Mental Health Bill [Lords]

Helen Morgan Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Helen Morgan (North Shropshire) (LD)]

I welcome this piece of legislation, which I think is generally in a very good place. I have had a tragic situation in my constituency, where somebody who had been admitted to hospital in a suicidal state discharged themselves, after which, unfortunately, no follow-up care was provided, and they took their own life. It has been devastating for their family. Would the Secretary of State consider looking at how the community supports people experiencing a mental health crisis who might have discharged themselves, and how we can keep them safe in future?

[Wes Streeting]

I am very grateful to the hon. Lady for that intervention. The Bill deals to an extent with cases that would fall under the category she describes, in particular through reforms to community treatment orders. However, it would not necessarily cover the full extent of the sorts of people who might find themselves in that position, which is where I think we can use technology—which is not the answer to every problem in the health service, by the way. However, through better use of data, patient records and analytics, we will be better able in the future to predict risk and prevent tragedies as in the case the hon. Lady describes, which are a tragedy not just for those whose lives are cut needlessly short, but for those who live their lives with that intolerable grief and loss for the many years that follow.

It is a shameful truth about our society that people with a learning disability or autism are detained, sometimes for years, with little or no therapeutic benefit. The Bill will put an end to that injustice, limiting detentions so that people with a learning disability and autistic people are no longer detained beyond 28 days unless they have a co-occurring mental health condition that would benefit from treatment in hospital. This will require the necessary community provision in place to support people with a learning disability or autism, and we are working to set out what strong community services look like and on the resources required to implement them, so that there are robust alternatives to hospital care.

To help to plug the flow of inappropriate admissions to hospital, the Bill places a duty on integrated care boards to improve monitoring and support for people with a learning disability or autism who may be at risk of future detention. The Bill will introduce statutory care, education and treatment reviews to ensure that patients are safe and receiving the right care and treatment when detained, and that a plan to discharge them to the community is being worked up. We will also remove prison and police cells from the definition of “places of safety”. Police cells are for criminals, not patients in desperate need of medical help.

Throughout the development of these reforms, we have maintained the central purpose of the Mental Health Act—to keep individuals and the wider public safe. The vast majority of people with mental illness, including severe mental illness, present no risk to themselves or others, and, for the majority of people, treatment can be provided without compulsion. However, there are some people whose illness, when acute, can make them a risk to themselves, and sometimes to others.

No one knows this better than the families of Ian Coates, Barnaby Webber and Grace O’Malley-Kumar, the victims of Valdo Calocane’s violent rampage in Nottingham, whose campaign for justice and accountability has been truly awe-inspiring, or indeed the family of Valdo Calocane, with whom I have also spent time, listening to their experience of feeling badly let down by health services. As the independent investigation into the murders found, both he and his victims were failed by the health service, and their families have been left to live with the consequences with a level of pain the rest of us can scarcely imagine. I would like to place on the record my thanks to all four families for meeting me as my team and I worked on the Bill.

Thanks to the amendments that we are making to the Mental Health Act, decision makers will have to consider the risk of serious harm when making decisions to detain. That will ensure that any risks to the public and patients are considered as part of the assessment process. We will also introduce a new requirement for the responsible clinician to consult another person when deciding whether to discharge a patient, putting in place robust safeguards against the release of potentially dangerous people.

Finally, as I have said, legislation alone will not fix the wider issues of increasing mental health needs and long waiting times. To do that, the Government are investing in earlier intervention to meet patients’ needs and prevent them from reaching crisis point.

--- Later in debate ---

[Ian Sollom (St Neots and Mid Cambridgeshire) (LD)]

I wish to draw the House’s attention to the appalling case of a young man who was very badly failed by mental health services and, indeed, tragically lost his life as a result. Today I am representing his family, my constituents Graeme, Sam and Kaitlyn, who have been campaigning to ensure that no other family has to go through the distress that they have endured and continue to endure.

Declan Morrison was 26 years old when he died. He had complex needs, and required some of the most specialist care and support throughout his life. He had autism, associated severe learning disabilities, bipolar disorder and attention deficit hyperactivity disorder. He was non-verbal and required 24-hour residential care, which he had needed and received since he was 11 years old. Declan’s behaviour could be challenging, and at times he would injure himself—and sometimes, latterly, staff members caring for him. That is why it is so important that he was supported by those who knew him well, and who were able to understand his behaviour and therefore provide, as best they could, for his needs. His family were unable to provide him with the care he needed in their home, and had to put their trust in the system and specialist carers to make sure that he was looked after. Sadly, their trust was broken, with the most devastating consequences.

Declan was moved into his final residential home in May 2021 after the previous placement had become unable to meet his needs, although in a subsequent independent safeguarding adult review following his death, that decision was called into question. For a brief period, Declan seemed to settle into his new placement, but quite quickly staff at the care home raised concerns that they could not safely care for him owing to his behaviour, which had become particularly challenging. However, attempts to find an alternative single-space home for him, which he needed, failed. There was nothing available, not a single appropriate placement, so he remained in that placement for a further 10 months, with his mental and physical health worsening. I will not describe here what life was like for Declan and his family at this time, because it is too distressing.

[Helen Morgan]

My hon. Friend is making an important point about lack of provision. Does he agree that the 10-year timescale for ensuring that that provision is available is critical? If the Government could speed that up, it would be extremely helpful in instances such as this.

[Ian Sollom]

I entirely agree, and I will come on to make that very point.

Needless to say, events took a very dark and ultimately heartbreaking turn. In March 2022, a serious incident occurred: Declan became very distressed, and assaulted some staff members. Police were called, and a number of officers assisted staff to restrain Declan. As a last resort, he was detained under section 136 of the Mental Health Act and taken to the section 136 suite at Fulbourn hospital. Some may not be aware that under the law, patients who are placed in a section 136 suite should be there for no more than 24 hours, or 36 hours in extreme circumstances. Declan was there for 10 days—10 days in an emergency suite that was entirely unsuitable for a person with his severe needs; 10 days while more than 100 places were contacted; 10 days during which not one bed in suitable accommodation could be found locally, regionally or nationally for him. Finally, he simply could not cope, and he banged his head repeatedly against a wall, inflicting a catastrophic head injury on himself. He was taken to hospital and operated on, but he died some days later in April 2022, when his family made the heart-wrenching decision to turn off his life support.

It is painfully relevant that we are debating the Mental Health Bill today, because clauses 3 and 4 specifically address the detention of people with autism and learning disabilities, like Declan. The Bill would limit detention for treatment under section 3 of the Act, but I must ask the Minister: would these provisions have been enough to prevent Declan’s tragedy? His case highlights the critical importance of having appropriate crisis provisions and suitable community placements available, not just in theory but in reality. The coroner’s report on Declan’s death and the independent care review found major failings in the system that was supposed to protect and care for him. He was acknowledged to have been in crisis for months. Ultimately there was, and there remains, an enormous shortage of available placements for someone with Declan’s complex needs, both in the community and within the NHS. As Declan’s father told me, in words that I hope will be heeded, the reliance on the section 136 suite to contain autistic individuals while they are in crisis is abhorrent, and must be seen as a breach of the Human Rights Act.

Declan’s sister, Kaitlyn, has called for specific crisis provisions to be funded and created for individuals with autism who need a designated place of safety when experiencing a severe mental health crisis. Such provisions would need appropriately trained and experienced staff. In fact, one was created in Cambridgeshire following Declan’s death. Sadly, the funding was pulled and it closed, but it operated at 90% capacity when it was open, showing the very real and immediate need for this kind of provision to exist permanently and across the country.

The Bill places new duties on integrated care boards and local authorities to provide community support for people with autism and learning disabilities, but how will the Government ensure that the duties it outlines translate into sustainable services that prevent cases like Declan’s from ever happening again? Duties without resources are merely words on paper. Although it is welcome that clause 49 removes police stations and prisons as places of safety, Declan’s case shows that even designated section 136 suites can be wholly inappropriate for individuals with complex needs. How will the Government ensure that appropriate alternatives are in place before the provisions commence?

I note with deep concern that the Government anticipate that full implementation of the Bill could take up to 10 years, which is too long for vulnerable people to continue to be at risk. In the light of the coroner’s findings in Declan’s case, will the Government commit to prioritising the provisions relating to autistic people and those with learning disabilities, particularly the development of appropriate crisis services, as outlined in the Bill?

On behalf of Graeme, Sam, Kaitlyn and all those people like Declan, I ask the Government whether they are satisfied that the provisions set out in the Bill will prevent tragedies like this one from ever happening again. If not, I urge them to make changes to ensure that it will. For Declan and all those with autism and learning disabilities, who deserve better from our mental health system, we must make sure that the Bill delivers the change they need—not in 10 years, but now. Their lives depend on it.