Mental Health Bill [HL]

Debate between Baroness Buscombe and Baroness May of Maidenhead

Committee stage
Monday 20th January 2025 Lords Chamber

[Baroness May of Maidenhead (Con)]

My Lords, the amendments in this group standing in my name, Amendments 37B, 38C, 42C, 42F and 128B, are all intended to widen the definition of those who can attend a mental health incident and act to detain an individual in a variety of circumstances.

It is a pleasure to speak after a number of noble Lords who have a considerable wealth of experience on the issues in this Bill. I can claim no such breadth of experience, but the amendments I have tabled speak to one issue, which I have dealt with in the past: that of who can attend a mental health incident and particularly the attendance of the police at such incidents.

Back in 2010, it became clear to me, as I spoke to more and more police officers in my role as Home Secretary, that there was one issue that was at the forefront of their mind, and it was the problem they had in dealing with people at the point of mental health crisis. Their concern was understandable: they had no training in mental health, they were not professionals in this area, yet they were being called out to situations. They were being expected to determine whether someone was at the point of crisis or not, and what should happen to that individual; more often than not that meant taking that individual to a police cell as a place of safety. For the police officer, there was concern that they were being asked to deal with something for which they had no training or knowledge.

Of course, the police presence was often not good for the individual concerned. Inevitably, it meant they were not being given the healthcare support they needed at that point in time; but more than that, the very essence of a police presence—somebody in the uniform coming to deal with them—could actually exacerbate their mental health situation, and a police cell is not designed to improve somebody’s mental health. Finally, for the police force, of course, it meant that it was taking up resource which could have been used elsewhere, and which was, in many cases, inappropriate; often if somebody was in a police cell as a place of safety it meant that an officer had to sit outside the cell to ensure that they did not harm themselves.

The issue of the use of a police cell as a place of safety is dealt with in other parts of the Bill, but they do not deal with this wider question of the police resource that is being used. Even if the police are lucky enough to get somebody to a hospital, they still could have to have an officer in A&E sitting with the individual to make sure they do not harm themselves or cause harm to others. Indeed, the Metropolitan Police, in its evidence to the Joint Committee on the draft Bill, cited a case study where a patient was required to be guarded by the police in A&E to prevent them becoming a high-risk missing person, and eight Metropolitan Police officers had to attend that individual for over 29 hours. Police officers were worried about the job they were doing, the individual concerned was not being treated or dealt with in the way that was appropriate for their mental health needs, and police resource was used unnecessarily.

Over the years, I and others have tried to address this situation, initially with some success. But what often happens in government, as noble Lords and the Minister will find over time, is that an initial success is turned back because over time people revert to the previous behaviour or mode of operation. That is what we have seen in this case, and it came, of course, to the point where the Commissioner of the Metropolitan Police said that the force would not give an ultimatum and would not turn up to these mental health incidents.

As drafted, the Bill has the capacity to at least maintain, if not exacerbate, this problem, but the Government could accept amendments or amend it in a way that would improve the situation. I should say that, of course, if there is an immediate risk to life or serious injury, the police will always have a role to play; but they are clear that they want to see mental health repositioned as a health matter and not seen through the lens of crime and policing-related risk. This is the position that the National Police Chiefs’ Council took in its letter on the Bill to the current Secretary of State for Health, which said:

“The current position of the law arguably views mental health through the lens of crime and policing related risk, which raises a number of issues including disproportionality in the criminal justice system, discrimination, adverse outcomes for people suffering with poor mental health as well as increasing stigma attached to mental health”.


That concern that the focus and statutory footing of the police as the primary responder to incidents of mental health should be removed from the Bill is what has led to my amendments—it is what they are intended to deliver.

I see similarities between my amendments and Amendment 158 in the name of the noble Lord, Lord Davies of Brixton. If I may be so bold, I think we are both trying to achieve a situation where the expected response to someone in mental health crisis is not limited to police; in other words, “right care, right person”. My amendments are intended to widen the description of those who can attend mental health incidents beyond a constable, but they specify that a police officer—the holder of the position of constable under the Crown—can respond if there is a genuine need for a police presence.

Recognising that we do not want to see healthcare professionals put at risk, the amendments specify that the authorised person attending an individual should have been

“trained and equipped to carry out detentions”

and by carrying out that function should

“not be put at unnecessary risk”.

It is worth noting, perhaps at this point, that the College of Policing’s mental health snapshot 2019 found that almost 95% of calls that police attend that are flagged as a mental health response do not require a police response.

I referred to the reasons behind my amendments in relation to the police, but there is support among healthcare professionals for such changes. In the joint Home Office and Department of Health review of Section 135 and Section 136 powers, 68% of respondents to the survey, alongside the review, agreed that all or part of Section 135 and Section 136 powers should be extended so that healthcare professionals could use them provided they were not putting themselves at risk. Paramedics particularly supported the change, with 93.3% of paramedics agreeing and 61.1% strongly agreeing.

Beyond the interests of the police and healthcare professionals, of course, we must also remember the interests of the individual at that point of mental health crisis. They deserve the right response, the right care, the right person—and I do not believe that that is always a police officer. This Bill should reflect that and enable a wider range of authorised persons to attend mental health incidents. I beg to move.

[Baroness Buscombe (Con)]

My Lords, this is an area where I feel I have the possibility of a solution or part of a solution, while supporting very much what my noble friend has put forward in her amendment. My solution comes from knowledge that we have gained from the world of palliative care. It is a subject matter that we covered in detail on the joint scrutiny committee, because the whole issue of the police turning up to such an incident where somebody is absolutely in crisis can, in many instances, lead only to an increase in the fear and extraordinary pain that that person is feeling when they are in crisis. It is not the fault of the police; it is just the situation that they find themselves in.