Examination of Witnesses (Questions 137-139)
Dr Marcus Roberts, Mr David Stone, Mrs Alexandra
Burner and Mr Paul Corry
23 NOVEMBER 2006
Q137Chairman: Welcome to our inquiry, which
we are doing at as a great a speed as we can manage. Obviously
your two organisations are very important witnesses in this particular
inquiry, and we have seen your written evidence. We realise that
the potential scope of this inquiry is very wide and we are trying
to keep it limited, in a way, to a very strict understanding of
what it is the Commission is trying to do and why it is trying
to do it, and what the limits of its actions are, rather than
allowing ourselves to wander down a very wide consideration of
different Member States' national health systems and how they
affect mental health. You can think of 20 other subjects that
we can discuss in this context, but we are trying not to do that.
We are being assisted in our work by Professor Knapp, whom I am
sure you probably all know, and we want to particularly study
the views about the Green Paper proposals and representatives
of mental health service users, and there is a question on that
and your evidence was very useful in that respect. A few, what
we call, housekeeping points. This session is open to the public
and it will be recorded for possible broadcasting or web casting,
and a verbatim script will be taken of your evidence as well,
and that will be published on the Parliamentary website and in
an annex to the report. You will be sent a copy of the script—you
have probably done all this already, but to make sure it is on
the record—and you can obviously check it for accuracy,
and if you do have any concerns please get in touch immediately
with our Secretary and we will deal with that. If you want to
submit supplementary evidence after our discussion—and that
is something very useful and to the people who have given us evidence—of
course we will be absolutely delighted to receive it. You should
have a notice of Members' interests. The last thing is the question
of acoustics. This room has a horrible acoustic; it seems to disappear
up there somewhere, so if you could, when you are speaking to
us, lift your heads as much as you can off the printed page. I
know it is nice to have your notes as your comfort blanket, but
you probably know what you want to say well enough and not really
need it! So please speak as clearly as you can. I would like you
to start by giving your official names and titles for the record,
and if anybody wants to make an opening statement we will be happy
to hear that as well. If you could start off, Mr Stone.
Mr Stone: My name is David Stone and I am a
Parliamentary Officer at Mind.
Dr Roberts: I am Marcus Roberts and I am Head
of the Policy Unit at Mind.
Mrs Burner: I am Alexandra Burner; I am Senior
Campaigns Officer at Rethink.
Mr Corry: I am Paul Corry, Director of Public
Affairs at Rethink.
Q138 Chairman: Thank you. Does anybody
want to make an opening statement?
Dr Roberts: Yes. Thank you, my Lord Chairman,
and thank you for giving us the opportunity to come and share
our thoughts with you about the European Green Paper and the prospects
for a European mental health strategy. I would like to say two
things in introduction. Firstly, I think that is what happening
at European level is very encouraging in terms of the way that
Europe is starting to think about mental health as a core European
issue. Basically the Green Paper and the World Health Organisation's
action plan for Europe on mental health are recent signs of this.
I would like to say very quickly what we think is good about the
approach that is being taken, and then a little bit about what
I think you were referring to in terms of the practicalities of
what this means for us, working on the ground in the UK. Very
briefly on the things we welcome, I think it is great to see Europe
adopting a social model of mental health, which recognises the
close relationships between mental well being and things like
poverty, exclusion, lack of social connectedness, isolation and
so on, not as simply a disease of the brain, as it were, but as
something that is very much bound up with relationships and so
on. Secondly, I think it is really good to see Europe recognising
the sheer scale and significance of this problem for European
populations. They estimate that three to four per cent of European
GDP is the economic cost of mental health, but if you add in the
wider human cost then that figure is going to be astronomical.
The Sainsbury Centre for mental health calculates that in England
alone it is about £77 billion a year, so if you think of
that across Europe it is a very big figure in terms of the human
costs there are 58,000 suicides a year in Europe—suicide
causes more premature death than, for example, road accidents;
so that we welcome. And we welcome the emphasis on deinstitutionalisation
and we welcome the commitment to well resourced, evidence-based
mental health services, which combine health and social care and
also respect the basic human rights and liberties of people caught
up in the system, and we like the commitment to tackling stigma,
and of course we like the commitment to promoting service user
involvement. So that is the case for. Just a couple of very brief
disclaimers. What we have at the moment from the World Health
Organisation and the European Union are some very promising statements
of good intention. How they actually translate into resource and
effective change on the ground is something that we are not entirely
clear about and we do not come here with a clear sense of how
that would happen. Linked to that, I guess, is a bit of a disclaimer
that Mind's focus is very much domestic—we do not do a huge
amount of European work and we do not have a sophisticated knowledge
of the way in which EU institutions work. But I think that is
a point in itself that is worth noting at the outset. I think
there is a reason that organisations like Mind in the UK are quite
insular and quite focused on domestic policy. It is partly about
not being clear what the benefits are of investing resource on
and engaging with European institutions; there is a skills deficit
in terms of how Europe works and how you can effectively work
in it, and there is a general lack of clarity about what the benefits
of EU engagement are. So I think that is both a disclaimer about
our knowledge but also there could be a role for the European
Union there in skilling-up and thinking about how it can more
effectively engage with organisations like Mind.
Mr Corry: If I may add a few words from Rethink's
perspective? In terms of the evidence that Mind and Rethink are
giving today, we will not waste the Committee's time by repeating
things, so we will endorse many of each other's comments, I think,
and we would certainly associate ourselves with all the comments
that Marcus has made. Perhaps the slight difference between ourselves
and Mind on this is that Rethink historically has tried to engage
with Europe both in terms of making connections with other voluntary
sector organisations but also with the institutions of Europe,
and it is actually quite a difficult thing to do in terms of mental
health, certainly up until recent years. I think that is for two
reasons. I think there is a cultural difference between the way
voluntary sector organisations operate in this country and those
in Europe. Rethink is a member of an organisation called EUFAMI,
which represents organisations, such as Rethink itself, who are
member-based organisations made up of people experienced in severe
mental illness, and their family members. But it would be fair
to say that of all the organisations in EUFAMI Rethink is by far
the largest, the best resourced and the most connected with both
the political will in this country and with civil society itself.
The feedback that we get from voluntary sector organisations in
Europe is very often that they feel marginalised, under-resourced
and lack effectiveness in the political process. So I think in
looking at an across-European approach to mental health there
is something to be said for the European Union institutions making
it easier for the voluntary sector organisations to actually work
and connect with the institutions in Europe. Where we have had
success in the past—and it is something worth pursuing in
the future—is in the area of academic research. Rethink
works in association with the Institute of Psychiatry on a number
of cross-European projects to do with discrimination and stigma,
and one of them is called Indigo, which is a study of 26 different
countries, looking at the day-to-day living experiences of people
with all kinds of mental health conditions, and the barriers that
they feel are put in the way of full social inclusion, and the
evidence that you will hear from both Mind and Rethink this morning
will show that at the top of their list of concerns is the issue
of discrimination and stigma and public understanding, and if
we can look at it from slightly different points of view. I think
if there is a consistent message from people using the service
across Europe that they very much appreciate—and this is
perhaps what the European Union's contribution can be—is
a wider public space in which mental health issues can be freely
discussed. I do not think we should underestimate the importance
of getting services right and getting investment right, but it
is also particularly true of mental health where there is so much
for individuals and organisations and governments to talk about
it, and we should not underestimate the importance of creating
that public space, and it is one of the valuable things of the
work of this Committee that, in Europe more generally, I hope
in future years we will be able to have the debate more openly
about people's personal experience.
Q139 Baroness Howarth of Breckland: Mr
Corry is dropping his voice. My disability is a slight hearing
impediment! I am very interested in what you are saying.
Mr Corry: I have a feeling that I was repeating
myself towards the end anyway! I was just trying to make the point
that it is extremely important that we have the public space available
to us to talk about mental health, and although we all have concerns
about how much the European Union can do to influence the types
of services and the investment going into services in a particular
country, we still think it is extraordinarily important that strategy
documents and principles and so on are being discussed at that
European level.
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