Prejudice and Mental Health

Charles Walker leads a debate calling for Government and society in general to address the culture of prejudice towards to those suffering with mental illness.

Mr. Charles Walker (Broxbourne) (Con): It is with great pleasure that I rise to speak in tonight’s Adjournment debate on prejudice and mental health. We live in enlightened times. People no longer face persecution because of their sexuality, the colour of their skin or the nature of their physical disability. That is an extremely good thing; it is the mark of a civilised society. However, that enlightenment does not yet extend to how we relate to people with mental illness. There still seems to be a permitted culture—or, if not a permitted culture, a tolerated culture—of prejudice and discrimination towards them.

It is sad that, over the past 15 years, society’s view of the mentally ill has gone backwards. Our level of empathy for people with mental illness has actually deteriorated since 1994, and it is time that society and we in this place addressed that. Like many Members of Parliament, I was extremely privileged and honoured to attend the launch of Time to Change, a group of charities that have come together to try to dispel the stigma attached to mental illness. Society is still not reaching out to the mentally ill. We are still keeping them at arm’s length. People with mental illness are afraid to connect with the health services because they are afraid of losing their liberty. Perhaps they are even more afraid, however, of how their friends, neighbours and workmates will respond to them. They face an unwarranted level of prejudice, and that should not be tolerated.

One of the first things that I did when I became a Member of Parliament was to go to a local charity in my constituency. It was a charity that supports people with mental health problems. I met a number of constituents with schizophrenia and other forms of severe psychosis, and I learned a huge amount in those two hours. It was a hugely informative afternoon.

One event left me absolutely marked for the rest of my professional and adult life; it was seared into my heart. A carer told me that one of the patients—the service users—wanted to have a word with me in private, and asked whether I would object. I said that I would not at all object, and that I would very much like to have a private conversation with him.

The gentleman had suffered from schizophrenia for a number of years. He had had very severe schizophrenic events throughout his adult life, but he wanted me to know that he experienced hopes and aspirations, fears and concerns, joy and loathing—all the same emotions as people who do not suffer from mental illness. He wanted me to know that, although he suffered from schizophrenia, he still had hopes, and that there were still things in his life that he wanted to achieve. In essence, he was justifying himself and his illness to me. That was very moving, even though there was no need for it. If he had cancer or heart disease, there would be no reason or expectation for him to justify his illness. I was shocked and saddened that he felt the need to address what he perceived would be my prejudices against him. It was, as I say, a very moving experience, and I learned a lot from him.

Society reinforces the stigma of the mentally ill. We are guilty of that in this very place. If a Member of Parliament is sectioned for more than six months, they will be removed from the House of Commons and a replacement will be found for the seat; there will necessarily be a by-election. What message does that send out? It is no wonder that not a single serving MP in this place has admitted to having a mental health problem. They are fearful of what will happen to them if they do so. If someone running a company has a breakdown or a psychotic event, they can be removed from the board with no right of return. Again, what message does that send out?

One of the saddest aspects of the problem is that people who have had an episode of mental illness are banned from serving on juries. I know that the Government are looking further into that. Each year, 9,000 people are disqualified from serving in this country’s justice system. The tragedy and the comedy of that, if I may make that connection, is that many of the people disqualified from serving on juries will be leaders in their respective fields. Some, yes, will be captains of industry; some will be leaders in the field of medicine, science or industry.

In fact, millions of people across our society who—day in, day out—make a huge contribution to it have mental health problems. They may well be people at the top of Government, or at the top of the Opposition parties, who manage mental health problems each and every day in a way that allows them to make a full and thorough contribution to public life. There should be no need for them to hide away or to hide their illness away. If they admitted that they had a mental illness today, they would remain exactly the same people tomorrow and would carry on doing an equally good job. People with mental illness are no more prone than others to fail or to succeed or even perhaps to be happy or sad; they are ordinary people, managing their illness and making a contribution. There is thus a huge job of work for us in this place to do in amending or getting rid of laws to send the message that mental illness is not something that people should be ashamed of and is not a crime.

I have spoken about mental illness on a number of occasions in this place over the past four years. I have sometimes been critical of coverage by the press. Indeed, I was critical of it three weeks ago. However, I have updated my thinking on this matter. Today I instructed my researcher to look at the News of the World, The Sun and the Daily Mirror over the past six weeks and find some examples of those newspapers taking a prejudicial approach to people with mental illness. I am pleased to say that I could not find one example.

I am aware that Shift, an organisation that the Government are involved with, has published some guidance, which has been distributed to the media, suggesting ways in which they can report mental illness without driving people who have it further underground. I am also pleased to see that some very senior people in the media—people such as Jon Snow, Alastair Campbell and others—have taken the issue to heart. Alastair Campbell himself has suffered from mental health problems and he is leading the campaign to change how the press report mental illness. Let us remember that people with mental illness are 11 times more likely to be the victim of violent crime. They are the victims.

This big campaign, Time to Change, is running at the moment. There is a big media campaign and a big advertising campaign. One in four people, we are told, suffers from some form of mental illness in his or her lifetime: depression, anxiety, and conditions that are far worse and far longer-lasting. For many people, a period of mental illness is something that they will work through. They will obtain the necessary support, and they will come out of that bleak and dark period. But we must not let the figure of one in four diminish the fact that for one in 100 people—perhaps one in 50—mental illness is a life sentence. For those with schizophrenia, there is very little hope of a lasting recovery. Their symptoms can be managed; their equilibrium can be maintained through drug therapies; but, in the main, they will not recover from schizophrenia. There was a very good article in The Times today by Sathnam Sanghera, who wrote about his family’s experience of schizophrenia: his father’s experience and his sister’s experience. As I have said, it is a long-term condition, which will be with them for the rest of their lives.

As a society, we probably have the greatest problem with schizophrenia and severe psychosis, and the way in which those conditions have been represented. I believe that in the coming years we will tackle people’s concerns about depression, anxiety and obsessive-compulsive disorder, but there will be a huge job to be done in breaking down the barriers of concern surrounding schizophrenia, which have been built up for so long by, I am afraid, the media and others through irresponsible headlines.

This is how difficult I believe it will be. A month ago, I got on to a train at Finsbury Park. I am an enlightened person living in an enlightened age; I understand these things. Yet when someone near me on the train was clearly having a severe turn—psychosis—and was clearly a troubled soul, every sinew in my body demanded that I get up and move. Of course, I had to persuade myself that I was being stupid. This man posed no threat to me; he posed a greater threat to himself, and he was deserving of my compassion and sympathy. Yet I, as someone who claims to understand, still wanted to get up and move. If I find it difficult, others who are not so aware of this illness and the terrible, ravaging effect that it has on the sufferer will find it more difficult—difficult not to get up and move, difficult not to form negative opinions, and difficult not to stereotype sufferers from schizophrenia. So there is a huge job to be done, not just this year and next year but for decades to come.

Every day, we in this place must ask ourselves whether we are doing enough to address the stigma and prejudice attached to mental illness. If the answer is no, as it often will be, we must do a great deal more. We are a caring and a compassionate society, and we should set the highest expectations for ourselves. No one should be condemned to suffer in silence; no one should feel ashamed of having an illness. We must wrap our arms around those people and hold them close to us, to show them that we care and that we are with them.

Thank you, Mr. Deputy Speaker, for giving me the opportunity to raise this hugely important topic on the Adjournment.


6.13 pm


The Minister of State, Department of Health (Phil Hope)
: I congratulate the hon. Member for Broxbourne (Mr. Walker)—as I have done before—on securing the Adjournment debate, and thank him for again using the opportunity to raise the key issue of mental health. He spoke with enormous passion and terrific eloquence. I have heard him speak before on the issue, and our view on it is very much shared across the House.

I echo what the hon. Gentleman said about us as a society. We like to think that stigma of this kind is a sin of the past: we do not like to think that any sort of discrimination can be endemic in our modern society, or that it can still have—as the hon. Gentleman made clear—such a profound and negative impact on people’s lives. On this and previous occasions, the hon. Gentleman has done a very good job of pricking that bubble of complacency. As he rightly said, when it comes to mental health, stigma is unfortunately very much alive and well—thriving, in fact—and is something that we need to confront and defeat as a matter of urgency.

Let me briefly make an observation, because I was interested in the hon. Gentleman’s description of how we have made progress on various matters. This might be a crude simplification, but it seems to me that we have made a breakthrough on discrimination in every decade: in the ’70s, on gender discrimination; in the ’80s, on racism; in the ’90s, on homophobia; and in this decade, perhaps on ageism. I am not suggesting that we have totally eradicated discrimination on any of those grounds— obviously there is a lot more that we can do—but we made big leaps forward in those years.

The stigma attached to mental health is the elephant in the room. Approaching the second decade of the 21st century, we may have mental health services that rank among the best in Europe according to the World Health Organisation, but I agree with the hon. Gentleman that popular attitudes to mental health are well behind the times. He eloquently gave an example of someone he met in his constituency. I was struck by the story of a lady who had suffered from breast cancer, and who said that her friends and colleagues found it much easier to deal with her cancer than with the depression that followed when she went into remission. As a rule, people with a physical illness get flowers, sympathy and support; with mental illness, they are often met with silence and solitude—and sometimes reproach. Moreover, this is just the tip of the iceberg, because stigma and discrimination—in businesses, in the media, in public services and across communities—mean that many people never really escape the legacy of their mental health problems not because of poor health, but because of poor attitudes. Giving people flowers or sympathy is fine, but we must address the harsh reality of disadvantage and social exclusion—problems in finding and keeping work, in securing housing and in education and training. What stigma does is deny people opportunity and hope for a better future; I am thinking of the example the hon. Gentleman gave of the individual in his constituency whom he met after he was first elected.

Certain groups are more affected than others and suffer a “double discrimination”—this came up in a debate we had in the House a few weeks ago. Some black and minority ethnic groups have high rates of severe mental illness as well as facing greater inequality in terms of their access to, and experience of, mental health services. That must change. Our five-year action plan, “Delivering race equality in mental health care”, aims to address that by showing how services must adapt to offer timely and culturally sensitive care to different cultural groups. We will also put race inequality—and age inequality, which is another key issue—at the heart of the new horizons project, which is the new vision for mental health we are currently developing.

Having agreed with much of what the hon. Gentleman said, I wish to add that it would be wrong to portray this as a “year zero” moment in tackling this matter, or any other kind of stigma in mental health. Thanks to more than £1.5 billion of further investment in mental health since 2001, the reality is that things are changing: services are improving and experiences are better for people with mental health problems.

Since the last debate, I have had the pleasure of seeing at first hand how a combination of investment and innovation is changing lives. I visited Newham, and if the hon. Gentleman wants to see some excellent practice I recommend he sees what is happening there, too. It has pioneered new ways of improving access to psychological therapies. I met a young French mother who told me how the service she receives linked her to a whole network of support, including a children’s centre and a job club. Her therapist was always available to her, including by text message on her mobile phone, so she always knew somebody was there when a moment arose when she needed support. I spoke to her directly, and it was clear that that support made all the difference. She is now much better and she is receiving help to look for a job—and I am sure she will find one very soon. What was even more encouraging was how the treatment centre I visited linked her with other people who used the centre—and although she has moved on, she still goes there for a cup of tea and a chat when she needs it.

Indeed, the whole community in Newham is starting to break down barriers. Another group, who had received cognitive behavioural therapy, has volunteered to take leaflets round to local clubs and community venues, letting people know help is available. The hon. Gentleman may not know Newham, so may I tell him that it is one of the most ethnically diverse boroughs in the country? That word-of-mouth support has been key to improving the number of black and Asian people receiving treatment. They can self-refer, walk into that centre and get the benefits from it. That has not led to an avalanche of responses from the worried well, as some people feared. People were coming forward with illnesses as serious and enduring as those referred by doctors, so this approach has opened up services for the black and minority ethnic community in a way that others have not.

All in all, the visit I made was an inspiring one. The hon. Gentleman described how he was inspired by the people whom he has met and, likewise, I have been inspired by the people whom I met in Newham. The Government are investing £173 million over the next three years to deliver similar programmes around the country, so that what happens in Newham will soon happen everywhere.

Transforming mental health services is not enough—as the hon. Gentleman said, we must transform attitudes across all public services. Every touch point for people with mental health problems needs to be aware of that and must not hang on to discriminatory attitudes. Our national social inclusion programme and public service agreement No. 16 are focusing minds in public services, bringing together action across central Government and translating it into progress at the local level, particularly on issues associated with settled employment and settled accommodation for individuals.

As the Minister for the East Midlands—that is another role that I have—I have created a regional sounding board in the east midlands to develop practical action across all the agencies that operate regionally on housing, on jobs and on education and training, so that we can bring those people together to examine what more we need to do. That is particularly important now, when people who are a long way away from the employment market are likely to become further away from it if we do not take action to support them.

The Government have a raft of smaller initiatives in place that are aimed at offering individual services that confront and do not compound stigma: the Open to All training package for museums and galleries; the “Really Useful Book of Learning and Earning”, which has been distributed to carers, jobcentre advisers, colleges and training providers; and the Work Matters advice for occupational therapists, which helps them to obtain the advice and guidance necessary to meet their clients’ needs.

Getting local services right can be a springboard for wider changes across society. I am grateful to the hon. Gentleman for mentioning Shift, which is funded by the Department of Health and is doing great work to confront prejudice in two key areas: the workplace and the media. It was great to hear what he had to say about the analysis done by his researcher; perhaps we are beginning to have an impact and perhaps some of that work is beginning to have an influence. He is right to say that leading figures in the media who are prepared to stand up and challenge their own industry on all this are important to making progress. The work being done is also contributing to our forthcoming national mental health and employment strategy, to be led by Dame Carol Black, which will be vital to breaking down barriers to employment in all sectors. It would be great if we could work with the media so that instead of taking an unhelpful, sensationalist approach, they could suddenly become the solution to the problem of changing attitudes to mental health.

That leads me to my final point: the need to create a deeper cultural change across society. The hon. Gentleman and I very much share that aim, which requires political leadership. That is why it is so important that we are having these debates in the House. I know that there is a growing consensus between the political parties and, indeed, between Governments on the issue. I recently attended an international conference on stigma in mental health, where I shared a platform with the hon. Member for Guildford (Anne Milton), who speaks on behalf of the Conservatives, and the hon. Member for North Norfolk (Norman Lamb), who speaks on behalf of the Liberal Democrats. No one could have put a cigarette paper between us; we shared the view that we should challenge that stigma.

I was delighted that the Prime Minister and I attended a cross-party photo opportunity to mark the launch of Time to Change. It has rightly been described as pioneering work. It is a new social marketing programme, rightly led by the third sector—by Mind, Rethink and Mental Health Media—and it is very significant. This is the start of another long journey on which those organisations are going to take us. The fact that the impetus is coming from those organisations will help to garner support in the wider community. We have to reach far deeper into the public’s mindset if we are to achieve the outcomes that the hon. Gentleman and I seek.

An exciting range of activities is planned as part of Time to Change, such as more community-based projects, challenging stigma through social contact and physical activity; training offered to new teachers and doctors on support for people with mental health problems; and even tackling discrimination through test cases in court.

Our efforts in Westminster must join up with Time to Change to create a social movement for change that involves everyone—politicians, practitioners, journalists, the general public—and, of course, people with mental health problems must be at the helm.

Stigma is the enemy of fairness and a barrier to progress. As a society, we must stand united against it. I am proud of what we have achieved in mental health services. I am proud of the significant expansion in community-based support for people with mental health problems, and of the praise that the World Health Organisation reserved for our system in its recent report. But stigma threatens those achievements. So we need the same conviction, the same strength and the same focus that helped us to break down past sources of discrimination—which I mentioned earlier—to end this one too. We all want this period to be the one that we will look back on and say, “That was the moment. It was 2009, the start of the second decade of the 21st century—that was when we made the breakthrough. That was when we opened people’s eyes and changed their minds about mental health.” I know that the hon. Gentleman wants to see that as much as I do. I hope that we can continue to work together to make it happen.


Question put and agreed to.

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