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Mental Health Services
Mr. Heald: To ask the Secretary of State for Health what private finance initiative projects in mental health services have (a) been given approval and (b) had contracts signed since 1 May 1997. [10529]
Jacqui Smith: The table shows the number of private finance initiative projects in mental health services which have been given approval and had contracts signed since 1 May 1997.
| Trust | Project description | Date full business case approval given | Date financial close reached |
|---|---|---|---|
| Bay Community NHS Trust | New Mentally Ill Unit | 25 September 1998 | 30 September 1998 |
| Birmingham Specialist Community Health NHS Trust | Reprovision of accommodation for people with learning disabilities | 12 February 1999 | 17 May 1999 |
| Black Country Mental Health NHS Trust | Mental Health Unit | 6 October 1998 | 8 October 1998 |
| Bradford Community Health NHS Trust | Horton Park Centre—range of primary and community services including medical centres for GP practices, rehabilitation centre and Mental Health resource centre | 26 November 1998 | 15 March 1999 |
| Central Nottingham Healthcare NHS Trust | Learning disability/Mental Health team base | 30 March 2000 | 15 May 2000 |
| Doncaster and South Humber NHS Trust | Elderly Mental Health Services and Mental Health Rehabilitation Services | 14 September 2001 | 17 September 2001 |
| East London and the City Mental Health NHS Trust | Mental Health reprovision | 10 August 2000 | 30 July 2000 |
| Enfield Community Care NHS Trust | Elderly/Mentally Ill home | 7 May 2000 | 9 May 2000 |
| Leeds Community and Mental Health Services Teaching NHS Trust | Reprovision of Mental Health Services, High Royds | 28 February 2000 | 24 January 2001 |
| Local Health Partnerships NHS Trust | Mental health unit | 15 August 2000 | 24 January 2001 |
| North Staffordshire Combined Healthcare NHS Trust | Reprovision of Mental Health facilities | 29 November 1999 | 8 December 1999 |
| Northern Birmingham Mental Health NHS Trust | Reprovision of Mental Health facilities | 9 August 2000 | 10 August 2000 |
| Oxfordshire Mental Healthcare NHS Trust | Mental Health Medium Secure Unit | 1 June 1998 | 1 June 1998 |
| Oxleas NHS Trust | Reprovision of Mental Health | 4 December 1998 | 11 December 1998 |
| Redbridge Health Care NHS Trust | Mental Health Reprovision and Geriatric Day Centre | 27 June 2000 | 4 July 2000 |
| Rotherham Priority Health Service NHS Trust | Elderly Mental Health | 19 March 1997 | 15 May 1998 |
| Stockport NHS Trust | New Mentally Ill Unit | 18 September 1998 | 10 October 1999 |
| Thames Gateway NHS Trust | Acute Psychiatric—Stonehouse Hospital | 14 December 1998 | 14 December 1998 |
| West Berkshire Priority Care Services NHS Trust | Prospect Park mental health redevelopment | 1 February 2001 | 2 May 2001 |
Mr. Heald: To ask the Secretary of State for Health what the occupancy rate of NHS mental health beds, excluding day only, is in each London hospital. [10531]
Jacqui Smith: The latest data available are for 2000–01 and are shown in the table.
The data are collected annually at national health service trust level, rather than by individual hospital site.
(34) Pre April 2001 Trust Configurations
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Mr. Heald: To ask the Secretary of State for Health what steps he is taking (a) to promote mental health and (b) to encourage people to seek help at an early stage, among those from an ethnic minority background. [10523]
Jacqui Smith: We have asked local health and social services to ensure that by March 2002, as required by Standard One of the National Service Framework for Mental Health, they develop and agree an evidence-based mental health promotion strategy based on an assessment of local needs which incorporates action to reduce discrimination. In August 2001, the Department issued to local services "Making it Happen: a guide to delivering mental health promotion". The document recognises the need to promote mental health for ethnic minority groups and it includes examples of good practice including working with Asian communities and assessing the needs of refugee children.
The mental health taskforce is preparing a draft strategy, which we expect will be launched for consultation in spring 2002, to promote more accessible and appropriate services for people from black and ethnic minorities.
The Department also plans to commission the development of a toolkit to support mental health services in promoting mental health for people from ethnic minority communities.
Mr. Heald: To ask the Secretary of State for Health how many mental health carer support workers have been recruited in accordance with the NHS Plan. [10525]
Jacqui Smith: The NHS Plan set a target for 2004 that 700 more staff will be recruited to increase the breaks available for carers and to strengthen carer support networks. In pursuance of this target, all regular carers of people with mental health problems will have been identified, received an assessment and have their own care support plans by April 2004. By June 2004, local support networks for these carers will have been developed. The statutory and voluntary sector currently provide support to carers, and the Department is currently developing a service specification for carers support services against which we will measure progress.
Mr. Heald: To ask the Secretary of State for Health what assessment he has made of levels of major depression and self-harm in children; and if he will make a statement on recent trends. [10517]
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Jacqui Smith: In August this year the Office for National Statistics reported on the prevalence rates of self-harm (defined for the purposes of the report as any attempt to harm, hurt or kill themselves) among children and adolescents aged five to 15 in England, Scotland and Wales during the first half of 1999. The report represents a secondary analysis of data originally collected for the national survey of the mental health of young people published in March 2000.
The main findings were that, according to parents, approximately 1.3 per cent. of the sampled five to 10-year-olds had ever tried to harm, hurt or kill themselves. The rate of self-harm among those with no mental disorder was 0.8 per cent. but the rate increased significantly to 6.2 per cent. among young children with an anxiety disorder and 7.5 per cent. for those with conduct/hyperkinetic disorder. However there was no recorded link with depressive disorder in this age group.
According to parents, approximately 2.1 per cent. of the sample of 11 to 15-year-olds had ever tried to harm, hurt or kill themselves. The rate of self-harm among 11 to 15-year-olds with no mental disorder was 1.2 per cent. but the rate rose markedly to 9.4 per cent. of those with anxiety disorders, 12.6 per cent. of those with a conduct disorder and 18.8 per cent. of young people with depression.
As was the case with younger children, the prevalence of self-harm among 11 to 15-year-olds was influenced by factors relating to family constitution, exposure to discord and frequency of punishment, and, most significantly, the number of stressful life events.
At present there is no firm information on trends but it is believed that the prevalence of mental health problems among children and young people has increased over recent decades, both in this country and in the rest of western Europe.
Mr. Heald: To ask the Secretary of State for Health what the prevalence of mental illness is in children; and if he will make a statement setting out his assessment of recent trends. [10515]
Jacqui Smith: A survey of the mental health of children and adolescents in Great Britain was carried out in 1999 by the Office for National Statistics on behalf of the Department, the Scottish Health Executive and
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the National Assembly for Wales. The intention was to provide up-to-date baseline information on the prevalence of mental disorders among five to 15-year-olds. Prevalence rates were produced for the three main categories of mental disorder, for example, conduct disorders, hyperactivity and emotional disorders.
Key findings on prevalence were about 10 per cent. of children aged five to 15 in Great Britain had a mental disorder in 1999, 5 per cent. had conduct disorders (e.g. aggressive and antisocial behaviour), 4 per cent. had emotional disorders (e.g. anxiety, depression) and 1 per cent. were hyperkinetic (inattention, over-activity); and mental disorders were significantly more common in boys than girls in both the five to 10 and the 11 to 15-year-old age groups.
At present there is no firm information on trends, but it is believed that the prevalence of mental ill-health among children and young people has increased over recent decades, both in this country and in the rest of western Europe. It is the intention to repeat the original survey in approximately five years in order to detect any changes in prevalence over time.
Mr. Heald: To ask the Secretary of State for Health how many prescriptions were issued in 2000–01 for medicines used to treat mental illness. [10513]
Jacqui Smith: The number of prescription items dispensed in the community in England for the treatment of mental illness during the financial year ending 31 March 2001 is given in the table.
Information about the diagnosis for which the drugs were prescribed is not available. Drugs used to treat mental illness have therefore been defined as those within British National Formulary (BNF) paragraphs hypnotics and anxiolytics (4.1), drugs used in psychoses and related disorders ( 4.2) and antidepressant drugs (4.3).
| Prescription items (thousand) | |
|---|---|
| BNF description | Number |
| 4.1 Hypnotics and anxiolytics | 16,561 |
| 4.1.1 Hypnotics | 10,677 |
| —Benzodiazepine | 7,112 |
| —Chloral and derivative | 179 |
| —Other hypnotics | 3,386 |
| 4.1.2 Anxiolytics | 5,826 |
| —Benzodiazepine | 5,722 |
| —Other anxiolytics | 104 |
| 4.1.3 Barbiturates | 58 |
| 4.2 Drugs used in psychoses and related disorders | 5,857 |
| 4.2.1 Antipsychotic drugs | 4,920 |
| 4.2.2 Antipsychotic depot injections | 216 |
| 4.2.3 Antimanic drugs | 722 |
| 4.3 Antidepressant drugs | 22,634 |
| 4.3.1 Tricyclic and related antidepressant drugs | 9,722 |
| —Tricyclic antidepressants | 9,233 |
| —Related antidepressants | 489 |
| 4.3.2 Monoamine-oxidase inhibitors (MAOIs) | 96 |
| 4.3.3 SSRIs | 10,884 |
| 4.3.4 Other antidepressant drugs | 1,932 |
Notes:
1. The therapeutic classifications are based on British National Formulary, Number 40 (September 2000).
2. These data are based on items dispensed by community pharmacists, appliance contractors, dispensing doctors and prescriptions submitted by prescribing doctors for items personally administered. The data are from the Prescription Cost Analysis system.
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Mr. Heald: To ask the Secretary of State for Health how many people were formally admitted to hospital under the Mental Health Act 1983 in (a) 1996–97, (b) 1997–98, (c) 1998–99, (d) 1999–2000 and (e) 2000–01. [10521]
Jacqui Smith: The Department collects and publishes information annually relating to patients detained under the Mental Health Act 1983 on: admissions to hospitals under the Act by section of the Act; sex and category of disorder as defined and required under the Act; changes in patient's legal status while in hospital; and patients in hospital at the end of the year, by sex and category of disorder.
The latest data are published by the Department, in a statistical bulletin "In-patients formally detained in hospitals under the Mental Health Act 1983 and other legislation, England: 1989–1990 to 1999–2000". The National Assembly for Wales published a separate statistical report entitled "Admission of patients to mental health facilities in Wales, 1999–00 (including patients detained under the Mental Health Act 1983)". Both publications are available in the Library.
Mr. Heald: To ask the Secretary of State for Health what assessment he has made of the proportion of those admitted to psychiatric wards who come from ethnic minority backgrounds; and if he will make a statement. [10510]
Jacqui Smith: Certain ethnic minorities, especially black ethnic groups, are over-represented in psychiatric care. While there are demographic and socio-economic factors which can partly account for over-representation of black ethnic groups, these cannot explain all of the disparity.
Due to this disparity and the acknowledgement that mental health services are not fully meeting the needs of ethnic minorities, my right hon. Friend the Member for Barrow and Furness (Mr. Hutton), when Minister of State with responsibility for community health, asked the mental health taskforce to prepare a strategy to address the issues surrounding black and minority ethnic mental health. A taskforce member, Professor Sashidharan, is taking forward the development of a draft strategy under the guidance of the ethnicity and mental health reference group. We expect consultation papers on the draft strategy to be issued in spring 2002.
Mr. Heald: To ask the Secretary of State for Health what assessment he has made of the annual number of people with a diagnosis of severe mental illness who are refused treatment when they ask for it. [10526]
Jacqui Smith: Our policy is that nobody with severe mental illness who asks for treatment should be refused. The National Service Framework for Mental Health (NSF), published in September 1999, spells out national standards for mental health. The NSF contains seven overarching standards, two of which are specifically about the provision of effective services for people with severe mental illness. The standards aim to ensure that each person with severe mental illness receives the range of mental health services they need
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In addition, the NHS Plan, published in July 2000, contains a number of commitments relating to the provision of services for people with severe mental illness. These include the establishment of crisis resolution and early intervention teams, and an increase in the number of assertive outreach teams.
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