Sir Norman Lamb on mental health care and recent XenZone appointment

In an interview for the MedTalk Podcast, Ian Bolland and Reece Armstrong spoke to former health minister Sir Norman Lamb about his recent appointment at digital health player XenZone, and his thoughts on access to mental health treatments and services in the UK.

Former health minister Sir Norman Lamb has described the availability of mental health care for young people as ‘unacceptable’.

Sir Norman, who chairs the Science and Technology Parliamentary Select Committee, was recently appointed as chair of an advisory board at mental health firm XenZone.

“We would never tolerate it in any area of physical healthcare. We have a fundamental problem that we have people waiting very long periods of time for access to support.

Explaining why he took up the role at XenZone, Sir Norman spoke about the personal aspect of being such a prominent campaigner on mental health after his son Archie was diagnosed with obsessive compulsive disorder (OCD) at the age of 16, and how he feels the company he’s joined can make a difference.

“Archie is now 31 as in a much better place but at the age of 16 he finally spoke out to us about what he was going through.

“He subsequently told us he had been trying to cope with these fears and thoughts for the best part of two years, and it’s painful as a parent to hear that.

“Kooth, the youth platform, you can go on and find information, ask questions, involve yourself in chatrooms that are all moderated. If necessary you can get counselling support online but you can do it anonymously. I was left thinking if that had been available to him it might have prevented a horrific deterioration.

“A substantial part of the role will be – in a way – to hold XenZone’s feet to the fire, and to make sure they are staying true to their objective of building an evidence base, staying clinically focussed, not cutting corners, and chairing an advisory board which will include clinicians and people who have experienced mental ill health.”

Sir Norman said he will always make the case for additional funding in mental health services, highlighting cutbacks in local authorities. He highlights the need for investment in preventative, early-intervention treatments.

“We know that the share of disability impact that mental health makes up is well over 20% yet the funding is about 10-11% of the NHS budget.”

The MP for North Norfolk feels that reforms are needed to improve the treatment of patients with mental ill-health, a view strengthened after bringing together a group of reformers who feel that the current way people are supported is suboptimal.

“The fascinating but also disturbing thing is we spend a significant proportion of mental health budgets on, in effect, institutional care which often breaches people’s human rights.

“The whole system focuses inadequately on repairing damage once it’s been done.

“That’s not working, it frankly needs disruption and change, and there’s very rarely any focus on how we can prevent mental ill-health in the first place.”

He said that digital services can have a role in helping early intervention and to stop ‘over medicalising’ conditions and explained how Kooth can attract young people to its service.

“Digital is not the solution on its own but it’s got to be part of the new landscape of support for children and young people, and indeed for adults.

“I’ve talked to a couple of young people and ambassadors who have been through the whole (Kooth) process. When you hear a young person describe how being able to talk to other people who have gone through similar issues anonymously, at any time of day and night, how they find it more helpful than the traditional type of service, you have to take that quite seriously.

“I’m only interested in interventions that are effective and I’d only put my name to a company that was willing and determined to build that evidence base, working with academics, with centres of mental health and so forth.”

Reforms from government are also an aspect that Sir Norman believes that can bring about positive change, and he is frustrated following the publication of a blueprint to change services in the UK called ‘Future in Mind.’

He also feels that education on mental health needs to be in some way part of the national curriculum, and that recent legislation passed by the government depends on how the education is delivered if it’s to be effective.

“It’s critical that staff who deliver it have the skill, and the empathy, to deliver good mental health guidance and education. I think for us all to have a better understanding as we grow up about our own mental health – we all have mental health it just depends where we are on the spectrum.

“We need to have a much more sophisticated understanding but they need to understand what might be going on so they can make the necessary referrals so the individual can get help.

“In the final coalition budget Nick Clegg secured an extra £1.25 billion for children’s mental health. In the first year we said to every area of the country we said you’d get this year’s money provided you get all the stakeholders together and provide a transformation plan.

“The problem was in subsequent years the government put it into the baseline funding of CCGs. They weren’t using the money effectively to drive change, they could have used it as a lever to continue the shift towards prevention.

“I’m very frustrated overall but what it clearly led to is a load of CCGs recognising that giving digital support to teenagers in particular early on was a sensible part of their reform agenda.”

Sir Norman feels that platforms like XenZone can help address the variation in care that exists across the country, though he admits only partly, and explains that being able to spot signs of physical harm and symptoms of a mental health condition also attracted him to the project.

“XenZone will have an identifiable person that they can get referred straight into so that it helps prioritise cases where there’s clearly a need for an early response. I think if we can develop that network across the country, it can have an impact in reducing the awful variation.”

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