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Mental Health Budget: Domestic and Sexual Violence

Volume 794: debated on Thursday 22 November 2018


Asked by

To ask Her Majesty’s Government how much of the National Health Service mental health budget goes towards intervention to address domestic and sexual violence and abuse.

My Lords, it is not possible to provide a precise figure because expenditure is not identified by cause of health condition. Abuse victims accessing services are not identified separately: they receive treatment based on clinical need rather than on the cause of their condition. However, the NHS is expanding psychiatric liaison services in A&E, in which staff are trained to assess the risk to patients of violence. Sexual assault referral centres then provide health support to victims and have £31 million of funding in 2018-19.

I thank the Minister for that Answer. Given that the Government have recognised the scale of the mental health challenge, particularly for victims of domestic abuse and sexual violence, and have put some money aside for this area to be spent at local level, how do they plan to ensure that the funding is available and gets to the refuges and organisations on the front line that are desperate to tackle this desperate need?

I am grateful to the noble Baroness for her recognition of the work that is going on in funding. It is important to point out that NHS England published a sexual assault and abuse strategy this April. That involved funding for sexual assault referral centres and a range of other innovations, including an Identification and Referral to Improve Safety project, which has now been rolled out in 800 GP practices. So work is going on not only to roll out these kinds of services but to make sure that many more victims are coming through to them. I know that the Women’s Mental Health Taskforce is due to report later this month and I will speak to my colleague, Jackie Doyle-Price, who is the lead Minister, to find out if we can give more specificity on how we track the number of users of these kinds of services.

My Lords, we know that sexual violence in childhood, whether as a victim or secondary victim, correlates closely with mental illness in adulthood. Will the Government make childhood trauma a local commissioning priority and invest in trauma-informed models of care?

The noble Baroness is right and I can reassure her that some of the additional £100 million of funding that the Government are providing for this issue is going on children who have been victims of abuse. Indeed, the draft domestic abuse Bill that we look to bring forward this Session will propose tougher sentences when a child has been involved in domestic abuse.

My Lords, is it possible for the Department of Health to assist the police in some way? So many victims of sexual violence, several of whom have approached me personally, say that there is quite a long delay between their reporting the violence and the police bringing the perpetrator to court—if the case gets that far. Is there any way to shorten that timescale, without any implication of justice not being allowed or cut too short for the accused? Is there anything that the Department of Health could do to bridge that gap a little? It would be so helpful.

My noble friend is right: that is a really important part of the approach. It is encouraging that 88% of women would now tell someone about abuse they have suffered and that there has been a 20% increase in domestic abuse convictions since 2010. As we discussed in this House last week, we are seeking through the GP contract negotiations to abolish the fees that some GPs charge for the letters needed for referral to legal aid and other things. That is something we continue to push.

My Lords, the statistics tell us that for every two women who are affected by domestic violence or abuse, there is one man. Can the noble Lord reassure the House that spending allocations reflect this?

The noble Baroness is quite right. The strategy, of course, has a focus on women and men. Women are the greater victims of abuse; indeed, the more severe the abuse, the more likely it is that the victim is a woman. However, I can tell her that it is a broad strategy which encompasses both. We still have a problem, in that men are much less likely to come forward if they have been abused than women.

My Lords, it is much to be welcomed that the Government are allocating this money. I am also glad that the needs of young people have been highlighted, but the Minister will be aware that statistics show that roughly 340,000 elderly people are suffering abuse in the community each year. If we are not tracking how the money is spent, how can we be sure that the mental health needs of the elderly are being properly addressed at a particularly vulnerable point in their lives?

The right reverend Prelate makes an excellent point. The intention is that there will be greater reach into care home settings as well as domestic settings, so that people who experience abuse in those settings are able to come forward and we can provide such protections for people in homes.