Mental Health Bill [Lords]

Jim Shannon Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Wes Streeting]

I wholeheartedly agree with my hon. Friend. As he has heard many times from this Dispatch Box, we want to see a shift in the centre of gravity in the NHS out of hospitals and into the community as one of the three key shifts that will underpin our 10-year plan for health, which we will be publishing in the not-too-distant future.

The Mental Health Act is designed to keep patients and the public safe, but it is clear to anyone who has seen how patients are treated that it does so in an outdated and blunt way that is unfit for the modern age. It is too easy for someone under the Act to lose all sense of agency, rights and respect. It is sometimes necessary to detain and treat patients, but there is no reason why patients experiencing serious mental illness should be denied the choice and agency they would rightly expect in physical care. Not only should the health service treat all its patients with dignity and respect anyway, but giving people a say over their own care means that their treatment is more likely to be successful. In the foreword to his independent review, Sir Simon Wessely said:

“I often heard from those who told me, looking back, that they realise that compulsory treatment was necessary, even life-saving, but then went on to say ‘why did it need to be given in the way it was?’”

Another patient in the 2018 review said:

“I felt a lot of things were done to me rather than with me”.

We need to get this right. We need to give these patients a voice.

[Jim Shannon (Strangford) (DUP)]

I commend the Secretary of State for bringing this Bill before the House. On all occasions when I have inquired of him, he has been keen to share ideas and thoughts on legislation in relation to Northern Ireland. On mental ill health, deprivation and poverty, the figures for Northern Ireland are some of the highest in the United Kingdom, which worries me as the MP with responsibility for my constituents back home in Strangford. I know he will, but will the Secretary of State share all the ideas in the Bill with Mike Nesbitt—the Health Minister back home—so that Northern Ireland can also benefit?

[Wes Streeting]

I am happy to reaffirm that we have a really strong working relationship with Minister Mike Nesbitt and the Northern Ireland Executive, and we are keen to share insight wherever we can.

The hon. Gentleman makes a very important point, which refers back to the remarks I made about the limitations of the legislation. Reform of the statute book is important in terms of how the law treats people. But as well as reforming the model of care, clinical pathways and looking at new treatments, innovations and technologies, we also need to focus on prevention, attacking the social determinants of ill health, including mental ill health, of which poverty is a key driver of stress, anxiety, depression and worse. That is why the Government will keep such a focus not just in our 10-year plan for health, but more broadly across public policy.

The current legislation has left many people with a learning disability and many autistic people in mental health hospitals, when they could receive much better care elsewhere. Around four in 10 people with a learning disability or autism could be cared for in the community. The Bill aims to improve the care and treatment people receive when detained, while keeping patients and the public safe. Through the Bill, we are: strengthening and clarifying the criteria for detention and community treatment orders to better support clinicians in their decision-making; introducing increased scrutiny and oversight for compulsory detention and treatment; and providing patients with a clear road to recovery by introducing statutory care and treatment plans for all patients detained under the Act, except if under a very short-term section.

--- Later in debate ---

[Jim Shannon (Strangford) (DUP)]

It is a real pleasure to speak in this debate, Madam Deputy Speaker. Thank you for allowing me the opportunity to make a contribution. I shall begin by saying that it is essential that we get this right. In his introduction, the Secretary of State outlined his case very well, and I welcome his policy, his strategy and his legal way forward here in Westminster. I also believe that that will set a trend for the rest of the regions of this United Kingdom of Great Britain and Northern Ireland, and particularly for Northern Ireland. I know that the Minister has direct contact every month with the Health Minister in Northern Ireland, Mike Nesbitt, and that a very constructive dialogue takes place between the Secretary of State here and the Minister back home. Hopefully, this will allow all the regions across the United Kingdom of Great Britain and Northern Ireland to ensure that we are all on the same page when it comes to mental health support and obligations. The Minister and the Labour Government have set a strategy in place that I welcome.

Mental health has increasingly, and rightly, come to the forefront of our minds. We are now taking it on board and teaching our children coping mechanisms from their early school days, for example with teachers practising breathing exercises with children and helping and guiding teenagers through exam situations. Those things are happening already; we have come forward in leaps and bounds. However, this is not a sprint. This is a generational marathon, and we are struggling to make the mile markers. That is why I welcome the whole premise and thrust of the Bill.

The “Mental Health in Northern Ireland Fundamental Facts 2023” report was launched around 18 months ago, and it contained some interesting stats to consider. The wide-ranging report shows that 30% of people in the most deprived areas are likely to have a probable mental illness, compared with 20% in the least deprived areas, and that poverty, particularly child poverty, is a key contributor. It also shows that 24% of children in Northern Ireland are living in poverty. Stable housing is also a key driver of wellbeing, and almost 70% of people experiencing homelessness have a diagnosed mental health condition. In my intervention on the Secretary of State earlier, I welcomed his agreement to share the Bill and its recommendations with the Health Minister in Northern Ireland, because I believe that its constructive, helpful recommendations will help us to achieve some of the aspirations and policies of the Government and the Minister here.

The report also highlights the association between poor mental health outcomes and adverse childhood experiences, with 47.5% of young people aged 11 to 19 experiencing at least one adverse childhood experience. Young people in the least deprived areas are more likely to experience no ACEs compared with those in the most deprived areas. One in five adults and one in eight children in Northern Ireland have a probable mental illness, according to the report, with rates in adults similar to other regions. However, our history of conflict and some 30 years of a terrorist campaign—with terrorists murdering and the IRA trying to kill Unionists and those who objected to their way of life—have repercussions and contribute to more complex mental health difficulties in the population.

This is a snapshot of any, and indeed all, of the regions in the United Kingdom. We are all facing the same difficulties and we all need a more effective solution and support for individuals and families. I have had many anxious parents whose children have been referred to child and adolescent mental health services. The waiting list in Northern Ireland has approximately 2,100 total waits for a CAMHS assessment, with 1,104—over half of that number—waiting for more than nine weeks. These are children who may be self-harming or have OCD and whose bodies are feeling the effects of obsessive hand washing when stressed. These are just some of the things that young people have to deal with. There are so many things that affect their education.

This is why I welcome the aims of new section 125A, which provides for the making of arrangements for ensuring that care, education and treatment review meetings take place for children. Education, hope and a future are essential and I welcome this aim. It is all about giving hope, and I think every one of us, as an elected representative, wants to give hope to our constituents—to the parents and to the children—of a better future. That is why we welcome this positive Bill.

I gently question whether the Bill goes far enough in its legal obligations for children’s reviews on education and health. I look to the Minister for his opinion on whether more should be done to ensure that children and vulnerable adults have a pathway to education and a better health programme, and therefore hope and a better future. We must not have a postcode lottery. Indeed, children and vulnerable adults in each region deserve the same rights and deserve dedication and services. I hope that while this Bill applies only in England and Wales, it will make changes for the good of the entire United Kingdom of Great Britain and Northern Ireland and will put in stone—I use that political term—a focus that all can benefit from. The Minister and the Secretary of State gave me a commitment in my intervention. I look forward to the Minister continuing his positive thoughts on how we can all gain because tonight is one of them good nights in this House.