Policing and Crime Bill

Debate between James Morris and Norman Lamb

Monday 13th June 2016 Commons Chamber

[James Morris]

I thank the Minister for that intervention. There may be a role for police and crime commissioners to explore the need to work more closely with the health service and others to provide the capacity for appropriate places of safety such that police officers do not have to make the sorts of decisions implied by new clause 58.

The overall changes to sections 135 and 136 of the Mental Health Act are essential and quite transformative. We have to be very clear about what we mean by the exceptional circumstances in which people are detained, perhaps moving to a system where it becomes inappropriate in all circumstances even for adults to be detained in police cells. I recognise that there may be a need to define the exceptional circumstances in which that might happen. The proposed changes are positive. The new clauses I have discussed raise important questions that the Minister should consider in summing up.

[Norman Lamb]

It is a pleasure to follow the hon. Member for Halesowen and Rowley Regis (James Morris). I also welcome the contribution made by the hon. Member for Broxbourne (Mr Walker), who does an awful lot of campaigning on this issue.

I have tabled a number of new clauses and amendments. The first issue I want to deal with is whether we should disallow the use of Tasers on psychiatric wards. Before I get into the detail, I, like other speakers, want to acknowledge the inspiring leadership of many police leaders who, through force of strong moral leadership, have managed to change practice in many parts of the country. We owe them an enormous debt of gratitude.

On the issue of Tasers on psychiatric wards, the hon. Gentleman referred to Black Mental Health UK, an important campaigning organisation. As he said, it has drawn attention to the fact that

“in particular Black African Caribbean men”

are

“disproportionately over-represented in S136 detentions compared to the general population.”

That, incidentally, is a conclusion from the joint Home Office and Department of Health review of sections 135 and 136. It has also been reported that the police are more likely to use force against black African-Caribbean men.

I want to challenge the assumption that force is necessary at the level with which it is used at the moment. Black Mental Health UK refers in its briefing for this debate to the United Nations committee against torture, which has stated that Taser X26 weapons provoke extreme pain and constitute a form of torture and that in certain cases they can also cause death. Although they are termed non-lethal, almost 10 known deaths have been associated with the use of Tasers in the past 10 years.

I want to get a debate going on the subject. I am delighted that the Home Secretary herself has said:

“I have been hearing stories, for example, of Tasers having been used in mental health wards and you think, ‘Hang on a minute, what is happening here?’”

That is what we should all be doing: we should be questioning whether that is appropriate, and that is why I tabled new clause 40.

My amendment 124 would, in effect, prohibit the use of police cells as a place of safety for adults. I welcome the fact that the Government are implementing, through this Bill, the joint review’s recommendation to end the use of police cells for children and young people. However, the inspiring leadership of many police officers, working closely with mental health services, means that, in all but the most extreme cases, the use of police cells for such purposes has ended in some parts of the country. In London, for example, hardly any adults go into police cells as a result of section 136, and the same is true about the west midlands over the past two years. If those areas of the country with impressive leadership can do it, we should challenge every part of the country to do so, and the Bill should lead the way.

I welcome the fact that the Minister himself said on Second Reading:

“Unless we actually put a stop to that”—

the use of police cells—

“and say, ‘Enough is enough,’ we will not get the provision we need from other agencies.”—[Official Report, 7 March 2016; Vol. 607, c. 102-103.]

That is absolutely right. We cannot use the fact that the NHS is under pressure as an excuse not to do this. If it is wrong, it is wrong, and it needs to be challenged.

My new clause 45 would ensure that, in every case where there has been evidence of child sexual exploitation, the victims are referred for a mental health assessment. “Future in mind”, the report that I published in March 2015 following a taskforce that we set up to consider children’s mental health services, set out the need for trauma-focused care and for sexually abused and exploited children to receive

“a comprehensive specialist initial assessment, and referral to appropriate services providing evidence-based interventions according to their need.”

The new clause seeks to implement that recommendation.

In its briefing for this debate, the Local Government Association supports the intention, but again raises concern about investment. Are we really saying that the lack of availability of mental health services is a reason not to ensure that every child who has suffered sexual exploitation gets the chance to receive a proper assessment? Surely we have to set what is right in legislation and then ensure that we provide the facilities to make it happen. Anything short of that is not acceptable.

--- Later in debate ---

[Norman Lamb]

The hon. Gentleman is absolutely right. The fear is that that will become the default position in some localities because of the lack of resources available. That would be a big mistake. In circumstances where section 136 is used, surely the person should be taken to a health-based place of safety. A real effort is under way around the country—it is showing signs of success—through the use of approaches such as the street triage service, to reduce substantially the use of section 136 at all and to deal with issues in a more informal way. However, where it has to be used, we must make sure that the person is taken to the right place.

[James Morris]

Does the right hon. Gentleman accept that perhaps we need to think about the definition of “health-based place of safety”? The definition is in the control of the national health service, but perhaps it needs to be broader so that it can mean a voluntary organisation or elsewhere. That would be one way of improving our capacity.

[Norman Lamb]

I noted the hon. Gentleman’s remarks in his speech a few moments ago and he is absolutely right. A crisis house or a place of safety provided by a particular community for one of its people may well be the best place for them to go. We should be willing to open up the definition in an appropriate way.

New clause 59 centres on the right of those detained under sections 135 and 136 to an appropriate adult. Anyone detained under the Mental Health Act 1983 has a right to an independent mental health advocate, except when the detention is under sections 135 or 136. In such circumstances, the person may be very vulnerable, so surely the Bill should embrace the idea, as Mind has argued, that they should have a right to an appropriate adult.

Finally, I want to address the issue of when the clock should start. I welcome the fact that the Bill reduces to 24 hours the maximum length of time for which someone should be held under section 136 while the assessment takes place. There is a critical question, however, about when the clock starts. If there is pressure on resources and facilities, someone could be kept in a police van and driven around a city—that does happen sometimes. That time, under the Government’s proposed definition, would not count. Some hours could pass before the person arrived at the place of safety. Mind’s argument, which is contained in amendment 125, is that the clock should start when a person is detained rather than when they arrive at a place of safety.

Mental Health Taskforce Report

Debate between James Morris and Norman Lamb

Wednesday 13th April 2016 Westminster Hall

[James Morris]

My hon. Friend makes a powerful point. We need to deal with some of the issues to do with fragmentation in the system—he refers to substance misuse. The thrust of the recommendations in the report is about making sure we have a more integrated approach to commissioning mental health services across the piece.

The second important facet of the implementation challenges that the report throws up is research into mental health services. It mentions the need to have a proper, coherent 10-year plan for research into mental health to fill what are, as many of us would agree, big gaps in the evidence base.

[Norman Lamb (North Norfolk) (LD)]

I congratulate the hon. Gentleman on securing the debate. Does he share my horror at the fact that the Medical Research Council spent 3% of its budget on mental health research in 2014-15? That bears no relation to the degree of disease burden in our country, yet it chose to spend just that much on research.

[James Morris]

I thank the right hon. Gentleman for that intervention and pay tribute to him for all the work that he has done, particularly when he was Minister with responsibility for this area. I agree that we need to spend much more on mental health research, and we need to know what we want to research. For example, there is much talk about the power of peer support in mental health. There is an assumption that it is a good thing and that it works, but we do not have a particularly rich evidence base about whether it does.

On the efficacy of certain psychotherapies, the evidence base shows that cognitive behavioural therapy can be effective for people with mild depression and anxiety, but we do not really know about the effectiveness of other psychotherapies that we may want to promote and develop in the national health service. We clearly do not know very much about a lot of emerging areas that have an impact on mental health. For example, using technology and mobile phone and other apps to help people with mental health problems is a big emerging area, but we do not know much about its effectiveness. We certainly do not know in any coherent sense about the implications of genomic medicine on mental health care. A coherent strategy on mental health research is required over the next decade so that we can extend and expand the evidence base, because the truth is that we are often flying blind.