Mental Health Bill [Lords]

Ian Sollom Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[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.

Mental Health Bill [Lords]

Ian Sollom Excerpts

Report stage
Tuesday 14th October 2025 Commons Chamber

[Sojan Joseph]

I would like to speak in support of new clause 37, tabled by my hon. Friend the Member for Thurrock (Jen Craft). On Second Reading, I warmly welcomed the changes that this legislation will introduce regarding autistic people or those who have a learning disability. As a result, it will no longer be possible for someone to be detained in a mental health hospital indefinitely simply because they have autism or a learning disability. In the current system, autistic people and those with a learning disability have experienced inappropriate care, over-medication and extended periods of detention because of a lack of facilities in the NHS and social care, so this change is welcome and long overdue.

The Government have confirmed that the changes will be implemented once the necessary community provision is in place. Establishing strong support in the community is essential for not only enabling safe discharge from hospital settings but preventing unnecessary admissions in the first place. I recognise that the Government are working on setting out what strong community services look like and what resources they require to implement them. From serving with the Minister in Committee, I have no doubt about his commitment to ensuring that this community provision is introduced in a timely manner, but I support the proposal of my hon. Friend the Member for Thurrock that there should be a road map in the legislation that will provide a clear framework outlining how those services will be introduced. After all, ending inappropriate detention requires robust community-based alternatives to ensure that people with autism or a learning disability who would have previously been detained do not fall through gaps in the system.

Having a road map developed in conjunction with autistic people, people with learning disabilities, their carers and healthcare professionals will help to identify and address any gaps in service provision and workforce capacity. I also believe that it will help to reduce the risk of people with autism or a learning disability needing police intervention or emergency hospital care because the support is inadequate. By putting in place a road map, new clause 37 would help to ensure that we end all the sooner the injustice of people with autism or a learning disability being detained.

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

I will speak to amendments 24 to 28 and 36 to 38 in my name, which address gaps in crisis provision and accountability for autistic people and people with learning disabilities.

On Second Reading, I told this House about Declan Morrison, my constituent who died aged just 26 after spending 10 days in a section 136 suite that was wholly inappropriate for his complex needs. I remind the House that section 136 suites are designed for 24-hour stays, or a maximum of 36 hours in extreme cases. The coroner who investigated Declan’s death found that

“there is a risk that future deaths could occur unless action is taken.”

The timeline of what happened in the run-up to Declan’s death shows a cascade of systemic failures. Declan’s family, Graeme, Sam and Kaitlyn, have asked me to ensure that Parliament learns from what happened. These amendments in my name reflect those lessons and the coroner’s recommendations.

In Committee, the Minister made several points about earlier versions of these amendments, which I have tried to address in these revised versions. In particular, on crisis accommodation, the Minister argued that existing duties on ICBs already cover crisis provision and that the amendment was too prescriptive, potentially restricting ICBs in designing provision, emphasising the importance of flexibility for ICBs to meet local needs. I understand the desire not to be overly prescriptive, but in Declan’s case, over 100 places were contacted and no suitable accommodation could be found anywhere in the country. Flexibility failed Declan.

The revised version of the amendment allows for regional solutions beyond the ICB, but I suspect that the Minister will still find it too prescriptive. However, the fundamental question remains: should there not be a duty to ensure that provision exists somewhere? The Cambridgeshire and Peterborough ICB established a crisis service after Declan’s death that operated at 98% capacity, demonstrating both need and viability, but it closed when funding was withdrawn, highlighting the challenge with voluntary provision.

[Steve Darling (Torbay) (LD)]

On funding, the Devon partnership NHS trust looks after people with mental health challenges in the Torbay community, where levels of depths of despair are particularly high. The trust is facing a £21 million cut, so does my hon. Friend agree that changes will be irrelevant if we do not have adequate funding?

--- Later in debate ---

[Ian Sollom]

I agree that resources need to be put in place to support the many good measures in the Bill and in many of the proposed amendments. In Declan’s case, services were created in the wake of tragedy and funding was found, but too often such services disappear when attention moves elsewhere.

I recognise that the implementation challenges are real, and I appreciate that the Minister has committed to providing annual written statements on progress, but I believe the principles in the amendments around crisis provision, proactive intervention, accountability and co-production with autistic people merit consideration. As much as I would like him to, I do not expect that the Minister will have a late change of heart on the amendments today. However, I hope he will be willing to meet me after the Bill receives Royal Assent to discuss how we can work together to ensure the systemic failures that led to Declan’s death are properly addressed during implementation of the measures in the Bill. In stopping those systemic failures, we would honour the memory of Declan.

[Josh Dean (Hertford and Stortford) (Lab)]

In the interest of time, I will turn straight to new clause 25, tabled in my name.

The Bill sets out a range of situations where the competence of a patient aged under 16 will be relevant, but it does not set out a framework for how it should be determined. That puts patients under 16 years old at a huge disadvantage. Unlike those aged 16 and over, there is no clear mechanism for determining whether a child under 16 can make decisions and the law assumes that under-16s cannot make decisions for themselves, unless they demonstrate they are able to do so. That means that under-16s may not benefit fully from the rights and safeguards set out in the Bill because they are assumed to lack competence to make the relevant decision. For example, they may not be able to exercise their right to choose a nominated person or to access enhanced safeguards around treatment.

There is currently no statutory test for determining a child’s ability to make decisions. While some may refer to Gillick competence, the Joint Committee on the draft Mental Health Bill noted that Gillick competence is “broad”, “ambiguous” and that there were significant inconsistencies in its application. A similar observation was made by the Court of Appeal in a decision earlier this year, which also indicated the Court’s approval of a functional test to determine a child’s competence.

New clause 25 addresses this disparity by introducing a “functional test” to determine an under-16’s ability to decide. This reflects the suggested approach in the current code of practice, adopted by some judges. The Law Commission has recommended a similar test as part of its proposed legal reform concerning disabled children’s social care. This test fills a significant gap in the Bill, providing important clarity for professionals when a child’s competence needs to be determined. Crucially, the test set out in new clause 25 is explicitly limited to decisions made under the reformed Mental Health Act. It does not cover decisions falling outside of the Act, so does not affect the existing decision-making powers of the courts or those with parental responsibility. A clear and consistent approach to assessing a child’s competence can only be achieved by including a test on the face of the Bill, as the code of practice can only reflect the law—it cannot prescribe a test for competence. I would be grateful if the Minister addressed that point at the end of this debate, and if he would consider meeting me to discuss my amendment in more detail. This Bill has many strengths that will deliver for people and modernise mental health care, and it is crucial that we ensure children and young people can benefit from those strengths in the same way adults can benefit.