That this House notes with concern the rise in mental ill health among women, with one in five now experiencing common mental disorders and young women the most at-risk group; recognises that women’s mental health problems are often rooted in experiences of violence and abuse; believes that mental health services often fail to respond to women’s specific needs, including their experiences of trauma; calls on the Government to ensure that the gender- and trauma-informed principles of the Women’s Mental Health Taskforce are adopted by mental health services and that women’s mental health needs, including their experience of violence and abuse, are prioritised and taken seriously in all mental health policy, strategy and delivery.
Constituents often come to us at their lowest point, and we see them going through anxiety, depression and trauma. Poor mental health affects not only the individual, but everybody around them. Women are far more likely to experience serious mental health issues. Young women are at the greatest risk, with one in five having self-harmed and 13% having been diagnosed with post-traumatic stress disorder.
Over the course of this Parliament, there has been a great deal of talk in this House about mental health, which is progress, but the opportunity to discuss women’s specific needs when it comes to mental health services has been limited. Ten months after the publication of the final report of the Women’s Mental Health Taskforce, little has changed. There is a long way to go before our mental health services work for women. There is an obligation on Government to step in and respond to the growing crisis in women’s mental health with a substantive policy.
I very much welcome the work of the Women’s Mental Health Taskforce, its report, and the principles laid out in it. Does the hon. Lady share my concern that those principles will not be effectively implemented unless there are clear targets and concrete commitments from the Government, and that the next stage needs to be a full strategy on women’s mental health, with those targets and commitments in it?
I could not agree more. We need a strategy. More than half of women who experience mental ill health have a history of abuse, meaning that their conditions are rooted in experiences of gender-based violence. In yesterday’s moving debate, we heard many harrowing examples of that. We have a long way to go if we are to change the whole culture around domestic violence and treat its consequences. When it comes to treatment, we must ensure that frontline mental health services for women are trauma-informed. There is a legal framework that we could use; it is called the Istanbul convention. We signed up to it back in 2012, but so far we have failed to bring it into domestic law.
One consequence is that we do not have enough rape crisis centres across the country. Earlier this year, Fern Champion, a survivor of sexual violence, came forward after being turned away by her local rape crisis centre. She launched a petition asking the Government to ratify the Istanbul convention, which has so far received 171,000 signatures. It is hard to suggest that we can do the groundwork to support women and their mental health challenges effectively when there are fewer than 100 rape crisis centres across England and Wales. This is simply not good enough if we are to support women effectively and prevent them from developing serious mental health problems after suffering abuse. Ratifying the Istanbul convention would mean that the UK was upholding international standards on survivors’ rights.
Earlier this year, I tabled a Bill that would guarantee mothers a health check-up six weeks after giving birth. Depression before, during and after birth is a serious condition that is unrecognised and untreated for nearly half of new mothers who suffer from depression. Statistics suggest that mothers are afraid to speak up, and 47% of new mothers get less than three minutes to discuss their mental health with a healthcare professional. Conversations about the reality of motherhood and perinatal depression are still few and far between. This is a huge problem—and not just for the mother; undiagnosed mental health problems in mothers have serious consequences for the newborn child and their development.
I am absolutely in accord with the hon. Lady. Before she gets off the subject of perinatal illness, she will agree, I am sure, that it is a shocking statistic that in the UK, suicide is the leading cause of direct maternal deaths occurring within a year of the end of pregnancy. Perinatal mental illness can actually lead to a loss of life among mothers. We need to do so much better for them in those early mental health checks.
Absolutely. Post-natal depression is hidden, and the NCT’s “Hidden Half” campaign addresses that. Anyone who has been a parent knows that parenthood is not easy. Probably all mothers go through some form of depression, or feel really down after birth. I keep saying that if anybody had asked me how I felt, I would probably have said, “Oh God, I am not feeling particularly well.” The problem is in not addressing that early on, because these things can develop into something much more serious. That is why it is very important that there be a check-up six weeks after birth for women, not just for the newborn child.
I thank the hon. Lady for giving way again; she is being very generous. A number of my constituents have been in touch about perinatal check-ups. My constituent Catherine told me of her experience:
“I asked for a 6 week check with a GP—this was, at best, brief. Physical symptoms were looked at, but nothing was checked with regards to my mental health. There needs to be a standard physical and mental health check for ALL new mothers.”
Does the hon. Lady agree that we need to do better?
Yes indeed. I talk to campaigners, who are now looking at the new general practitioner contracts that are going out. That is definitely a way forward, but we also need to ensure adequate training, because people have to ask the right questions. The issue is sort of stigmatised; everybody thinks, “You’re a new mum—you should be on top of the world.” Nobody really wants to admit that motherhood can be very difficult, and that one does not always feel great. We need training, so that when new mums come in, they are asked the right questions.
Going back to eating disorders, they have the highest mortality rate of all mental health conditions. There are about a million sufferers from eating disorders. That is an epidemic of illness that is going undiagnosed and untreated. We must do much better. Our NHS is not well equipped to spot the problem early and treat it. Waiting times for adults have been shooting up over the last few years. Outdated methods, such as the body mass index measurement, are still being used to diagnosis the condition, but that fails to recognise that at the core of an eating disorder is a mental health, not a physical health, problem. Despite increasing public and professional awareness of eating disorders, medical students receive only two hours of training in the condition and its treatment during their entire time in medical school.
Those are just a few examples of where our NHS does not work for women’s mental health. We need a strategy. The Women’s Mental Health Taskforce did some extremely important work, but its recommendations have been left on the shelf. A Government strategy would help individual trusts to make the changes required to implement the recommendations. The Liberal Democrats have championed the fight for better mental health care for many years, and we believe that mental and physical health should be supported equally by our services. I have highlighted a few areas where women’s mental health provision could be improved, and I am looking forward to the debate and to the Minister’s response.
As a man, I make no apology for contributing to this debate, Madam Deputy Speaker, because I come from a household in which four of my five children are women. My late mother had a big role in my life and, of course, I do have a wife. I am prepared to say that I think women are the fairer sex but, by and large, they do have the tougher deal in life. I certainly would never fancy giving birth to a baby, and there are so many other things that women face that men do not.
I congratulate the hon. Member for Bath (Wera Hobhouse) on allowing us to debate this subject. I agree with all her points, and I just want to pick out a few other subjects that colleagues may not talk about later in the debate. With World Mental Health Day just one week away, I am pleased that the hon. Lady has secured this debate because, as she said, reports indicate that one in six people has experienced a common mental health problem in the past week—truly shocking. With a population of roughly 65 million in the UK, almost 11 million people need to access publicly funded support. The prevalence of mental health issues is similar for men and women in the UK but, as I have said already, women have to deal with different challenges. The House of Commons Library’s superb briefing on this topic makes it clear that the greater caring responsibilities and a high risk of domestic violence are contributing factors to the challenges that we are discussing today.
I was not in the Chamber yesterday for the Second Reading of the Domestic Abuse Bill—I was in my House of Commons office—but I was dumbfounded by the speeches. The hon. Member for Dewsbury (Paula Sherriff) may sit on the Opposition Benches, but she is a thoroughly wonderful colleague in every respect. She has had some terrible issues to deal with over the past few months and beyond, and I think of her struggle and hope that colleagues are rallying round to support her. We then heard the speech from the hon. Member for Canterbury (Rosie Duffield) the likes of which I have never heard before. It was so brave and truly shocking, but she was prepared to share that with colleagues. The hon. Member for Bradford West (Naz Shah) then told us about her life and I just could not believe it. It must have taken enormous guts and courage to speak publicly about it, knowing that all sorts of people on social media are going to pick up on the issue while not necessarily being sympathetic. It was a wonderful debate, and I absolutely agree with Mr Speaker that the tone used yesterday and today is far better than that used in recent months.
I go to many schools. Mental health problems often start early, when people are teenagers, so does the hon. Gentleman agree that it is important that mental health services are also provided through schools? That is where we are falling very short.
I entirely agree. That is why I am so pleased with my constituents Carla and Kelly. That is exactly what they intend to do: we have written to schools, and they are going to go in to try to help and support not just sixth-formers but younger children. The hon. Lady is absolutely right about that.
I want the Government to ensure that people throughout the country who are not fully aware of the challenges women face are aware that there is help and support available. I know my hon. Friend the Minister will share with the House what support is available.
One group that needs particular attention is women who are serving time in prison. To express some sympathy for people who are in prison perhaps is not the cool thing for a Conservative to do, but we used to have a women’s prison local to me—Bullwood Hall, in the constituency of my right hon. Friend the Member for Rayleigh and Wickford (Mr Francois)—and I remember visiting it for the first time and being shown around. Of course, so many of those women were convicted not as a result of violence but following domestic abuse, infanticide and all sorts of issues like that.
I am grateful for the briefing from the Howard League for Penal Reform, which states that a recent study found that more than 50% of women in prison report a history of violence and trauma, which contributed to 8,317 cases of self-injury in 2017 alone. We all understand that prison’s fundamental role is to deliver justice to people who have done wrong, but as the focus shifts towards rehabilitation, I very much want the Ministry of Justice to re-evaluate the practical support that is made available to female inmates.
I must say, Madam Deputy Speaker, that I am delighted that there are five Members from Essex in the Chamber. We have a real issue with mental health provision in our county, and I know that we all speak with one voice not only in expressing gratitude for the services we have but in hoping they will be developed and expanded. Of course, my hon. Friend the Member for Chelmsford (Vicky Ford) has the prison in her constituency.
It is a pleasure to speak in this debate. I thank the hon. Member for Bath (Wera Hobhouse) for securing it.
Although the issue of women’s mental health is wide-ranging, I will limit my contribution to maternal mental health, an issue that is close to my heart given that I am eight months pregnant with my second child. In response to a recent survey by the National Childbirth Trust, 50% of women reported that they experienced mental health or emotional difficulties at some time during their pregnancy or in the year after their child’s birth, yet many women are reluctant to admit to having difficulties. Society tells us that being pregnant and having a baby should be a wonderful, joyous time, but for many the reality can feel quite different. All too often, women do not discuss their problems because they feel embarrassed, ashamed or worried that health professionals would think they were not capable of looking after their baby.
I think it is important for me to say that I was one of those women. With my first son, I suffered from pre-natal depression, which led to an exacerbation of anxiety and obsessive compulsive disorder. At the time, I did not have enough knowledge of the condition to do anything about it. It is not something that gets talked about, so I did not know how to ask for help. This time around, I have been able to spot the triggers and deal with any problems before they escalate. I also had the confidence to tell my history to my GP, who was able to give me some options. At times, preventing the onset of pre-natal depression this time around has felt like a daily battle, but it is one that I am pleased to say I have won. However, for too many new mums, their mental health difficulties remain hidden, with research by the NCT showing that nearly half of new mothers’ mental health problems are not picked up by a health professional.
A simple solution would be to ensure that the six-week mandatory post-natal baby check included a mandatory maternal check. However, despite National Institute for Health and Care Excellence guidance, a six-week maternal check is not included in GPs’ contracts, which means there is no specific funding for it. As a result, the NCT found that a third of mothers had three minutes or less for their maternal six-week check; a fifth of mothers were not asked about their mental health at all at their six-week check; and half of mothers who wanted to discuss an emotional or mental health problem at their six-week check did not feel able to do so. With rushed appointments and without the right questions being asked, it is not really surprising that many women keep their problems hidden.
My hon. Friend is making a very good point. Does she agree that we need not just to look at GPs and that one visit, but to try to ensure that we embed in health visitors and other professionals who come into contact with new mothers the importance of looking for early signs of mental illness?
That is absolutely right. Health visitors have a huge role to play, and we know from our constituency work that they are under a huge amount of strain and often the same issues apply. Health visits are often rushed, not through any fault of the health visitor, but because of the pressures and constraints they are under. The situation for both GPs and health visitors needs to be considered.
The NCT is currently running a campaign that I fully support. It seeks full funding for the six-week maternal post-natal check, so that GPs have time to give every new mother a full appointment. It also seeks to improve guidance for GPs on best practice around maternal health, with dedicated appointments for the six-week maternal check, and to encourage the disclosure of maternal mental health problems. Finally, it wishes the NHS to support GP education in maternal mental health. The consequences of not tackling maternal mental health are far reaching, with around 20 new or expectant mothers taking their own lives ever year. Maternal mental health problems are considered an adverse childhood experience, and urgent action really is needed.
I will end by championing some of the great support that is available to new and expectant mothers in my constituency, and which plays a fundamental role in maternal health and wellbeing. Bromley, Lewisham & Greenwich Mind offers a Mindful Mums course and a volunteer-led maternal befriending service. Our children’s centres offer drop-ins, mindfulness and breastfeeding support. Mytime Active offers a comprehensive pre and post-natal fitness programme in Bromley leisure centres, which I know has been instrumental in me not developing pre-natal depression this time around. Bromley Libraries offers free Baby Bounce and Rhyme and other activity sessions, and there are local NCT groups and baby cafes, to name but a few. I thank the dedicated staff and volunteers, without whom such services would simply not exist.
However, those organisations cannot do it alone, and their budgets are already stretched. Since 2010, 12 children’s centres in Bromley have shut. Bromley library staff have been on strike since June due to cuts to the service, and Mind is operating with waiting lists, such is the demand for its maternal services. Without proper investment in maternal health, and without breaking down the stigma surrounding pre and post-natal depression, women will continue to suffer alone. I hope that the Government are listening, and that this debate will be the start of much needed change.
Order. Before I call the next speaker, may I say to the hon. Lady that however difficult it might be, it is wonderful to hear the truth spoken in this place, especially in an atmosphere that for decades—indeed, until very recently—considered childbirth to be some form of weakness, rather than the process through which every human being arrives in this world. Speaking the truth, and dealing with matters as people deal with them in their everyday lives in the constituencies that we represent, is terribly important, and it marks a refreshing new attitude to the way we do business in the House of Commons.
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I have been campaigning for better treatment of eating disorders. Eating disorders disproportionately affect women, although they do not discriminate. Women in the LGBTQ community are particularly susceptible.
Women are more likely than men to experience anxiety, depression, post-traumatic stress disorder and eating disorders, as the hon. Member for Bath said. We need to recalibrate entirely how the media put ideas into young women’s minds about how they should look and how they live their lives. There is so much pressure on them to have the perfect figure or the perfect look, which is unreasonable and definitely adds to mental health issues. The suicide rate for young women has more than doubled in the past 10 years, which is shocking. Such facts are easy to speak about, but it is for the House of Commons to try to come together to think of some solutions.
I have two former Ministers behind me—my hon. Friends the Members for Thurrock (Jackie Doyle-Price) and for East Worthing and Shoreham (Tim Loughton)— who have more expertise in this subject than me and who did great work. I really am glad that this subject has at long last reached the top of the political agenda. I sat on the Select Committee on Health for 10 years and although we held inquiries into abuse in institutions in which people with mental health issues were detained, we never really tackled what lay behind those issues, so I am glad that we are highlighting them today. Since 2010, Back Benchers have come together to put pressure on Governments of different persuasions to set up the Women’s Mental Health Taskforce, which was a clear indication of the Conservative party’s commitment to understand and address problems with current women’s mental health support. It was also announced at the party conference in Manchester that funding will be made available for 1,000 extra staff in community mental health services.
I congratulate the Under-Secretary of State for Health and Social Care, my hon. Friend the Member for Mid Bedfordshire (Ms Dorries), on her appointment, and I wish her well. However, my hon. Friend and parliamentary neighbour, the hon. Member for Thurrock, spent two days at the Dispatch Box just before we—how can I put it delicately?—formed a new Government responding to points about mental health issues. She was a first-class Minister, and I thank her very much for her work highlighting the mental health challenges that women face. I am glad to see her here today, and I shall enjoy listening to her speech.
My hon. Friend used to be the Parliamentary Under-Secretary of State for Mental Health, Inequalities and Suicide Prevention and was kind enough to meet me together with my constituent Kelly Swain and her team at N.O.W Is The Time For Change. Kelly works tirelessly to provide alternative therapies and wellbeing classes to people of all ages. Before my hon. Friend left office, she seemed to have a magic wand, because I find that Kelly Swain is now pushing at open doors in trying to spread her message throughout Essex, so I thank my hon. Friend for that. The all-women leadership team led by Kelly Swain works so well together, and I am glad that local organisations, along with the clinical commissioning groups, are now considering how they can integrate and support the ideas that Kelly has promoted.
Another trailblazing constituent is Carla Cressy. I look to the hon. Member for Dewsbury at this point, because she was present at a meeting with Carla and my hon. Friend the Member for Thurrock. Again, it may seem strange to have a chap as the chairman of the all-party parliamentary group on endometriosis, but it was decided that I should chair it, and I am very proud of that. I now understand the damaging effect that the condition can have on women’s mental health, and I salute my constituents. Carla’s charity is called Women with Endometriosis, which seeks to provide comprehensive mental health support to any woman facing that uphill battle, and I will continue to support her work in any way that I can.
Something that both those charities have in common, other than the brilliance of the two founders, is a commitment to pulling down barriers and removing any stigma around mental health. As the hon. Member for Bath so rightly said, it is difficult to talk about these topics, and people can be branded very unfairly. We must do something to change people’s perception of women who have mental health issues, and there are still more barriers to be brought down. I have been in this place for 36 years—some people might say that that is too long, but I still have a bit more that I want to do—and there are still issues to tackle, and my two constituents have brought the challenges home for me in very different ways. Both their organisations provide tailored support to individuals, and they are always ready to listen without judgment. That is a basic requirement for mental healthcare at any level, and it would be a great asset to our nation if we could provide that service to every person who required it.
As the hon. Member for Bath rightly pointed out, mental health issues are probably the most difficult healthcare issues to deal with. When I first became a Member of Parliament, I did not see many people with mental health issues at my surgeries, but now that is a regular occurrence. Of course, people with mental health issues need our time, but Members of Parliament are not necessarily equipped with the expertise to give advice and support; we try to signpost people in the right direction. I am sure all Members would say that, although they are very grateful for their local mental health services, we could all do better. That is where the real investment needs to be made.
As I said, a recent study found that more than 50% of women in prison report a history of violence and trauma, and the issues of self-injury are very distressing indeed, but I am glad that in 2018-19 the NHS in England spent £12.2 billion on general mental health. That is a huge amount of money, but I think we all want to ensure that it is well spent, and I would be very pleased if some of it found its way to Carla Cressy’s charity and Kelly Swain’s charity.
I am proud of my party’s continued effort to treat mental illness with the same seriousness as physical illness. In all the discussion of figures, it is essential that Ministers and officials remember that women’s lives are on the line. Every year, 1,604 women commit suicide. That is absolutely horrendous. Looking at these Benches, I am reminded that it was reported nationally only this week that a young member of my party committed suicide, which must be awful for those who loved that individual. Units are busier than ever before and, as a result, they are under increasing stress. If we do not take swift and effective action to address these challenges, there is a very real risk that the number of suicides and instances of self-harm will increase further.
I have received a number of briefings from various groups asking me to call on the Government to introduce various plans and schemes, and I am sure colleagues will be supportive of such programmes. My message, though, is plain and simple. As a group of politicians, whichever party we belong to, we should always remember that we are sent here to serve our constituents. That is why I am so pleased that my constituents Carla and Kelly have got off their backsides with real enthusiasm for sharing the message that we must support women with mental health issues. I pay tribute to Carla, Kelly and all those women throughout the United Kingdom who are doing everything they can to improve the care of women who suffer from mental health issues.