Mental Health Bill [HL]

Baroness Bennett of Manor Castle Excerpts

2nd reading
Monday 25th November 2024 Lords Chamber

[Baroness Bennett of Manor Castle (GP)]

My Lords, as the last Back-Bench speaker in this rich and informed debate, I note that we in the Green group start our meeting each week by asking ourselves what original things we have to say, specifically as Greens, about a Bill or a debate—so it is useful to come at this particular point in the circle. As Greens, we very much agree with the need for the Bill, which virtually every noble Lord noted. We also very much agree with the need to strengthen it.

I respectfully disagree, however, with a number of noble Lords who have suggested that we are seeing an overmedicalisation of life events. Perhaps this is not quite what they meant to suggest, but it sounded like they were saying that we do not have a mental health crisis in our society. I would very much say that we do. I agree with the noble Lord, Lord Crisp, that there is a great need for more talking therapies and that, for want of those, medical professionals are very often forced to resort to pharma solutions.

We need the talking therapies, but we also need treatments because we have a mental health crisis. Behind that is not any characteristic of individuals but a deeply unhealthy society and, when we are thinking about this Bill, we have to think about it in that context. We have to think that when we compare ourselves to the societies we generally consider comparable, we have much greater health problems than them. We must ask ourselves why. This is true of mental and physical health, in so far as it makes any sense to make a division between those two. I do not think anyone this evening has yet used the phrase “the gut-brain axis”, but in the last decade there has been an explosion of understanding of the link between the microbiome and mental health. We have, particularly in the UK, a broken food system. This is of course a long way from legislation but, if we are to think systemically, it is the context in which we have to think about the Bill.

As some noble Lords have made reference to, there are also the social issues to consider, whether the levels of poverty, the insecurity of income and housing, or the pressurised jobs that treat workers like robots and make them ill. We have a loneliness epidemic, which I do not think anyone has mentioned yet, but that is very much related to our mental health epidemic. We have a huge problem with domestic violence, which is also related to mental ill-health, particularly among the victims. We need to take a public health approach to mental health. While that is not directly part of the Bill, we cannot talk about mental health without talking about all those issues.

On other areas on the Greens’ unique approach to mental health issues, we do not believe that the coercive power of the state—which is what the Bill is talking about—should ever be put into private hands; nor do we believe that healthcare should ever be run on a for-profit basis. Here, I remind us of the points made by the noble Baroness, Lady Keeley, about when the private provision of mental health care has gone horribly wrong.

A number of noble Lords have focused on the problem of stigma; perhaps we have made progress over recent decades, but we still have a long way to go. We have to think very carefully about using the rhetoric of “strivers versus skivers”, and the suggestion that all we have to do is get these people into a job and then they will be fine, because that is the underlying message we are hearing from certain very senior quarters in our society. I must mention that there has been talk of combining support for people seeking jobs and mental health care. I would not necessarily say not to do that, but it has to be done with extreme caution to ensure that it is not something that puts more pressure and stress on people, interfering with them becoming well.

More positively, I commend the Government on bringing the Bill forward so early in their term and on making it a Bill that starts in the House of Lords. I compare it to the Domestic Abuse Act, during the passage of which many noble Lords who have taken part in today’s debate also took part. There was a genuine effort from all sides of the House to make that Act better, and it has been very clear this evening that there is the same desire in this Chamber today.

Many noble Lords have made the point about the need to resource what is in the Bill—we also said that about the Domestic Abuse Bill—including, to single out a few, the noble Lords, Lord Alderdice and Lord Adebowale, and many others. There have also been some really good ideas in this debate, and here I particularly single out the noble Baroness, Lady Watkins. The idea of a safe staffing level for community services strikes me as a potentially transformative idea that is really essential. Far too often, care in the community has simply meant being abandoned in the community, being left in the hands of horribly overworked staff, who are then subject to abuse and questioning when things go wrong because they simply have not been able to handle the workload, through no fault of their own. It is really crucial that we tackle those issues.

I will quickly whizz through some specific points of the Bill, particularly focusing on things that other people have not said. I have not heard a great deal of discussion of the idea, as recommended by the Joint Committee on the Draft Mental Health Bill, that we have a mental health commissioner. The briefing from the Centre for Mental Health draws a parallel with the powerful impact of the Children’s Commissioner; I would also add the impact of the Patient Safety Commissioner, on which I worked with the noble Baroness, Lady Cumberlege, over many years. Again, that was a case in which your Lordships’ House was very powerful in pushing to create that position. Having the Patient Safety Commissioner has made a real difference, and having a new statutory role to champion mental health across government and speak up for people with mental illness is something we really should be including in the Bill.

Very briefly, I agree with the noble Baroness, Lady Fox, on community treatment orders. The Bill still allows these to be continued indefinitely rather than placing a time limit on them with an option for a new one if needed. These should not be renewed without proof of necessity and proportionality.

I will use my remaining time to focus particularly on the importance of children and young people. Many other noble Lords have addressed and given us statistics on how our mental health services are failing young people. I want to draw another parallel with another element of what the Government are doing and which I have praised. A couple of nights ago, rather late in your Lordships’ House—about this sort of time, actually—we were discussing the Government’s plan for a new youth strategy and their plan to make sure that there is really strong consultation on it with young people. The one direct question I will put to the Minister is: I am sure the noble Baroness is aware of the phrase “Nothing about us without us”. What is being done to ensure that there is a real say for young people, particularly young people with experience of the mental health system, to ensure they actually have the chance to be involved in the Bill?

I will rush into one final, technical point. The Bill introduces the new statutory care and treatment plans for all patients. That is welcome, but many under-18s are admitted on an informal basis, so they will not be covered by this. How will that be dealt with?

One final rushed point is that the noble Lord, Lord Alderdice, and others, have talked about how we can learn from other parts of the UK. The mental health Act in Wales includes a measure to give people the right to have a mental health assessment if they request help. That is surely something we could learn from and include in the Bill.