Are we still guilty of having a victorian attitude to mental health problems as we settle into life in the 21st Century? As a relatively new MP I find myself frequently asking this question as I encounter problem after problem with mental health services.

On a constituency level it can take some time to become aware of the range of problems. If someone is a mental health service user they frequently suffer a lack of self confidence. Making an appointment to see your MP is a big step and can take a lot of courage. I am very grateful to David (not his real name) for visiting my surgery and outlining some of the problems from his point of view.

The more I delved into the world of support for those with mental health problems the more I realised that there are huge problems out there.

The problem of stigma is still very much with us. My eyes were opened to this when I went along to a MIND coffee morning in my local Town Hall one Friday morning. Usually anything providing a hot drink and cakes on a Friday morning is a winner but not this time. Typically people are put off as soon as they realise who is hosting the event. From my point of view I met some very nice people and had some wonderful cakes and left with a sense of outrage that most people had turned away.

Later that year at Party Conference I met protesters from mental health charities MACA and MIND. They were standing in wheelie bins because they claim that people feel they have been "thrown away like rubbish".

I have since met with a number of workers from the local Mental Health Trust. I made an appointment with one and she was so pleased that I was showing an interest that she bought along half a dozen colleagues in different fields so that they could tell me what they were trying to do and what the problems were.

Problems are mostly associated with funding but time and time again the problem of public perception was hinted at. Last June psi (the pharmaceutical schizophrenia initiative) surveyed MPs on their attitudes to mental health services. The survey showed that 87 per cent of MPs believed that the anti-stigma campaign was little known to the public and only 17 per cent of MPs rated their local mental health services as good. I do not believe that this is a reflection on the staff involved but more a reflection of inadequate budgets.

In England the National Service Framework should have the potential to improve mental health services. However the question needs to be asked: "Does it have enough teeth?" Although the framework is supposed to be mandatory, in reality there is no legal duty for agencies to respond to the needs of people with mental health problems. For example whilst the framework calls for mental health needs to be identified, assessed and treated there is no means of redress if an individual's needs are not met.

These problems have long been identified. In November 1999 the government produced a Green Paper, Reform of the Mental Health Act 1983 - Proposals for Consultation. The paper was based on the report of the Expert Committee who had been appointed in July 1998 to advise on the review of the Mental Health Act. The Expert Committee recommended that individuals should have the right to assessment of their mental health needs and this recommendation was made as a result of a large number of submissions which highlighted the difficulties encountered in gaining access to the necessary services.

Access to services is essential but it must be timely. The old adage "a stitch in time saves nine" is very appropriate. The problem is that, for a variety of reasons, requests for help are often ignored or refused and people are left alone to try and cope until crisis point is reached. One of the gravest omissions from the green paper was that there was no recommendation that unmet assessed needs should be recorded in some way. This was a recommendation of the Expert Committee that has been studiously ignored and one can only assume that this is because the government are only too aware of their poor provision in this area.

In an increasingly complex world where there are an increasing number of stress factors there is a huge range of situations which may trigger mental health problems. Children are now more vulnerable than ever before. The increased incidence of family breakdown and the incessant pressure to perform at school are both factors that have contributed to the increase of mental health problems in our young. These and other risk factors are all well documented but there is too little proactive work being undertaken.

Young women are more likely to suffer from an eating disorder and there is a high suicide rate among young men. Help for both vulnerable groups is still too thin on the ground.

At the end of life there is an increased problem with our elderly but our older people with a mental health problem are faced with the double whammy of poor access to mental health services coupled with age discrimination.

In between all of this are those with specific identified problems such as schizophrenia. Last year the Zito Trust highlighted the problem of access to the newer treatments for schizophrenia - the so-called "atypicals". The new drugs control the condition but have far fewer side effects. Needless to say they are also more expensive so the prescribing rate is 18 per cent as a total of antipsychotic preparations in the UK compared with 65 per cent in the USA.

It sums it all up really. There are no perceived votes in "mental health services" so the service is underfunded. This in turn often leads to a "this will have to do" attitude to treatment and prescribing because solving the question, "What is the best I can do for this patient?", is often fraught with hurdles.

It was disappointing that there was no new Mental Health Bill this year. Maybe next year we will be able to put things right but as early signs are that the government is very exercised by "high risk" patients, and not interested in advocacy or the individual, there appear to be many battles that have to be fought and won.