Rural mental health
Environment, Food and Rural Affairs Committee
Closed
Inquiry
Improving the quality of mental health provision has been an increasing priority for the Government and the NHS in recent years. The NHS Long Term Plan, published on 7 January 2019 sets out the NHS’s aim to advancing mental health equalities, and commits it to providing an additional 380,000 people …
Read more
21
Recommendations
10
Conclusions
1
Report
5
Oral sessions
5
Events
Activity timeline 12 events
3 Nov
2023
2023
18 May
2023
2023
Report published
12 Jul
2022
2022
Oral evidence
12 Jul
2022
2022
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
21 Jun
2022
2022
Oral evidence
21 Jun
2022
2022
Formal meeting (oral evidence session) · Room 6, Palace of Westminster
24 May
2022
2022
Oral evidence
24 May
2022
2022
Formal meeting (oral evidence session) · Room 6, Palace of Westminster
26 Apr
2022
2022
Oral evidence
26 Apr
2022
2022
Formal meeting (oral evidence session) · The Grimond Room, Portcullis House
15 Mar
2022
2022
Oral evidence
15 Mar
2022
2022
Formal meeting (oral evidence session) · Room 6, Palace of Westminster
Oral evidence sessions 5 sessions
12 Jul 2022
View on parliament.uk
Environment, Food and Rural Affairs Committee
Claire Murdoch · NHS England
Gillian Keegan · Department of Health and Social Care
Jonathan Baker · Department for Environment, Food and Rural Affairs
Rt Hon The Lord Benyon · Department for Environment, Food and Rural Affairs
Samantha Allen · North East and North Cumbria Integrated Care Board
Zoe Seager · Department of Health and Social Care
21 Jun 2022
View on parliament.uk
Environment, Food and Rural Affairs Committee
Dr Jaspreet Phull · Lincolnshire Partnership NHS Foundation Trust
Dr Tim Sanders · Royal College of General Practitioners
Jacqui Morrissey · Samaritans
Kate Miles · DPJ Foundation
Professor Jim McManus · Hertfordshire County Council
Sarah Connery · Lincolnshire Partnership NHS Foundation Trust
24 May 2022
View on parliament.uk
Environment, Food and Rural Affairs Committee
Carol Stockman · Cotswolds Community Wellbeing Service
Danny Hutchinson · Invictus Wellbeing
Edward Richardson · Farm Cornwall
Janette Smeeton · Derwent Rural Counselling Service
Mrs Melinda Raker · You Are Not Alone
Stephen Dodsworth · Darlington Farmers Auction Mart
Trudy Herniman · Farmerados
26 Apr 2022
View on parliament.uk
Environment, Food and Rural Affairs Committee
Alicia Chivers · Royal Agricultural Benevolent Institution
Barbara Piranty · Gloucestershire Rural Community Council
Dan Mobbs · Mancroft Advice Project
Dr Jude McCann · Farming Community Network
Dr Rosie Allister · Vetlife
James Russell · British Veterinary Association
Karen Black · Off the Record Bristol
Melanie Costas · Rural Mental Health Matters
15 Mar 2022
View on parliament.uk
Environment, Food and Rural Affairs Committee
Dr David Rose · University of Reading
Dr Rebecca Wheeler · Centre for Rural Policy Research (CRPR), University of Exeter
Rachel Hutchings · Nuffield Trust
Sarah Hughes · Centre for Mental Health
Reports 1 report · click to expand
| Title | HC No. | Published | Items | Response |
|---|---|---|---|---|
| Fourth Report - Rural Mental Health | HC 248 | 18 May 2023 | 31 | Responded |
Recommendations & Conclusions
31 results
1
Recommendation
Accepted
Fourth Report - Rural Mental Health
Incomplete data on rural mental health indicates a serious failure of foresight.
The current data and information relating to the shape and nature of mental health specifically in rural areas, communities and occupations is regrettably incomplete or unavailable and there have been many calls over time for this to be rectified. Given …
Read more
Government Response
The government acknowledges the need for current data on rural mental health and states that the next Adult Psychiatric Morbidity Survey has been commissioned, with fieldwork underway and results expected in early 2025, which will inform improvements for agricultural and veterinary communities.
2
Conclusion
Acknowledged
Fourth Report - Rural Mental Health
Rural isolation creates significant mental health challenges for residents and agricultural workers.
While experience of nature and the countryside is consistently identified as potentially beneficial for people’s mental health, our evidence is equally clear that the isolation inherent in rural living poses a significant challenge to the mental health of those who …
Read more
Government Response
The government recognizes that individuals living and working in rural areas may face specific challenges in accessing necessary mental health services, directly acknowledging the committee's observation.
3
Conclusion
Acknowledged
Fourth Report - Rural Mental Health
Urgent, preventative action is warranted for rural mental health, despite no immediate crisis.
We believe that, while the available evidence does not reveal a mental health crisis in rural England, there are more than enough glaring gaps, and obvious red flags, to warrant urgent and meaningful action, aiming to achieve a degree of …
Read more
Government Response
The government states the new Suicide Prevention Strategy for England 2023-2028, published on September 11, 2023, identifies priority groups and risk factors, including those affecting rural areas and specific occupations. It also notes that the ONS is using Census 2021 data to improve understanding of suicide rates in different occupations to help prioritise actions.
4
Conclusion
Accepted
Fourth Report - Rural Mental Health
Addressing risks and stressors for farming and veterinary workers represents an immediate priority.
In particular, the long list of risks and stressors affecting the farming community and veterinary workers is perhaps the immediate priority, not least because there are real opportunities for substantial gains in this area with significant levers for change in …
Read more
Government Response
The government published a new Suicide Prevention Strategy (2023-2028) that identifies priority groups, including agricultural and veterinary workers, and launched a £10 million Suicide Prevention Grant Fund. The Office for National Statistics is also using Census 2021 data to improve understanding of suicide rates in different occupations.
5
Recommendation
Acknowledged
Fourth Report - Rural Mental Health
Require DEFRA to establish a clear and active role in national suicide prevention strategy
DEFRA should be an active stakeholder in any national suicide prevention strategy, as the Department is responsible for populations and occupational groups arguably at higher-than-average risk of poor mental health and death by suicide. However, DEFRA does not appear to …
Read more
Government Response
The government acknowledged the importance of addressing suicide risk factors in rural, agricultural, and veterinary populations, noting the new 2023-2028 Suicide Prevention Strategy identifies these groups. It also highlighted a new £10 million grant fund and ongoing ONS data work to understand occupational suicide rates for targeted support.
6
Conclusion
Acknowledged
Fourth Report - Rural Mental Health
Joined-up public health approach essential for preventing suicide among agricultural and veterinary workers
Adopting a more joined-up approach to public health focused on early intervention could make a positive contribution to preventing suicide amongst agricultural and veterinary workers. It would need to ‘wrap-around’ people at potential risk, incorporating the NHS, other key public …
Read more
Government Response
The government pointed to the new 2023-2028 Suicide Prevention Strategy, which includes actions to tackle risk factors for rural, agricultural, and veterinary workers. It also highlighted a new £10 million Suicide Prevention Grant Fund and ongoing ONS data work to improve understanding of occupational suicide rates, indicating a multi-faceted approach.
7
Recommendation
Accepted
Fourth Report - Rural Mental Health
Create clear objectives and actions for agricultural and veterinary workers in national suicide prevention strategy
We are very concerned by the evidence indicating that agricultural and veterinary workers have a higher-than-average suicide rate compared to the rest of the population. Although more accurate information is needed, a clear enough picture Rural Mental Health 77 was …
Read more
Government Response
The government states the new Suicide Prevention Strategy for England 2023-2028 was published on September 11, 2023. This strategy identifies priority groups including agricultural and veterinary workers and sets out steps and actions to tackle known risk factors. The Office for National Statistics is also using Census 2021 data to improve understanding of suicide rates in different occupations to help prioritise actions.
8
Conclusion
Acknowledged
Fourth Report - Rural Mental Health
Local government suicide prevention plans lack rural focus and ringfenced funding
Local government is carrying a substantial proportion of the responsibility for delivering the existing national strategy through local suicide prevention plans. However, it is unclear how much these have identified, or address, the specific needs of rural areas. Finally, we …
Read more
Government Response
The government points to the new Suicide Prevention Strategy for England 2023-2028, which identifies risk factors affecting rural areas and specific occupations. It mentions a £10 million Suicide Prevention Grant Fund, but confirms funding beyond 2024/25 is subject to future Spending Reviews. The ONS is also using Census 2021 data to improve understanding of suicide rates in different occupations, including farmers.
9
Recommendation
Accepted in Part
Fourth Report - Rural Mental Health
Ringfence local suicide prevention funding and commission ONS for real-time occupational suicide surveillance
We recommend that the Government: a) confirm the timeline and consultation process for revising the new National Suicide Prevention Strategy b) confirm and ringfence additional funding beyond 2023/24 for local suicide prevention to allow local authorities to contribute effectively to …
Read more
Government Response
The government states the new Suicide Prevention Strategy for England 2023-2028 was published on September 11, 2023. It notes a £10 million Suicide Prevention Grant Fund but clarifies that funding beyond 2024/25 is subject to future Spending Reviews. The Office for National Statistics is already using Census 2021 data linked with other datasets to improve understanding of suicide rates in different occupations, including farmers.
10
Conclusion
Rejected
Fourth Report - Rural Mental Health
DEFRA's prioritisation and resources for rural mental health policy remain unclear
Although DEFRA is clearly responsible for working with the Department for Health and Social Care (DHSC) to ensure mental health policy and services are rural proofed, it is unclear what priority, resources and energy DEFRA has assigned to achieving impact …
Read more
Government Response
The government acknowledges the importance of rural proofing health policy and inter-departmental collaboration but rejects the idea of a joint Defra/DHSC rural mental health policy and delivery team, stating existing channels are more effective. It confirms the Rural Wellbeing Framework is not intended for measuring rural mental health and will not be used for that purpose, pointing instead to the roll-out of a Mental Health Impact Assessment Tool.
11
Recommendation
Rejected
Fourth Report - Rural Mental Health
Establish a national working group and set targets to improve rural mental health outcomes
DEFRA has produced a welcome framework and associated guidance for rural proofing policy but, for instance, claimed close working with DHSC and NHSE 78 Rural Mental Health over the new 10-year cross-government Mental health and wellbeing plan has not so …
Read more
Government Response
The government rejects the recommendation for a new joint DEFRA/DHSC rural mental health team and a national working group, preferring existing collaborative channels and a new Mental Health Impact Assessment Tool. It also rejects consulting on using the Rural Wellbeing Framework for measuring rural communities' mental health.
12
Recommendation
Accepted in Part
Fourth Report - Rural Mental Health
Require joint DEFRA/DHSC team to integrate interventions with DfT and DSIT for rural mental health access
The solution to providing accessible rural mental health services is unlikely to be “one thing” but more likely a package involving innovation and imagination from both patients and service providers. The new joint DEFRA/DHSC rural mental health team should consider …
Read more
Government Response
The government cited its 'Unleashing Rural Opportunities' report, ongoing work to improve rural transport and digital connectivity (Project Gigabit), and increased online options for mental health services to address accessibility challenges. The Department for Transport committed to looking for opportunities to work with Defra, DHSC, and NHS England to maximize health outcomes for rural communities through the transport system.
13
Conclusion
Accepted
Fourth Report - Rural Mental Health
Rural communities face inaccessible NHS mental health services due to centralisation, transport, and connectivity
We conclude that NHS mental health services are often not fairly accessible for rural communities, with centralised services creating barriers to access, compounded by poor rural transport and weak digital connectivity.
Government Response
The government acknowledges accessibility challenges for rural mental health services and outlines existing initiatives under 'Unleashing Rural Opportunities,' including work to improve transport, digital connectivity, and digitally enabled care pathways, with future collaboration on transport systems.
14
Recommendation
Accepted
Fourth Report - Rural Mental Health
Improve rural mental health service access through mobile provision, community involvement, and stigma reduction
Locally the NHS must focus on providing rural communities with good access to services in terms of location and/or via mobile or outreach services, through effective consultation and co-design, and bring the voluntary and community sector into the delivery landscape …
Read more
Government Response
The government acknowledges the importance of accessible rural mental health services, stating work is already underway through Integrated Care Systems and local public health teams. It rejects launching a new consultation, preferring existing accountability mechanisms.
15
Recommendation
Rejected
Fourth Report - Rural Mental Health
Open up NHS access for rural veterinary community, supporting flexible appointments and appropriate digital provision.
The NHS also needs to open-up access to the rural veterinary community to reflect restrictions on their ability to attend appointments, and support people who need to Rural Mental Health 79 continue practising. Better digital provision could improve service access …
Read more
Government Response
The government highlights existing support initiatives for the veterinary profession but states there are no plans to commission a specific training programme for rural NHS staff. It promotes existing digital and remote access options for mental health services as beneficial for rural communities.
16
Conclusion
Acknowledged
Fourth Report - Rural Mental Health
Integrated Care Systems are crucial for improving rural mental health service response.
We believe Integrated Care Systems (ICS) will be crucial to determining whether NHS mental health services are able to respond better in future to rural communities’ needs.
Government Response
The government acknowledges the importance of Integrated Care Systems in providing accessible mental health services for rural communities, stating work is already underway and funding formulas account for rural costs.
17
Recommendation
Rejected
Fourth Report - Rural Mental Health
Issue call for evidence on ICS effectiveness for rural mental health services by March 2024.
We recommend the joint rural mental health policy and delivery team issue a call for evidence on the effectiveness of the ICS-model for providing rural communities with access to mental health services and publish its findings with proposals to address …
Read more
Government Response
The government rejects launching a call for evidence or setting national targets related to the ICS model for rural mental health, stating it does not align with NHS England's new operating model of local accountability. It reiterates that work is already underway through ICSs and local public health teams.
18
Recommendation
Rejected
Fourth Report - Rural Mental Health
Consult on proposals to expand preventative mental health support for rural children and young people.
Child and Adolescent Mental Health Services (CAMHS) have been under intense pressure for many years, but a lack of alternative rural social infrastructure and a fall in support for youth services means CAMHS is often the “only show in town”. …
Read more
Government Response
The government outlines its existing rollout for Mental Health Support Teams (MHSTs) but does not commit to expanding provision to 100% of rural schools by 2026/27. For Early Support Hubs, it has commissioned a longitudinal study but does not commit to establishing and funding them by 2024/25.
19
Recommendation
Rejected
Fourth Report - Rural Mental Health
Identify farming and veterinary mental health as priorities and develop specific NHS staff training.
It is very important for the farming and veterinary communities to feel that their circumstances are understood by NHS staff when seeking to access, or receiving, support (otherwise this may work against help-seeking behaviours). Charities with specialist-knowledge can gain people’s …
Read more
Government Response
The government recognizes the importance of mental health for farming and veterinary communities but explicitly rejects developing a work programme with specific measures and targets, citing misalignment with NHS England's operating model. It also states there are no plans to commission a specific training programme for rural NHS staff.
20
Recommendation
Not Addressed
Fourth Report - Rural Mental Health
Provide detailed statement on NHS funding allocation formula for rural mental health needs.
We welcome the Government’s commitment to provide more funding for mental health and to ensure local mental health spending increases by the same proportion as overall increases in local health funding. Despite this, we are concerned by the possibility that …
Read more
Government Response
The government described how NHS England's weighted capitation formula for Integrated Care Systems already accounts for rural area costs, by factoring in population age, supply-induced demand, distance of services, and ambulance response times. However, it did not provide the detailed statement of the process and formula requested for independent assurance.
21
Recommendation
Accepted
Fourth Report - Rural Mental Health
Set out timeline and process to revise Index of Multiple Deprivation for rural deprivation.
We recommend that DEFRA and the Department for Levelling Up, Housing and Communities set out a timeline and process by which to review and revise the Index of Multiple Deprivation with the aim of more accurately capturing rural deprivation. The …
Read more
Government Response
The government recognizes that the current Index of Multiple Deprivation does not adequately capture rural deprivation and has commissioned an update to the English Indices of Deprivation, with a provisional release anticipated in 2025.
22
Conclusion
Accepted
Fourth Report - Rural Mental Health
Rural communities receive minimal NHS mental health support during and after crisis events.
Crisis events can have short- and long-term effects on people’s mental health, but civil society groups told us NHS support is minimal or short-term, despite greater support being likely to help people deal more successfully with trauma. Rural health providers …
Read more
Government Response
The government outlined existing guidance, partnerships with charities, and multi-agency coordination through Local Resilience Forums for mental health support during emergencies. It stated there are no plans for a dedicated funding stream for rural mental health needs, though Defra and DHSC recognise the need for close planning and provision of support.
23
Recommendation
Accepted
Fourth Report - Rural Mental Health
Adopt proactive approach to mental health implications of rural crisis and shock events.
However, as more extreme weather events are predicted to occur, the Government and NHS England need to adopt a more proactive approach to the mental health and well-being implications of crisis and shock events rather than just leaving it to …
Read more
Government Response
The government highlighted existing guidance from the UK Health Security Agency, collaborations between the Environment Agency and charitable organizations, and multi-agency coordination through Local Resilience Forums for mental health support during emergencies. It also stated that there are no plans for a dedicated funding stream for rural mental health needs, though Defra and DHSC recognize the importance of careful planning and provision.
24
Recommendation
Rejected
Fourth Report - Rural Mental Health
Establish dedicated funding stream for rural communities' mental health needs during crisis events.
We recommend that by the end of this year, 2023: a) DEFRA and DHSC, working with all relevant public health, environmental and first responder stakeholders, assess the readiness of local plans for crisis events, and commence consultations on upgrading local …
Read more
Government Response
The government rejected the recommendation to establish a dedicated rural mental health funding stream, stating there are no such plans. While acknowledging the need for close planning and provision of support, the response did not commit to assessing the readiness of local plans or commencing consultations on upgrading preparedness as recommended.
25
Conclusion
Acknowledged
Fourth Report - Rural Mental Health
Re-evaluate Environmental Land Management programme to embed mental health support for farmers.
Government policies and regulatory activity are key sources of stress for the farming community so Ministers should think hard about the impact of their decisions. The Environmental Land Management (ELM) programme is a case in point given the prolonged uncertainty. …
Read more
Government Response
The government recognized policy uncertainty as a stressor for farmers and detailed how the Farming Resilience Fund provides business support expected to have an indirect positive impact on farmer wellbeing, with providers asked to offer signposting to mental health support.
26
Recommendation
Rejected
Fourth Report - Rural Mental Health
Fund and roll-out Mental Health First Aid training for front-line staff supporting farmers.
We hope that DEFRA’s attempt to reduce regulatory stress is a positive change in cultural practice. However, encouraging and investing in Mental Health First Aid (MHFA) training for people dealing with farmers is a pre-requisite to ensure they are skilled …
Read more
Government Response
The government did not commit to prioritising mental health support as a key deliverable within the Farm Resilience Fund, instead noting its indirect positive impact and current signposting services. It rejected developing an implementation plan to fund and roll out Mental Health First Aid training, stating existing regulations allow employers to tailor first aid provisions rather than prescribing specific mental health training.
27
Recommendation
Accepted
Fourth Report - Rural Mental Health
Address occupational demands and cultural barriers preventing rural workers taking time away.
The Government should look at how to respond to the occupational demands placed on farmers, agricultural and veterinary workers and any cultural barriers that: prevent these workers from taking time away from work, are detrimental for mental health without opportunity …
Read more
Government Response
The government highlights its close existing work and regular engagement with the veterinary profession, and points to several initiatives already in place by organisations like the RCVS and BVA to support the mental health of veterinary professionals. It does not commit to new government action to specifically examine and respond to the occupational demands and cultural barriers.
28
Recommendation
Accepted
Fourth Report - Rural Mental Health
Establish DEFRA working group to explore leave and support options for rural workers.
Although it will be challenging for the Government to address this given such occupations can involve lone workers in often isolated rural locations, we recommend that DEFRA sets up a working group to: a) explore options to establish or expand …
Read more
Government Response
The government highlights its close existing work and regular engagement with the veterinary profession, and points to several initiatives already in place by organisations like the RCVS and BVA to support the mental health of veterinary professionals. It does not commit to setting up a new working group or undertaking the specific explorations and reviews recommended by the committee.
29
Recommendation
Accepted in Part
Fourth Report - Rural Mental Health
Government must accelerate rural transport strategy and address digital infrastructure shortfall.
Some of the challenges of rural daily life can have a significant impact on people’s mental wellbeing. The UK Government needs to address these, including through its various funding routes for levelling-up; but without more detail we cannot evaluate the …
Read more
Government Response
The government outlined existing rural-proofing mechanisms and the Levelling Up and Regeneration Bill, along with increased digital access to mental health therapy. It committed to the Department for Transport soon publishing its Future of Transport Rural Strategy and stated DfT will work with Defra, DHSC, and NHS England to maximize health outcomes for rural communities through the transport system.
30
Recommendation
Not Addressed
Fourth Report - Rural Mental Health
Require Government to detail rural proofing, funding, transport, and digital health access plans.
We recommend that: a) the Government set out how rural proofing has been applied to the Levelling-up and Regeneration Bill; and work with the Office for National Statistics (ONS) to rural proof the Levelling-Up metrics to ensure progress in rural …
Read more
Government Response
The government states it already has extensive rural-proofing mechanisms and publishes annual reports, and describes existing digital therapy options. The Department for Transport will publish its Future of Transport Rural Strategy soon and will look for opportunities to work with other departments, but there is no specific response to setting out the geographical distribution of projected funding or issuing a call for evidence on digital access.
190
Recommendation
Accepted in Part
Fourth Report - Rural Mental Health
Establish national mission, assess, and fund rural youth mental health services provision.
Given the over-reliance on CAMHS in rural areas as a response to mental ill- health amongst children and young people there is an urgent need to address the shortfall in youth services. Including youth services under the levelling-up agenda would …
Read more
Government Response
The government states mental health is a priority driver for the Levelling Up mission and reiterates the National Youth Guarantee by 2025. It rejects a new call for evidence, citing a recent review, but points to existing £300m investment in the Youth Investment Fund and its ongoing independent evaluation, whose findings will be shared with Defra.