Mental Health Act 1983

Debate between Debbie Abrahams and Neil Coyle

Thursday 25th July 2019 Westminster Hall

[Neil Coyle]

I completely agree. Sadly, the figure for people with schizophrenia in work remains at about 5%. It is just 5%, because the support simply is not there and the medication and treatment are not there on a routine basis to ensure that they are able to work.

Figures suggest that one in four of us will experience mental ill health at some point in life, often because of bereavement or a relationship breakdown. I pay tribute to all the organisations involved in the Time To Change campaign, which has done brilliant work to challenge the stigma and discrimination that affect people with mental health conditions in employment and elsewhere.

The change in language and awareness of conditions is one reason to seek reform now. For example, the Mental Health Act 1983 is defined as:

“An Act to consolidate the law relating to mentally disordered persons.”

The language around mental health has changed much since the current law was enacted. We also need to consider its far reaching powers.

The independent review of the Mental Health Act, published seven months ago concluded:

“The Mental Health Act gives the state what are amongst the most significant powers that it has; the power to take away someone’s liberty without the commission of a criminal offence and the power to treat that person even in the face of their refusal. Because of that, we think that is important that the purpose of the powers is clear, as should be the basis on which they should be used.”

It is hard to disagree with that conclusion, especially given the number of people who are affected by those extensive powers.

[Debbie Abrahams (Oldham East and Saddleworth) (Lab)]

I congratulate my hon. Friend on securing this debate, and on his personal and emotional contribution—I believe that adds everything. People living with dementia also fall under the Mental Health Act. There are concerns around section 117 and the right for aftercare support once someone is detained under the Mental Health Act, particularly those living with dementia. Does my hon. Friend share my concerns on that?

[Neil Coyle]

Certainly, there is insufficient support for a whole range of people. We have sadly seen a roll-back of support, independence of choice and control in a number of areas, including social care support, health services and direct benefits for some disabled people, particularly in the past nine years.

The extensive powers, which I described, were used to detain 50,000 people last year—a 47% increase in the past decade. The only other people detained in this country are those in criminal custody. Those citizens have safeguards to protect them from going to jail, but we do not have the same safe standards of support and safeguards for mental health care. Those who commit a criminal offence have a police investigation, the CPS evidence threshold, a trial, the right of appeal and advocacy throughout, but for the 50,000 detained under the Mental Health Act few such safeguards exist, despite the deprivation of liberty, choice and control.

We can turn this situation around. The independent review of the Mental Health Act, chaired by Professor Sir Simon Wessely, recommended that four principles be written into a revised Act. First, it recommended that choice and autonomy, even for someone detained under the Act, must be respected, enabled and enhanced wherever possible. Secondly, it recommended that the compulsory powers contained within the Act should be exercised in the least restrictive way possible. Thirdly, it recommended that services and treatments should be of therapeutic benefit and delivered with a view to minimising the need for Mental Health Act powers to be used. Fourthly, it recommended that the individual must be respected, and that care and treatment must be provided in a manner that treats them accordingly.

I seek the Minister’s views on those principles being incorporated in forthcoming plans. If those four principles had existed when my mum was detained—she has been sectioned more times in my lifetime than I can remember—I would have had more reassurance that her needs, rights and wishes would have been the starting point for the care and treatment she received. Sadly, that was not the case.

This is the first debate to be held on the Mental Health Act since that review was published, which is astonishing, given the level of use of the powers in the Act and the level of support for reform. The review made 154 recommendations. The Government accepted two immediately and agreed to publish a White Paper by the end of this year to bring forward full legislation. I welcome that; there is no one who does not want to see that. However, given the paralysis caused by Brexit, and the new Prime Minister and Cabinet, can the Minister confirm that that timetable has not slipped?