Mental Health Bill [Lords]

Marie Tidball Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Dr Marie Tidball (Penistone and Stocksbridge) (Lab)]

One of the reasons I stood for Parliament was to work hard to create a society that values disabled people, that treats us with dignity and respect, and that ensures there is nothing about us without us. It is right that this Government will fix the broken system to ensure that we give mental health the same attention as physical health. I am pleased to see the four key principles from the independent review of the Mental Health Act at the heart of the Bill: choice and autonomy, least restriction, the principle of therapeutic benefit and, most importantly, treating people as individuals.

After 14 years of a Conservative Government, over 2,000 autistic people and people with a learning disability are in mental health hospitals in England. Some 92% of those people are detained under the Mental Health Act 1983, and the average length of stay for in-patients is almost five years. This is a human rights scandal, as the Joint Committee on Human Rights concluded in 2019. The current situation is simply wrong. Autism and learning disabilities are not mental health conditions, and yet under the current Mental Health Act, autistic people and people with a learning disability can be detained in mental health hospitals indefinitely. In my 15-year career working with autistic people and those with learning disabilities, along with autism organisations up and down the country, including the National Autistic Society and the Autism Alliance, I have seen the tragedy of autistic people cycling through the mental health system because of those measures and the failure of public services to provide adequate social care on discharge from hospital orders. As an MP, I know from my constituency that too many people are still being detained who could be supported to live well in our communities by organisations such as Greave House Farm Trust and Action for Autism Barnsley which are on my doorstep.

The most significant change in the Bill is the removal of autism and learning disability from the definition of mental disorder under section 3 of the existing Act. This vital change means that autistic people and people with a learning disability cannot be detained for treatment unless they have a co-occurring mental health condition that requires in-patient mental health care. The Government have said that

“the proposed changes to the detention criteria for people with a learning disability and autistic people will only be switched on when systems are able to demonstrate a sufficient level of community support”.

It is crucial for that to happen quickly, through the Government working closely with autistic people and those with a learning disability, as well with as advocacy groups, to publish a plan to build sufficient support in our communities up and down the country.

My book on the treatment of autistic people in the criminal justice system demonstrated that ensuring that there is an appropriate level of services in the community is essential in preventing the needs of autistic people and people with a learning disability from becoming too complex, leading to admission to mental health hospitals. It also demonstrated the need to support safe discharge out of hospital. Critical to reducing the numbers of those currently detained in hospital under the current law are care, education and treatment reviews for adults and children who are autistic or have a learning disability, which will help speed up discharges, prevent admission and ensure that the person is being given appropriate care. I am delighted that the Bill will make those reviews statutory in in-patient settings. The responsible commissioner, clinician, integrated care board and local authority must have regard to the recommendations arising from them. As chair of the all-party parliamentary group on autism, I am aware that recommendations are often not followed in an expeditious manner. Therefore, there is an opportunity to strengthen the duty on responsible parties to follow recommendations from those reviews.

The Health Secretary has been moving mountains to work on our 10-year plan. I therefore hope that the Bill’s 10-year implementation period for the changes to detention criteria will align with his important work. He is also doing an incredible job to move to a prevention-led health system, and that provides an opportunity for an integrated approach to community support, including working with the Ministry of Housing, Communities and Local Government to ensure there is adequate housing in every integrated care system.

The exclusion and marginalisation of autistic people and those with learning disabilities through their institutionalisation in hospital perpetuates their exclusion from our society. I am proud that our Government are tackling these issues so early on in this Parliament, alongside their commitment to the mental health investment standard, the recruitment of 8,500 mental health workers, and work to deliver a long-term plan for the reform of adult social care. Society is an order of equality and non-discrimination. It is all the richer where autistic people and people with learning disabilities are included within it to fulfil their potential. I commend this Bill to the House.