Mental Health Bill [HL]

Debate between Baroness Browning and Baroness Fox of Buckley

Report stage
Wednesday 2nd April 2025 Lords Chamber

[Baroness Browning (Con)]

Before the noble Baroness sits down, she mentioned autism several times, but the whole purpose of the Bill is to remove autism and learning disability from mental health, where it previously was. In fact, I served on the Bill Committee, as did others in the Chamber, in 2005-06, when I was really opposed to autism being added to the 1983 Act. But it was added, and now it is being taken out, I am very pleased to say.

I hope that the noble Baroness will accept that there is a piece of legislation about this on the statute book: the Autism Act 2009, which is being reviewed by the House at the moment. Autism is not some fad, something that people just make up, or something temporary; it is a lifelong neurological condition. I raise the failure to provide the right services for people with autism who are in that part of the spectrum where they need support. Not everybody does: it is a spectrum, and I quite agree that there are people on the spectrum who cope quite well with life, knowing that they have autism and not needing that sort of support. We have discussed that support a lot in the course of this particular Bill, and if you do not provide it where it is needed—this is the weakness that we are looking at in the current Autism Act—that leads to quite serious mental health conditions, including suicide. Of all the conditions that the noble Baroness mentioned, among the autistic community the suicide rate is the highest.

[Baroness Fox of Buckley (Non-Afl)]

I genuinely appreciate that intervention. That is what I think too. It is precisely the inappropriate use of terms such as autism in relation to this overdiagnosis that concerns me, because it is too glibly used. That is part of what I am talking about. I absolutely want those people who need the intervention to get it, but my concern is if it becomes widely used socially, in the way that I did not want to go into in great detail, on university campuses or in society in general. I note the TikTok phenomenon of people getting diagnoses and that being used, and so on. My concern is that the label, the labelling process and the demand for diagnosis and treatment squeeze out the very people that the noble Baroness is talking about.

I too have spent many years trying to distinguish between autism and mental illness. It drives me mad that people do not know the difference. My problem is that, in the debate about this issue, they are very often all lumped together in a way that is medically not clarifying, but the demand for a medical label can mean that people are not even that choosy about which one they get. That is where I have tried to raise an issue.

[Baroness Browning (Con)]

I am very grateful for that response. The noble Baroness said that autism is different; it certainly is different, which is why it has its own Act of Parliament.

Mental Health Bill [HL]

Debate between Baroness Browning and Baroness Fox of Buckley

Committee stage
Monday 24th February 2025 Lords Chamber

[Baroness Browning (Con)]

My Lords, I too was pleased to add my name to Amendments 155 and 156 in the name of the noble Baroness, Lady Hollins. She has already spoken on this subject, and it would be remiss of me not to say that the title of the report she mentioned, My Heart Breaks—which is of course in her name and authorship—was chosen for a purpose. This is a heartbreaking situation, and on the piece of paper I am holding in my hand, headed GOV.UK, it says: My Heart Breaks—Solitary Confinement in Hospital Has No Therapeutic Benefit for People With a Learning Disability and Autistic People.

As we have heard, it is not just that it is not therapeutic; it is actually harmful. On the terminology, other speakers have already spelled out why they have dumbed down the real raw facts of the language that they use to describe this type of incarceration—for that is what it is. It reminds one of prisons. Look at the legal structures needed to put somebody into a prison, yet people who are ill are treated in the same way as prisoners.

I remember visiting a school for autistic children many years ago. It had a single room where they took children who were having a meltdown. It was a padded room, and they felt that was the appropriate treatment for children. We know, from the many debates in this House about people who have been held for extended periods in mental health hospitals, the damage it does and the difficulties when these practices are in place.

Ironically, this does not happen everywhere. You have to ask why it happens in some institutions and not in others. There is an answer to that. It is not because of a different profile of patients in these two different types of settings but because in some places they understand the problem and have sufficient training and resources. Training of personnel, particularly senior personnel, is key. If the person in charge says, “This is what we are going to do”, very few people in the structure below them are going to challenge it, so that is what they do and it becomes the norm.

Fifteen months ago the noble Baroness, Lady Hollins, produced this report, which now bears government approval and GOV.UK and the Department of Health and Social Care on it. It is now really time for the Government to adopt the amendments from the noble Baroness, Lady Hollins, and her recommendations. It is a wealth of experience that we can only admire, and I urge the Minister to please accept these recommendations. They come from the very highest level. We are very lucky in this House to have the expertise of my dear friend, the noble Baroness, Lady Hollins.

[Baroness Fox of Buckley (Non-Afl)]

My Lords, I will speak very briefly and on a slightly related topic. I want to talk about a different group of people who are in long-term segregation who are not sectioned and often do not get mentioned—prisoners. Long-term segregation is used when very mentally ill people in prison are not transferred to hospital and nobody knows what to do with them. They are put into isolation and left there, psychotic, delusional and forgotten—dumped, in effect.

The noble Baroness, Lady Browning, alluded to prisons, but even prisoners should not be treated like prisoners sometimes. The confusion and conflation of punishment and treatment outside prison is no less shocking when it is inside prison. You are not meant to punish somebody doubly because they are in prison and happen to get ill.

The Chief Inspector of Prisons, Charlie Taylor, has made the point that the segregation units are completely unsuitable for people who are severely unwell. They are also a significant drain on the hard-pressed staff, because very often the restraints are of people literally going out of their mind. They are not getting any medical intervention at all. According to the chief inspector, it requires multiple officers to unlock the cells even just to deliver meals.

Is it possible for the Minister to give any thoughts on that? Also, in a way, this is an appeal to the noble Baroness, Lady Hollins—if she takes this amendment forward—to bring that into the situation, even though I know I am slightly squeezing it in because I have Amendment 160A on reviewing prisons.

On Amendment 146 and the use of force, I absolutely agree with the mover of the amendment in relation to the need to keep records. That is obvious. I suppose the nightmare for us all is the misuse of force. It is horrifying—the stuff of nightmares—when people are ill.

I do not want to be naive. I know that when people are very ill and very psychotic, sometimes appropriate force is necessary; I just think it needs to be recorded. When I say force, I obviously do not mean violence or anything not within the realms of professional intervention. Sometimes I think we forget how ill people can be and how violent and how difficult it is for the people who work with them. We should record every instance of the use of force but be wary of demonising or damning every use of it, because it is not quite as simple as that.