"We really want to treat people as a whole": Why Mental Health Minister Maria Caulfield is switching strategies
Maria Caulfield (Credit:)
Having worked as a nurse for over 20 years, mental health minister Maria Caulfield has “a foot in both camps”. She speaks to Sophie Church about how the government is increasingly taking a holistic approach to mental health, and sheds light on her spat with a certain Countdown presenter…
“The first few days I remember we were doing shifts and everyone was so scared. We weren’t allowed to go to the canteen if [we] were working on the Covid ward; we were restricted in where we could go and when we could go. They used to open the door, throw a tray of sandwiches in and close them. We would all be scrambling for the food because people were just so scared.”
Mental health minister Maria Caulfield is casting her mind back to 2020, when she was practising as a nurse on the Covid wards. Caulfield had worked in nursing for over 20 years before becoming Conservative MP for Lewes in 2015, but when the pandemic took root she says she felt duty-bound to return.
“Every pair of hands made a difference at that time,” she explains. “There were many retired nurses… or midwives or doctors who were not actively practising who came back to help out. I just didn’t feel I could have asked them to do that – return to practise – and then not do it myself.”
Caulfield found herself in the unique position of being able to report back to Parliament on the waxing and waning of Covid cases in her hospital. However, she found the emotional impact of seeing patients isolated from their families challenging. She recalls going down into the hospital car park to receive pyjamas from relatives and returning to the wards to deliver them to patients who had had no contact with the outside world for weeks. “That was pretty difficult,” she says.
We really want to treat people as a whole. And so that’s why it’s so important that mental health is part of the Major Conditions Strategy
Having worked in the pandemic’s maelstrom, how does she look back on the flouting of lockdown rules in No 10?
“If you look at Boris, I’m not making excuses for anyone, but he got Covid himself, he was pretty poorly with it,” she says. “I think he was touch and go at some points, and he knows more than most what that was like, and so I think sometimes we are very easy to judge.”
Tendrils of the pandemic are still visible today, both in Westminster committee rooms and represented in the backlog of people seeking mental health support. “I am seeing constituents now who maybe were trying to get access to mental health services during lockdown, and couldn’t, because for very good reasons some of those services were not operating,” says Caulfield. “There is just a real backlog, and some of them have had an escalation in terms of their mental health because they couldn’t make access during lockdown.”
Caulfield attributes these waiting lists, in part, to the successes of the Conservatives in getting people talking about their mental health. “We are a real victim of our own success; we’ve done a really good job in removing the stigma, removing the taboos about talking about mental health [and] encouraging people to ask for support when they need it,” she says.
The government’s ambition, Caulfield says, especially for young people, is to get to a place where physical health and mental health are treated equivalently. And so, in January 2023, the Mental Health and Wellbeing Plan was scrapped, in favour of combining mental health into the Major Conditions Strategy.
“I wouldn’t say it was shelved,” says Caulfield staunchly. “It is really important that mental health is not seen as a standalone issue that someone faces, because we know from our evidence that people with mental health problems are much more likely to have poor outcomes from their physical health. We really want to treat people as a whole. And so that’s why it’s so important that mental health is part of the Major Conditions Strategy.”
While mental health charity Rethink Mental Illness has accused the government of “diluting its focus on mental health”, Caulfield points to the government’s financial commitment to the area. “[We have] record levels of funding going into mental health services – an extra £2.3bn a year,” she says.
Caulfield is particularly excited about the government’s Suicide Prevention Strategy, which is slated to come out in the summer. “We’re doing work with mental health charities, with various stakeholders, using the consultation that’s already been done, and really focusing on high-risk groups and locations of concern to try and see how we can reduce the suicide numbers,” she says.
As part of reforms to the Mental Health Act, the government has recently announced £450m for crisis intervention. More than 90 mental health ambulances have already been rolled out, with specialised paramedics able to funnel patients away from A&E or police cells into crisis centres and crisis cafés.
For all the work government is doing on mental health, certain statistics remain stark. For example, NHS statistics from 2020-2021 show that black people are four times more likely than white people to be detained under the Mental Health Act. Caulfield accepts there is a problem there, adding, “they are both more likely to be sectioned, and they are more likely to be subjected to a community treatment order as well.”
She thinks the answer to tackling these statistics could lie in a localised approach to mental health provision – where patients remain in their home area with a community team who support them consistently from admission to a unit through to discharge. “I think being much more community-based – rather than sectioning and inpatient facilities, which is quite prevalent now – will actually benefit those communities where we see high incidence rates,” she says.
While Caulfield’s mental health brief keeps her busy, her role as women’s minister has seen her make headlines in recent weeks. When she was unable to attend a Women’s Equality Select Committee hearing, former Countdown co-host Carol Vorderman, who did attend the meeting, took to Twitter to criticise the minister for not being “bothered to turn up”. She subsequently said she had seen Caulfield in Portcullis House having a cup of tea – adding, “that’s not much of an example, is it?”
Caulfield seems faintly exasperated in the retelling of this tale. “If Carol did see me in Portcullis House, which I’m not quite sure she did, because I don’t recall having a cup of tea that day, but if she did, why didn’t she just come up to me and say, ‘really sorry, you couldn’t make that meeting. Why couldn’t you make [it]? Let’s have a chat about menopause in the workplace.’ But instead, it’s all about going on Twitter, naming and shaming and getting a Twitter storm going on people.”
The irony of an inquiry into making the workplace more adaptable and flexible for menopausal women provoking a row is not lost on Caulfield. “I was lambasted because I couldn’t do one date for that select committee – there was no flexible working there. There was definitely presenteeism there. We want to make the workplace more adaptable, more flexible, more female-friendly. And I just think as women, we should be working together to do that, rather than turning on each other if we are not quite in agreement with those responses.”
Caulfield’s response to Vorderman – that she was “not a punchbag” – is telling of her views on political point scoring in general. “We are all facing the same issues of Covid backlogs, long waiting lists, staff being tired and worn out. I say this probably from my nursing background, I would much prefer it if we could work collectively together.”
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