To ask Her Majesty’s Government what plans they have to address mental health factors in their public health agenda.
My Lords, mental health is recognised as an integral part of public health. The public health White Paper will set out a new approach to public health, giving mental health the same prominence as physical health conditions such as cancer and heart disease. The Government recognise that there is no public health without public mental health.
I thank the Minister for that encouraging reply. Of course, he will recognise that there is a long way to go. Some 50 per cent of all smoking related deaths in this country are attributed to people with mental disorders, and in fact those with mental illnesses account for almost half of all the tobacco consumed. People with schizophrenia and other mental illness have by far the worst outcomes in terms of mortality, losing on average 20 years of their lives. Will there be specific targets in the forthcoming White Paper around the physical health outcomes in terms of mortality and morbidity of those with serious mental disorders?
My Lords, yes. We know that people with severe mental illness die on average 20 years sooner than others and that the majority of these deaths are smoking related. Improving public health is at the core of the Government’s health policy, as I expect the noble Baroness is aware. We will make clear our priorities in this area when the public health White Paper is published.
My Lords, we know that early years development is absolutely critical to whether adults will be vulnerable to mental illness later. What things do the Government intend to do in terms of early development, not just in health but across departments, to try to ensure less vulnerability not only in young people, although that is important, but also in adults, since these vulnerabilities develop early on?
My Lords, my noble friend is absolutely right: this is a cross-government effort. It is not simply for the Department of Health to deal with the issue because just about every department has some sort of remit in this area. I would say that, in particular on the attainment of children at school, we will focus very much on children from disadvantaged backgrounds because there is a high correlation between mental ill health and poverty, and mental ill health and deprivation. That will be a major focus.
My Lords, what steps are the Government taking to ensure that GP consortia have access to the expert advice they will need if they are to commission positive mental health messages and the prevention of mental illness?
My Lords, many GPs understand the issues very well and are keen to get on with the agenda. Our proposed model of GP commissioning means that practices will have flexibility within the new legislative framework to form consortia in ways designed to secure the best healthcare and outcomes for their patients. That will include mental health and could involve, for example, taking commissioning decisions collectively with perhaps a lead consortium for mental health.
My Lords, I know that the number of young people being detained in adult mental health hospitals is decreasing steadily, but can the Minister tell us, first, how many remain, and secondly, what policy will be set out in the framework for seriously disturbed young people who will be contained within the community?
My Lords, the noble Baroness is right to say that there is legislative provision to ensure age-appropriate accommodation for young people in particular suffering from mental health difficulties. A range of products has been produced by the National Mental Health Development Unit to assist hospitals to meet the legal requirement to provide that age-appropriate setting. It does not mean, of course, that no under 18 year-olds may be treated on adult psychiatric wards as there are circumstances where that is appropriate. But my understanding is that this legislation is being observed and is making a difference.
My Lords, given that two-thirds of the women in prison have diagnosable mental health disorders and that services are currently commissioned through primary care trusts, how will such services be provided once the trusts are abolished?
My Lords, we have just completed the consultation on the White Paper and we have received 6,000 replies. We intend to publish our response before the end of the year, and prison health, in particular, will form a part of that response.
My Lords, the noble Earl has already mentioned children with mental health problems. Does he agree that a parent with mental health problems can have a serious and damaging effect on a child’s life chances? Are there any statistics on how many children are today growing up in families with a parent with mental ill health? If not, will the Government consider collecting such statistics in the future?
My Lords, I do not believe that we collect data on the attainments at school of children with parents who have mental health difficulties. However, we know that severe parental mental health problems are one of a range of risk factors that are statistically associated with poor emotional health. There are some statistics, which I will endeavour to supply to the noble Lord, but my understanding is that long-term outcomes are not particularly clear. Nevertheless, there is evidence that children and young people who are emotionally and mentally healthy and active achieve more and participate more fully with their peers at school.
My Lords, we know that a range of mental health issues disproportionately affect black and minority ethnic communities—for example, the high risk of developing psychosis among the black Caribbean community. What steps are the Government taking to ensure that we have targeted prevention strategies in this area to continue the work of the previous Government?
My Lords, the previous Government’s Delivering Race Equality in Mental Health Care programme ended in January of this year. That programme was delivered through working in partnership with service users, carers, clinicians and third sector agencies. A tremendous amount of information came out of it and the learning and findings from that programme will inform the work that we are now carrying out on a new mental health strategy, which we plan to publish in a few weeks time.
My Lords, Professor Marmot’s review of health inequalities found that unemployment has a significant impact on both physical and mental health. In the light of that and indeed of the rest of that excellent report, what are the Government doing to implement its recommendations?
My Lords, we very much welcome the Marmot review. Fairness and social justice are both key principles of the coalition Government. The Secretary of State for Health has said that he wants to build on the review’s findings and its six main policy objectives, from early years to ill health prevention. The forthcoming public health White Paper will set out our approach to tackling health inequalities and addressing the wider determinants of health.