Mental Health Act 1983

Johnny Mercer Excerpts

Thursday 25th July 2019 Westminster Hall

[Johnny Mercer (Plymouth, Moor View) (Con)]

It is a pleasure to serve under your chairmanship, Ms Buck; thank you for calling me to speak. First, I pay tribute and give my thanks to the hon. Member for Bermondsey and Old Southwark (Neil Coyle) for securing the debate. Some of the best days we have in this place are when people recount their personal experiences and what drove them to the interests and causes they have in this place. It was remarkable listening to his experiences, which reinforced why we need to move what we do on mental health away from having a good conversation to actually changing things in a way that means something in the communities we serve.

With a new Prime Minister just two days into the job, it is a welcome opportunity to put this important issue on the agenda before summer recess. I look forward to the Government delivering on the White Paper that they have promised to publish by the end of the year. Mental health is an area that I have been trying to make a difference on since I came into this place. I have spoken openly about my own experiences of obsessive-compulsive disorder. I have said before that while I might like to pretend it is a distant memory, those who know me well know that it is not.

Reforming the Mental Health Act 1983 matters to me because I think it is important that we give specific, considered attention to the people whose mental illness is so severe that the state needs to step in to protect them or potentially other people. When people are unwell they need support. The 1983 Act provides that, but as I recently discussed at an all-party parliamentary group on mental health event on that very topic, that support is not always as beneficial and therapeutic as it might be.

Members will know that I am chair of the all-party parliamentary group on mental health. At the event I mentioned, we were pleased to welcome Sir Simon Wessely as one of our speakers. His speech was very informative about some of the key changes that the review recommends and where we are at politically in making the new vision a reality for those who suffer with their mental health in our communities.

One thing that stood out to me in Sir Simon’s address to the group was that, while rates of detention have increased, the rates of severe mental illness have remained relatively stable. Gold standard studies such as the adult psychiatric morbidity survey show that, so how do rates of detention shoot up by 47% in the last decade when the rate of mental illness among the population is almost unchanged? Something is not working, and I welcome the review’s recommendation to raise the bar and tighten up the criteria for detention.

We were also privileged to hear at that meeting from Georgi Lopez, a young woman who bravely shared her experience of being detained under the Mental Health Act with members of the APPG. Her powerful testimony made it clear that legislative reform is required to change things for the better. I will share some of Georgi’s story with the House to illustrate how the Act negatively affects some people’s lives when they are vulnerable and very unwell. I thank the hon. Member for Bermondsey and Old Southwark for sharing his experiences of the Act. We must keep such stories in mind when we talk about the potential of the forthcoming White Paper.

Georgi is 23 years old. She was first detained under the Act when just 17, and was detained for the majority of the next four and a half years. Georgi was diagnosed with anorexia nervosa shortly after completing her A-levels. She had been preparing her application to the University of Oxford. Shortly after her AS exams, she was taken to A&E, as she was severely dehydrated and malnourished. Her parents were given an ultimatum: to have Georgi voluntarily admitted to a psychiatric hospital or for her to be sectioned. They chose voluntary admission.

For the first few weeks in a psychiatric hospital, Georgi complied with all the treatment she was given, but following her first meeting with a psychiatrist she was told that she would be assessed to be detained under section 3 of the Mental Health Act. She was also put on highly sedative medication. She and her parents objected to her being detained because, up until that point, she had followed her treatment plan as asked, without need for coercion or detention. They were not listened to and she was detained.

Hon. Members can imagine how someone who has done everything that they have been asked to do to manage their condition would feel on having that control taken away from them, with little to no reason given. Georgi dealt with that loss of power by declining to take the medication that she had been prescribed. She was then forcibly injected with sedatives. That experience shows why Professor Wessely’s report is aptly titled “Increasing choice, reducing compulsion”.

I later heard about Georgi’s second experience of detention, which was completely different. She said that she was treated like a human being, and the staff were very interested in her past, her interests and her aspirations. Her care team involved her and her family in every decision about her treatment. Although it took her some time to rebuild her trust in the system and the Act, she believes that she owes her life, health and happiness to that positive experience, where she had choice and autonomy.

Georgi was clearly right when she told our APPG that her first experiences of treatment were neither caring nor conducive to her recovery. I agree with her, but her second experience, where her team involved her in her own care and helped her to rediscover herself and her identity, shows that it is possible to provide good psychiatric care. Georgi is in fact now an aspiring psychiatrist. People think that it gets easier to share your story; it does not—it always takes courage and bravery. I hope that by listening to Georgi’s varied experiences of the Act we can see that, although it is possible to provide care that involves patients in decision making, that does not always happen.

The Act shapes the culture and practice in mental health units. We need to change it so that Georgi’s positive experience of the Act is standard across the country. I fully support reform and I am pleased that the Government have committed to a White Paper by the end of the year. We need to seize the opportunity to get this right, and I am sure that our new Prime Minister will show leadership on this issue, which is important to my party and my constituents.