Bishop of St Albans on links between inequality, unemployment and mental ill health

Inequality, unemployment and mental ill health are three interconnected, intersecting areas which are important to address if we are to have a flourishing and thriving society in which all can participate. As we know, mental ill health is one of the two main disabilities affecting participation in work. I am glad that the Government have decided that the NHS long-term plan will assist people with mental health issues into work. That plan recognises that mental health problems disproportionately impact on people living in poverty and those who face various forms of discrimination. This is a huge step forward in the visibility and awareness of this issue, and I hope that it really will help us move ahead.

In my own area of work, I note that last year poor mental health was identified by clergy in this country as the number one social issue that they had to grapple and deal with. That is what we are picking up as happening on the ground. It is in all our interests that we look at this issue to make sure that all people have access to safe, stable and well-paid work, which is why I commend the TUC’s Dying to Work campaign. As many noble Lords will know, it addresses the particularly difficult situation of those who have been diagnosed with a terminal illness but who either want to work, because it is an important way of them coping with some pretty devastating news, or simply have to work for financial reasons, as they are still trying to support a family.

When people face the emotional stress, fear and uncertainty of being diagnosed with a terminal illness, they often face a lot of difficulties at work, especially if they have a long-term or progressive disease. This can be an horrific situation if unsympathetic or obstructive employers simply do not understand what is happening when people are at a particularly vulnerable point. That is why the TUC’s voluntary charter is to be applauded. Indeed, it is shocking to think of people being dismissed or forced out of jobs that they love at a time of such acute personal difficulty.

I am pleased to be part of a Church that has always taught the innate value of human life and its unique dignity for all people. That is why it is even more important that, when people face a terminal illness, they should be given the support and respect that they need. This initiative is part of the progress that we are making.

The intersection between inequality in employment and mental health manifests itself in other areas. As the Mental Health at Work 2018 report made clear, we know that those who are poorly paid or in insecure work, as well as black and minority-ethnic people, face worse than average mental health problems. The Church has worked with BAME people to put together a mental health toolkit that recognises the issues this community faces—for example, overdiagnosis of schizophrenia, overprescription of drugs and under-engagement by healthcare professionals, all of which have huge impacts that we need to address. The toolkit is designed to reduce stigma, disseminate crucial information and continue to confront racism wherever it is found.

At a time when we know that young people from BAME backgrounds are almost twice as likely to be unemployed as their white counterparts, it is vital that we explore the reasons behind that. There is a need to support those with mental health issues, which are sometimes wrongly used by bosses as a barrier to employing these people. This lack of access to mental health support cannot continue. Indeed, at a time of high unemployment, when we need more people for the sake of the economy, it is in everybody’s interests that it does not continue.

In the 2014 NHS Five Year Forward View, published by NHS England, a commitment was made to work towards a more equal response across mental and physical health, achieving parity of esteem by 2020. That was five years ago and time has moved on very rapidly. Although there are of course issues around some communities accessing physical healthcare, they appear to be less acute than in the mental health equivalents. Can the Minister clarify the progress towards this aim, set out back in 2014, and what steps are being taken to mitigate the impact of accessing this care?

Of course, this is much bigger than just the responsibility of government; we cannot take just a top-down, centrist approach to tackling the problem. One of the privileges of my job as I travel around Bedfordshire and Hertfordshire visiting charities is to see so many groups trying to work in innovative ways. I think particularly of some of the charities getting people into gardening and working on allotments. My right reverend colleague the Bishop of Carlisle, who is sitting next to me, appeared last month in various national newspapers launching an initiative at Lambeth Palace to help communities think about using gardening, gardens, allotments and suchlike to help people with mental health problems.

We need to get a much wider commitment to addressing this problem. Yet again, there is an economic disparity between those with and without access to green spaces. We in the Churches are trying to encourage people—and, indeed, our churches and churchyards—to work with mental health charities to create spaces where people can get experience and make a contribution to society.

There is so much more to be said, but we have limited time. I hope that we can learn that we need to address this multifaceted, complex issue and work together to help those with mental health problems.

Baroness Sherlock (Lab): My Lords, I thank the noble Lord, Lord Bird, for using the initiative he described to us at the start to seize the opportunity of securing this debate and giving us the chance to talk about these issues. I thank all noble Lords who have spoken, for some very interesting speeches. I thank the right reverend Prelate the Bishop of St Albans for some really thoughtful reflections on the interaction between mental health and employment, issues around stigma and discrimination, and the role of the Church and communities. There is so much more that one could go into…

…While I am here, it is worth noting that poverty is also a significant driver of stress and poor mental health, a point made by the right reverend Prelate. The 2016 report from the Mental Health Foundation and the JRF found that:

“Poverty increases the risk of mental health problems and can be both a causal factor and a consequence of mental ill health”…

The Parliamentary Under-Secretary of State, Department for Work and Pensions (Baroness Buscombe) (Con):…Much has been done to increase awareness and reduce the stigma of mental health. The DWP is working increasingly closely with the Department of Health and Social Care but, as the noble Lord, Lord Bird, said, it must be joined up and be cross-government. Also, as the right reverend Prelate said, it is not just about government. We have to think beyond government to all those who can offer support, including our religious institutions. How can they support, and what can we use to help those with mental disabilities?..

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