Mental Health: Parity of Esteem

I will call Liz Twist to move the motion and then call the Minister to respond. I remind other Members that they may make a speech only with prior permission from the Member in charge of the debate and the Minister. As is the convention in 30-minute debates, there will not be an opportunity for the Member in charge to wind up.

I beg to move, That this House has considered parity of esteem between physical and mental health.

It is a pleasure to serve under your chairship, Mrs Hobhouse. In my constituency surgeries I see the devastating consequences of our failure to treat mental illness with the urgency it requires. In my role as chair of the all party parliamentary group on suicide and self harm prevention, I hear from young people about their experiences and the impact of waiting for treatment from mental health services. Bad mental health is routinely cited as a reason for economic stagnation, low school attendance rates and an increase in benefit claimants. Long waits for mental health support are directly linked to worsening symptoms and, tragically, to spikes in self harm and suicide attempts.

Tragically, my constituent’s husband, John, took his own life in 2021 after a mental health crisis while in the care of NHS mental health services. Does the hon. Member agree that we need more Government support and funding for access to quality mental health services in rural areas? If we were losing people in this way to physical conditions, it would be a national scandal.

The hon. Member might be reading my mind, because I will come on to that issue. I am sorry to hear of the death of his constituent—it is tragic.

I commend the hon. Lady for securing the debate, and she is absolutely right to address this issue. In Northern Ireland, we have extreme mental health issues; indeed, the figure is 25% higher than it is here on the mainland. The Government have made a commitment to address the nation’s physical health. Does the hon. Lady agree that they must now treat the nation’s mental health equally? In doing so, they will address the emotional issues among the people we represent here.

I do agree, and I will expand more on that theme.

Parity of esteem means tackling mental health with exactly the same respect, funding and clinical focus as physical conditions.

I thank my hon. Friend for securing this important debate, and I know that she is a strong advocate for mental health in her role on the APPG. In the NHS, it is vital that funding for mental health keeps pace with funding for physical health care, and the mental health investment standard has been a crucial policy in driving parity of investment. Does she agree that it is vital that the mental health investment standard is retained in the NHS?

I agree with my hon. Friend on the importance of the mental health investment standard as one of the measures for securing good mental health support and for making mental health equal with physical health.

As I was saying, parity of esteem means tackling mental health with the same respect, funding and clinical focus as physical conditions. We are here today to debate that principle, which has been discussed in this place for over a decade, yet it remains unfulfilled. We have made great strides in mental health: the Mental Health Act 2025, investment in mental health support teams for schools, which were rolled out this week, and additional mental health workers. Now it is time to deliver on our manifesto commitment to “give mental health the same attention and focus as physical health.”

We need to look at the current waiting lists for mental health support, but before I look at the figures, I remind Members that every patient waiting to access mental health support is in urgent need of support, just as those on physical health waiting lists are. Sadly, and all too often, people see their condition worsen as they wait, which can lead to extreme consequences. Furthermore, physical illnesses frequently cause profound psychological distress, yet our services treat the physical and the mental in isolation. From my experiences of working with people who have rare conditions, I know the impact that that can have.

The most recent figures show that almost 1.87 million adults and over 576,000 children and young people currently hold open referrals for mental health services. If these were patients waiting for hip replacements or cardiac care, that would dominate the national discourse. NHS England has developed waiting list targets for mental health patients after referral—the longest being four weeks after referral for access to community based services for non urgent mental health care—but those developed standards have never been adopted. Research shows that 12 times more patients with mental health conditions are waiting longer than 18 months for treatment, compared to those with physical conditions. The Government have rightly instructed the NHS to drive down waiting times for elective physical health care, but so far mental health services have been excluded from that ambition.

The situation for our children and young people is particularly concerning. Barnardo’s says that one in five children now has a probable mental health disorder, which is double the rate in 2017. Demand has increased hugely, yet around 28% of referred children are still waiting for help, with nearly 40,000 facing unthinkable waits of over two years for treatment. We see the human cost of those delays in the lives of people like Amy, a young woman diagnosed with complex post traumatic stress disorder. She has spent over a decade isolated at home, yet she has seen a psychiatrist only once in those 10 years. We also see it in the harrowing accounts collected by Rethink Mental Illness. One patient told Rethink that their psychosis was full on and that an attempted suicide was the only thing that got them help. That is an unacceptable threshold for care.

I have heard of more experiences from the suicide prevention charity Body and Soul, with which I have worked. One young person it supported spent almost a year on an NHS waiting list for cognitive behavioural therapy. Just as they neared the top of the list, their health deteriorated into a severe crisis, and they attended A&E, battling suicidal thoughts. Instead of receiving urgent intervention, they were informed that their crisis made them “too severe” for the therapy they had waited so long to access. They were removed from the waiting list entirely and, with nowhere else to turn, they attempted to end their own life. As Body and Soul rightly highlights, no patient with a life threatening physical condition would be told they are too ill to qualify for treatment, unlike in this case.

Mental health charity Mind is calling for the development of open access mental health support pathways, ensuring that people can seek help early and directly, without facing unnecessary referral barriers or rigid clinical thresholds. When we fail to provide accessible care, the results can be fatal. People living with severe mental illness face a premature mortality gap of 15 to 20 years, compared to the rest of the population. Closing that gap by treating mental health with the same urgency as physical health must be the baseline of our approach. Rethink Mental Illness recently found that 83% of people said their mental health deteriorated while waiting for support, and nearly a third of those whose health worsened attempted suicide. Families are making impossible choices, with some parents reporting that they are skipping meals to pay for private therapy for their children because they cannot get the help they need.

This crisis in mental health impacts on our Government’s core mission to kick start economic growth. We are seeing a rise in economic inactivity driven by long term sickness, and poor mental health is a primary factor. The Mental Health Foundation estimates that the economic and social costs of mental health problems reach £118 billion a year. Those figures have not arisen overnight; the previous Conservative Government have much to answer for in this crisis.

We need to make sure that we maintain the emphasis on mental health. Last year, the Department of Health and Social Care reported that the proportion of NHS funding spent on mental health is expected to decline over the next two years. We need to look at that again.

My hon. Friend was a champion for mental health long before I came to this House, and I congratulate her on securing the debate. She makes a point about spending, and I read this morning that despite 28% of cases in the NHS being related to mental health, it receives only 13% of the funding. That is at the same time that parity of esteem has been a legal requirement for over a decade. If we are serious about parity of esteem between physical and mental health, the spending must follow the rhetoric.

My hon. Friend is quite right to point to those figures and to say that we need much more input into tackling that difference in funding.

As I said, the proportion of NHS funding spent on mental health is expected to decline, and we need to look again at that. That is exactly why the mental health investment standard was introduced, and why we need the planned 10-year mental health strategy, when it is published, to set out the actions we need to take to ensure that mental health has parity of esteem with physical health. It is vital that the MHIS continues to protect mental health spending until a suitable long term funding measure is firmly in place to ensure that funding matches need.

Three weeks ago, the interim Milburn review highlighted the unique combination of pressures faced by young people entering adulthood today, including a mental health system that cannot respond to the current level and severity of demand, a pandemic that affected their social development and an ongoing loneliness crisis.

My hon. Friend is being very generous in giving way. I know that this is a topic she understands deeply and has campaigned on for many years. She is right to highlight the Milburn review. Does she agree that part of the response has to be developing a mental health support system that is preventive, not just reactive? We see that in child and adolescent mental health, particularly in Scotland, where there are enormous waitlists. We have to tackle those, but we also have to have a system—in education, for example—where we prevent people from reaching crisis, whether in childhood or when they become adults.

I absolutely agree with my hon. Friend, which is why I am so pleased that we set up mental health teams in schools.

We need to look at preventive measures so that we do not keep getting into this position. When people are left to languish on waiting lists, their ability to participate in the workforce collapses. We must stop waiting for people to hit rock bottom before we step in: we have to deploy preventive measures. It is simply not good enough that one in three young people must wait more than 18 months for treatment after referral.

I welcome the changes the Government have implemented, the extra investment for mental health support in schools, and the expansion of that support to 100% of schools by 2030, but I have some specific asks of the Minister, supported by mental health charities. First, will she ensure that reducing waiting times for non urgent community mental health care is included as a specific priority in NHS planning guidance? That would send a clear message to local systems that this must be tackled alongside elective physical care.

Secondly, Mind, the mental health charity, says that reducing mental health care waiting times must be treated as a core test of parity of esteem; Rethink makes the same point. Will the Minister commit to fully rolling out the access and waiting time standards consulted on by NHS England in 2021 to ensure that emergency mental health care is provided within one hour, urgent care within four hours and community care within four weeks?

Thirdly, to help us to meet our shared ambitions for parity of esteem, will the Minister outline how we will work together to reverse the projected decline over the next two years in the proportion of NHS funding spent on mental health? Will the Government also commit to protecting the mental health investment standard until a long term alternative funding plan is firmly in place?

Finally, the Government have outlined an ambitious shift toward neighbourhood health services. How will the Department ensure that community mental health is a central component of this roll out, so that patients can access multidisciplinary support before they reach crisis point? We have a historic opportunity to build a national health service that treats the mind and the body with equal respect. I look forward to the Minister’s response on how we will finally deliver true parity of esteem between physical and mental health services.

It is a pleasure to serve under your chairship, Mrs Hobhouse. I am grateful to my hon. Friend the Member for Blaydon and Consett (Liz Twist) for securing this important debate, for her long standing commitment to improving mental health services, and for her phenomenal work in her role as chair of the APPG on suicide and self harm prevention. I am also grateful to all hon. Members who have contributed to the debate and shared experiences from their constituencies. I am sorry to hear of John’s death. Men’s suicide is a huge concern; many of us, myself included, can share personal stories. We need to do much more in that space.

This debate speaks to the heart of what a modern health and care system should be. For too long, mental health has not been given the same attention, priority or esteem as physical health. That has had profound consequences for individuals, families and communities across the country. It also has significant economic impacts, as we heard from my hon. Friend, with an estimated 1.26 million 16 to 64-year olds economically inactive due to mental health issues in 2024-25. The National Health Service Act 2006 states that health includes mental health. This Government are committed to giving mental health the same attention and focus as physical health, and ensuring that people can access timely, high quality support, regardless of whether they are experiencing a mental or a physical health condition.

As my hon. Friend said, parity of esteem means recognising that mental and physical health are inseparable. Far too often, services have treated them as distinct issues, when in reality they are connected. Of course, many people experience mental and physical health conditions at the same time, with a cause and effect relationship that goes both ways. We know that poor mental health can increase the risk of developing physical health problems, while living with a long term physical condition can have a significant impact on a person’s mental wellbeing. People living with severe mental illness experience some of the poorest physical health outcomes in our society, and on average die 15 to 20 years earlier than the general population. That is why we are committed to improving the ways that services respond to people with co occurring mental and physical health needs.

Care must be co ordinated around the individual rather than around organisational boundaries, ensuring that people receive holistic support that addresses all aspects of their health and wellbeing. NHS England has developed the mental health personalised care framework, which sets out how services should assess and manage people’s care in partnership with them and in collaboration with all relevant teams. That framework places particular emphasis on joined up care, safety and risk management. It has been tested in local systems and will be published shortly. I know that will answer some of the questions from my hon. Friend the Member for Blaydon and Consett, but not all of them, so I shall try to address those points in my speech.

On wraparound care, we have a fantastic initiative in Winchester where Citizens Advice spends time with patients at Melbury Lodge, the in patient unit, to help them deal with all their life admin, such as debt issues and money issues. It has been shown that those who receive that service have a shorter stay in hospital, are significantly less likely to be readmitted and are more likely to engage with social services once they have been discharged. Is the Minister willing to meet me and the team to discuss that initiative? For every £1 spent on it, £14.08 is saved in cost avoidance for the NHS.

I thank the hon. Gentleman for mentioning the wraparound care in Winchester citizens advice bureau. We need the local health ecosystem to partner with initiatives in the voluntary or charity sector such as that one, and acknowledge their impact, fund and support them. Some may think that things such as debt are basic, but their impact on mental health cannot be overestimated. I am sure that officials will want to meet the hon. Gentleman and others to look at the landscape across the country, because there are some fantastic initiatives that we need to recognise, partner with and support.

The Government are taking action to elevate the status of mental health. For 2026-27, NHS mental health spending is forecast to increase to a record £16.1 billion, representing a real terms increase of around £140 million compared with the previous year. Alongside that, the mental health investment standard remains in place. Integrated care boards are required to protect mental health spending in real terms over the next three years, ensuring that mental health continues to receive the investment needed to improve services and outcomes.

Investment alone is not enough. We must transform how care is delivered. That is why the 10-year health plan sets out our vision for a neighbourhood health service, which my hon. Friend the Member for Blaydon and Consett mentioned. That is about bringing care closer to people’s homes, communities creating genuinely patient centred services, and moving away from a fragmented system that often leaves people navigating multiple services without the support they need. I hope the ICBs are engaging hon. Members in all parts of the House to feed into the design of the neighbourhood health centre model and asking about the unmet needs and service gaps in their constituencies and regions.

The Minister is being kind with her time, as always. As part of our inquiry into mental health services, the Health and Social Care Committee visited the 24/7 neighbourhood mental health centre pilots and Trieste, where the model originated. They have clearly been hugely successful already. The Minister mentioned the broader neighbourhood healthcare changes; can she assure us that the learnings from those hubs will be spread across the country? Will there be a clear road map for rolling out these services to every area?

My hon. Friend is absolutely right; this is a great pilot, and there are some real, huge successes. The Government must learn from the impact that the hubs will have, and of course we want to roll them out. That is why we are piloting six community based health centres across England in Tower Hamlets, Lewisham, Whitehaven, York, Sheffield and Birmingham. Those centres provide round the clock open access treatment and support for adults with severe mental health needs and work closely with primary care and community services to provide joined up care.

All hon. Members across the House will recognise that it is not appropriate for someone who is facing crisis or poor mental health to be sat in A&E; that just exacerbates their condition and situation. The community based health centre pilots show that a different model can work. In May, my noble Friend Baroness Merron visited the community based mental health centre in east Birmingham, where she met staff and service users to hear directly about the service’s impact. The visit demonstrated the important role that community based mental health support has in providing earlier intervention, improving experiences of care and helping people to access support before reaching crisis point.

I know that my hon. Friend the Member for Blaydon and Consett is particularly interested in how the reforms will benefit her constituents. Although her constituency is not home to one of the six core or the 16 associated community based mental health pilot sites, a range of community based support is already available locally. Gateshead Connects hubs provide accessible community drop in spaces that offer mental health and wellbeing support alongside practical advice on issues such as housing and finances. Residents can access NHS talking therapies through services based at Blaydon primary care centre, and community mental health support networks operating across County Durham provide peer led groups and safe spaces for people living in and around Consett. Those local services reflect the wider direction of travel in our 10-year health plan, which will bring support closer to people’s homes, strengthen community based provision and ensure that people can access help earlier, before their needs escalate into crisis.

Significant progress has also been made in building a stronger crisis care pathway. That pathway includes the NHS 111 mental health option; the expansion of crisis cafés, about which we hear from so many hon. Members, as well as sanctuaries and crisis houses; and the roll out of crisis tech services across England. We have completed delivery of the mental health response vehicle programme, with 88 vehicles now operating across local systems. There is now full national coverage of 24/7 mental health liaison teams in acute hospitals, and we are investing up to £120 million to increase the number of sites with mental health emergency departments to 85.

The Government have also delivered on our commitment to modernise the legal framework that underpins mental health care. The Mental Health Act 2025 brings mental health legislation into the 21st century and ensures that people receiving treatment have greater choice, autonomy and involvement in decisions about their care.

My hon. Friend says that parity of esteem must extend to children and young people, and she and many other hon. Members spoke about cases of children facing crisis. The children and young people’s modern service framework is being developed and remains on track for publication in autumn 2026. The framework will support a more integrated approach to physical and mental health.

Hon. Members rightly spoke about access to services and waiting times. It is unacceptable that some people are waiting far too long to receive the mental health care that they need, particularly children and young people and those experiencing a mental health crisis. ICBs must do more. No child should be left waiting. The Government have delivered three years ahead of schedule our commitment to recruit an additional 8,500 mental health workers across the NHS, in the hope of easing pressures on services and improving access to care. We are also expanding NHS talking therapies and continuing the roll out of mental health support teams in schools and colleges to achieve full national coverage by 2029. We know that we need to go further.

Some residents in rural Somerset have said to me that they are waiting 18 months to receive talking therapies. That is just not good enough.

I absolutely agree. That is the responsibility of the ICBs, which have been informed that they must make sure that waiting lists come down.

We know that we need to go further. We are developing a new cross Government mental health strategy for England covering all ages, which will be published later this year. The Department is keen to hear the views of hon. Members from across the House and I am happy to share with any hon. Member details of how they can feed into that work. The strategy seeks to transform mental health support by setting out a plan to respond earlier, reducing waiting times and helping people to remain active. Importantly, it will look beyond the NHS and recognise the critical role of schools, employers, local government and the voluntary and community sector, because achieving parity of esteem is not solely the responsibility of the NHS.

This debate has highlighted both the progress made and the challenges that remain. We are under no illusion about the scale of the task, but this Government are committed to building a health and care system where mental health is treated with the same seriousness, urgency and ambition as physical health. Parity of esteem is not an aspiration; it is a necessity. Through sustained investment, service reform and a renewed focus on prevention, particularly early prevention, we are determined to make it a reality. I once again thank my hon. Friend the Member for Blaydon and Consett; I have a huge amount of respect and regard for her, not only because she secured this debate but because of all the work she continues to do. I know that she will continue to hold us to account. I thank all hon. Members for their thoughtful contributions.

Question put and agreed to.