(8 years ago)
Lords ChamberMy Lords, as has been said, the Bill bans the use of police cells for those aged under 18 in a mental health crisis, and for those aged 18 and over it states that they may be held in a police station,
“only in circumstances specified in the regulations”,
made by the Secretary of State. As I understand it, in 2015-16, 43 children and some 2,100 adults in a mental health crisis and covered by Sections 135 and 136 of the Mental Health Act 1983 ended up in police cells rather than at an appropriate health-based place of safety.
Amendment 190 in the group provides that no person of any age in this situation should be held at a police station as a place of safety, and that is an objective with which no doubt there is widespread agreement. The question that has to be asked, though, is what would happen if the provision in line with this amendment was introduced relatively soon and there were still insufficient non-police-cell appropriate places of safety available and police cells could no longer be used. What would happen to the vulnerable people concerned in those circumstances?
The Bill’s objective in relation to children not being kept in police cells is clearly considered to be achievable by the Government, no doubt because, as I understand it, we are talking about fewer than 50 children. However, the figure for adults appears to be some 50 times higher. Can the Government say how the figure of 2,100 adults in police cells in 2015-16, or whatever alternative figure they have, compares with the total number of adults in a mental health crisis who were placed in an appropriate health-based place of safety? I believe that the noble Baroness, Lady Walmsley, mentioned the figure of some 28,000. Can the Government also say how quickly they estimate that the terms of Amendment 190 could be met through the provision of the necessary additional places of safety, what the costs would be, and within what timescale they currently intend to meet the objective of this amendment, since I assume that this is a Government objective too?
Why are there wide variations, as has been said, in the current extent of the use of police cells for people in a mental health crisis, and why do some areas appear not to need to use police cells at all in this situation, but others do? Is it due to poor management, the inadequate provision of suitable health-based places of safety, or a lack of suitably qualified staff? Can the Government also set out in what circumstances they expect to specify that an adult can be kept in a police station as a place of safety under the regulations that can be made by the Secretary of State under Clause 79(6) of the Bill? Finally, along with my noble friend Lord Bradley, I look forward to hearing the Minister’s response to the proposal put forward by my noble friend in relation to a fresh and independent review.
My Lords, I rise to support the amendments tabled in the names of the noble Baronesses, Lady Walmsley and Lady Hamwee, and my noble friend Lady Howe. They mark important steps across the board to bring the treatment of mental ill-health in line with our 21st-century understanding of that arena. I have, perhaps regrettably, close personal experience of dealing with and attempting to cope with people suffering a mental health crisis. I bring to bear that experience as well as the advice offered by the Mental Health Alliance and specifically the charity Mind, both of which have been referred to, in my endorsement of these amendments.
The amendments regarding the use of police cells and homes as supposed places of safety—neither are appropriate, I agree—and concerning the period of detention in those places awaiting a mental health assessment are most important. I acknowledge the positive steps that this Bill in its original form recommended in both of these areas, but they do not go far enough. Perhaps I may reflect for a moment on who it is that these clauses are designed to protect. It is the vulnerable, the needy and those less able to help themselves. We have a special duty to those people in our society. These amendments are an important step of progress in improving their treatment at the hands of the police in times of crisis. That said, I am not criticising the police. I have seen at close quarters the awkward circumstances of the police having to enforce the rules. I admire the sensitivity and empathy I have seen displayed.
When a person is in a mental health crisis there is a very high risk of private anxiety, emotions of distress, confusion, aggression and perhaps threatening behaviour. What is required is probably support and compassion. Confinement in a cell is bound to add to this distress. Surroundings matter.
As we have heard, the Government have begun to dedicate funds to mental health services, improving the provision of suitable places of safety and achieving parity of esteem between mental and physical health. These are important steps and this work must continue. We must step up to this challenge on the behalf of those affected. This disadvantaged group, unlike most in our society, seldom makes its own case for better care. The reality is, of course, that they cannot—they are confused and they are not organised—but we can. They rely on us, and on the charities and other groups that work with them.
We must be sure to try our best to legislate so that the trend continues and relevant investment goes toward providing for those in need. The amendments tabled by the noble Baroness would do exactly that. This is legislation that will help bring the Mental Health Act 1983 into the 21st century. If we think for a minute, that Act was enacted more than 30 years ago. The quantum leaps of progress in medical understanding of mental health issues have been huge. Yet, the Act on the statute book is more than 30 years old. We must take every opportunity we can to improve the terms of the Act wherever we can.
I thank the noble Baronesses for their work in tabling the amendments and request that the Minister accepts them.
I thank noble Lords for this important debate. As the noble Baroness, Lady Walmsley, explained, these amendments seek to restrict, in different ways, the premises that can be used as a place of safety for persons detained under Sections 135 or 136 of the Mental Health Act 1983.
Of course it is important that people detained at a time of crisis be taken to the most appropriate place of safety for their medical needs. That principle is behind these amendments and also represents the Government’s position. Where we differ is on how this should be achieved in terms of the full range of options that should be available to professionals. Amendments 189 and 190 to Clause 79 would completely prohibit the use of police stations as places of safety. The Bill provides that police stations cannot be used as places of safety in the case of children or young people aged under 18. The issue for the Committee is whether this prohibition would also apply to adults.
The noble Baroness and other noble Lords who have spoken are concerned that a police station should never be an appropriate place for a person of any age to be taken at a time of such distress. The Government accept that police stations have been used to detain people under Section 136 far too often. Although much progress has certainly been made to address this, including a 54% reduction between 2014-15 and 2015-16, there is no doubt that police cells are still used inappropriately in some areas.
This will be addressed through regulations governing the circumstances in which a police station can be used for an adult. We have heard from experts that there are occasions when the behaviour of adult detainees can be too violent to be safely managed in a health setting. I expect the regulations to also set out the expected standards of care to be provided to any adult taken to a police station. These decisions will be determined on a case-by-case basis, but I stress that the emphasis is on the exceptional nature of such situations, with health-based places of safety used for the vast majority of cases. The Government have engaged experts and other interested parties in the development of those regulations. I expect to be in a position to say more about our approach ahead of Report.