Drug-related Mental and Behavioural Disorder Hospital Admissions

Question

Asked by

To ask Her Majesty’s Government what assessment they have made of the 21 per cent increase in hospital admissions for drug-related mental and behavioural disorders since 2009/10; and what action they intend to take as a result of any such assessment.

My Lords, in 2019-20 there were 7,027 admissions for drug-related mental and behavioural disorders. Admissions were 5% lower that year than in the previous year and 18% lower than at their peak in 2015-16. The factors driving changes in this data are complex. None the less, admissions are too high and the Government are committed to further progress in reducing them, including through increased funding for drug treatment and mental health services and improving co-ordination between their provision.

My Lords, I thank my noble friend for her Answer. Cannabis use does not just lead to mental ill-health and behavioural disorders; it is also contributing to the existential threat that is falling fertility levels and particularly falling sperm counts across the western world. Do the Government recognise the seriousness of these outcomes from recreational drug use and will they factor them into policy decisions, rather than being deterred by liberal individualism?

My Lords, any illegal drug use, including use of cannabis, can be harmful both from immediate side-effects and from long-term physical and mental health problems. It can, for some, have a negative impact on fertility. Cannabis is classed as a class B drug, which is a matter for the Home Office, but there are no plans to change that classification.

Look, my Lords, there is no great mystery: people with mental health problems have seen their community services reduce over time, which means that there is an inevitable increase in admissions to hospitals under a section of the Mental Health Act. The promised reform of the Mental Health Act might help and will be welcome in any event, but it is obvious that more resources in community support are needed to prevent admissions, as well as an increase in the numbers of skilled professionals to provide the therapy. What is the Government’s plan to improve these mental health services outside hospitals and where are the necessary resources?

My Lords, the Government are committed to increasing resources for drug treatment services in England next year and we have put in an extra £80 million for that. That will fund, among other things, additional in-patient detox beds. We are also committed to increasing the resources that go into mental health treatments through the NHS long-term plan.

My Lords, with the number of people across the United Kingdom suffering from drug-related mental and behavioural disorders at a serious level, what education awareness or other preventive measures are the Government providing to stem the tide of drug-related illnesses? When will adequate mental health resources be made available? What percentage of those admitted to hospital with these illnesses are readmissions?

My Lords, one of the complexities in the data that I referred to is that we do not know whether the increase in admissions relates to different people being admitted each time or multiple readmissions among people with drug misuse problems and mental health issues. On education, Public Health England’s Rise Above social marketing campaign aims to equip 11 to 16 year-olds with the skills required to reject or manage risky behaviours, including taking drugs. Talk to FRANK is the Government’s drugs information and advice service, which provides information and advice to young people and parents to help to protect children from drugs and/or alcohol misuse.

My Lords, a recent report from the Centre for Social Justice found that the number of young people in treatment for drug and alcohol dependency had dropped by 35% since 2009. It is accepted, however, that this cannot be explained by differing consumption levels. Since 2014, approximately 30 residential rehabilitation centres have been forced to sell assets to survive public funding cuts. What assessment, if any, have the Government made of the CSJ report recommendations, including returning funding to the sector to at least the levels of 2012 and the creation of a prevention and recovery agency for the formulation of an addiction strategy?

My Lords, to address this, we have asked Dame Carol Black to complete part 2 of a review of drugs to look at treatment for people with substance misuse problems. As I said earlier, we have increased the funding for drug treatment services in England next year, including for additional in-patient detox beds.

We now have several reports showing that LGBT people have a greater than average incidence of mental health and substance misuse problems. Yet there is no mention of this community in the latest mental health proposals and a complete absence of any mention of this group of people in the NHS plan. What will the Government do to make the leadership of the NHS stop ignoring this particular bunch of taxpayers?

My Lords, in April 2019, we appointed Dr Michael Brady as the first national adviser on LGBT healthcare, and we also had the £1 million LGBT health and social care fund to tackle health inequalities experienced by LGBT people. Projects funded by that initiative included Advonet, which developed a self-advocacy course for LGBT people with mental health issues, and training by the Royal College of General Practitioners for GPs and surgery staff on LGBT health and inequality.

My Lords, can the Minister confirm that there will be an advertising campaign highlighting how recreational cocaine use destroys the lives of vulnerable young people because of county lines activity? Can she ensure that the campaign includes cannabis and skunk use, not least because of the mental health harms raised by my noble friend, which we as a nation are increasingly concerned about?

My Lords, there are the two educational campaigns that I have already referred to: PHE’s Rise Above social marketing campaign and Talk to FRANK. My noble friend mentioned county lines activity, which is of great concern to the Government. On 20 January, we announced £40 million of dedicated investment to tackle drug supply and county lines and to surge our activity against these ruthless gangs.

My Lords, alcohol is by far and away the most common and popular drug, yet 9% of people with alcohol dependence account for 59% of alcohol-related admissions to hospital, which take up 1.4 million beds a year. This seems a shameful waste of resources and source of human misery. Can the Minister assure me that the detox beds are only a part of the solution, as just taking someone away from alcohol for four days will not be a long-term solution?

Absolutely. Part 2 of Dame Carol Black’s review of drugs, which should report to the Government shortly, is expected to include recommendations on what can be done nationally and locally to tackle drug and substance misuse and the support needed for those who face addiction and mental health issues.

My Lords, in 2019, five out of 12 English regions did not have a doctor training to specialise in addiction psychiatry. Indeed, funding for addiction services in England fell by 29% in real terms from 2013 to 2020—and we can add to that the fact that virtually all services and treatments available have been disrupted by the Covid-19 epidemic. Do the Government have a plan to address the regional disparities of drug misuse and drug-related mental and behavioural disorders?

My Lords, the noble Baroness is absolutely right that we need to do more in this area and that Covid has made it harder. That is one reason why the Government have announced an additional £500 million for 2021-22 to support NHS mental health services to recover from the pandemic, address wait times and invest in the NHS workforce.

What plans do the Government have to address the shortfall in supported housing for vulnerable people, such as recovering drug and alcohol users and people with mental health issues?

My Lords, the Government are committed to putting more funding into both the provision of more affordable housing and more social housing, which will help to address these issues.

The long-term use of cannabis and high-strength cannabis contribute a great deal to diseases of the mind and the brain. Have their effects been factored into social care and dementia strategies and the long-term NHS plans? Can the Minister elaborate on that?

My Lords, one challenge among drug treatment services is an ageing population for certain drug users. I will certainly take my noble friend’s point away and write to him with any further details.

My Lords, the time allowed for this Question has elapsed.