Mental Health Bill: Legislative Scrutiny

Peter Swallow Excerpts

Thursday 22nd May 2025 Commons Chamber

[Peter Swallow (Bracknell) (Lab)]

It is an honour to present to the House the Joint Committee on Human Rights’ report into the Mental Health Bill. As Members will know, the Joint Committee is a cross-party body of both Houses, chaired by Lord Alton of Liverpool, whose remit is to examine matters relating to human rights within the UK, including through legislative scrutiny.

Over the course of our inquiry into the Bill, we have examined legal frameworks and witness submissions and, crucially, heard from those with direct experience of the mental health system. As part of our inquiry, the Committee convened a roundtable with individuals who had experienced detention under the Mental Health Act 1983. Their testimonies were powerful, candid and often harrowing. They spoke of the trauma of being sectioned, the overuse of medication and restraint, and the disempowerment from being detained in facilities that too often felt isolating rather than therapeutic.

Participants have since shared with us

“how important this visibility was to them, to see their evidence truly listened to and shared publicly”.

Hearing directly from people with lived experience was not just informative; it was essential. These conversations grounded our scrutiny in the realities faced by patients and families. The insights shared at that roundtable shaped our thinking and sharpened our final recommendations. As one participant told us:

“lived experience matters. Using it to inform policy should be the standard, not a shock.”

I take this opportunity to thank all those who contributed to the roundtable, often at the cost of revisiting past trauma. The Committee is also grateful for the expert work of the Committee’s legal counsel, particularly Alex Gask who led on this work, as well as Thiago Simoes Froio and Hafsa Saeed who led on the delivery of the roundtable event.

It became clear over the course of our scrutiny just how overdue the Mental Health Bill had become. It will introduce substantial changes to the Mental Health Act, which provides the legal framework for the detention and compulsory treatment of people with “mental disorders”—an outdated term, but one that remains part of our law. The changes introduced by the Bill will bring our mental health legislation into the 21st century, strengthen patient rights and help end practices that bring more harm than good.

When people hear about detention under the Mental Health Act, many instinctively think of those who have committed the most serious and violent crimes. They picture high-security hospitals such as Broadmoor, which happens to be located in my constituency. I have had the opportunity to visit Broadmoor. The work they do there is outstanding; it is vital, world-leading work that deals with some of the most complex and challenging cases in psychiatric medicine.

Let us be clear, though: the reality of detention under the Mental Health Act is not limited to high-security hospitals or individuals convicted of serious crimes. Many people detained under the Act are not criminals. Many of them are children, young people and adults with autism or learning disabilities who are detained not because they pose a danger to others, but because the support they need in their communities simply is not there. This is not just inefficient, it can often be deeply traumatising and raises significant human rights concerns.

That is why the Committee welcomes the major changes introduced by the Government’s Bill. It will end the detention of individuals under section 3 of the Mental Health Act solely on the basis that they are autistic or have a learning disability; tighten the criteria for detention and require decision makers to consider the nature, degree and likelihood of harm before deciding to detain; introduce the concept of a nominated person to replace the outdated nearest relative system; and remove police stations and prisons as places of safety for individuals in crisis. As stated in the evidence we received from witnesses, those are important, welcomed and long-awaited reforms. They reflect the breadth of the Government’s consultations and prove that the Government listened to the information they received.

While welcoming the Bill’s direction of travel, the Committee believes that there are areas where the Government could go even further to provide enhanced protections for human rights. That is why, based on the evidence we received during the inquiry, we have recommended a few key amendments. First, we recommend a new clause to ensure that children detained under the Mental Health Act are accommodated on adult wards only when that is demonstrably in their best interests.

Secondly, we recommend an amendment to clause 1 to include equity as a fifth guiding principle under the Act. This would refer specifically to addressing inequalities in treatments and outcomes on racial grounds in particular, and I welcome the Health Secretary saying on Second Reading of the Bill on Monday:

“People from ethnic minority communities, especially black African and Caribbean men, are more than three times as likely to be sectioned.”—[Official Report, 19 May 2025; Vol. 767, c. 783.]

In our report, we find that adding equity as a guiding principle would do more to address racial disparities.

Thirdly, we recommend an amendment to clause 32 to shorten the review periods for restricted patients who are discharged into conditions amounting to the deprivation of liberty. The first review will be required within six months, rather than 12, and subsequent reviews will take place annually, rather than every two years.

Those key amendments come amid a range of other recommendations. Recent case law shows that mental health patients in state-commissioned and funded but privately provided care do not come within the protection of the Human Rights Act. That loophole must be closed, and we recommend that the Government do just that.

We also heard evidence that the question of when the Mental Health Act and when the Mental Capacity Act should govern a patient’s deprivation of liberty and treatment is far too complex and raises human rights concerns, not least because depriving a person of their liberty on any ground can be justified only if the legal basis is clear. We therefore recommend that the Government carry out an urgent review and provide the clarity that is currently lacking on this question.

Another crucial area the Bill covers is the rights of children, who are particularly vulnerable when assessed or treated under the Mental Health Act. Many of the proposed changes to the law will be positive for children, including the introduction of an opt-out approach to receiving a report from independent mental health advocates, but we recommend that the Government consult on introducing a statutory test for assessing whether under-16s are competent to consent or to refuse consent to treatment—a cornerstone of compliance with a child’s human rights.

The Committee also deems it vital that prisoners whose mental health makes holding them in prison unsuitable are transferred promptly to an appropriate setting. Keeping them in prison may result in human rights breaches. In our report, we welcome the introduction in the Bill of a statutory 28-day timeframe for hospital transfer. Relevant data should be collected and made available to monitor and help to ensure compliance with that standard.

The Committee welcomes changes to restriction orders placed on a small number of offenders detained under a hospital order, but the Government should consider introducing more prompt and regular reviews by the mental health tribunal, to ensure that any loss of liberty is justified. Witnesses told us that, in the absence of effective support in the community, autistic people and people with learning disabilities could still end up in unjustified detention on other legal bases. The Government have stated that the change in the Bill will come into force only where there are strong community services in place, but it is vital that this does not delay the much-needed reform. We therefore welcome the Government’s commitment to provide a written ministerial statement annually to both Houses of Parliament setting out progress to date on implementation. On what more the Bill could do to improve the prospects of patients receiving timely care in the community, we also ask the Government to consider introducing an English equivalent to the right to a mental health assessment that applies in Wales.

The report makes it clear that much more is needed to fix the broken mental health system in this country, and I know the Government recognise that as well. This is a small, targeted Bill, which will not change everything, but the changes it will introduce are significant and long overdue. The Government have committed to introducing mental health experts in every school, to set up Young Futures hubs and to recruit 8,500 more mental health staff. By focusing on community-based interventions and driving down waiting lists for mental health support alongside the welcome changes in the Bill, we can turn the tide and fix our broken mental health system, so that the human rights of all those with mental health needs are properly protected and they can get the support they need.

I commend this report to the House.

--- Later in debate ---

[Dr Luke Evans (Hinckley and Bosworth) (Con)]

I commend the hon. Member for Bracknell (Peter Swallow) and his Committee for the report. We on the Opposition Benches will be looking favourably at it, especially as the Bill goes into Committee. I have one technical question. He talked about restraint for people who have autism and learning disabilities. Currently, the timetable for working out whether they have a mental health disorder or it is related to their condition is 28 days. Did his Committee look at that from a human rights perspective, to see whether it is the right time in which to make that assessment?

[Peter Swallow]

We did look at whether the process for assessing people was appropriate, and that issue came up. It is one where the individual’s human rights are exercised, and we must strike a careful balance between the need to protect them and those around them and to ensure that the deprivation of liberty is only ever a last resort. Off the top of my head, I seem to remember that the report finds that the balance currently struck is appropriate, albeit it is one that the Government should look at. If I have got that wrong, I will happily correct the record.

[Chris Bloore (Redditch) (Lab)]

I congratulate the hon. Member on his Committee’s report. I was really interested in the point he made about an English equivalent to the right to a mental health assessment in Wales. With admissions to acute mental health settings increasing year by year, does he agree that it could drastically improve admissions if we were to introduce such equivalence for England and did not wait until a crisis point for people—particularly young people—to get the support they need?

--- Later in debate ---

[Peter Swallow]

My hon. Friend makes a really good point. It is vital, as we have seen across health, education and the justice system, that we get back to having a laser-like focus on early intervention, because we know that the earlier we intervene, the better it is for all involved. As he suggests, improving our mental health system through the measure recommended in the report would mean that we do not get to a crisis point where individuals have to be sectioned under the Mental Health Act. Instead, community support, which we know works when it is there, can be used to provide these individuals with the help they need.

[Richard Foord (Honiton and Sidmouth) (LD)]

I am grateful to the Joint Committee for this report. I note the Committee’s call for

“more prompt and regular reviews by the Mental Health Tribunal.”

The basis for that call is compliance with the individual’s right to liberty, but does the hon. Member agree that regular reviews by the tribunal are also in the interests of the families and neighbours of mental health patients, given how disruptive and upsetting it can be for them to have patients living in the community?

[Peter Swallow]

Absolutely. We heard through our reporting of families being in real distress, particularly where a child is in treatment and where treatment is happening a long way away from where the family lives, making access to the family member even more difficult. The hon. Member’s point is really important. Of course, our Committee was scrutinising this Bill through the lens of human rights, though it was important to us, as I said in my statement, that we hear from those with lived experience of the mental health system to inform our recommendations. He makes a powerful point.