Mental Health: Parity of Esteem

I will call Liz Twist to move the motion and then call the Minister to respond. I remind other Members that they may make a speech only with prior permission from the Member in charge of the debate and the Minister. As is the convention in 30-minute debates, there will not be an opportunity for the Member in charge to wind up.

I beg to move,

That this House has considered parity of esteem between physical and mental health.

It is a pleasure to serve under your chairship, Mrs Hobhouse. In my constituency surgeries I see the devastating consequences of our failure to treat mental illness with the urgency it requires. In my role as chair of the all-party parliamentary group on suicide and self-harm prevention, I hear from young people about their experiences and the impact of waiting for treatment from mental health services. Bad mental health is routinely cited as a reason for economic stagnation, low school attendance rates and an increase in benefit claimants. Long waits for mental health support are directly linked to worsening symptoms and, tragically, to spikes in self-harm and suicide attempts.

Tragically, my constituent’s husband, John, took his own life in 2021 after a mental health crisis while in the care of NHS mental health services. Does the hon. Member agree that we need more Government support and funding for access to quality mental health services in rural areas? If we were losing people in this way to physical conditions, it would be a national scandal.

The hon. Member might be reading my mind, because I will come on to that issue. I am sorry to hear of the death of his constituent—it is tragic.

I commend the hon. Lady for securing the debate, and she is absolutely right to address this issue. In Northern Ireland, we have extreme mental health issues; indeed, the figure is 25% higher than it is here on the mainland. The Government have made a commitment to address the nation’s physical health. Does the hon. Lady agree that they must now treat the nation’s mental health equally? In doing so, they will address the emotional issues among the people we represent here.

I do agree, and I will expand more on that theme.

Parity of esteem means tackling mental health with exactly the same respect, funding and clinical focus as physical conditions.

I thank my hon. Friend for securing this important debate, and I know that she is a strong advocate for mental health in her role on the APPG. In the NHS, it is vital that funding for mental health keeps pace with funding for physical health care, and the mental health investment standard has been a crucial policy in driving parity of investment. Does she agree that it is vital that the mental health investment standard is retained in the NHS?

I agree with my hon. Friend on the importance of the mental health investment standard as one of the measures for securing good mental health support and for making mental health equal with physical health.

As I was saying, parity of esteem means tackling mental health with the same respect, funding and clinical focus as physical conditions. We are here today to debate that principle, which has been discussed in this place for over a decade, yet it remains unfulfilled. We have made great strides in mental health: the Mental Health Act 2025, investment in mental health support teams for schools, which were rolled out this week, and additional mental health workers. Now it is time to deliver on our manifesto commitment to

“give mental health the same attention and focus as physical health.”

We need to look at the current waiting lists for mental health support, but before I look at the figures, I remind Members that every patient waiting to access mental health support is in urgent need of support, just as those on physical health waiting lists are. Sadly, and all too often, people see their condition worsen as they wait, which can lead to extreme consequences. Furthermore, physical illnesses frequently cause profound psychological distress, yet our services treat the physical and the mental in isolation. From my experiences of working with people who have rare conditions, I know the impact that that can have.

The most recent figures show that almost 1.87 million adults and over 576,000 children and young people currently hold open referrals for mental health services. If these were patients waiting for hip replacements or cardiac care, that would dominate the national discourse. NHS England has developed waiting list targets for mental health patients after referral—the longest being four weeks after referral for access to community-based services for non-urgent mental health care—but those developed standards have never been adopted. Research shows that 12 times more patients with mental health conditions are waiting longer than 18 months for treatment, compared to those with physical conditions. The Government have rightly instructed the NHS to drive down waiting times for elective physical health care, but so far mental health services have been excluded from that ambition.

My hon. Friend was a champion for mental health long before I came to this House, and I congratulate her on securing the debate. She makes a point about spending, and I read this morning that despite 28% of cases in the NHS being related to mental health, it receives only 13% of the funding. That is at the same time that parity of esteem has been a legal requirement for over a decade. If we are serious about parity of esteem between physical and mental health, the spending must follow the rhetoric.

My hon. Friend is quite right to point to those figures and to say that we need much more input into tackling that difference in funding.

As I said, the proportion of NHS funding spent on mental health is expected to decline, and we need to look again at that. That is exactly why the mental health investment standard was introduced, and why we need the planned 10-year mental health strategy, when it is published, to set out the actions we need to take to ensure that mental health has parity of esteem with physical health. It is vital that the MHIS continues to protect mental health spending until a suitable long-term funding measure is firmly in place to ensure that funding matches need.

Three weeks ago, the interim Milburn review highlighted the unique combination of pressures faced by young people entering adulthood today, including a mental health system that cannot respond to the current level and severity of demand, a pandemic that affected their social development and an ongoing loneliness crisis.

My hon. Friend is being very generous in giving way. I know that this is a topic she understands deeply and has campaigned on for many years. She is right to highlight the Milburn review. Does she agree that part of the response has to be developing a mental health support system that is preventive, not just reactive? We see that in child and adolescent mental health, particularly in Scotland, where there are enormous waitlists. We have to tackle those, but we also have to have a system—in education, for example—where we prevent people from reaching crisis, whether in childhood or when they become adults.

I absolutely agree with my hon. Friend, which is why I am so pleased that we set up mental health teams in schools.

We need to look at preventive measures so that we do not keep getting into this position. When people are left to languish on waiting lists, their ability to participate in the workforce collapses. We must stop waiting for people to hit rock bottom before we step in: we have to deploy preventive measures. It is simply not good enough that one in three young people must wait more than 18 months for treatment after referral.

I welcome the changes the Government have implemented, the extra investment for mental health support in schools, and the expansion of that support to 100% of schools by 2030, but I have some specific asks of the Minister, supported by mental health charities. First, will she ensure that reducing waiting times for non-urgent community mental health care is included as a specific priority in NHS planning guidance? That would send a clear message to local systems that this must be tackled alongside elective physical care.

Secondly, Mind, the mental health charity, says that reducing mental health care waiting times must be treated as a core test of parity of esteem; Rethink makes the same point. Will the Minister commit to fully rolling out the access and waiting time standards consulted on by NHS England in 2021 to ensure that emergency mental health care is provided within one hour, urgent care within four hours and community care within four weeks?

Thirdly, to help us to meet our shared ambitions for parity of esteem, will the Minister outline how we will work together to reverse the projected decline over the next two years in the proportion of NHS funding spent on mental health? Will the Government also commit to protecting the mental health investment standard until a long-term alternative funding plan is firmly in place?

Finally, the Government have outlined an ambitious shift toward neighbourhood health services. How will the Department ensure that community mental health is a central component of this roll-out, so that patients can access multidisciplinary support before they reach crisis point? We have a historic opportunity to build a national health service that treats the mind and the body with equal respect. I look forward to the Minister’s response on how we will finally deliver true parity of esteem between physical and mental health services.

It is a pleasure to serve under your chairship, Mrs Hobhouse. I am grateful to my hon. Friend the Member for Blaydon and Consett (Liz Twist) for securing this important debate, for her long-standing commitment to improving mental health services, and for her phenomenal work in her role as chair of the APPG on suicide and self-harm prevention. I am also grateful to all hon. Members who have contributed to the debate and shared experiences from their constituencies. I am sorry to hear of John’s death. Men’s suicide is a huge concern; many of us, myself included, can share personal stories. We need to do much more in that space.

This debate speaks to the heart of what a modern health and care system should be. For too long, mental health has not been given the same attention, priority or esteem as physical health. That has had profound consequences for individuals, families and communities across the country. It also has significant economic impacts, as we heard from my hon. Friend, with an estimated 1.26 million 16 to 64-year-olds economically inactive due to mental health issues in 2024-25. The National Health Service Act 2006 states that health includes mental health. This Government are committed to giving mental health the same attention and focus as physical health, and ensuring that people can access timely, high-quality support, regardless of whether they are experiencing a mental or a physical health condition.

As my hon. Friend said, parity of esteem means recognising that mental and physical health are inseparable. Far too often, services have treated them as distinct issues, when in reality they are connected. Of course, many people experience mental and physical health conditions at the same time, with a cause and effect relationship that goes both ways. We know that poor mental health can increase the risk of developing physical health problems, while living with a long-term physical condition can have a significant impact on a person’s mental wellbeing. People living with severe mental illness experience some of the poorest physical health outcomes in our society, and on average die 15 to 20 years earlier than the general population. That is why we are committed to improving the ways that services respond to people with co-occurring mental and physical health needs.

On wraparound care, we have a fantastic initiative in Winchester where Citizens Advice spends time with patients at Melbury Lodge, the in-patient unit, to help them deal with all their life admin, such as debt issues and money issues. It has been shown that those who receive that service have a shorter stay in hospital, are significantly less likely to be readmitted and are more likely to engage with social services once they have been discharged. Is the Minister willing to meet me and the team to discuss that initiative? For every £1 spent on it, £14.08 is saved in cost avoidance for the NHS.

I thank the hon. Gentleman for mentioning the wraparound care in Winchester citizens advice bureau. We need the local health ecosystem to partner with initiatives in the voluntary or charity sector such as that one, and acknowledge their impact, fund and support them. Some may think that things such as debt are basic, but their impact on mental health cannot be overestimated. I am sure that officials will want to meet the hon. Gentleman and others to look at the landscape across the country, because there are some fantastic initiatives that we need to recognise, partner with and support.

The Government are taking action to elevate the status of mental health. For 2026-27, NHS mental health spending is forecast to increase to a record £16.1 billion, representing a real-terms increase of around £140 million compared with the previous year. Alongside that, the mental health investment standard remains in place. Integrated care boards are required to protect mental health spending in real terms over the next three years, ensuring that mental health continues to receive the investment needed to improve services and outcomes.

Investment alone is not enough. We must transform how care is delivered. That is why the 10-year health plan sets out our vision for a neighbourhood health service, which my hon. Friend the Member for Blaydon and Consett mentioned. That is about bringing care closer to people’s homes, communities creating genuinely patient-centred services, and moving away from a fragmented system that often leaves people navigating multiple services without the support they need. I hope the ICBs are engaging hon. Members in all parts of the House to feed into the design of the neighbourhood health centre model and asking about the unmet needs and service gaps in their constituencies and regions.

The Minister is being kind with her time, as always. As part of our inquiry into mental health services, the Health and Social Care Committee visited the 24/7 neighbourhood mental health centre pilots and Trieste, where the model originated. They have clearly been hugely successful already. The Minister mentioned the broader neighbourhood healthcare changes; can she assure us that the learnings from those hubs will be spread across the country? Will there be a clear road map for rolling out these services to every area?

My hon. Friend is absolutely right; this is a great pilot, and there are some real, huge successes. The Government must learn from the impact that the hubs will have, and of course we want to roll them out. That is why we are piloting six community-based health centres across England in Tower Hamlets, Lewisham, Whitehaven, York, Sheffield and Birmingham. Those centres provide round-the-clock open access treatment and support for adults with severe mental health needs and work closely with primary care and community services to provide joined-up care.

All hon. Members across the House will recognise that it is not appropriate for someone who is facing crisis or poor mental health to be sat in A&E; that just exacerbates their condition and situation. The community-based health centre pilots show that a different model can work. In May, my noble Friend Baroness Merron visited the community-based mental health centre in east Birmingham, where she met staff and service users to hear directly about the service’s impact. The visit demonstrated the important role that community-based mental health support has in providing earlier intervention, improving experiences of care and helping people to access support before reaching crisis point.

I know that my hon. Friend the Member for Blaydon and Consett is particularly interested in how the reforms will benefit her constituents. Although her constituency is not home to one of the six core or the 16 associated community-based mental health pilot sites, a range of community-based support is already available locally. Gateshead Connects hubs provide accessible community drop-in spaces that offer mental health and wellbeing support alongside practical advice on issues such as housing and finances. Residents can access NHS talking therapies through services based at Blaydon primary care centre, and community mental health support networks operating across County Durham provide peer-led groups and safe spaces for people living in and around Consett. Those local services reflect the wider direction of travel in our 10-year health plan, which will bring support closer to people’s homes, strengthen community-based provision and ensure that people can access help earlier, before their needs escalate into crisis.

Some residents in rural Somerset have said to me that they are waiting 18 months to receive talking therapies. That is just not good enough.