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Baroness Andrews: My Lords, on the first part of the question, we believe that the funds allocated are sufficient. We are beginning to see growth across the servicefor example, 22 new early intervention teams are in place in local communities. These are particularly intended to pick up young people who display psychotic attitudes and episodes. We have 63 new crisis resolution teams for people in acute need; we have 191 assertive outreach services. We are already noticing the difference now that we have these community developments in place. For example, where the crisis resolution teams are in place, we have seen a 30 per cent drop in admissions to hospital.
Baroness Masham of Ilton: My Lords, is the Minister aware that the National Health Service is now working more closely with the Prison Service? Will there be any new initiatives to help those prisoners who are mentally ill, of whom there are far too many?
Baroness Andrews: My Lords, that is a very important question when one considers that 90 per cent of people in prison have some sort of mental disorder. Again, the health service has been working much more closely with the Prison Service for over a year; the PCTs will be driving the funding for the Prison Service as of this April. We are seeing a much more integrated service, which is very helpful.
We already have 48 teams working in 48 prisons to develop inreach services and more psychiatric services. We hope that there will be 70 of those by next April. Although it was not exactly a target, we hope that by 2006 every prison will have these additional and very important services.
Baroness Andrews: My Lords, I am not entirely sure which population the noble Lord is talking about, but I can tell him that because of the development of the range of community services as a whole and the development of specialised mental health trusts, there should be increased capacity across the service.
Baroness Andrews: My Lords, as I said, there have been concerns that the new atypical antipsychotic drugs, which were the subject of NICE guidance last summer, have not been reaching patients quickly enough. However, we have seen the rates of prescription going up, so we think that they are reaching more of the people who need them.
Lord Addington: My Lords, does the Minister think that, given the complications caused by mental illness and its diversity, there should be at least some form of legislation to ensure that people who have one episode of mental illness are not discriminated against in employment and so on for the rest of their lives?
Baroness Andrews: My Lords, that is an extremely important matter. We are considering ways of ensuring that people with mental health problems are not excluded from employment. For example, the Social Exclusion Unit is about to start work on a report examining social exclusion of people with mental illness. It will examine particularly the employment prospects of such people.
Baroness Andrews: My Lords, there was an extremely large response to the consultation on the draft Bill. Over 2,000 responses were received. They are still being evaluated. A report will be published but the Bill itself will have to wait for parliamentary time.
The Earl of Listowel: My Lords, does the Minister agree that research suggests that a healthy relationship between an infant and his or her parents is likely to reduce susceptibility to certain kinds of mental disorder in adulthood? Does she further agree that the work of my noble friend Lord Northbournewho I see is presentin championing support for parents, that of the noble Baroness, Lady Brigstocke, with Home Start and that of the Government's own Sure Start programme are likely to prevent many children developing certain kinds of mental disorder in
Baroness Andrews: My Lords, I entirely agree. There is no doubt that loving family relationships are absolutely essential for people to develop into sound adults. We are investing in parenting schemes such as Home Start, through which homes are accessed that would otherwise be very difficult to reach, and Sure Start, which helps many families who are not entirely confident about bringing up their children and want advice and support. Those are fundamental building blocks to a better and healthier society in terms of mental health.
Earl Howe: My Lords, is the Minister aware that in the five years from August 1997 the number of people claiming state benefit on grounds of mental illness has dramatically increased? There has been an increase of 78 per cent in those claiming Disability Living Allowance and an increase of 25 per cent in those claiming incapacity benefit. What do those figures say about the state of mental health services in Britain? Do they not underline the priority that the Government should be giving to this area of healthcare?
Baroness Andrews: My Lords, the reasons for those figures may be complex and diverse. For example, they may reflect an ageing population and the forms of dependence that come with it. As I said, one of the matters that the Social Exclusion Unit will examine is how to increase employment opportunities for people with mental health problems. I imagine that many people on incapacity benefit could be helped with extra support resulting from the changes in incapacity benefit. The figures say a lot about the health of the nation but we are putting new remedies in place.
Baroness Howells of St Davids: My Lords, one of the most worrying considerations for the Caribbean community is the number of black males in mental institutions and the treatment they receive. Can the Minister tell the House whether there has been any advance in the type of treatment that they now receive, or whether there is any on offer?
Baroness Andrews: My Lords, we are certainly aware that black and ethnic minority people are disproportionately represented in the part of the population with mental health problems. A report was published in March on how to improve mental health services for black and ethnic minority people which explores some of the reasons services fail. After consultation we shall publish implementation guidance in the summer which will address the question of how we get the black and ethnic minority workers we want; how we deal with language issues; how we build capacity; and how we clear pathways for people in need to get the help they want. We hope that by making that a prioritycertainly the National Institute of Mental Health will help us do thatwe shall be able to make a significant difference to that population.
Lord Ackner: I have received indirectly a message from the Chief Whip that if I intend to speak to the Question that the clause stand part I should do so expeditiously. Despite the dulcet tones of the Chief Whip, I intended to do so in any event.
What I wish to say I can put very shortly. Clause 1 is without redemption. We have two matters to consider. First, the clear-cut issue; namely, whether the existing law, which requires the proof of a guilty mind as in all serious offences, subject, of course, to a measure of objectivitybecause by statute the jury is told that the reasonableness or otherwise of a belief is evidence of whether the belief was genuinely heldshould stand having been in existence for some 40 years without any complaint. Alternatively, we should consider whether the golden thread, as that obligation is known, should be cut and in its stead there should be put in place a new obligation which results in the accused being guilty of rape if he is negligent. That is the clear-cut issue.
The second matter is the feasibilitythe practicalityof what is now proposed. In that regard I wish to refer to one and only one quotation. It has already been referred to by me on Second Reading but it is particularly apposite in view of the debate yesterday. It is from an essay of Professor Hogan, written in 1978, and given in honour of Professor Glanville Williams, who was virtually a permanent member of the Criminal Law Revision Committee of which the noble and learned Lord, Lord Lloyd, who gave such an admirable speech yesterday, was also a member. He stated:
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