Mental Health Bill [Lords]

The Minister is nodding her head the wrong way, from left to right. I want it to go more north to south. I shall make this case again if I serve on the Committee. The Minister has heard me make the point before. The difference of knowledge of this subject now compared with 1983 is clear. I have been very critical of psychiatrists and I am pleased to say that they are responding in the way in which they treat people with autistic spectrum disorders, particularly Asperger’s syndrome. But if we have a combination of diagnoses—an ASD diagnosis and a mental health diagnosis that are quite distinct and separate, or even a triple diagnosis of an ASD, a learning difficulty and a mental illness—we require people with a lot of experience and specialisms to sort out the behavioural messages coming from those different diagnoses. My worry about the broadening of the definition of mental disorder is that for many people with an ASD, what many of us would regard as ““normal”” autistic behaviour will be misdiagnosed as psychotic behaviour because there are simply not enough mental health professionals around the country to be able to disaggregate those different behaviours. As I have often said, the result of that is misdiagnosis and mistreatment, which can have a serious and adverse effect on the health of an autistic person and on the environment into which the person is taken. One would put someone diagnosed with ASD into a hospital only if one were 100 per cent. sure that that was truly the last resort, because that environment itself would be extremely disturbing to them. Advocacy is related to the issue I have been addressing, but it has broader implications in terms of mental disorders generally. I am pleased that under the Bill the Minister has closed the so-called Bournewood gap, about which she and I have had many discussions, by amending the Mental Capacity Act 2005. However, huge advocacy implications arise from closing the Bournewood gap, and other advocacy implications arise from the rest of the Bill. Therefore, it is with some distress that I learn that the Minister has reduced the amount of support—legislative and otherwise—that would give appropriate levels of advocacy to mental disorders both generally within the context of the Bill and particularly in terms of closing the Bournewood gap. In Committee I hope that she will propose impact assessments in respect of advocacy for the Bill as a whole and particularly the advocacy requirements that she anticipates will be needed to do true justice to the way in which she has decided to close the Bournewood gap. I am unsure whether information on that is available now, or if it is being worked on. [Interruption.] The Minister is replying from a sedentary position, but perhaps she could respond to that later. I have participated in many mental health debates in the House, and I wish to share my experiences not only on the autism front but of other cases that I have dealt with, particularly as a constituency Member of Parliament. I have had many cases where people have committed suicide, sometimes while they were in-patients, unfortunately. Some committed suicide after they had been an in-patient and had received community services. I dealt with one tragic case of somebody who was treated in the community and who ultimately murdered his mother. In all those cases, when I read the medical records—they have been made available to me—it is clear that there are common themes. There is a lack of early intervention: there is a long journey from the moment when the symptoms or concerns first begin to getting the person concerned in front of the professional who might be able to help. Having got to that point, there is also an issue to do with the long, ongoing treatment. Members understand that many people have cyclical conditions where there is a period when they are fairly stable but then go down, as that is the nature of many mental health disorders. However, there is often a lack of continuity in intervention so that such people simply fall through the net. That is a common theme in all the cases I have dealt with, including those ending in suicide and the one case where somebody else was found dead.