Mental Health Bill [Lords]

In any case, Winston Churchill achieved a great deal in his career as a Member of Parliament, and in recent weeks and months various people in public life have said that they have had mental health problems, but they too have achieved a great deal. I was a member of the Mental Health Act Commission for several years and visited people who were detained in in-patient facilities in London and the south-east. The experience of meeting people who had been sectioned, received compulsory treatment and lived in wards—some of them in appalling conditions—was a salutary lesson for me about how we treat people with mental illness. It is important to remember, as my hon. Friend the Member for Bridgend (Mrs. Moon) said, that only a very few people end up sectioned and as in-patients in hospital, but they are an important group and we must get their treatment right. For a long time, they have been pushed to one side and not focused on properly. That is why I am really pleased by several aspects of the Bill, including the community treatment orders. I am not saying that the care and attention given by NHS staff was lacking in any way, but I saw distressing conditions in some wards in some in-patient facilities where some people found it very difficult to hold themselves together. I remember seeing one person who refused to wear clothes and had to be kept in a room with no furniture and restrained for much of the time, because he was so unwell. We must get the treatment of such people right. I raise that point because it is important to remember that in-patient facilities have improved enormously, but the whole thrust of the NHS reforms is about providing care in the most appropriate place for the person. For some people that will be an in-patient facility, but many people want care close to their home, if not in the home, so CTOs will be a real step forward in giving people with mental health problems that option. We want people to receive other forms of NHS treatment close to their homes, as some already do—so why not people who have mental health problems? The multidisciplinary approach is prevalent in the mental health field, so it is right that we consider who should make decisions about sectioning people; for instance, amending ““responsible medical officer”” to ““responsible clinician”” is the right way forward, as are the provisions amending the role of the approved social worker to include ““approved mental health professionals””. Such steps will allow psychologists, therapists, nurses and social workers to play a full role, along with clinicians and consultant psychiatrists, and would show that we are taking a much more modern approach to dealing with mental health care, rather than using only a medical model, which is rather old-fashioned. In Committee, I hope that we can look again at the provisions on nearest relatives to allow patients the option to nominate the person they want as their nearest relative. The list is too prescriptive at present and the patient is allocated a person. Family relationships are often difficult and the patient may not want their actual nearest relative to speak for them and take important decisions. I was pleased that my hon. Friend talked about the advance directive, as it is an important issue, although it may not be appropriate for the Bill. An advance directive allows the patient some dignity; when they are well they can say, ““This is what I would like to happen if I am ill again.”” That is a positive step forward for mental health services. It is distressing that sometimes police cells have to be used as place of safety accommodation, although I understand why it is necessary. I hope that the Government will reconsider that practice and think more creatively, especially in light of the massive NHS building programme; for example, some of the local improvement finance trust buildings or provision in the acute sector might be used as places of safety. The police need training. I was shocked to find that most police officers do not receive substantive training in dealing with people with mental illness. Finally, we need to try to remove stigma. An important development in schools in recent years is the national healthy school standard, a key aspect of which is promoting emotional health and well-being in our youngsters. We should try to raise the issue of mental well-being with our children early on, so that they do not think of mental illness as a frightening, distressing condition to be backed away from. I remember a nurse telling me that if a person has a broken leg the general public will always help; when they see that a person has a physical injury they do everything they can to help because they can see the problem, but if someone has a mental illness, people run away—they do not want to help. We have to try to address that issue with our youngsters in school, by saying that we should not be frightened of mental illness; it is treatable and we can do things to help people. Let us treat it like any other illness and not see it as a distressing, frightening condition.