Coronavirus Act 2020 (Expiry of Mental Health Provisions) (England and Wales) Regulations 2020

Baroness Barker Excerpts

Wednesday 25th November 2020 Grand Committee

[Baroness Barker (LD)]

My Lords, I warmly welcome the noble Lord, Lord Davies of Brixton, to your Lordships’ House and congratulate him on his speech. I was unaware of his professional background, but his explanation has led me to understand why there is such a sense of excitement among those Members of your Lordships’ House who are mere accountants. I look forward to the noble Lord joining the long-standing gang of Members who take a considerable interest in mental health and who often act as a bulwark against Members of the House of Commons who feel unable to take action on mental health legislation because of the grief they get from the popular press.

I declare an interest as a member of a special advisory panel for Rethink Mental Illness; I am indebted to it and to Mind for their briefings. When the Coronavirus Act went through, the mental health provisions were among the most controversial and the most feared, not only by lobby groups and patient groups—there was also a considerable amount of discomfort on the part of mental health professionals about what was being done. Under the Mental Health Act 2007, there is already a lack of patient involvement in decision-making, specifically in mental health. That is a fundamental flaw.

It was, on that basis, wrong to take away the safeguards that are the subject of these statutory instruments, and I am very glad that they have not had to be used. They have not had to be used because of the extraordinary efforts of both staff and indeed patients in the early part of this year. Both Mind and Rethink have done a considerable amount of work talking to people who were in acute services in particular. The surprising finding was the extent to which patients were deeply grateful to staff for continuing to look after them when the staff might well have been putting themselves in danger.

The extent to which patients were comfortable with incarceration during Covid was directly related to two factors: first, their ability to contact friends and family remotely and, secondly—because they are people just like the rest of us—the extent to which they were enabled to get out into the grounds and get fresh air. It is worth noting at this point that, in the recently announced hospital-building programme, only one of the new hospitals will be a mental health hospital. Given that we are likely for some considerable time to be going in and out of periods of physical restrictions because of the virus, we should do well to look at the physical estate of mental health services.

I agree with others that the £3 billion announced is very welcome, but there is a grave danger that it will be stretched way too thinly. A lot of it was earmarked before we entered the current situation. As others have said, and as the studies done by Mind and Rethink have shown, it is evident now that people are coming into community services with a greater degree of severity of mental distress and agitation. This is a clear signal that we will, in the coming months, see a much greater level of more severe illness if we do not put money now into rapidly accessible community services—patients are telling us that they cannot access those services. What efforts will be made to ensure that input of both staff and resources into a greater degree of community services?

In all the Government’s lockdown announcements, I have never seen anything acknowledging that those areas of the country that have been under severe lockdown for several months might have a greater need of mental health services than those that have not. Is that part of the analysis that the Minister’s department is undertaking? This is part of the question that I really wish to put to him. We are sitting waiting for the Government’s response to Sir Simon Wessely’s review. To what extent will the things that been learned during these last six months go into that review? For example, what have we learned about disproportionate levels of mental illness and lack of services among black and minority-ethnic communities, and what are we doing about children and young people? Can he tell us to what extent we have learned the lessons of the last six months and whether they will be in that new legislation?