Mental Health Bill [Lords]

Layla Moran Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[Layla Moran (Oxford West and Abingdon) (LD)]

It is a decrease in the proportion of the mental health investment standard for the first time in, I believe, nine years. It is incredibly concerning. It was hard-won, cross-party support that made that proportion go up over time. It was incremental, but it was starting to make a difference to the system. Does the hon. Gentleman agree that it would be helpful if the Government clarified whether that will continue in 2025-26? When Baroness Merron came to our Committee, she could not confirm that. If there is not going to be a continuation, the system needs to know by now, frankly, so that it can prepare adequately for it.

[Dr Evans]

The Chair of the Health and Social Care Committee is absolutely right. A simple answer from the Minister today, on Report, would go a long way to alleviating those fears from the mental health sector. I look forward to his response on that.

Amendment 40 would add a simple but important requirement that each care and treatment plan must include an assessment of the levels of risk to public safety posed by the patient in the community. The purpose of the Bill is right; the Government want to make the system more compassionate, therapeutic, patient-centred and modernised, and we strongly agree with that ambition. However, modernisation must go hand in hand with public confidence, and the public and patients themselves must know that every plan for treatment and discharge is rooted not only in care, but in safety.

In Committee, I argued that the framework still omits one dimension, which is public safety. As far as I can see, there is still no explicit requirement in the Bill for clinicians to assess and record the level of risk posed to the public.

--- Later in debate ---

[Madam Deputy Speaker (Ms Nusrat Ghani)]

To squeeze in a few more Back Benchers, the speaking limit is now three minutes.

[Layla Moran]

This is a long-overdue and very welcome Bill, but frankly it will not even touch the sides of what most of our constituents and communities need when it comes to the wider mental health landscape. I support many of the amendments to improve it, not least those laid by my hon. Friends on the Liberal Democrat Benches. I need to make a couple of quick points, because we want the Bill to succeed.

The Minister will know that since December the Health and Social Care Committee has been conducting an inquiry into community mental health services, because we recognise that unless we start tackling these matters upstream, we will not achieve the Bill’s aims. For so many, it feels like they are walking through an NHS desert: they simply cannot get the appointments they need; they do not feel supported; and no one can navigate this complex system.

Just a few weeks ago, while still on maternity leave, I decided to have a keeping-in-touch day and the Committee decided to visit an oasis in this desert—the incredible Barnsley Street neighbourhood mental health centre in Tower Hamlets. Unfortunately, the centre is one of only six pilots set up to this level across the country, but we heard some amazing stories of how people had been diverted away from in-patient mental health units by an approach that truly puts the patient at its centre. It was inspiring. However, we heard from the centre that its funding will not continue beyond April. It is only just starting to gather the data it needs; system change is desperately needed in this space, but the concern is that the system will change without robust data behind it. My question to the Minister is, will the centres be funded beyond April? If not, how can the Department make decisions about the system based on data that does not represent a full calendar year?

I also want to speak in support of amendment 9. I pay tribute to Cyril and Dianne whose son Leon suffered from schizophrenia for many years and sadly completed suicide in January 2019. He was let down by community mental health services. Leon’s mother, Dianne, saw the illness get worse and worse, and when she tried to re-refer him into the system after he had been detained, she was told, “Computer says no.” This Bill will improve the lives of families like Dianne and Leon’s, because Dianne’s pleas would have been heard under the new nominated persons provisions. Amendment 9 would be an extra step, ensuring that the plan is shared with parents and carers—with the nominated person. I pay tribute to those who have campaigned so doggedly for the inclusion of nominated persons in the Bill.

[Anna Dixon (Shipley) (Lab)]

I am no expert on mental health law, but I do have decades of experience in the health and care sector, and my sister is a psychiatrist. I know that the decision to detain someone with severe mental illness is never taken lightly, and that psychiatrists must weigh up a range of factors and information to come to a final decision. I tabled amendments 43, 44 and 45 and new clause 34 after a number of conversations with the Royal College of Psychiatrists, which has expressed concern about the wording used in the detention criteria.

Taken together, the purpose of my amendments is to ensure that the detention criteria are aligned with good clinical practice. It is important that they are reflected in the primary legislation, rather than simply relying on a code of practice. They would remove from the detention criteria mention of the terms “likelihood” or “may be caused” to allow psychiatrists to make a straightforward, holistic assessment of individual risk in the context of significant mental disorder. The risk is that “likelihood” suggests that it is possible for clinicians to predict serious harms such as violence or suicide when it is not possible to do so, while the idea of causation neglects the fact that complex background conditions can be the genesis of a harm. There is a risk, too, that the language may lead to preventive detention—more detention, not less. It is always easier with hindsight, when unexpected harms have happened, to oversimplify causation and ask, “Why was this person not detained?