health and is publishing an update on our progress against these recommendations. The Government’s response to the Mental Health Task Force is attached.
But we must go further still. The challenge of mental illness is growing and we must all - at every stage of life and every level in society - take steps to tackle it.
First, because we know that children and young people are most susceptible to mental illness and most disorders originate in childhood, we must make mental health a priority in our classrooms and in our families. The Government had therefore announced a series of steps to ensure children and young people get the support they need. We will:
- commission a major thematic review of children and adolescent mental health services across the country, led by the Care Quality Commission with assistance from Ofsted – the first of its kind.
- bring forward a new Green Paper on Children and Young People’s Mental Health later this year, to set out plans to transform services in schools, universities and for families.
- introduce new support for schools with every secondary school in the country to be offered mental health first aid training and new trials to look at how to strengthen the links between schools and local NHS mental health staff.
- develop peer support for children and young people’s mental health and emotional wellbeing - confirming a programme of pilot activity on peer support, as outlined earlier in the year, along with £1.5 million in funding.
- launch a programme of randomised control trials of promising preventative programmes, across three different approaches to mental health promotion and prevention.
Second, we must work with employers to ensure better mental wellbeing in the workplace. Because we know that there are important steps businesses can take to support their workforce, and those that do see benefits in higher productivity and lower absence. The Prime Minister has therefore appointed Lord Dennis Stevenson, the long-time campaigner for greater understanding and treatment of mental illness, and Paul Farmer CBE, CEO of Mind and Chair of the NHS Mental Health Taskforce, to drive work with business and the public sector to support mental health in the workplace. These experts will lead a review on how best to ensure employees with mental health problems are enabled to thrive in the workplace and perform at their best. This will involve practical help including promoting best practice and learning from trailblazer employers, as well as offering tools to organisations, whatever size they are, to assist with employee well-being and mental health. We will also review recommendations around discrimination in the workplace on the grounds of mental health.
Third, we need to offer alternatives to hospital to support people in the community. We recognise that seeing a GP or going to A&E is not or does not feel like the right intervention for many people with mental ill-health, the government will build on its initial £15m investment to provide and promote new models of community–based care such as crisis cafes and community clinics. The initial £15m investment led to 88 new places of safety being created. Since 2011-12, there has been an almost 80 per cent reduction in England of people experiencing a mental health crisis being taken to police cells, utilising health-based place of safety, rather than being held in a cell, ensuring people get the best support – in the right place, at the right time, in the right way. The Government now plans to spend up to a further £15m to build on this success.
Fourth, we will expand treatment by investing in and expanding digital mental health services. Digitally assisted therapy has already proved successful in other countries and the government will speed up the delivery of a £67.7m digital mental health package so that those worried about stress, anxiety or more serious issues can go online, check their symptoms and if needed, receive clinically-assisted therapy over the internet, when this is clinically appropriate for the person rather than waiting weeks for a face-to-face appointment – with face-to-face sessions offered as necessary. We will:
- introduce a major £60m investment, £30m from Government and £30m from Trusts, of digitally assisted mental health services in six mental health trusts, badged Global Digital Exemplars for Mental Health. Global Digital Exemplars will be expected to make a step change in their use of digital technology, informatics and data to improve value overall by improving the processes of care, using information to better inform decision making about care, improving the levels of safety and effectiveness of care, improving the ability to sustain continuous quality improvement and improving patient access to appropriate evidence based care
- pilot digitally-assisted therapy for the NHS’s talking therapies programme. This £3m pilot will trial existing treatments and offer patients faster effective therapy for illnesses such as anxiety and depression and involve working with NICE to establish a new accelerated accreditation process, to ensure mental health patients can access treatments that take full advantage of changing technology which have been properly tested and accredited, with products becoming part of the mainstream offer to people if meeting NICE standards.
- strenthen the mental health content of the clinical triage platform for NHS 111 with a £3.3m investment, ensuring improved triaging of those experiencing mental ill-health using the NHS’ online platforms, as well as allow self-referrals online.
- Pilot and further roll out the Health Based Place of Safety Capacity Management App at a cost of £900,000 to help police and health services manage places of safety spaces in real time.
- Develop a set of apps and resources for £500,000, which will be included on an online digital health tools library, and rolled out on commercial platforms like the Apple App store.
Fifth, we must right the everyday injustices that those with mental health problems face. We will:
- work with Money and Mental Health Policy Institute to undertake a review of the mental health and debt form and agree an approach that will end this unfair practice.
- support NHS England’s commitment, made this year, to eliminate inappropriate placements to inpatient beds for children and young people by 2020/21.
- publish the refreshed Government Suicide Prevention Strategy, a copy of which is attached.
The latest figures from the Office of National Statistics show that 4,820 suicides were registered in England during 2015 - equivalent to 13 people per day. Self-harm is also on the rise, with up to 300,000 hospital attendances per year in England categorised as resulting from self-inflicted injury.
We are already taking steps to help reduce suicide. The £247 million investment in mental health liaison services will see trained psychiatrists and counsellors made available in Emergency Departments to assess, counsel and refer patients onto other mental health services if they present with signs of self-harm or other psychological distress.
Local authorities will also be expected to strengthen local suicide prevention plans, and there is an explicit focus on improving how services respond to cases of self-harm, which is the biggest single indicator that a person may be at increased risk of suicide.
It is hoped that the new strategy, which sets out how local areas should do more to support those at high risk of suicide, will also encourage local authorities strengthen efforts to reach other groups known to be at increased risk.
These include young men – who are three times more likely to die by suicide than women - those in contact with the criminal justice system and certain occupational groups.
Many parts of the country already have established preventative plans. These vary by area, but have included: stronger outreach and liaison services, dedicated services for young people who self-harm and training programmes to help health professionals, police and other community services to understand how to identify and respond to people in acute distress.
All local authorities will now be expected to develop strong, multi-agency suicide prevention plans by the end of 2017, ahead of these being checked and approved by the Department of Health.
In addition, NHS England will develop a new care pathway for self-harm, which will provide greater consistency in how those groups are cared for across the NHS, with consistent treatment guidelines for the recognition, treatment and management of self-harm.
There will also be an increased focus on ensuring those who have been recently bereaved – which are another group at increased risk of suicide – receive information and follow-up support to help them cope with their loss.