Mental Health Bill [Lords]

Lauren Edwards Excerpts

2nd reading
Monday 19th May 2025 Commons Chamber

[Lauren Edwards (Rochester and Strood) (Lab)]

I welcome today’s Second Reading of the Bill. I would like to focus on one aspect of the legislation: the removal of autism and learning disability from the definition of mental disorder under section 3 of the Mental Health Act 1983.

I recently visited a wonderful local charity, the Challenging Behaviour Foundation. It is the only UK charity specifically focused on the needs of children, young people and adults with severe learning disabilities whose behaviour may be described as challenging, and their families. On that visit, I was shocked to learn that under the Mental Health Act, autistic people and people with a learning disability can be detained in mental health hospitals indefinitely, just because they are autistic or have a learning disability.

I thank the hon. Member for Runnymede and Weybridge (Dr Spencer) for sharing his extensive professional experience, but I disagree with him on one point: in my view, autism and learning disability are not mental health conditions, and I do not believe that they should be treated as such in law, which is a view shared by a lot of people in the sector who I have spoken to in advance of the debate.

This issue is currently affecting a lot of people. As my hon. Friend the Member for Penistone and Stocksbridge (Dr Tidball) said, over 2,000 autistic people and people with a learning disability are in mental health hospitals in England today, the vast majority of whom are there under the Mental Health Act. Importantly, around 225 of them are under the age of 18, so this is affecting a lot of our young people.

Mental health hospitals are often inappropriate for autistic people and people with a learning disability. Once detained, they can get stuck in those settings for many years, which can be deeply overwhelming and damaging and lead to lifelong trauma. As my hon. Friend the Member for Penistone and Stocksbridge mentioned, the average length of stay for current in-patients is nearly five years, and we have to ask ourselves why that is. The latest available data shows that the key reasons for delayed discharge are a lack of suitable housing and a lack of social care. Charities like CBF continue to hear worrying stories of abuse, over-medication, unnecessary restraint and seclusion in these settings.

Back in 2011, “Panorama” uncovered abuse at Winterbourne View hospital, bringing attention to the fact that many people with a learning disability and autistic people were being detained in hospitals, when they could and should be living in the community. Since then, there have been numerous policy interventions and action plans from the previous Government. However, sadly they have not resulted in the changes promised and all national targets to reduce in-patient numbers have been missed; in fact, the numbers have increased.

Legislative change is clearly needed, and I welcome the change to detention criteria in the Bill that will mean that autistic people and people with a learning disability cannot be detained for treatment unless they have a co-occurring mental health condition that requires in-patient mental health care. However, on page 72 of the impact assessment, the Government say that the proposed changes

“will only be switched on when systems are able to demonstrate sufficient level of community support”.

Ensuring appropriate provision of services in the community is crucial to supporting autistic people and those with a learning disability, so that they can be discharged from hospital, and so that we can prevent needs from escalating, and prevent admission to mental health hospitals. However, if there is no comprehensive, fully resourced plan to build capacity in the community and enable this change to be “switched on”, this vital reform could be delayed for far too long. I urge the Government to publish a comprehensive plan to ensure that the change to detention criteria can be commenced, and to ensure accountability for this process. Ideally, commencement would be in 2027, in line with modelling in the impact assessment. I also ask that those changes be co-produced with the people who will be affected by them.

The previous Government’s “Building the Right Support Service Model” could act as the starting point, but I draw the Minister’s attention to the challenging behaviour national strategy group, co-ordinated by CBF, which has developed a co-produced, lifelong action plan that sets out not only the changes that need to be made to get community support right, but resources and best practice. I encourage the Minister to meet families to better understand the impact of inappropriate detention on people with a learning disability or autism and their families. I would be happy to help co-ordinate that through CBF.