Mental Health Bill [ Lords ] (Fifth sitting)

Debate between Danny Chambers and David Burton-Sampson

Committee stage
Tuesday 17th June 2025 Public Bill Committees

[Dr Chambers]

I hope that that is the case. I know that is the aim, but I suppose we will see in four, five or six years’ time what the mental health resources are. No one aims to underfund these services, but the demand on them changes and they need to be resilient. Darzi said that in April 2024 there were 1 million people on mental health waiting lists, and we know that some children wait 15 months, so we must not just maintain the current investment standard, but try to catch up on the huge backlog, which will not change unless we reform the system or invest in more staff and resources.

[David Burton-Sampson (Southend West and Leigh) (Lab)]

The hon. Gentleman makes a good point—mental health services are in a very bad place—but does he agree that the Government have already announced investment in mental health specialists in all schools, and in mental health crisis centres? I have no doubt that once the 10-year plan for the NHS comes out, there will be an even clearer path for how we tackle mental health issues.

[Dr Chambers]

I am really looking forward to the 10-year plan and reading about how it will improve mental health. We shared Labour’s manifesto commitments to mental health practitioners in each school and mental health hubs, so we certainly support that.

The hon. Member for Hinckley and Bosworth made some very good points and said that this proposal should possibly not be in primary legislation. I accept that integrated care boards do not have control over how every part of the service is delivered, so I am happy not to press the new clause to a vote, but I think the second part, which says that integrated care boards should have a duty to assess and report on the resource needed to meet the demands on services every two years, is important.

--- Later in debate ---

[David Burton-Sampson]

I appreciate the hon. Member’s intervention. He makes the point that there may be situations in which the young person’s request might be inappropriate. However, on the flip side, there may be a situation in which it might be inappropriate for the person with parental responsibility to be the nominated person. They could have been involved in the situation that has led to that young person entering a mental health spiral—an abuse situation, for example, which has not been discovered by the authorities. That person would still have parental responsibility at that time. I think it is important that the young person can choose the person to support them in their ongoing care. I will be supporting clauses 24 to 28 and Government amendments 40 and 41.

[Dr Chambers]

Amendment 49 extends the support offered by mental health advocates to cover social and financial stresses and to family carers and other members of the household when the patient is discharged.

Other hon. Members have today discussed how social and financial struggles can play a major role in someone’s mental ill health and in blocking their recovery, and how those are often the areas where someone can most benefit from advocacy and advice. As we are all aware, patients should not be viewed as a collection of symptoms, but within their whole context, including the situation they are living in. Addressing someone’s housing insecurity, debt or family breakdown should not be viewed as a separate consideration, but as a core part of supporting them to live happily, healthily and independently. Furthermore, family carers and the wider household are absolutely critical for people’s wellbeing and recovery, and should be properly equipped to prepare for their loved one returning from hospital. They, too, may need advocacy and may be missing out on support that they can and should receive.

A good example comes from Winchester, where Winchester Citizens Advice has a member of staff—a former mental health nurse—based at Melbury Lodge in-patient mental health unit. Often, someone may be admitted for two, three or four months, and when they are discharged, they go home to all their life admin—there will be final demands for credit cards or requirements to repay personal independence payments and that type of thing. It is very overwhelming, particularly for those who already have fragile mental health, to have to sort out a whole backload of administration—especially financial and complicated administration. For two days a week, that staff member supports in-patients in sorting out all their administration from anything that needs to be done.

What is interesting is that when these patients are discharged from Melbury Lodge in Winchester, if they have had that help, they end up being hospitalised and on medication for a shorter time. They are also more likely to engage with various support and community services once they have been discharged and are much less likely to be readmitted to hospital. For every £1 spent on that initiative, £14.08 is saved in cost avoidance. That initiative run by Melbury Lodge and Winchester Citizens Advice was up for an NHS award last year. It is a proven concept and something that should be done across the entire country. It has been running for two years and has proved how much money can be saved. Unfortunately, it was a pilot project and is struggling to secure money to continue indefinitely. I urge the Government to look at how that type of initiative could be rolled out around the whole country.

Mental Health Bill [ Lords ] (Second sitting)

Debate between Danny Chambers and David Burton-Sampson

Committee stage
Tuesday 10th June 2025 Public Bill Committees

[Dr Chambers]

On the surface, what the shadow Minister says seems logical and makes sense. I am not a mental health clinician, so I want to be really careful about pushing in one direction. Whether someone has an eating disorder or is waiting for a diagnosis of something like ADHD, the waiting times are too long. We must better structure a system that ensures that everyone gets healthcare when they need it, rather than prioritising what we perceive as most important.

One of the most heartbreaking things that I hear from parents in Winchester, who are worried sick, is that young teenagers with an eating disorder have been told that they have to hit a lower BMI to reach the threshold to qualify for treatment. That is essentially saying that someone has to be sicker for longer. No one would ever say, “We’ll wait until your cancer reaches stage 4 before we start treatment,” but that is happening with eating disorders. The treatment will end up being longer, more complicated, more costly for the taxpayer and maybe less successful.

A question often comes up—the hon. Member for Farnham and Bordon alluded to this—about the pressures on local authorities to deliver mental health care. Actually, the question is “How we can afford not to deliver it?” People with mental health disorders are ending up in A&E or prison and costing police time. It costs £52,000 a year to keep someone in prison, yet apparently we cannot afford to give them the community interventions that might stop them going there in the first place.

[David Burton-Sampson (Southend West and Leigh) (Lab)]

The Labour Government are working on a range of early interventions for young people in the area of mental health and to stop them spiralling into crime, such as the Young Futures hubs and introducing mental health support in every single school. The hon. Gentleman makes a valid point, but it sits outside the Bill, and there is plenty that the Government are doing. Regrettably, there will always be a need, at certain times, for a young person to be under a section 2 notice and to be brought into care for a period of time, for their own safety. That is unavoidable and will be the right thing for that individual, but there is so much work being done outside this Bill to help young people and others with their mental health.

[Dr Chambers]

We support all efforts to keep young people happy and healthy in their communities. I visited Winchester Youth Counselling recently, where pupils can self-refer to talk through their issues. That does not involve any clinical personnel. It is hugely impactful and cost-effective and is part of the community. We support those community hubs.

Amendment 47 would specify risk factors for detention for people on the register of people at risk of detention under clause 4, including homelessness, addiction, domestic abuse, miscarriage and traumatic birth, experience of armed conflict, and bereavement. For anyone, including people with learning disabilities, life events can have a profound impact on mental ill health and can drive mental disorders. Well over a third of women with mental health problems have been a victim of domestic violence, and 50% of rough sleepers have mental health problems. The disastrous impact that bereavement can have on anxiety and depression, which are key factors in suicide, has been well documented.

It seems obvious, frustratingly, that public services do not currently reflect that key fact. There are no registers of bereaved children to ensure that they get the right support in the community and in school. There are no registers of veterans, despite their far higher risk of mental ill health and suicide. Women who have suffered a miscarriage do not receive an automatic referral, including to mental health services. The Government need to ensure that people can get mental health assessment and support at key points in their life, including the most traumatic moments.