Mental Health Units (Use of Force) Bill

Rishi Sunak Excerpts

2nd reading: House of Commons
Friday 3rd November 2017 Commons Chamber

[Rishi Sunak (Richmond (Yorks)) (Con)]

It is a privilege to be called to contribute on this important topic. Many constituents wrote to ask me to participate in this debate, so they will be delighted that I have the opportunity to highlight some of the issues they raised. I commend the hon. Member for Croydon North (Mr Reed), not only for securing this debate and championing the Bill but for the constructive and consensual way he has gone about it.

So much has changed about our understanding of mental health. There was a time when we thought of mental health problems as something that happened to other people, away from ordinary life. Now, how many of us have a friend, a colleague or a family member who we know has suffered from mental ill health? That is because more people rightly no longer feel any shame about a mental health problem. Because society is on a journey of understanding, attitudes are changing and stigmas are breaking down.

We all recognise that good mental health is no less important than good physical health, but there is still so much more for us to do. The Bill is the next step in our national journey towards ending the injustices that those who experience mental health problems still face. It is for that reason that I congratulate the hon. Member for Croydon North, who has spent many years working with the family of the late Seni Lewis as they fought for the truth about what happened to their son. It is crucial that we learn the right lessons from what happened to Seni, which is why I am pleased to be able to discuss the important changes that the Bill will make to transparency in mental health units.

I wish to highlight three issues: first, I shall discuss how young people in particular are affected by mental ill health; secondly, I shall discuss some of the measures that the Government have already put in place to improve diagnosis and treatment; and lastly, I shall touch on just a few of the vital changes that the Bill will introduce.

I shall start with the topic of mental health and young people. I am passionate about helping young people to get the best possible start in life. Children and young adults should face no barrier to making the most of their unique talents and enjoying their lives to the full. Often in this Chamber, we think of the obstacles that young people may face in terms of social mobility, access to a good job or apprenticeship, or getting the right education. We are right, however, to highlight today that mental health merits no less of our attention. If we are to ensure that young people can make the most of the opportunities they have and deserve, mental health provision for them must be as accessible and high quality as possible.

The sad truth is that mental health issues disproportionately affect young people. Many of us in the Chamber are all too familiar with the negativity and hurtful comments that some people choose to spread via social media. I ask hon. Members to put themselves in the shoes of a young impressionable teenager or primary school student. One in 10 young people say they have been a victim of cyber-bullying. It is hard to imagine how difficult it might be for a young person when their smartphone or social media become ways for bullies to reach them.

I commend Google, with which I recently participated in a workshop in my constituency talking to primary school children about internet safety and how young people can protect themselves online from unwanted and hurtful attention. Google, I believe, is rolling out this project across the country, and I would urge hon. Members on both sides of the House to work with it when it comes to their constituencies, visits their schools and talks to young people about the importance of protecting themselves online.

[Bob Stewart (Beckenham) (Con)]

That is fascinating. Will parents be able to put some sort of inhibitor on Facebook, or just the child?

[Rishi Sunak]

My hon. Friend makes an excellent point. The workshops provide packs for teachers to give to children to take to their parents so that parents become much more engaged with their children’s online presence, which is something that I, as a parent of young children, am becoming more aware of, as I am sure many others in the House are. We all must be aware of what our children do online, just as we are careful when they cross the street or go to the park.

[Alex Chalk (Cheltenham) (Con)]

My hon. Friend is right to draw attention to the sensible measures being put in place to help potential victims, but we have to go beyond that: perpetrators of vile abuse have to understand that there will be consequences for them. The onus should not always be put on the victim: the perpetrator must expect to be punished too.

[Rishi Sunak]

My hon. Friend makes an excellent point—and one he has spoken about before. My hon. Friend the Member for North West Hampshire (Kit Malthouse) has also spoken passionately in the House about what more we need to do to protect children online and ensure they have a safe space to play and learn about the world around them.

[Oliver Dowden]

My hon. Friend rightly pays tribute to the work of our hon. Friend the Member for North West Hampshire and makes an important point, which pertains to mental health, about children needing a safe architecture in which to grow up. Just as we, as parents, give them safety and security in the physical world, so they must have safety and security in the online world, where they spend increasingly more of their time.

[Rishi Sunak]

My hon. Friend is absolutely right and puts it better than I could myself, so I will move back to the physical world, if I may.

Sadly, the evidence is that self-harm among young people is on the rise. It is right, therefore, that the Government have responded by improving mental health training in schools. Many colleagues have already mentioned the importance of appropriate training for those dealing with children—or adults—with mental health issues. This vital training will help teachers and staff at schools not just to identify but to assist at-risk children.

[Helen Whately]

My hon. Friend is talking about mental health treatment for children and young people, where we know a huge amount of work is needed to improve services and meet rising demand, but does he welcome, as I do, the fact that last year an extra 21,000 children were treated by children and young people’s mental health services? We are making progress in this area.

[Rishi Sunak]

I thank my hon. Friend for her comment, and I know that she is a tireless advocate for healthcare services, especially mental health services, in this place. I did not know that particular statistic, but it is indeed very welcome and will be welcomed, I am sure, by hon. Members on both sides of the House.

Furthermore, it should be our aim that children are not sent out of area to be treated for general mental health conditions. Representing a large and sparsely populated rural constituency, I am particularly focused on this issue of accessibility. Right now, the local mental health trust is looking to shift in-patient services away from our excellent local hospital, the Friarage, in Northallerton, to places as far afield as Darlington, Middlesbrough and Bishop Auckland, which will mean more than an hour and a half’s drive for some patients. This is of considerable concern to me and no doubt an issue that other colleagues will have experienced themselves. Against that background, we owe it to young people to ensure that mental health services are safe and transparent, so that when young people seek help, as Seni and his family did, they will receive it, secure in the knowledge that they will receive the high standard of care we all expect.

Secondly, I turn to the action that the Government are already taking on this important topic. Legislating for parity of esteem was a landmark step in the journey to tackling the injustices faced by people suffering from mental health problems. As we all know, however, making this parity of esteem a reality in everyday life will require not just effort but determination. We cannot, however, be in any doubt about the Government’s efforts, led by a Prime Minister passionate about this issue and determined to do more than ever before to bring about real change and to tackle what has aptly been described as a burning injustice.

The Prime Minister has overseen a £1 billion increase in the funding available for mental health and, as my hon. Friend the Member for Torbay (Kevin Foster) mentioned, championed a reduction in the number of people suffering a mental health crisis who end up in a police cell rather than a place of safety in the healthcare system. The whole House eagerly anticipates the conclusion of the review led by Professor Sir Simon Wessely, who is looking at why detention rates under the Mental Health Act are increasing.

[Afzal Khan (Manchester, Gorton) (Lab)]

I congratulate my hon. Friend the Member for Croydon North (Mr Reed) on bringing the Bill, which I support, to the House. I wish to make two points. First, constituents of mine, including professionals working in this field, have pointed out to me that racism causes people from black and minority ethnic backgrounds to experience mental health issues. We have heard statistics today showing that BME groups—especially black Caribbean people, who are also over-represented in hospitals and as detained patients—are more likely to be admitted to hospital. Secondly, unconscious bias among clinical professionals affects how mental health services respond to and meet the needs of people from different racial and religious backgrounds. Does the hon. Gentleman agree that it is right that the Bill will increase data and transparency on this issue?

[Rishi Sunak]

The hon. Gentleman’s intervention was timely, for I was just about to say that we should examine the important, complex and sensitive issue of whether minorities are disproportionately suffering poor mental health treatment or outcomes. We should be careful, however, about reaching for the knee-jerk—and potentially mistaken—conclusion and labelling the problem as one of institutional racism.

In that regard, I hope that Sir Simon Wessely takes note of the arguments made forcefully by Munira Mirza, the former Deputy Mayor of London, who has cited Professor Swaran Singh, a social and community psychiatrist with, I think, 30 years of clinical experience in this area, who has argued that institutional racism in his profession is not the primary cause of BME communities’ being disproportionately affected by these issues. He cites academic studies showing that BME communities and migrant groups are more exposed to mental health risk factors. We should tackle those underlying risk factors as a matter of priority. They include things such as family breakdown, substance abuse, poverty, living in areas with low social cohesion and, of course, the personal experience of migration and prior instances of racial prejudice. It is a sensitive area. The headline numbers obviously pose difficult questions for our public services, but we should get to grips with the underlying data before reaching for conclusions that may well be incorrect and that may not pay tribute to the work that people are doing with the best of intentions.

We must be more ambitious and use every opportunity available to further our efforts. Programmes such as mental awareness courses in the National Citizen Service or the £150 million that the Government are investing to support teenagers with eating disorders are practical, and will ensure that discussing mental health is not something that we do only in isolation or that happens only in a clinical setting.

[Helen Whately]

Does my hon. Friend agree that the recent announcement that 1 million people will be trained in mental health first aid is a huge step forward in raising the skills and awareness of those who help people with mental health issues?

[Rishi Sunak]

As ever, my hon. Friend makes an excellent point and displays her knowledge of this area. It is absolutely right that we bring help to people wherever they need it and in as many settings as possible. I very much welcome the extraordinary increase in the number of people being trained.

Indeed mental health provision needs to be part of an ongoing conversation about the development of young people and the issues that they face. I am confident that we as a society are now heading in the right direction. However, as I have noted, despite that substantial progress, we can in no way believe that the job is done. That is why I will now turn briefly to a few provisions in the Bill and say why they will make a real difference to the transparency in treatment of young people across the country.

The Bill will establish the requirement that mental health units must publish how and when they use force. That appears to be an eminently sensible change. All of us will be familiar with the detailed reports from Ofsted and the Care Quality Commission. The information that they publish gives us a window into how our public services are being run. Making information available about the strengths and weaknesses of organisations gives us the transparency that is needed to know what improvements need to be made. I see no reason why this should be any different with data on the use of force. This transparency is needed not just by the general public, but by the families of patients against whom force has been used. Of course, sometimes, health professionals will make the difficult judgment to use proportionate force in certain circumstances, but it took seven years for the Lewis family to get the full truth about the event that led to their son’s death. No family should be put in that position ever again.

The Bill also establishes a duty on the service provider of a mental health unit to record any instance of the use of force on a patient, in addition to recording several demographic characteristics. Added together with the requirement for police officers attending units to wear a body camera, the Bill will help us to be much clearer about how force has been used, against whom and why.

I wish to highlight the provision which says that, in the event of the death of a patient who was subject to the use of force, the Government will appoint an independent investigator who will produce a report on the incident in a timely fashion. Families who undergo such a tragic loss will have the official help that they need to get to the truth about what happened to their loved one. Those are essential changes that I hope will ensure that, in future, no family will have to fight as hard as the Lewis family did to get the truth that they deserve.

In conclusion, as many as one in four of us will experience mental ill health at some point in our lives. This is an issue that is simply too profound for us not to ask ourselves as legislators in this place, “What more can we do to prevent injustice occurring? What barriers must the House help to break down?” That is why, once again, I commend the hon. Member for Croydon North for his long-standing efforts on behalf of both the Lewis family and, more broadly, the many people across the country who suffer from mental health problems. The provisions in this Bill will give families and the public the transparency that is needed to ensure that force is used only when necessary. It is part of the journey that we are on as a nation to ensure that people with mental ill health are viewed no differently to those with physical ill health. I commend the Government for backing this vital piece of legislation, and I have been delighted to speak in favour of it today.