Contribution
My Lords, I begin by thanking my noble friend Lady Maclean for securing this important debate. The question before us is not whether mental health conditions are serious or deserving of support, because we all agree that they are. Nor should we overlook the very real impact that anxiety, depression and other conditions can have on people’s lives: on their education, on their employment and on their relationships. The noble Baroness, Lady Nargund, spoke movingly about women’s and maternal mental health. The noble Baroness, Lady Shah, spoke incredibly movingly about living with her husband’s and daughter’s mental health challenges. It took a lot of courage to share that with noble Lords.
However, as parliamentarians, while we should show compassion and understand that every case is different, and that, as the noble Baroness, Lady Pidgeon, said, it is important to remove the stigma, we would be failing our duty if we did not seek to understand why the number of diagnoses has risen so dramatically in recent years. We should do that not only for the well-being of those with mental health conditions, but because of the demographic challenge facing the UK and many other countries with ageing populations. While the dependency ratio—that is, the proportion of young and old dependants relative to the working age population—is climbing, Governments of all colours are asking what that rise means for individuals, for state-provided services, for the economy and for the taxpayer.
The latest data, from 2023-24, suggests that 20% of adults meet the criteria for a common mental health condition, and that, among younger adults, prevalence has risen significantly over the last two decades. At the same time, the number of people who receive health-related benefits has increased sharply. The Office for Budget Responsibility reported that spending on incapacity benefits as a share of GDP increased between 2019-20 and 2023-24. Department for Work and Pensions data shows that 68% of work capability assessment decisions between January 2022 and November 2024 involved claimants whose primary condition was a mental or behavioural disorder.
These trends raise a number of questions. Are we witnessing a substantial deterioration in our nation’s mental health? Has greater awareness led more people who might previously have gone unsupported to seek help, or have aspects of our health, education and welfare systems become too reliant on diagnosis as the gateway for support? Are parents and children incentivised to claim mental health conditions, as the noble Baroness, Lady Murphy, suggested?
These are the issues that the Government’s Independent Review into Mental Health Conditions, ADHD and Autism was established to examine—something that these Benches welcome; I have noticed noble Lords across the House welcome it. The interim report recognises the growing demand for diagnosis and increasing pressure on services, and it raises important questions about whether support can sometimes become too narrowly tied to obtaining a formal diagnosis rather than being based on need.
As the noble Baroness, Lady Tyler, said—and the noble Lord, Lord Davies, agreed—those with serious conditions struggle to access timely support, while families often feel compelled to pursue a diagnosis simply to obtain assistance that should perhaps be available more broadly. As my noble friend Lady Cash said, the recent Milburn review highlighted that the proportion of disabled young people not in education, employment or training who cite mental health as their primary condition has almost doubled over the last decade. That should concern us all, and a truly compassionate society helps those who can work to do so.
Good work can provide purpose, independence, routine, social connection and societal contribution, all of which can contribute positively to mental well-being. But we should be very careful about saying that it is some sort of panacea—although it is still very important. The previous Government took steps through WorkWell and the wider employment support programmes, and we welcome efforts by this Government to continue helping people into sustainable employment. But the scale of that challenge, I believe, demands greater urgency.
I end by asking the Minister four questions, to be answered now or perhaps later in writing. When will the Government publish the final report of the independent review, and how much longer will we have to wait to know which of the recommendations the Government will implement? Do the Government have any existing assessments of the relationship between the rise in diagnosis and the increase in economic inactivity, or do we have to wait for a report? What thinking is there in government about ensuring access to support for those who need it without creating a system that makes diagnosis the only route to getting support and assistance?
Those with genuine mental health conditions deserve effective treatment and support, but taxpayers deserve confidence that our welfare and healthcare systems are sustainable and focused on the outcomes and those who need help. The challenge for this Government—any Government—is to achieve both. I look forward to the Minister’s response.