Babies and bathwater. I’m keen to avoid the reality of this and other familiar cliches as I get to grips with my role as minister for community and social care at the Department of Health. And if I may invoke another familiar phrase, new brooms often do more harm than good as policies and processes are swept aside in service to the erroneous notion that it is better to be seen doing something than risk the perception of nothing.
When it comes to mental health this is a pitfall I am determined to avoid and a point I made recently to the Royal College of Psychiatrists where I spoke of the need for continuity of policy – accelerated improvement based on established principles, not endless reorganisation.
And I wouldn’t be saying this if there wasn’t already evidence that our approach to mental health is yielding positive results in some areas – a testament in part to the good work of my predecessor in this brief, Norman Lamb, and the combined dedication of our many sector partners.
The launch of the Mental Health Crisis Care Concordat last year is a case in point. It was a watershed moment for the police and local health and care services as they signed up to joint crisis care declarations and action plans intended to reduce the use of police cells for those detained under the Mental Health Act.
The concordat is clear that local mental health services – including appropriate places of safety – must be available whenever someone needs them, round the clock, seven days a week. A broken mind must be treated with the same urgency and care as a broken leg. This step change in dealing with those experiencing psychological trauma is already making a real difference. In 2011 to 2012, the number of reported cases of people detained in a police cell under section 136 of the Mental Health Act was 8,667. We set a goal to halve this by the end of the last financial year. We actually exceeded it – in 2014-15 there were 3,996 cases.
There is more to do in this area of course, and my honourable predecessor also made it clear that detaining under 18s in police custody had to go. This is not to say the police are always inappropriate guardians – and I was struck by an observation in the recent Care Quality Commission report into crisis care that skilled police intervention is well regarded. However, it also noted more needed to be done to address the risk that young people themselves might feel criminalised, and that we should be providing a better alternative for their safety these days.
I look forward to maintaining close working relationships with local police forces, mental health professionals and care service providers, as together we seek to provide even greater protection and support to children and young people.
This was a big motivation for making my first official ministerial visit to the South London and Maudsley trust near King’s College hospital in Denmark Hill. Here I witnessed first-hand their ground-breaking and truly community-based approach to treating young people in crisis and the excellent support extended to their families and carers. Good mental health care must extend beyond clinical walls.
More broadly, I will continue the support and promotion of mental health services across the age spectrum, for expectant mothers suffering psychological distress, increased access to talking therapies for all, and enhanced education and counselling services in schools. On this latter point, I’m looking forward to working with ministerial colleagues in the Department for Education on the recently announced “single point of contact” pilot schemes in schools. Building on the work of last year’s children and young people’s mental health taskforce, co-chaired by the Department of Health and NHS England, this is another positive step on the road to continuous and effective mental health care for young people.
We know the majority of adults with mental health problems began to suffer during childhood or adolescence. Intervening early is critical to reducing the impact and severity of mental ill-health in later life. Children and young people’s mental health – and the services that exist to help them – will therefore be my priority and I am dedicated to doing what I can to help get them right.
I hope that by the end of this parliament we will be offering the distraught parent or carer – phoning in a panic – the early referral, or the nearby bed for their child in an emergency, rather more often than we are now.
I will continue to lend my voice and support to those in the care and support sector who are challenging stigma and lack of understanding of mental health issues – to the experts, charities and medical professionals whose wise counsel I will use to inform existing and future policy initiatives.
Most importantly, I and my colleagues, inside and outside government, will continue to listen and engage with end users – with the people it is our duty and privilege to help.
