Mental Health (Discrimination) (No. 2) Bill
(11 years, 10 months ago)
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Lord Stevenson of Coddenham
My Lords, just over a year ago during the previous Session, I introduced the Second Reading of what can accurately be described as a close sibling of this Bill. I said then that I would be brief, partly because although there was no threat of snow, it was taken even later on a Friday. Noble Lords will be pleased to hear that I will be brief again for the reason that this Bill, while it is very important to our society, is blisteringly simple. Its straightforward purpose is to make inroads into one of the last of the major discriminations in our society; namely, the discrimination against people suffering from mental ill health.
I believe that as a society we can be proud of having removed discriminations in law on gender, disability, sexual orientation, age and ethnic origin. However, it is quite remarkable that there remain blatant and, I would say, disgusting discriminations against those suffering from mental ill health. I am glad to report that since the Second Reading of my previous Bill, the Department for Education has removed the discriminations on school governors that were covered in that Bill. I also draw to the attention of noble Lords the clause concerned with the disqualification from jury service. That situation has been improved. However, everything else remains the same. I will not reiterate the details, not least because they have been extremely well summarised in the Cabinet Office briefing which is available to us all. Suffice to say that the Bill removes a number of clearly outdated and dysfunctional discriminations against the following interesting groups of people: MPs, company directors and, more widely, all potential jurors.
This comes at a time when we are beginning to see the first green shoots of a change in public attitudes to mental ill health. For far too long it has been stigmatised, as everyone will be aware, and let us make no mistake that it is still heavily stigmatised. However, we can see the start of greater public awareness that mental ill health is an illness like any other, be it a frozen shoulder, a broken leg or the flu bug. The fact that a Member of another place could stand up and describe himself as a “practising fruitcake” and a week or so later be elected as chairman of a very important Select Committee speaks for itself as to the progress that has been made. A number of so-called public figures have now, for some time, bravely paraded their brushes with mental ill health and talk about it just as they would talk about breaking a leg or getting a horrible illness, such as a heart problem or whatever. Stephen Fry and Ruby Wax come to mind, who have not jumped on any bandwagon but have been at it bravely when it was not popular and was risky for them.
However, we are a very long way from removing the stigma of mental health. This Bill is one step along that way. I beg to move.
Lord Ryder of Wensum
My Lords, I congratulate the noble Lord, Lord Stevenson of Coddenham, on bringing forward this Bill. I believe that I am the only former Member of the other place taking part in this debate, so I am delighted about the support—often courageous support—given to the Bill by honourable and right honourable Members. It is generally held that about 18% of adults in the UK suffer from at least one form of common mental disorder. This means that in any one Parliament, over 100 MPs fall within that category. Although I understand that just one Member of Parliament was removed for the reason of unsoundness of mind in the 20th century, this Bill has obliged elected Members to be far more conscious of the problems of mental health. Psychiatric disorders take many forms: depression, anxiety, bereavement, bipolar disorder, schizophrenia, post-traumatic stress syndrome, obsessive-compulsive disorder, phobias and adult ADHD.
More Members of Parliament recognise the human costs of these disorders as well as the costs to the economy in terms of welfare, sickness, absenteeism and the loss of productivity which sets the economy back by £41 billion a year, merely in England. Mental health consumes 14% of the NHS budget. That is why we should all welcome the fact that the noble Lord, Lord Stevenson of Coddenham, is setting up a new charity, seeded by a £20 million grant from the Wellcome Trust, to conduct,
“research that helps our understanding of the brain’s innate characteristics and responses to external influences in order to reduce the burden of psychiatric disorders”.
I hope that this charity is a great success, because a great deal of work still needs to be done on mental disorders. The noble Lord, Lord Stevenson of Coddenham, warrants our praise and gratitude for setting up this charity.
Lord Patel of Bradford
My Lords, I am extremely pleased to see this Bill reaching Second Reading, after enjoying wide cross-party support in the House of Commons and, indeed, among noble Lords in this House. I take great interest in this Bill, having been a keen advocate for most of my life for greater tolerance and understanding about the problems of mental health and for tackling the extreme and dangerous discrimination and stigma which attach to these issues.
We have heard much about the unfortunate and arbitrary discrimination that has been enshrined in our laws for far too long, in terms of mental health and being a Member of Parliament, school governor, or company director, or serving on a jury. It is high time that these pernicious exclusions of what amounts to a significant part of the population are done away with, and I give my wholehearted support to this Bill.
I know that noble Lords do not need persuading of the value of the Bill, but it is worth reminding ourselves, just for the record, of some of the reasons why this is so important. I am sure that noble Lords are well aware of the recent report by the London School of Economics’ Centre for Economic Performance, which found that mental illness is widespread, growing and generally more debilitating than most chronic physical conditions. For example, one-third of all families in Britain have a family member with mental illness. Nearly half of ill-health in those aged under 65 is due to mental illness, and only a quarter of those needing treatment receive it. It is estimated that 6 million adults have depression or anxiety and 700,000 children have a mental health disorder. There is an economic effect as well: mental health problems account for nearly half of absenteeism at work and a similar proportion of people on incapacity benefit.
We also know from the excellent work undertaken recently by Mind, Rethink Mental Illness and the Time to Change campaign that out of 2,700 people surveyed, 80% said that they had experienced discrimination, two-thirds were too scared to tell their employer about their condition, 62% were too scared to tell their friends, and one third were too scared to seek professional help. These are shocking statistics and unworthy of a modern society, so everything we can do to address the stigma of mental ill-health and demonstrate our commitment to removing the discrimination that comes with that is vital.
That is what this Bill starts to do. It is not going to change the world, at least not overnight, but it is a significant step in sending a clear and unambiguous message that mental illness should be treated on the same basis as any illness. That is the key principle at stake here and one that we recently affirmed in this House during the passage of the Health and Social Care Bill, which confirmed that mental health should be treated on a parity of esteem with physical illness.
Some may think that this does not affect many people. Very few people actually seek political office or become directors of corporations or school governors and we are not all asked to serve on a jury—although that might come in time—but that is not the point. The Bill affects us all because it is about the kind of society in which we want to live and work and ensuring that everyone has a fair chance to achieve their ambitions without arbitrary discrimination.
The Bill is also about protecting people. As we have heard, there is a much greater risk that people will not come forward about mental health problems if they fear discrimination. This Bill will help ensure that if a Member of Parliament, a school governor or a director of a company has a mental health problem, they can be confident about seeking help, certain in the knowledge that they will not lose their job as a consequence.
On the basis of fairness, equality and human rights, I support this Bill; on the basis of ensuring the health of people, I support this Bill. I urge all noble Lords and the Government to do the same.
Lord Low of Dalston
My Lords, I rise to give my enthusiastic support to this measure. Given the conditions outside and what I am sure is the desire of noble Lords to get home as soon as possible, I can probably signify my support fairly formally—or, at any rate, briefly.
As someone who has had a bit to do with anti-discrimination and equality legislation in my time, I am a bit embarrassed that it should be necessary to bring a Private Member’s Bill to remedy the injustices this Bill seeks to correct. I suppose any piece of generic, comparatively unfocused legislation like the Disability Discrimination Act, and now the Equality Act, is bound to miss a few specific provisions—pockets of discrimination, which, to our shame, remain hidden away in the interstices of the statute book. We should be grateful to the noble Lord, Lord Stevenson, for winkling them out and bringing them to us today so that we can root out once and for all these anomalies, which, inappropriately in the 21st century, continue to disfigure our legislation and have unaccountably escaped the consolidator’s pruning knife.
Perhaps we should not be altogether surprised that these anomalies should have survived, because of course they reflect the particular stigma that mental illness has traditionally attracted, and still attracts—greater even that that attaching to physical disability. For that very reason, we should warmly welcome this Bill as sending a strong message that the outdated attitudes reflected in the discriminatory provisions that the Bill sweeps away are no longer regarded as appropriate in a civilised society.
Like other noble Lords, I do not propose to say anything about the specific provisions of the Bill, which, as the noble Lord, Lord Stevenson, pointed out, are fully covered in the briefing which has been provided. Rather, I will simply give the Bill a warm welcome, thank and commend the noble Lord for bringing it before us today and express the hope that your Lordships will give it an enthusiastic Second Reading and speed it on its way.
Of course, that will not be the end of the story. As the noble Lord said, the Bill makes just an inroad in the problem of discrimination which still attends those who suffer from mental illness. Mind, Rethink Mental Illness and the Royal College of Psychiatrists point out that there is still a good deal to do before parity of esteem between physical and mental health is achieved. That means valuing those who suffer from mental illness equally with those who suffer from physical illnesses.
They say that several things need to be done to improve outcomes for those who suffer from mental illness. The notion of parity needs to be embedded in the NHS constitution. Mental health services should be funded to a level which accords with the scale of mental illness. Currently, mental illness accounts for 23% of all illness, but receives only 13% of the NHS budget. Waiting times for mental health treatments need to be comparable with those for physical illnesses. They recommend annual health checks for people with mental health problems, and enhanced training on co-morbidity to avoid people with severe and enduring mental health problems dying 20 years younger than the general population.
The Bill can be a springboard to end wider discrimination, which is still endemic in the delivery of mental health services, and to move towards the parity of esteem which the advocates for those who suffer from mental illness desire. Given that, this time around, the Bill has already passed all its stages in the Commons before reaching us, I trust that, with a fair wind and a helping hand from the Government, it will now reach the statute book with the minimum of delay.
The Lord Bishop of Exeter
My Lords, I, too, want to speak only briefly, but I give wholehearted support from this Bench for this important Bill. We were very pleased to note the stated objective of the current Government to make mental health a priority, stating that there is no health without mental health. We see this as an area where the church is well placed to make a significant difference. To that end, we committed ourselves to working with our partner churches and mental health professionals to end the stigma experienced by people with mental illness and to make our churches, schools and other institutions places of inclusion, welcome and ministry. Through the programme Mental Health Matters, which offers a wide range of training events and resources for parishes, we are working to make mental well-being a priority in our churches today—no spiritual health without mental health.
However, one of the barriers to both mental and spiritual health is to be found in anything that reinforces, or fails to reduce, the stigma which many who have experienced mental health problems find continues to dog them for the rest of their lives. That is particularly true for those who have been sectioned, and that is further reinforced when they are barred from participating with their fellow citizens in certain areas of our common life. The reason for such barring seems to be predicated on the view that recovery from mental ill-health is not possible; but it most certainly is.
I could cite the case of a very good priest in my diocese who was once sectioned, but who is now fully recovered with a most effective ministry—perhaps even more so than it might have been, given his empathy for others going through a similar experience which he can offer as a result. I think, too, of a solicitor, also sectioned, after a severe bout of postnatal depression, who is now debarred from jury service under current regulations but who is, ironically, giving excellent legal advice to others for whom no such bar exists.
From my experience, I suggest that sometimes people find themselves sectioned largely because medical intervention to deal with their mental health problems has not been made available at a much earlier stage. Had it been, the whole of the rest of their lives may well have been different.
I am most grateful to the noble Lord, Lord Stevenson of Coddenham, for promoting this Bill, which offers many people simple justice, proper opportunities to fully participate in the political, legal, commercial and educational process of our country, and, even more, the prospect of living the rest of their lives with a new but much deserved peace and hope.
Baroness Hollins
My Lords, I congratulate my noble friend Lord Stevenson on pursuing this concern so assiduously. I also would like to take this opportunity to congratulate Members of Parliament who spoke about their own experience of mental illness, which took considerable courage. I hope that it signifies the beginning of the end of the discrimination that people with mental illness experience not just in their everyday lives but in some policies, such as the law that we are seeking to change today.
The passing of this Bill will be a crucial step in addressing discrimination against people with mental health problems. Current legislation enabling the removal of the seat of an MP following a period of detention in a hospital is simply outdated. The idea that anyone suffering from a mental illness is incapable of becoming well again is very much against the principles of mental health recovery. I should draw the attention of noble Lords to my interests as a psychiatrist, albeit no longer in clinical practice, and my previous role as president of the Royal College of Psychiatrists, which I know has briefed many speaking in the debate today. With confidence, I can say that mental health problems are treatable. The majority are highly treatable, some having a better prognosis than physical illness.
With appropriate support and treatment people can return to previous levels of functioning, just as people with physical illnesses do. In keeping with the Government’s commitment to parity of esteem for mental and physical ill health, as outlined in the mental health strategy, we must treat those who experience mental illness in the same way as those who have physical illnesses. It follows that, if someone who suffers serious physical health problems such as cancer or cardiovascular disease, no matter how debilitating, is able to retain their seat in Parliament, so should those with mental health problems, even if they require reasonable adjustments to be made to enable them to continue to be present in the workplace. The Disability Discrimination Act requires that of employers and workplaces. Parliament should be setting a benchmark for standards in equality, not lagging behind. It should be possible for Members of Parliament to seek help for and to be open about their mental health problems without fear of discrimination.
To pick up on points made by other noble Lords, some people end up being detained for treatment because they have been afraid to seek treatment earlier—a stitch in time really does save. The right to occupy a position for which you are well qualified should not be prevented simply because of the experience of mental ill health. Sometimes that mental ill health comes about because of some quite devastating life experience. Yesterday, I was fortunate to visit Headley Court, where I saw members of the military services receiving rehabilitation, and to visit in particular its mental health and cognitive services department. I saw the very positive way in which that rehabilitation service helps people suffering from post-traumatic stress disorder, or having difficulty adjusting to life with the injuries that they have acquired on the battlefield, return to their previous lives and make whatever adjustments are required. I was very impressed by the attitude and opportunities being offered to servicemen. We need to see that very positive attitude to getting people back to work being provided in all employment situations.
I welcome the Second Reading of this Bill and hopes that it truly represents an important milestone in the efforts to achieve positive outcomes for people with mental illness. I trust that the Government will fast track this Bill so that it becomes law at the earliest opportunity. I look forward to the Minister’s assurances on this; it is in line with the Government’s commitment to ensure parity of esteem. This important issue must continue to be tackled at both national and local level, and I hope that we will see further improvements in the services offered for people with mental illness so that they achieve true parity, such as sufficient funding for mental health services, as has also been raised.
The final point that I want to make is that people need improvements, and access to and choice of high-quality services. They need evidence-based treatments—and, importantly, we need increased funding for mental health research to make this a possibility. I thank all those who provided briefings for Peers, including the Royal College of Psychiatrists, Mind and Rethink Mental Illness, and for their commitment to continuing to raise these important issues.
Baroness Barker
My Lords, I forgot to put my name on the list, but I hope that noble Lords will permit me a couple of minutes to make two points that have not been made so far in this debate. I, too, thank the noble Lord, Lord Stevenson, for his work in bringing this issue back to the House.
The legislation that the Bill seeks to repeal was passed because, at the time, Members of Parliament thought that they were protecting people vulnerable because of mental illness and the organisations named in the Bill. Since then, there have been two significant developments that make this Bill appropriate. The first is that the Mental Health Act 2007 states that mental disorder,
“means any disorder or disability of the mind”.
The effect of that, which was intended by the then Labour Government, means that today mental health legislation extends to a very wide range of people, including those who have mild depression. People who would never believe it until it happens to them can find themselves subject to mental health legislation and being excluded from the duties set out in the Bill. That should not be the case.
Secondly, the Mental Capacity Act 2005—a piece of legislation of which the last Labour Government should be rightly proud—enshrines in law the common understanding that we all have, that people with mental health problems or learning disabilities can vary day to day. Their condition can vary; it can sometimes be good and sometimes be bad. Since the legislation was passed, it has become much more common for people with mental health problems, such as those who are bipolar, to state at a point when they are well that they know from past experience that they may during a period of illness make unwise decisions. They can make an advance statement that says, “Now that I am well, I wish to say that if during my illness I make unwise decisions, I wish those decisions to be ignored”. That makes episodes of mental distress much more manageable than they ever were in the past. For those two reasons, it is very important that we pass the Bill. For example, with juries, there is no reason why a major trial should be jeopardised, because people can recuse themselves; they can go to see the judge and make sure that they are not holding things up.
There is one other reason why this provision is important, and I refer back to the new organisation of the noble Lord, Lord Stevenson, Insight: Research for Mental Health. It is the objective of everyone who works in mental health services to fund research that will one day find the cause of mental distress, new treatments and ultimately, one day, a cure. If we continue to debar people from aspects of public and economic life, in particular from roles that give them meaning, we delay the point at which we will be able to find those treatments and cures that will enable people with mental health problems to do as they do in many cases now—to continue to function day by day as valued and valuable economic and social contributors to our society.
For all those reasons, this is not just a Bill that we should commend. It is one that we should ask the Government not only to pass but to help to be implemented as quickly as possible.
Lord Collins of Highbury
My Lords, this has been an excellent debate, if too brief. I, too, thank the noble Lord, Lord Stevenson, for bringing the Bill back to your Lordships’ House.
In having this debate, we signify that attitudes have changed, but we are also helping to move those attitudes on. I have devoted much of my life as a trade unionist to fighting discrimination in all its forms, but I know only too well that, despite all the efforts outside Parliament, what happens in this House and the other place is often pivotal and a signifier of a decisive change in the public mood.
Mental health is one of the huge policy challenges of the 21st century. As we have heard, Parliament needs to do many practical things with regard to policy and organisational issues, but in lifting the veil of stigma, signalling that public attitudes must change and turning the corner on attitudes to public health, there will be no more important moment in Parliament than when this Bill is agreed to.
As my noble friend Lord Patel highlighted, we know that the proportion of people who have mental health episodes in their life is high. That is why it is both important and useful to have people in the other place and in this House who are willing to talk about their experiences and how they came through their problems. I know that we will fully succeed in changing attitudes only when people feel able to speak openly of their own personal experiences.
As the noble Lord, Lord Ryder, and the noble Baroness, Lady Hollins, have indicated, in the past, Members of the other House have not talked of their own personal experiences. That was so until the recent debate when Charles Walker, Member for Broxbourne, and my honourable friend Kevan Jones, Member for North Durham, spoke bravely and openly about the issues that have affected them. No one can dispute that they are, and have been, very effective MPs because they can often better understand the issues affecting many of their constituents. Their experience also shows that mental health can be an issue for anyone, anywhere, from all walks of life, at any time. It does not necessarily have to be permanent either. As with any chronic condition, it is how someone adapts and learns to live with the condition that makes them able to participate in society.
As we have heard, the presence of Section 141 in the 1983 Act is a barrier to those who may have had mental health problems in the past or who may still be grappling with them. Those individuals should be welcomed into Parliament with open arms because their experience is valuable. Parliament must reflect all of society. If it does not, it is a lot less effective and will therefore not make good legislation.
As the noble Lord, Lord Low, indicated, the changes in this Bill are long overdue. Mind and other mental health organisations have long campaigned for these laws to be repealed. They are clearly discriminatory and there is widespread agreement among MPs, political parties and all noble Lords in this House that they have no place in a modern and fair society. However, what is worse is that they are symptomatic of the prejudicial view that having had a mental illness makes you incapable of being a citizen with all the rights and responsibilities that that implies. They stigmatise this illness unlike any other. They put out the message that anyone with a mental health problem is not fit to be an MP. It is a message picked up, in my opinion, by all employers and is something that we know is experienced by the overwhelming majority of people who have suffered mental illness.
By adopting these measures, we can send a clear message to all employers that we need to address mental health problems in the workplace and put an end to the discriminatory attitudes that prevent capable people working. But we cannot expect people to be out and proud when laws that stigmatise mental illness still exist.
Every time a citizen is summoned for jury service, as I was a couple of years ago, they are reminded in the most explicit terms that someone who has suffered a mental illness is a second-class citizen. By passing the Bill, we will send a clear message that discrimination is wrong and that people have a right to be judged as individuals, not stigmatised or discriminated against.
Lord Wallace of Saltaire
My Lords, I am grateful to my noble friend Lord Stevenson for taking up this Bill for a second time. His Bill in the previous Session was the genesis for the Bill before us today, and it is regrettable that there was not enough time in that Session to carry it through both Houses. I am very grateful to my noble friend for his continued support and pursuit of the opportunity for legislative change on mental health. I am sure that the House will join me in congratulating Gavin Barwell MP, who expertly guided this Bill through the other place before it reached this Chamber.
We all accept that this Bill is modest in size, having only three clauses and one schedule, but its practical and symbolic effect is of great significance. I can assure the House that it has the full backing of this Government. Tackling stigma, mentioned by the noble Lord, Lord Collins, and others, and discrimination is at the heart of the Government’s mental health strategy. The provisions of the Bill are of integral importance to the Government's commitment to reforming mental health legislation and are in line with the Government's policy, No Health Without Mental Health.
However, this is an issue which goes beyond government. Shifting public behaviour and public attitudes requires a major, substantial and sustained change in the public at large—in effect, a wide social movement. Organisations representing the interests of people with mental health conditions are campaigning to inspire people to work together to end discrimination surrounding mental health. Like the noble Lord, Lord Ryder, I pay tribute to the brilliant work of Mind and Rethink Mental Illness on their anti-stigma campaign, Time to Change. I therefore agree strongly with my noble friend Lord Stevenson that this is an opportunity to make legislative changes and to give a powerful and symbolic statement that discrimination against mental health is no longer acceptable.
As I listened to the beginning of the debate, I reflected that when I became a parliamentary candidate in the Shipley constituency, there were two, large mental hospitals there, Scalebor Park and High Royds. High Royds had been built as the West Riding Asylum, with its own railway siding, in the late 19th century. I think we all recollect to some extent that people whom we would now recognise as having autistic conditions, depression, chemical imbalance and a whole range of things which are now eminently treatable and understandable ended up being put away there for life.
I am dimly aware, partly because my son has just completed a PhD in mathematical neuroscience, that understanding the workings of the brain and how to treat chemical imbalances and various interactions between experienced physical conditions and mental conditions is one of the most exciting areas of health. That also needs to feed into our better understanding of what is treatable, what is acceptable and how, as the noble Baroness, Lady Hollins, said, particular traumatic events can interact with one’s physical conditions to lead to temporary conditions of the brain which affect our mental balance. There is a great deal that we have to do in educating our public and putting money into mental health services in those areas which overlap with this very widespread condition, which so many people suffer from. This Bill helps enormously to take changing attitudes forward.
Perhaps I may clarify one small point. When this Bill had its Third Reading in the other place, Philip Davies, who is now the MP for the Shipley constituency, raised several important questions on it. My honourable friend the Minister for Political and Constitutional Reform wrote to him to address those questions. I am placing a copy of her reply in the Library of both Houses, so that noble Lords and Members of the other place have the opportunity to read it.
Repealing the provisions in this Bill would fit well with the Government’s ultimate aim that,
“fewer people will experience stigma and discrimination”,
as a result of mental health conditions. We all welcome this Bill; I hope that it continues to enjoy cross-party support on all Benches. That is support to which it has become accustomed so far and I hope that your Lordships will provide it with a smooth and timely path to see it through, without amendment, to its much deserved conclusion.
Lord Stevenson of Coddenham
My Lords, I thank all noble Lords who have spoken today and for the support that characterised all their speeches, obviously enough, but I also thank them personally for the subtleties and insights contained in every single set of remarks. I hope that this short debate will be read widely; perhaps people will read it because it is short. It will show people that we understand some of the contemporary realities and that we are not completely isolated. It is an important point.
I would like to take the opportunity to thank some of the many people who have been involved in the progress of this Bill. I join with the Minister in paying tribute to the superb way that Gavin Barwell MP has steered it through another place. It is worth adding, as others have said, that there is this wonderful phenomenon concerning Kevan Jones and Charles Walker, who is the chairman of the Mental Health APPG. They have been and are tireless. Anyone who knows either of them does not want to get in their way in their pursuit of removing stigma from mental health. I would not be here—perhaps we would not be here having this debate, although they might have got someone else—if Mind, Rethink and the Royal College of Psychiatrists had not been absolutely dedicated to making this happen. Their back-up to me personally and to this cause has been terrific.
I could thank many others. This Bill has gone across four departments. I am not sure whether one is supposed to say this but I do not care; I want to pay tribute to a number of outstanding public officials who have been involved in the Bill, one or two of whom may be present today. I would particularly like to mention, in the presence of the right reverend prelate the Bishop of Exeter, the late Christopher Jones, who worked for many years on mental health for the Church of England and who, sadly, died last year before he could see the possibility of the Bill hitting the statute book. Your Lordships will note that I am not taking anything for granted. His support and encouragement were crucial. I knew only him, not his family or his colleagues. If it is appropriate to take that message back, I would be very grateful because he was quite superb.
Finally, as an independent Cross-Bencher, I think it is appropriate for me to compliment the Government and the Opposition on embracing this Bill so thoroughly and constructively. I thank them.