All Party Parliamentary Group on Mental Health
I am co-Chair of the All Party Parliamentary Group on Mental
Health, which is attended not only by MPs and Peers with an interest in mental health but
also representatives of voluntary organisations and others active in mental health issues.
The Royal
College of Psychiatrists provide the secretarial support and the APG has
been a very useful discussion forum and has helped bring disparate groups together to form
the Mental Health
Alliance.
Annual review for
06-07
Please click here for the APG's annual reviews
Please click here for the notes of APG meetings
Access to Psychological Therapies meeting, Oct 2007
Meeting notes
My Speech during the Mental Health Bill, June 2007
Mental
Health Bill Speech
1 in 100 launch - July 2006
Click here for more information
on the launch of a campaign to provide more information to people experiencing
schizophrenia and their families and friends.
For the most recent information on the work I have been doing on mental health issues,
please see the APG archive
Some of my previous policy work from 2002/2001/2000 is detailed below:
On 25 June 2002 the Government published a
draft Mental Health Bill and there was an opposition day debate in Parliament. My
contributions to the debate are posted below.
Click here for Early Day Motions:
EDM 1432 THE ZITO TRUST
AND A WORLD CLASS MENTAL HEALTH SERVICE
12 June '02
EDM 1345 BENEFITS FOR PATIENTS RECEIVING LONG TERM IN-PATIENT CARE 20 May '02
Response to the Goverment's
statement on the Mental Health White Paper Dec 2001
November 2002 - Article for the House
Magazine
Government must
listen to expert committee on Mental Health
On 25 June 2002
the Government published a draft Mental Health Bill and there was an opposition day debate
in Parliament. My contributions to the debate are posted below.
Click here for information on the launch of the 'One in a
Hundred' campaign in the West Midlands
Intervention:
Lynne Jones (Birmingham, Selly Oak): Will
my right hon. Friend acknowledge that Government policy will have failed if the use of
compulsion does not decrease in future?
Mr. Milburn: That
is what we want. We must try and are trying to undertake two parallel processes. The first
is to deal with the loopholes in the law that, admittedly, only ever affect a small
minority of people and a small minority of patients, although with huge and sometimes
tragic consequences. However, our effort overall must be to develop services that are
capable, in an appropriate way, of dealing with people's problems without compulsion. That
is why we are trying to build up services in hospitals as well as crisis intervention
teams in the community, assertive out-reach teams and some of the new services that are
being made available for young people with the first onset of psychosis.
25 Jun 2002 : Column 770
Normally such young people,
who are among the most vulnerable in the community, are simply not dealt with at all. They
often have to wait years to be seen. However, we now know that the model that is being
rolled out in 18 local communities across the country works. It can provide quick,
interventional services and makes a real difference to those people. It prevents them from
ever requiring hospitalisation.
As I tried to make clear
earlier, the trick is to get the range of services right. Although the national service
framework and the NHS plan are, by necessity, 10-year programmes—we must build up
capacity and change the culture of the service—progress is under way. Last year was
the first year in perhaps decades in which the overall number of mental health beds in the
national health service rose rather than fell. There are more than 500 extra secure beds
and 320 extra 24-hour staff beds. Such services were never available in the past, but more
of them are to come.
Clearly, everything cannot be
done at once, because of staffing and capacity constraints. None the less, a range of
services that gets early intervention into place and ensures that appropriate services for
those who need them are available in primary and hospital care is in place across the
country as a whole.
Speech:
Lynne Jones (Birmingham,
Selly Oak): Today's debate has been interesting and enlightening. I agree with many of the
comments made by previous speakers, and congratulate the Conservative party on making
mental health the subject of this Opposition day debate.
There is much consensus
between Government and Opposition on this issue. It was, after all, a Conservative
Secretary of State for Health who coined the term "spectrum of services",
acknowledging that there had been a failure to put adequate services in place in the
community. It is sad that the hon. Member for Woodspring (Dr. Fox) did not acknowledge the
failures of the Conservative Government. I agree with much of the Opposition's motion, but
I am sad about its failure to acknowledge the positive progress that the Government have
made. They have made the vision of the spectrum of services a reality by increasing the
number of assertive outreach teams, improving talking treatments and psychology services
and investing in the physical infrastructure in our acute wards.
There will be considerable
investment in new mental health services in Birmingham. An acute hospital that is not very
old is to go. It was provided in the late 1980s, and when I went there, I was appalled at
the lack of therapeutic atmosphere in the building. It was a very constrained building
that had obviously been subject to a great deal of cost cutting. At last we will get new
services; many will be for in-patients, provided locally rather than at the main hospital
base. The Government are making that investment. The Conservatives are right to say that
we have a long way to go, but it is churlish not to acknowledge that great progress is
being made.
I have not yet had an
opportunity to look at the draft Bill, but I welcome its publication. I agree with the
hon. Member for Gosport (Mr. Viggers) that it should be subject to Special Standing
Committee procedure. It is now nearly 20 years since the last major piece of mental health
legislation. The draft Bill represents the opportunity of a lifetime, and we must ensure
that we get it right. We must ensure that we balance the emphasis on public
protection—which I think is over-emphasised—with people's right to receive
appropriate care. That right is not in place at present. Every time we use compulsion it
is an indication less of failing in the individual than of failing in the services
provided for people in need.
The Government are
initiating a 10-year programme to build up capacity. Goodness knows, more money is needed,
and we must be vigilant in ensuring that money allocated for mental health services is not
diverted to deal with other pressures. However, no matter how much money we put into
services, it is also essential that we have enough staff with the necessary skills.
We do not have enough staff
at the moment. The Sainsbury Centre for Mental Health has pointed out that in the existing
establishment, one in eight positions is
25 Jun 2002 : Column 789
vacant. If the ambitions of the Government, expressed in
the national service framework and other plans, are to be realised, we shall need an
additional 8,000 staff—a 12 per cent. increase.
Psychiatry is a Cinderella
service in more ways than one. It is not attractive to newly qualified graduates, and we
need to ensure that it becomes more attractive. One reason why people shy away from mental
health services is the culture of blame in our society, which creates problems in many
services, including social work. Because of the stresses and strains on a service, things
go wrong—and it is too easy to blame individual clinicians or social workers for
their mistakes. That is not to deny that bad mistakes are sometimes made, or that there is
some culpability. In many cases, however, people are working against the odds and we
should acknowledge that.
We must deal with the blame
culture, and we should move away from too much emphasis on public protection. The only
time there is any great publicity or press interest is when a tragic event, especially
homicide, occurs. In that context, it is commendable that the Opposition have initiated a
debate on mental health when that type of public interest is not current. It is also
commendable that they have adopted mental health as one of their priorities; it is already
a priority for the Government, so there is much consensus, on the basis of which we can
move forward.
At the last meeting of the
all-party mental health group, we discussed mental health appeal tribunals. We heard about
patients who had to wait more than 20 weeks for their case to be reviewed by a tribunal.
The Royal College of Psychiatrists has pointed out that the process is extremely
staff-intensive. A mental health appeal tribunal chair told the all-party group about the
constraints on the tribunal service, including the shortage of psychiatrists to serve on
the panels and the fact that the psychiatrists who have to provide reports for the
tribunal are over-stretched.
The White Paper proposed
automatic referral to a mental health tribunal after 28 days of compulsory treatment; my
right hon. Friend the Secretary of State suggested that the Bill would include such a
provision. There is concern, however, that even more psychiatric time will be taken up in
dealing with the process, so there is a danger that there will be even more delays in the
system. The Government need to consider that point.
Although there is consensus
among us, omitted from many contributions to the debate was the need to make the
experiences of users of the service central to its provision. We should have respect for
them and involve them in decisions about their care. A survey carried out by the National
Schizophrenia Fellowship showed that a quarter of mental health service users did not even
have the opportunity to discuss their medication, while 62 per cent. said that there was
no discussion of any possible alternative.
I am pleased to acknowledge
the report produced recently by NICE, which made it clear that the choice of
anti-psychotic drugs should be made jointly by the patient and the clinician. The report
also noted that the use of atypicals should be a primary consideration, and there should
be an end to postcode prescribing of such drugs. Compliance with medication is an
important issue, and the use of the more modern drugs must be more
25 Jun 2002 : Column 790
widespread. Those drugs are not new; they came out 10
years ago, and it is one of the great failures of our service that they were not taken up.
Advance directives should
have higher status; they should be given statutory recognition. If treatment is to be
compulsory, the people who make such decisions should take into account the wishes of
patients, who should have had the opportunity to express those wishes when they had the
capacity to do so. Consideration of such wishes should be a statutory obligation, and
patients should be encouraged to carry crisis cards.
The social security system
is important to the well-being of mental health service users. I urge Ministers in the
Department of Health to ensure that they have input to the development of services by the
Department for Work and Pensions. Compulsion causes great stress to people who are already
suffering from mental ill health. I draw the attention of the House to early-day motion
1345, which notes the poor availability of benefits to long-term patients, who receive
only about £15 a week. The chief executive of the mental health trust in my area has
pointed out that she has to use valuable trust resources to subsidise patients who cannot
afford such basic needs as haircuts and shoes.
Carers are important. Too
often, confidentiality is given as an excuse for excluding them. Obviously, if a service
user expressly wishes to exclude relatives, that wish should be respected—although
questioned. However, family members are too often excluded by default, because clinicians
and service providers do not discuss the needs of the whole family with the service user.
We must give greater priority to the involvement of carers. People who suffer from mental
ill health, as well as those who suffer from personality disorders—the distinction is
sometimes blurred—have often experienced trauma in their lives, and family members
can help to provide support and enlightenment.
We need joined-up services.
We need good services that take into account the fact that many mentally ill people also
suffer from alcohol or drug abuse. Too often, services are either not provided at all or
are provided separately, without appropriate links.
More and more health and
social services are being provided through partnership arrangements. However, that means
that when people want to complain about a service, there is no single point of reference.
The local government ombudsman deals with complaints about social services, while the
health service ombudsman deals with complaints about the health service. Will the
Government consider appointing an ombudsman specifically for mental health service users
and their carers?
Much has been said about
stigma. We will not be able to give priority to mental health services until we deal with
the stigma. The hon. Member for Woodspring began by saying that in mental health we
accepted services that would not be acceptable in any other aspect of health services, and
he is right. Too often, people are afraid to speak out about their experiences; they hide
their feelings under the carpet.
One day, the shame attached
to visiting a psychiatrist will be no greater than the feelings that people have when they
visit any other medical practitioner. People will seek help when they need it. They will
be able to talk about their experiences. Indeed, they will be proud of their
25 Jun 2002 : Column 791
ability to do overcome all the problems
associated with mental ill health in our society. Their family members will not suffer the
stigma of having someone with a mental illness in their families. The Government are
putting in place the policies to achieve that, and we all have a role to play in ensuring
that the day when people can talk about their experiences comes sooner rather than later.
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Early Day Motions
In February 2008 I tabled the
following motion in support of a new guide to tackle stigma and discrimination associated
with mental illness:
EDM 1027 - WHAT'S THE STORY MEDIA GUIDE
ON MENTAL HEALTH REPORTING
That this House welcomes the guide for the media entitled What's the Story produced by
Shift, the Department of Health-funded campaign to tackle stigma and discrimination
associated with mental illness; notes that headlines continue to carry derogatory terms
like nutter, schizo or maniac and considers that by challenging these stereotypes, rather
than reinforcing them, the media can encourage more openness about mental illness which
will dramatically improve the lives of all those affected and will encourage others to
come forward to get the treatment they desperately need; further notes the information
provided by the guide on the dangers to vulnerable people of sensational reporting of
suicides and the need to avoid reporting excessive detail about methods used in order to
prevent copycat suicides; and urges all those reporting on mental health issues to make
good use of this guide and the contacts listed within it
For more information on Shift or for a copy of the 'What's the Story' handbook: www.shift.org.uk/mediahandbook/
In November 2007 I tabled the following motion about the dangers of cannibis use:
EDM 209 - RESPONDING TO THE DANGERS OF CANNABIS USE
That this House supports the mental health charity Rethink in its call for a public
education campaign to convey the dangers of cannabis use; offers this support in light of
the recent review of research published in the Lancet, which concludes that frequency of
cannabis use increases the risk of psychotic illness such as schizophrenia by up to 40 per
cent.; calls for clarity on the cannabis debate, particularly regarding the strength of
skunk varieties of the drug; believes that reclassifying cannabis will not in itself lead
to a decrease in the number of people who use it; notes that the proportion of young
people using cannabis has actually fallen since it was reclassified in January 2004 from
25.3 per cent. of 16 to 24 year olds in 2003-04 to 20.9 per cent. in 2006-07; and urges
the Government to commit to the development of a long-term awareness and information
campaign with health promotion rather than a change in the law as the main lever to reduce
use, in addition to funding research into the link between cannabis use and mental ill
health.
For more information on Rethink: http://www.rethink.org/
In May and June 2002 I tabled the following Early Day Motions on Mental Health issues:
EDM 1432 THE ZITO TRUST AND A WORLD CLASS MENTAL HEALTH SERVICE 12
June '02
That this House notes the parliamentary launch on 13th June of The Zito Trust report
entitled, Looking Forward To A World Class Mental Health Service; welcomes the fact that
this report follows the recent National Institute for Clinical Excellence guidance which
recommends the first-line use of the modern atypical antipsychotics for people with
schizophrenia; recognises that the report highlights the current postcode prescribing that
NICE was in part established to address; and calls on the Government to ensure that
sufficient funds get through to healthcare professions to ensure that this landmark
guidance is implemented in a timely manner.
EDM 1345 BENEFITS FOR PATIENTS RECEIVING LONG TERM IN-PATIENT CARE 20 May '02
That this House notes that long-stay patients
receiving free in-patient care, including large numbers of people suffering from mental
ill health, receive only £15.10 per week state benefit; also notes the comments of the
Chief Executive of South Birmingham Mental Health NHS Trust that the trust is regularly
having to supplement this allowance from care budgets to ensure that people's basic needs
for clothing, toiletries, haircuts and other personal items are met, causing a drain on
NHS resources; further notes that this grossly inadequate personal income is depriving
patients of the means to develop greater independence and compromises severely their
social inclusion and integration into the ordinary life of the community; welcomes the
campaigning work on this issue by Derbyshire Patients' Council; and calls on the
Government to raise the amount of benefit that long-stay patients receive to at least
£30.00 per week.
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Response to the Goverment's statement on the Mental Health White Paper
Dec 2001
In response to the Government's
statement on the Mental Health White Paper, Reforming the Mental Health Act I
wrote to Alan Milburn, Secretary of State at the Department of Health, in my capacity as
co-chair of the All Party Group on Mental Health (copy of my letter posted below).
I have also tabled Early Day
Motion 128 condemning the stereotypes of people with mental illness portrayed in the
film 'Me Myself and Irene'
Letter to Alan Milburn on the Government's Statement of 20 December
Alan Milburn MP
Secretary of State
Department of Health
Richmond House
79 Whitehall
London
SW1A 2NS
Date: 21 December 2000
Dear Alan,
Mental Health Statement 20 December
I am writing about your reply to the point I made during the statement. Whilst I am
totally in agreement with your response, it did actually not address the point I was
making which was about the importance of people with symptoms of mental illness referring
themselves for help as quickly as possible. The stigma associated with mental illness and
the fear of compulsory treatment contribute to the delays in people seeking help.
The White Paper does make the point that good quality care and treatment is the key to
making sure that most people with mental health problems will never need to fall within
the scope of mental health legislation. I was hoping that my question would have given you
the opportunity to reinforce that point and also acknowledge the danger that the extension
of compulsory treatment into community settings might possibly increase the reluctance to
self referral.
I am sure that you would agree that the possibility of compulsory treatment in the
community should not be allowed to reduce responsiveness to a mentally ill person’s
or their carer’s request for care. Many mental health organisations fear that this
could be an unintentional effect. There is also a need to acknowledge that compulsory drug
therapy could involve the use of drugs with greater side effects, particularly depot
injections and this could inhibit future compliance once the period of compulsion is at an
end.
I hope these comments are helpful. I am very pleased with the progress that is being
made in improving mental health services but I am sure you will agree that we still have a
long way to go.
Yours sincerely,
LYNNE JONES MP
Article for Mental Health Today - December 2001
Every family in the land is touched in some way by mental illness
and yet the overwhelming public perception is that mentally ill people are dangerous and
their problems self-inflicted. The only logical interpretation of this inconsistency is
that people bottle up their own experiences, whether as a sufferer or as a relative or
carer, because of the stigma that continues to be associated with mental illness. Thus is
the low priority given to mental illness perpetuated.
We must break out of this cycle. Any reform in legislation must put at its heart the
need to treat people with respect. It is clear, from the increased use of existing
compulsory powers, that the cries for help of so many sufferers or those close to them are
ignored until a person’s condition deteriorates to the extent that compulsory
treatment is required. Those subject to compulsion should be seen as victims of inadequate
services rather than treated as convicts. Respect requires that service users should have
a say in their treatment. Advance treatment directives should be given statutory status.
We must end the use of ‘confidentiality’ as the excuse for preventing
relatives and carers from being involved. Service users should be encouraged to include
their close family in discussions about their treatment, which should not just be about
doling out medication. Mentally ill people and, indeed, people suffering from
‘personality disorder’ (the difference is usually artificial), have often
experienced some trauma in their lives, which needs to be understood. Except in
exceptional circumstances, family members are vital to this process and their continued
support must be nurtured. Only if a patient specifically wants to maintain
confidentiality, should next of kin be excluded. Measures need to be introduced to
positively review such exclusion.
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