Mental Health Bill [ Lords ] (Third sitting)

Aphra Brandreth Excerpts

Committee stage
Thursday 12th June 2025 Public Bill Committees

Although I acknowledge that police forces have faced an increase in workload pressures in recent years, I do not accept that the amendments passed in the other place are the correct way to address that. Indeed, I believe that keeping them in the Bill risks being counterproductive. The expertise, skills and equipment of the police remain essential for safely reaching individuals in crisis, especially where they might be an immediate danger to themselves, pose a risk to others, or face a threat from others. I therefore welcome the Government amendments and urge Members to support them.

[Aphra Brandreth (Chester South and Eddisbury) (Con)]

It is a pleasure to serve under your chairship, Ms Furniss.

Government amendments 26 to 29 risk undoing some of the good work done in the other place, where careful improvements were made to strengthen the Bill and ensure a more compassionate and effective response to mental health crises. I am concerned that by removing the words

“by a constable or other authorised person”

and deleting clause 5(7), which provides a clear definition of who the authorised persons are, we will open up ambiguity about who is permitted to detain someone under the Mental Health Act. This is not just a technical or drafting issue; it has very real consequences for the people involved.

I understand and support the principle of enabling more flexible and clinically led responses to mental health incidents. We all recognise that the police should not be the default option in every case. The amendments made in the Lords acknowledged that and broadened the group of people who could respond to mental health crises beyond police officers to trained and equipped professionals: mental health nurses, approved mental health professionals, paramedics and, crucially, someone trained and equipped to carry out detentions under the Act and who would not be put at unnecessary risk by doing so. “Trained and equipped”—that is the key point.

The definition of “authorised person” in the Bill as it stands makes it clear that those given such a serious responsibility must have the appropriate training and experience and must not be “put at unnecessary risk” when carrying out that role. That wording is important. As the shadow Minister, my hon. Friend the Member for Hinckley and Bosworth, said, it provides a framework of accountability, not a free-for-all. By removing that structure, the Government’s amendments will leave a legal vacuum. The law will say that someone must be detained, but not by whom. That uncertainty will create a risk that services will simply revert to defaulting to the police.

I stress again that that is not fair on the police, who are already under immense pressure. Yes, they are used to seeing people at their most vulnerable, but dealing with someone in a mental health crisis is a very particular challenge, and one that they might not be fully trained to manage. The College of Policing’s 2019 mental health snapshot found that almost 95% of police call-outs flagged as involving mental health did not actually require a police response, yet police officers continue to be sent out because the system lacks clarity and capacity elsewhere.

Baroness May, speaking from real experience as a former Home Secretary, made that very point in the other place. She said that police officers were being sent to mental health incidents for which they had no training or clinical expertise, and were being asked to make judgments that they simply were not equipped to make. She went on to say that

“the very essence of a police presence—somebody in the uniform coming to deal with them—could actually exacerbate their mental health situation”.—[Official Report, House of Lords, 20 January 2025; Vol. 842, c. 1525.]

I would add that, for the individual experiencing a mental health crisis, being approached by the police may feel criminalising rather than supportive. It reinforces a justice-led response rather than a health-led one. That is not the direction in which we should be going.

Although I welcome the Government’s intention to offer more flexibility in emergency and clinical settings, we have to be careful about how we achieve that. Removing the wording inserted into the Bill will not create clarity; it will create confusion. In a system already under pressure, confusion tends to mean delay, risk aversion and inappropriate responses. Removing the specification will not free professionals; it will expose them, and it will expose patients to the possibility of being handled by someone without the right qualifications, which may worsen their condition or create a longer-term distrust of mental health services.

I hope that the Minister can offer some reassurances, both about who will be expected to carry out these detentions and about how we can ensure that they have the proper training, resourcing and protection. Without a clear definition of “authorised person”, we cannot be confident that those involved will have the right expertise to support extremely vulnerable individuals at times of acute need.

I want to touch briefly on the importance of early intervention and de-escalation. Situations involving mental health crises can often be tense, and support in the early moments can be critical. De-escalation is a vital skill; the presence of a calm, trained mental health nurse, for example, in those early moments can change the outcome of a person’s crisis. Having the right professional present—someone who can act without waiting for the police to attend—can be the difference between escalation and calm. The identity of the responder matters.

This is not just about outcomes, but about the experience of the individual. Removing the criminal justice framing from the outset is essential to delivering dignity and the right kind of care.

[Jen Craft (Thurrock) (Lab)]

There seems to be some circular talk about the level of risk that clinicians and medical professionals can be expected to shoulder. I notice that clause 5(7), inserted in the other place, specifies that they would

“not be put at unnecessary risk”.

Is there not an inherent risk involved in detaining people who need to be detained under the Mental Health Act? Those people are not in a position to give consent and quite often do not wish to be detained. By stipulating that the police will not be involved in situations or by making medical professionals the first responders, is there not a risk of putting them in harm’s way?

[Aphra Brandreth]

It is extremely important that people are not put at risk, and that is exactly the point I have been making. People need to be properly trained, and we need to set out who those individuals can be, rather than leaving ambiguity in the wording. The Government amendment will undo exactly the protection that the hon. Lady rightly points out.

[Gregory Stafford]

My hon. Friend is making a clear point, but I want to add that there are clearly places and situations in which non-police professionals, such as mental health professionals, deal with extremely dangerous and violent patients. They are appropriately trained to do so. It is not in isolation that non-police public professionals are dealing with dangerous people. It is about the right situation, the right place and the right training.

[Aphra Brandreth]

My hon. Friend helpfully expands on the points that I and other Opposition Members have been making. If we are not careful, the Government amendments will move us further away from the aim of a person-centred approach.

I urge the Minister to reconsider the amendments. The wording inserted in the other place struck a thoughtful balance. The wording inserted in the other place struck a thoughtful balance. It allowed flexibility, but grounded it in clear criteria of training, safety and competence. Removing that definition will weaken the Bill. It will make it harder, not easier, to ensure that the right person is supporting someone at their moment of greatest need. We owe it to patients, professionals and the police themselves to get this right.

[Gregory Stafford]

The clause is a necessary reset—[Interruption.] Goodness, what a background noise! If only I had such a response to everything I said.

The clause is rooted in the central recommendation of the 2018 independent review of the Mental Health Act, that the criteria for detention are too broad and being applied too inconsistently. Too often we hear stories of people being detained not because they pose a real and present danger, but because services are stretched, community alternatives are not available, or there is simply a lack of clarity on when detention is justified.

This clause is necessarily corrective. It raises the bar by introducing a clear and structured risk threshold that requires the possibility of serious harm to health or safety, rather than vague concerns or subjective impressions. The inclusion of terms such as “likelihood” and the focus on actual risk mark a clear move towards the evidence-based practice that we want to see and away from overreach.

For me, the key strengths of the clause include, first, a higher threshold for detention. Under section 2 of the Mental Health Act, detention for assessment is permitted only if serious harm may occur. That means that professionals must assess the nature and the degree of harm, as well as the likelihood, injecting rigour and proportionality into decision making.

The clause also clarifies the treatment criteria. Under section 3 of the Act, detention for treatment is allowed only if serious harm may occur without it and if treatment is necessary, and, crucially, it must be available. That prevents people from being detained without any therapeutic benefit, a concern that has long plagued the system. The clause also aligns measures across the Mental Health Act: the new threshold applies not only to the initial decision to detain, but to emergency detentions and renewals. That brings consistency and coherence across the different parts of the legislation.

The final key point among the strengths of the clause is the definition of the authorised person, which is vital. It ensures that those tasked with detention powers are properly trained and equipped to deal with the complex and often volatile realities of mental health crises. Whether a doctor, an approved mental health professional or a specially trained nurse, the provision ensures that detention is exercised by someone with relevant expertise, not by default by the police. Taken together, the changes significantly strengthen the legal framework around detention, reduce the risk of misuse and reaffirm the principle of least restriction, the idea that coercive care should be used only when no other alternative exists.

The problems I have with Government amendments 26 to 29 are as follows. The Minister proposes to delete references to

“a constable or other authorised person”

from the clause. On the surface, that may appear to be technical, but in fact I think it is a profound and problematic shift. The amendments would weaken the very safeguards that the clause is trying to strengthen. We must be careful about how we frame this.

The amendments risk undoing the clarity and purpose of the clause by making it ambiguous who can lawfully detain someone under the Mental Health Act. Instead of defining the responsibility clearly and ensuring that it is held by trained professionals, the amendments will strip the clause back to vague flexibility, with no guarantee that the right expertise is present in real-time decisions.

The power to detain and to move individuals to a place of safety, in particular under sections 135 and 136 of the Act, is largely restricted and falls under the responsibility of police officers. These provisions, while designed to protect the public, can often result in the criminalisation of people in acute mental health crises, even when there is no threat of violence or risk to others.

Furthermore, the clause as passed by the House of Lords would relieve police officers of responsibilities that fall outside their core expertise, while also reducing the stigma and trauma associated with police-led interventions. It would streamline the process, ensure that individuals are supported by professionals trained specifically in mental health care, and maintain police involvement only where there is a clear and present risk to safety. In doing so, it would significantly strengthen the system and place mental health crises more firmly within the domain of health rather than law enforcement.

Let me set out the key problems with Government amendments 26 to 29. First, I think that they will blur the lines of responsibility. The clause rightly states that detention must be carried out by a constable or other authorised person, namely someone who has been designated and trained to carry out this high-stakes task. The Government amendments will remove that requirement. In doing so, they risk creating confusion on the ground about who is permitted to act. In a moment of crisis, ambiguity costs time, and time costs lives.