Mental Health Bill [ Lords ] (Ninth sitting)

Debate between Jen Craft and Natasha Irons
Natasha Irons Portrait Natasha Irons
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I beg to ask leave to withdraw the motion.

Clause, by leave, withdrawn.

New Clause 26

Use of restraint and restrictive intervention

“(1) The Mental Health Act 1983 is amended as follows.

(2) In Part II (Compulsory Admission to Hospital and Guardianship), after section 7, insert—

7A Use of force in connection with admission for assessment or treatment

(1) A relevant organisation that operates a hospital must appoint a responsible person for the purposes of this section.

(2) The responsible person must—

(a) be employed by the relevant health organisation, and

(b) be of an appropriate level of seniority.

(3) The responsible person must keep a record of any use of force by staff who work in that hospital against a person (“P”) who—

(a) has been admitted for assessment or treatment under sections 2 to 5 of this Act; or

(b) is on the hospital premises and is at risk of detention under this Act.

(4) The Secretary of State must by regulations provide for the risk factors to be considered under subsection (3)(b).

(5) A record kept under this section must include—

(a) the reason for the use of force

(b) the place, date and duration of the use of force

(c) whether the type or types of force used on the patient formed part of the patient's care plan;

(d) the name of the patient on whom force was used;

(e) a description of how force was used;

(f) the patient's consistent identifier;

(g) the name and job title of any member of staff who used force on the patient;

(h) the reason any person who was not a member of staff in the hospital was involved in the use of force on the patient;

(i) the patient's mental disorder (if known);

(j) the relevant characteristics of the patient (if known);

(k) whether the patient has a learning disability or autistic spectrum disorders;

(l) a description of the outcome of the use of force;

(m) whether the patient died or suffered any serious injury as a result of the use of force;

(n) any efforts made to avoid the need to use force on the patient; and

(o) whether a notification regarding the use of force was sent to the person or persons (if any) to be notified under the patient's care plan.

(6) The responsible person must keep the record for three years from the date on which it was made.

(7) The Secretary of State must ensure that, at the end of each year, statistics are published regarding the use of force by staff who work in hospitals under the conditions set out in this section.’”—(Jen Craft.)

This new clause would require hospitals to record information on all incidents in which force is used against patients with mental disorders, in line with the reporting currently required in mental health units, including force against those at risk of detention for assessment or treatment. It would also require the Government to publish annual figures on the same topic.

Brought up, and read the First time.

Jen Craft Portrait Jen Craft (Thurrock) (Lab)
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I beg to move, That the clause be read a Second time.

I will speak briefly to the new clause, which was tabled by my hon. Friend the Member for Sheffield Hallam (Olivia Blake). Its aim is to close a loophole in the current framework by which use of restraint is recorded. Currently, the use of restraint is governed by the Mental Health Units (Use of Force) Act 2018, which mandates that where force or restraint is used in a mental health unit, that must be recorded and reported. There are, however, a number of patients who are treated outside mental health units and therefore do not fall within the scope of the Act. My hon. Friend the Member for Sheffield Hallam has spoken about the issue, to which her attention was particularly drawn in the context of the treatment of patients with eating disorders. This happens quite often, either where there is a shortage of beds in a mental health unit or where the patient in question has co-occurring physical health conditions that require treatment outside such a unit.

Restraint is used regularly and often on patients with eating disorders, by which I mean restraining them to force them to eat, but there is currently no mechanism by which its use must be recorded. If a patient, particularly a young person, who is in hospital but is not in a mental health unit is subject to this restraint, which may be deemed necessary to preserve life and in their best interests, there is currently no mechanism by which that is recorded.

Mental Health Bill [ Lords ] (Second sitting)

Debate between Jen Craft and Natasha Irons
Jen Craft Portrait Jen Craft
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I rise to share a few brief reflections. I appreciate that the intent behind amendment 25 is to make sure that the relevant training is in place. I assume that the hon. Member for Guildford has in mind something similar to the Oliver McGowan training provided across hospital trusts, which mandates that all healthcare providers spend a certain amount of time training with someone who has lived experience of autism and of learning disabilities, in order to make sure that the very different ways in which people with autism or learning disabilities might present do not overshadow what they are attending hospital to demonstrate. Particularly for mental health, we all know that diagnostic overshadowing can be fairly significant. In a locked setting, someone with a learning disability or autism may be unable to demonstrate behaviours that show they are improving or getting better, which can undermine the care they receive.

I would just question whether primary legislation is the best vehicle by which to provide for this. We have spoken at length about how the NHS workforce plan and the 10-year plan are coming forward. I wonder whether this would be better placed within that wider framework. Training could be taken forward either as part of continual professional development, or for medical professionals at the start of their career.

Natasha Irons Portrait Natasha Irons (Croydon East) (Lab)
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On the point about training in the round for NHS staff, or any staff dealing with someone in crisis, might it be about taking a more contextual safeguarding approach that relates to not just the one setting? I agree with the point about looking at the 10-year plan, and making sure that mental health training is provided for all staff, because we know that people can present in very different ways, in many different contexts across the health system.

Jen Craft Portrait Jen Craft
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I think there is a concern about having a prescriptive mandate in primary legislation, rather than using a vehicle that could implement real change. Again, I would welcome the Minister’s thoughts on how to ensure that those working in a mental health environment have sufficient training on learning disabilities and autism. We need to make sure that those with a specialism in learning disabilities and/or autism are present and people have access to them, so that things like diagnostic overshadowing do not continue to occur.