Mental Health Bill [Lords]

Kevin McKenna Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Kevin McKenna (Sittingbourne and Sheppey) (Lab)]

I commend the hon. Member for Dorking and Horley (Chris Coghlan) on a powerful and vital contribution to this debate. In fact, I commend everyone who has spoken so far, often from personal experience and expertise. This is unfinished business, and this Bill is long overdue.

I have been reflecting on my first placement as a pre-registration student nurse. I went straight into a mental health ward. I am not a mental health nurse; that was not the route I took, but not because anything I saw there particularly turned me off it. However, it was a remarkable experience. When I walked into the unit for the first time, I was shown a burned pool table; it had been burned down the day before. The staff apologised and we moved on. The staff were full of compassion, but also frustration, and one of the things that they were frustrated with was the Mental Health Act 1983. This is some time ago; we are talking about 1996. In one of my very first teaching sessions on that unit, I was told about all the things that needed to be changed in the Act, so it is slightly surprising that I have wound up in this place, with the opportunity to change and challenge those elements.

The points made to me then were particularly about the challenges for different communities, and the way that people from different ethnicities and cultures were assessed for mental ill health. The Bill will help to adjust that, and hopefully we can mitigate those problems, and move beyond and progress from the 1983 Act. Some things were not even properly on people’s radar then; for example, there was less understanding of neurodiversity, autism and learning disabilities, and the inappropriate way that they were covered by the Act. Many Members have talked about the large number of people who are autistic or have learning disabilities who are incarcerated. That has been described as an offence against human rights, and I believe that to be true, but I also believe that it will be challenging to overcome.

In 2019, the long-term plan for the NHS was brought forward by Baroness May, and several Members of this House had a key part in driving forward that change. It said that we should challenge the detention of people who are autistic in mental health locations that people are left in for a very long time. We heard from my hon. Friend the Member for Penistone and Stocksbridge (Dr Tidball) that the average length of stay of someone who is autistic or has learning disabilities and is detained under the 1983 Act is 4.7 years. That is a lot longer than many people with psychotic illnesses would need to be detained.

That long-term plan for the NHS had great intentions, and made suggestions for overcoming the issue and liberating people from detention. It was not just the pandemic that came soon afterwards that kiboshed them: it is really hard to drive change in the system when the Mental Health Act protects clinicians and senior people in the NHS in not driving forward that change that is needed. To drive it forward, we need a change to the Act, and that is what we have in front of us. I commend everyone who has worked hard on the Bill to ensure that patients’ voices are heard.

In my constituency of Sittingbourne and Sheppey, we have big mental health challenges. We have the highest suicide rate in Kent and, I think, the 37th highest suicide rate of any local authority area in the country. That means that 37 other Members in this House have even bigger challenges when it comes to suicide and mental health provision. I am sure that what many of those places and Members have in common is the challenge of economic deprivation and inequality, which—let us face it—is the biggest driver of poor mental health outcomes. That was mentioned admirably by the hon. Member for Runnymede and Weybridge (Dr Spencer), who talked at length about the complexities of the 1983 Act. I commend him for his insight on the challenges of changing that. We have to change things across the board—in housing, access to employment and transport, things that are way beyond the bounds of the Bill. We should use this Bill to drive that forward. We should look around our communities and see the creative approaches that we can use.

On Saturday, I had a lovely day out in the sunshine at Curly’s farm on the Isle of Sheppey in my constituency. It is an active farm, set up by two fathers to support their son, who has profound learning disabilities and autism. It brings in children with learning disabilities, autism, mental health challenges and behavioural challenges generally. It is something like the Challenging Behaviours Foundation, which my hon. Friend the Member for Rochester and Strood (Lauren Edwards) talked about, and which is also very active in my constituency; I was glad to host an event for it. The farm really shows us that when we get people out of institutional settings and outdoors into different environments, they can thrive in a way that they do not in school, or in healthcare settings. It is transformational to the lives of the children and young people who go there, who often go on to work in agriculture. I am sure that many other hon. Members see that.

[Sojan Joseph]

My hon. Friend is absolutely right to say that patients with challenging behaviours should not be detained in a mental health ward for many, many years. They should be in a different setting. Does he agree that we do not have enough support or accommodation for patients? We need to invest more in community settings for some of these patients with challenging behaviours.

[Kevin McKenna]

My hon. Friend has jumped ahead of me on that—not surprisingly, given his background as a mental health nurse. That is absolutely true. We do need to invest more, but we need to think beyond the NHS. Although this is the Mental Health Bill and it has “health” in its name, this issue is much bigger than the services that the NHS can provide.

There is a weakness in this Bill. The concern I have, which several other Members have mentioned, is that it does not tie us down to a tight timeline for this transformation. The Bill provides a get-out. That is done to ensure that services in the community are properly set up, but I worry that that the timeline will slip and slip. The time to move is now. People have been languishing for too long in settings that do not offer them a therapeutic way forward, and in places that are frankly inhumane and breach what we would all consider to be our human rights. The Minister is here and listening, and I recommend that he thinks about how we can get an active plan, so that we do not let this issue slip, but actively ensure support for services in the community, invest in them where needed, and foster them.

[Jen Craft]

I very much support what my hon. Friend is saying about making sure that there is an active plan. One of my concerns is that implementation of this Bill will be delayed until community support is ready. Does he agree that it would be welcome if the Minister offered a reflection on what good looks like in this space, and what ready looks like, so that we know what we are aiming for?

[Kevin McKenna]

I absolutely agree. We should flip this around from a delay until we are absolutely ready to an active process of deciding what good looks like.

Two weeks ago in my constituency, I ran a mental health conference. That was largely because, as I was going around as a new MP talking to every different organisation I could, mental health was right at the top of nearly all their worry lists, whether it was the food bank, the schools, the police, the prisons, or organisations in my community that had set themselves up to support people with mental health. I have a MenTalk in Sittingbourne and a MenTalk in Sheppey; they work in different ways, but that shows the level of pressure that exists locally. All of those organisations brought out mental health as their biggest worry, even if it was not their primary purpose.

Just bringing people together and getting them to talk together—people who perhaps had not talked to each other until that point—really made a difference. You could see it in the room on that day. I am sure I am way behind the curve compared with a lot of other Members who have been doing this sort of stuff already, but for me, it really showed that we have got to be active in pushing this forwards. What we have learned from 2019 and the long-term plan for the NHS is that it is the implementation that matters. It is not the words in the strategy; it is getting an implementation plan really tight and fast on the ground. Given that the impact assessment talks about 2027 as a key point, I would like to see a commitment in the Bill to produce a workable plan by 2027 at the latest—one that can give us the road map we need for the future. That has been called for by organisations such as Mencap and the National Autistic Society, so I really commend it to the Minister.