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.