Election Q and A: mental health, children and housing

18th June 2024

bbc.co.uk/accessall

Access All – episode 110

Presented by Emma Tracey

EMMA-           We are back by popular demand with another panel of experts here to answer your General Election questions. On with the show.

MUSIC-           Theme music.

EMMA-           Hello, and welcome to Access All, the BBC’s weekly podcast where we delve into stories about disability and mental health. I’m Emma Tracey, and this time we are back with another panel of experts to talk about the things you said you want to know on the runup to the General Election. We had so many messages from you, the listeners, that we haven’t even touched the sides with our first panel, so we’re back again. But do keep your messages coming. You can email accessall@bbc.co.uk, and you can find us on the socials @BBCAccessAll.

                         We’ve chosen our topics for today based on the numbers of messages that we’ve had about each one. So, today we’re going to talk about mental health, disabled children and young people and their families, the COVID-19 pandemic and the fallout from that, and also housing. I would like to introduce my esteemed panel of experts, here to talk about each of those topics. We’ve got Fazilet Hadi, you’re back again, you were here last time. But remind people who you are and where you come from in terms of disability and these topics.

FAZILET-        Thank you Emma, and it’s very good to be back with you all. I’m head of policy at Disability Rights UK, and we’ve been campaigning with other disability organisations for something called the Disabled People’s Manifesto.

EMMA-           Okay, brilliant. Lovely to have you back. Sam Carlisle, you help the Disabled Children’s Partnership. Which is?

SAM-               The Disabled Children’s Partnership is a policy campaign group of 120 charities and children’s organisations that fights for change for disabled children.

EMMA-           And you’ve also got a disabled daughter yourself, and you’re a journalist.

SAM-               Yes, so I’ve got a daughter, Elvi, who’s now 22. So, we’ve lived every minute of this.

EMMA-           And Nil Guzelgun – best name I think in the podcast for a very long time – you’re the head of policy and campaigns for Mind mental health charity. What does that mean? What’s your job?

NIL-                 We work both with people with mental health problems and on behalf of them to campaign on issues that affect people with mental health problems, and take a really holistic approach to doing that, looking at both mental health services and improving support to access mental health services, but also welfare, employment support and also support for young people and marginalised communities.

EMMA-           Okay. We’re actually going to start with mental health. And someone on X, formerly known as Twitter, said that there has been almost a complete halt to mental health provision. Now, waiting times for mental health services have shot up according to the Health Service Journal; 8% of people are waiting more than 49 weeks to see a specialist, so that’s nearly a year. And if that trend continues that could be the longest wait for any specialist that people will have. That’s pretty strong stuff. Nil, which services are most overstretched would you say in terms of mental health?

NIL-                 I think we see a pressure on mental health services across the board. And we know that both adults and young people, but particularly young people, are struggling to access support. I mean, if I take the numbers for children and young people we know that since 2017 where the numbers were one in nine young people had a mental health problem, and now we have one in five young people and children who have a mental health problem but can’t get support. So, the numbers have increased drastically since 2017 and throughout the pandemic as well, and yet access has become more difficult for people for example.

EMMA-           So, it was one in nine and now it’s one in five?

NIL-                 That’s correct, yes.

EMMA-           Right. And why are children’s mental health services particularly overstretched? Are they more overstretched than most?

NIL-                 I mean, it’s a mix of two factors: one is a lack of investment and funding in mental health services, and particularly for young people, but also the numbers of young people who have mental health problems has increased. So, I think the demand has increased, more young people and children acknowledge, and there’s a higher level of awareness, which is a beneficial or benign factor. But also there is not just the level of support provided and the level of investment provided to address that level of demand.

EMMA-           So, more and more young people are experiencing mental health problems, but also there’s more awareness as well. What are the parties saying in their manifestos that they’re going to about this?

NIL-                 Overall the main political parties do commit to bringing in parity of esteem between mental health and physical health for example. In terms of the detail I think the key thing that we have been seeing is a support across schools for example so that there would be more mental health support provided across schools to give that early access when problems arise. And similarly we’ve also seen a commitment to fund early support hubs for young people. So, early support hubs provide access to mental health support in a setting which is outside of a kind of NHS service or a formal setting. And there are also other things like employment support or a youth club and it’s much more accessible for a lot of young people.

EMMA-           Let’s not forget, you’re talking about mental health across the board, we’re focusing on children and families, but older people are struggling too.

NIL-                 Absolutely. We know that adults are struggling to access mental health services too, and there is a commitment across the main political parties’ manifestos to reduce waiting times and to increase investment and address some of that gap.

EMMA-           Fazilet, you’ve noticed an interesting policy from the Liberal Democrats in terms of mental health and schools, haven’t you?

FAZILET-        They’re wanting to put a mental health professional in every school. It was interesting to see all the parties, as Nil was saying, pick up mental health. Having said that, my sort of general view is that disabled people and people with mental health aren’t really seen by the two main political parties, Labour and the Conservatives; the promises are quite vague. Interestingly the two, Lib Dems and the Greens, have much more progressive policies in general that would help all disabled people, including those with mental health issues. I think when I was on your podcast last time I was saying I felt disabled people, the 16 million of us are quite invisible; so we’re not invisible anymore. We are part of the political discourse, particularly in the Green party and the Lib Dem manifesto, nothing’s perfect obviously, Emma, but I really did feel they’d got to grips with something. So, when the Greens say they’re going to invest 20 billion in social care I thought yeah, that’s serious, they understand the scale of the issue. When the Lib Dems say they’re going to bring in free personal care, end institutionalisation, improve rights and incomes for carers, both paid carers and unpaid carers, you know, these are real hard-edged commitments. I know neither of those two parties are going to be the next government, but it still means that those issues are on the table and we should still carry on fighting for them as disabled people. But I think the main parties, Labour and Conservative, are still quite lightweight in terms of what they’re promising.

EMMA-           Because of course the last conversation we had was before the manifestos came out. And I’d like to think that some of our chat about the General Election and about disabled people might have got into their heads a little bit, Fazilet.

FAZILET-        That would be a lovely thought!

EMMA-           It would. Now, Nil mentioned earlier the Mental Health Bill. As far as I can tell the mental health charities and people around mental health are kind of baffled that that hasn’t been enacted yet. Have you been looking at that as well in Disability Rights UK, Fazilet? Do you think the next government will enact it quickly?

FAZILET-        It looks like it. Most of the parties are saying they will enact it. Disability Rights UK and disabled people’s organisations aren’t as committed to it probably as Nil is. I think that’s because we still feel it doesn’t go far enough in, if you like, pushing on community provision and almost making sectioning, forced detention the exception.

EMMA-           Nil, what do you think, does it go far enough? I mean, it’s supposed to tackle some of the racial disparities, which are quite prominent really, they’re quite obvious, aren’t they?

NIL-                 I totally agree with Fazilet that there are aspects that can definitely be improved. But I think our position at Mind is that we would rather see the current proposed bill being passed, and then through secondary legislation or additional measures it can then be improved.

EMMA-           But why do you want it enacted quickly? What would you hope that it would immediately help with?

NIL-                 Once some of the issues that were raised around detention and people having better rights I think it would make a huge impact in that sense. We know that for black people it could have an impact because currently the racial disparity means that they are disproportionately affected and detained.

EMMA-           Now, let’s talk about SEND, special educational needs and disabilities, which has been in the news a lot lately. We’ve just seen a news story on the BBC where there’s a one billion shortfall of funding for SEND in England at the moment. And we’ve had two BBC investigations recently about individual special schools: one in the Wirral, an undercover investigation where children were physically very badly treated, and another one in East London, where there was a lot of problems around seclusion in padded rooms etc. But we’ve also had a lot of chat about it when we asked people what they wanted us to talk about in the runup to the General Election. Here’s a voice note:

GRAHAM-      Hello, my name’s Graham and I’m a primary school teacher from Southend-on-Sea. And what I’d like to know is what the parties propose to do to increase the support available to children who have got special educational needs and also their families as well, because at the moment the system isn’t working for anyone. Thank you.

EMMA-           And Janice said that extra funding would reduce costly suspensions and exclusions. And she’s also looking for more funding for training for teachers who want to work in specialist provision.

                         Sam Carlisle, unpack that [laughs]. There’s a lot going on there, isn’t there?

SAM-               Where do we start? Disabled children, neurodivergent children are not prioritised. There’s not enough money in the system. The system is completely broken. The SEND review that the government did themselves admitted that. You’ve got areas of education, health and social care that are all failing young people. And all of that feeds into a picture of just letting children down. It’s just been shocking. It’s the government’s duty to provide an education to children and to make them feel safe, and at the moment we’re just not doing that.

EMMA-           And are there any policies that you’ve seen in the manifestos? What parties are going to do something about this?

SAM-               So, the policy that obviously hits home with families is the Lib Dem policy – and this isn’t my personal view – talking about establishing a national body for special educational needs and disabilities, to provide support for children with high needs, increasing funding to local authorities for SEND, because that’s what it all comes down to. I was really disappointed with the main parties; I just thought we’d got to a point where everyone was talking about SEND, there have been so many stories about SEND, and we just thought okay, now this is the chance to lay out your proposals. And the two main parties have been a bit, as Fazilet said, vague. There’s nothing really powerful there. The Conservatives have sort of said things that they’ve already committed to, so we will transform education for children with special educational needs by ending the postcode lottery of support, by delivering 60,000 more school places. That’s pretty much what their SEND improvement plan said, and they haven’t done it yet, they’re behind on that. They could be much more radical I think in their offer.

EMMA-           And Fazilet, what do you think about that?

FAZILET-        Well, I think certainly they’re not tackling the 3 billion shortfall in the special educational needs budget, never mind special school places, which is the focus. There is obviously a very live debate about special schools and whether disabled children should be segregated. Whatever you believe the mainstream sector has to be more inclusive because that is where the majority of disabled children are. And I agree with Sam that the political parties, the main ones are very weak on this. There are slightly more warmer words in Labour about doing more with local government and trying to improve the SEND system etc, etc. But because the Labour party is so unwilling to talk about pound notes that’s all just very kind of motherhood and apple pie at the moment. They’re not saying they’ll invest 3 billion per year in SEND to make sure that disabled children across whatever schools they choose to go to get the best education.

EMMA-           Nil, what about mental health provision for children outside of school? We’ve talked a lot about school provision there, but what about the young people who end up in wards that are for adults and the repercussions of that?

NIL-                 Yeah, we know that it is really difficult for children and young people who end up in a mental health crisis and therefore in a mental health hospital. And what we know is that they are sometimes actually sent into a mental health hospital which is not where they live, very far from where they live, which obviously isn’t ideal at all and isn’t acceptable actually at all. And they are then also in a ward with adults, and we know that a lot of young people find this experience traumatising. And oftentimes actually when they leave hospital they are then being promised to get a certain level of support and type of support which doesn’t materialise.

EMMA-           Anything in the manifestos about dealing with this issue?

NIL-                 The only promise that we did find is that there would be, in a very vague sense as Fazilet and Sam have also highlighted in their responses, that there would be a commitment to bring forward the Mental Health Act. But the detail obviously we need to look at that and see what that actually means for adults and children.

EMMA-           Before we finish on this topic around disabled children and young people, I do want to play you a message by Hugh Malyon who is an artist. And it’s about the Conservative’s promise to bring in national service:

HUGH-            I’ve not seen anything about young carers not being listened to, being forced to do national service.

EMMA-           Hugh goes on to say there about what about family members who are young carers and who might be gone for a weekend, a month, when the resilience of the family is quite low and when they don’t already have enough support because of cuts to budgets around social work and other areas that might have helped the family. I mean, Sam, what do you think about that?

SAM-               Yeah, we know the pressure on young carers, it’s a huge issue. I mean, you don’t want to be relying on brothers and sisters helping out, and they should be able to go on school trips and they should be able to live their lives without feeling that they have to support their brothers and sisters or parents if they’re disabled. So, it will be another area, if this were ever to come true, it would be another area where thought hasn’t been put into what that means for families. But I think actually it’s unlikely to happen. It feels like it’s written on the back of a cigarette packet that one.

EMMA-           Fazilet, I was so pleased to receive that message from Hugh. I really love our listeners, because that’s a disabled person worrying about this stuff. What did you think of that?

FAZILET-        Good for Hugh for raising it. I doubt the government, when Rishi Sunak announced it, I don’t think they had a disabled person in mind, someone experiencing mental health challenges, a young carer. I don’t know who their kind of image of a young person is but it wasn’t any of those people. And so it was very much without thought and it wasn’t an inclusive proposal. It wasn’t based on what young people were telling them they wanted. It was just like a rabbit picked out of a  hat kind of thing. So, yeah, I too hope that gets consigned to the dustbin of history.

EMMA-           And for disabled people as well, what about disabled people and national service?

FAZILET-        Yeah.

EMMA-           Will you have an assessment to see if you can do a national services? I mean, that’s me being a bit facetious, but.

FAZILET-        Well, exactly. They just didn’t think that through.

EMMA-           Now, one of the topics that we got more messages about than any other really was the COVID-19 pandemic. Many disabled people say that it’s a pandemic that’s ongoing for them but they’ve been forgotten. Here’s a voice message from Steph Anderson:

STEPH-           Many thousands of people who are clinically vulnerable and/or immunocompromised are in their fifth year of lockdown. This is most definitely a disability access issue that needs to be pursued during the election campaign.

EMMA-           Fazilet, that’s interesting, isn’t it? I mean, there are still people wearing masks. I interviewed Liz Carr recently, the actor, and she said that this very room that we’re in right now is the first situation she’d been in in a long time without a mask. But how many people are shielding still and minding themselves against COVID?

FAZILET-        There was a report in parliament last year, about November, that put the figure at 800,000, which is quite a lot of people.

EMMA-           That’s a lot, yeah.

FAZILET-        And 800,000 people are really still very worried. It was called Forgotten Lives, which echoes what the woman says really. Many of those people didn’t have the vaccinations because their bodies wouldn’t allow the vaccination. I think also now many of them are worried that if they do get COVID they can’t get easy, quick access to the antiviral treatments. So, I think the woman is right that the health service, if you like, isn’t in a position anymore, it seems to me, to react quickly. And that builds the fear because then you think oh my goodness, if I do get exposed I’m on my own and it could end in death.

                         I think the other thing about COVID is that the last figure I saw was that 1.9 million people were living with some after effects of long-COVID. Some of that figure, like 300,000 or 400,000 very, very serious long-COVID, almost like chronic fatigue syndrome. And so those people, if you like, have been added to the disabled community now, but actually find themselves in a position like a lot of disabled people without easy access to health services, without good access to social care, without reasonable adjustments in employment. I don’t think anyone’s mentioned COVID in this election. The COVID inquiry, public inquiry is still going on, and it will actually look at health services this autumn, and so that may be another opportunity to put some of the issues being mentioned on the political agenda of the new government.

EMMA-           Nil, what are the lasting impacts, from your perspective, on mental health of the pandemic?

NIL-                 We know that there has been a drastic increase of people who are trying to access mental health support. As I mentioned earlier, there are more children and young people who have mental health problems, similarly with adults the waiting times have reached nearly 2 million to access any mental health support.

EMMA-           And do you think that’s lot down to COVID? Well, obviously the waiting lists got longer when services weren’t available during, but also the pandemic and the effect on people’s mental health.

NIL-                 Absolutely. And we can’t bring it all back to the COVID-19 pandemic because some increases we had seen before the pandemic, particularly amongst young people in terms of the mental health prevalence. But certainly the pandemic has just catapulted the numbers and increased the numbers drastically and made it a bit more difficult for people who were maybe coping, and then obviously it tipped them off to maybe struggle a bit more. And the cost of living crisis etc made it even worse.

EMMA-           Sam, what lasting effect has the pandemic had on disabled children and families?

SAM-               The things that were taken away, so things like respite centres closed during COVID, and a number of those didn’t come back. So, care workers left the system during COVID, a number of those didn’t come back. So, families felt isolated, support was withdrawn, hospitals were struggling to catch up. We’ve seen the numbers of teachers have reduced since COVID I think because of the pressure at the time and increasing pressure. We’ve talked about mental health services. So, nothing has returned to what was a pretty low base rate before COVID.

EMMA-           Okay.

NIL-                 If I may just add on that, because I think what we saw during the pandemic, and this is what is so frustrating being in this situation where we are in a General Election and looking forward to what the next government should be doing, I think during the pandemic actually a lot of things that a lot of charities had been campaigning on for a long time had been slowly implemented such as, for example, better sick pay provision to enable people who might have COVID so that they can stay at home for example and do not need to go to work, they were given a better sick pay provision. But similarly with the increase, the uplift of benefits, which we know are inadequate for a lot of people who receive benefits. And that really focused attention on our healthcare system, not just mental health care system, but the wider healthcare system. And all of that was then, after 2021, 2022 slowly eroded and we have come back to a state of healthcare, all public services, as if there was never a pandemic.

SAM-               What’s terrifying is if that happens again I can’t see, you know, if we have another pandemic what would they do differently and what is in place? And I know that’s what the COVID inquiry is for, but there’s nothing in the manifestos about that.

EMMA-           Another thing that the manifestos haven’t covered massively but something that we've had a lot of messages about is housing and the shortage of adapted housing for wheelchair users and other disabled people. Fazilet, Disability Rights UK have been doing some work around rentals, and one in three disabled people are living in unsuitable rental accommodation. Is that right?

FAZILET-        The figures are pretty shocking on housing. I think it’s something like only 7% of the UK housing stock is accessible and there’s no actual way to find where that 7% is of them.

EMMA-           Yes, exactly. So, the housing doesn’t actually match up with the people, so there could be lots of people in accessible houses that don’t need it and vice versa.

FAZILET-        And then you raise the affordability issue, we’ve seen rents spiral. Housing I think is becoming more and more of an issue to everyone in the community, but disabled people will have additional challenges. So, we see the big parties saying “we’re going to build, you know, 300,000 homes a year” or they’re going to build even more than that. Actually that target has not been met during the course of this government, but anyway it’s in the manifesto that Labour will build 1.5 million homes over the course of the next parliament, and the Conservatives 1.6. I think Labour they’re giving us the warm words about “we’ll work with local government and make sure that a proportion of housing is affordable social housing,” but they don’t commit to figures. I think the Lib Dems do commit to a figure; they say that out of 380,000 homes per year they’d like 150,000 to be social housing. There’s also some proposals on upgrading the energy efficiency of homes that you’d expect from the Greens. And I think the Lib Dems also has that, but also a social tariff for energy, which we’ve not seen this government introduce although it did promise it.

EMMA-           So, there’s plenty about housing, Fazilet, but not much about specifically adapted homes?

FAZILET-        No. There’s nothing about 10% of new homes should be wheelchair accessible or 100% should be accessible; that was something the Conservatives promised in July 2022 but they’ve just not implemented. Nothing about personal emergency evacuation plans for disabled people, although we’re seven years now from the Grenfell Tower fire, we do have a building safety regulator so there is some hope for maybe people in high rise buildings. It is worth them contacting the regulator if they’re worried about not having a personal emergency plan.

EMMA-           Sam, I want to talk to you about housing for families with disabled children and young people. But first here’s a message that we got about housing:

FEMALE-        I’m a 33 year-old wheelchair user who was, up until recently, homeless for 18 months due to housing shortages. The provision for adapted housing is below the bare minimum, with priority for ground floor accommodation, the majority is reserved for over 55s. In my area there is a caveat to these age rated properties of being disabled and over 45.

EMMA-           Sam, have you noticed a big issue for families? I mean, I have, I’ve seen loads of stories. We had someone on last year where there were seven people living in a one-bedroomed flat because they were waiting on a house to be ready.

SAM-               Yeah, I think Contact, one of our member organisations, have a lot of calls about this. And if you can’t make your home accessible or have support then you don’t have great expectations for outside of your home. There’s a big issue around – I mean, certainly personally I’m going to talk about this – because looking for where Elvi will go and live after college I’m so shocked, I shouldn’t be [laughs] but I’m so shocked by the lack of provision for young people coming out of college. Where are they going to live? Where is their wheelchair accessible places that they can go to that’s got room for carers, where they can access the things they want to access? I mean, I’m absolutely terrified of what’s going to happen with Elvi when she leaves college. As I said, she doesn’t sleep, so if she comes back to us that means me being awake 24 hours essentially. It’s really depressing going out. Our local authority told me they didn’t have any wheelchair accessible places or housing for her, they didn’t have any, which I just couldn’t believe [laughs], it seemed extraordinary.

EMMA-           Yeah. We’ve run out of time big time. Now that the manifestos are out, all three of you, what’s the most positive thing you’ve seen for disabled people in those? Let’s start with you, Nil.

NIL-                 Goodness me. I think it is positive that firstly all major political parties acknowledge that mental health needs to be addressed, and they commit to creating parity of esteem between mental health and physical health. It is also positive to see that they are committing to introducing the Mental Health Act. But when you look into the detail as to what level of support they commit to it seems like it’s nowhere near enough.

EMMA-           Fazilet?

FAZILET-        I think the most positive things I’ve seen are in the party manifestos of the parties that aren’t going to get into power [laughter], the Lib Dems and the Greens. I do applaud them on being bold on personal care. And I do applaud the Greens on saying that social care needs 20 billion extra per year. And I hope that kind of more radical approach will seep into the next government.

EMMA-           Thank you. And Sam?

SAM-               I agree with Fazilet, the Lib Dems going to that place where they’re talking about Ed Davy’s personal experience is really important. I think the Greens also talking about transport for children to school was something that we weren’t expecting but is something again that Contact have campaigned on. But I really want to see the two main parties take this really seriously, commit funding. If the political will is there then there is no reason why they can’t commit to funding on education, health, social care for young people.

EMMA-           Fazilet, Sam and Nil thank you for joining me. Thanks to my guests, Nil Guzelgun from Mind mental health charity, Fazilet Hadi from Disability Rights UK, and Sam Carlisle from the Disabled Children’s Partnership. Between now and the General Election we are going to do our best to interview someone from all of the seven main political parties about their disability policies. So, keep your questions coming on email accessall@bbc.co.uk. You can send us a WhatsApp, a voice message or text message to 0330 123 9480, put the word “Access” before your message so that we can find it more easily. You can find us on the socials @BBCAccessAll. And do look out for our special series of political interviews starting next week. Thanks for listening. Bye bye.

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