My Lords, I shall speak also to Amendments 190 and 191, which are grouped with Amendment 189. We now come to the part of the Bill that deals with the Mental Health Act 1983. Amendment 189 would ensure that no one, regardless of their age, was taken to a police cell under an emergency section of the Mental Health Act. Amendment 190 defines a place of safety, and that does not include a police cell.
The Bill makes some very welcome changes to provisions under the Mental Health Act. It bans the use of police cells for children and young people in crisis; it seeks to reduce the use of police cells as places of safety for adults; and it reduces the length of time that a person can be detained from 72 to 24 hours. These are big, important and very welcome improvements. However, the Bill leaves the door open for police cells to continue to be used for adults in crisis. That should not be continued, and it does not need to happen. We have seen in places such as Hertfordshire and Merseyside, where no police cells have been used for people in crisis in the last year, that with careful planning and co-operation it is entirely possible for people to be supported in health-based places of safety instead of being taken to police cells. I commend the large reduction in the use of police cells that many other police forces have made over the last year across England and Wales.
The limited change to the use of police cells in the Bill is based on an assumption that 4% of people detained under Section 136 need to be taken to a police cell due to “exceptional circumstances”. However, these circumstances have not been defined. Clearly, we need further information on the exact situations in which the Government envisage a police cell being an appropriate place for someone in crisis. I do not believe that anyone in crisis should be taken to a cell. That is not a place of safety for someone in crisis. When someone has a mental illness, everything that a public authority does to and for them should help them recover. Putting them in a cell does not achieve this. Indeed, it often achieves the exact opposite. One patient told the charity Mind that, “Being put in a police cell where hardly anyone is trained in mental health issues is not good. To be locked up and isolated made me think I was worthless. All I wanted was to talk”.
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Section 136 is for use in an emergency. Can you imagine someone having a heart attack and then waiting for 24 hours in A&E to see a doctor? There would be outrage, and rightly so. We will not get real parity between physical and mental health, to which the coalition Government were committed, until we stop treating people in mental health crisis in this way.
On the other hand, health-based places of safety can support someone who has been detained under Section 136, and of course, if necessary, police assistance can be called upon to support staff in dealing with challenging behaviour. Last year, in England and Wales, over 28,000 people in mental health crisis were picked up by police. While most were taken to a health-based place of safety, 2,100 were taken to a police cell. Although this is a big reduction on the previous year,
there is still a long way to go. Those areas that have eliminated the practice have shown the way: where the police work collaboratively with local partners, even the most exceptional cases can be managed.
I would like to finish on this amendment with a point about funding. It is good to see the recognition from government that additional funding is needed to ensure that the number of people taken to police cells due to their mental health issues is reduced. The recent investment of £15 million is welcome, but it is going directly to NHS trusts and police forces and not to local authorities, which do provide residential services that can be regarded as places of safety. That needs correcting.
Areas that achieved zero numbers have shown that significantly more funding would not be required to ensure that no one in mental health crisis—right across the country—is taken to a cell. I understand that only an additional 33 beds would be required across the whole of England and Wales. Yes, there would be a cost, but there would also be a saving—in police costs. I am pleased that there is cross-party support for these amendments. The debate needs to focus on this opportunity for the Government to end completely the outdated use of police cells for people with mental health problems, rather than on the relatively modest cost required. This is crucial if we are to achieve parity of esteem between physical and mental health.
We should also end the discrimination that exists. Liberty has pointed out that Section 136 is the only part of the Mental Health Act 1983 in which one person acting without medical evidence or training has the authority to deprive another person of their liberty. It is also true that the power is used disproportionately for people from black and ethnic minority backgrounds. This discrimination has to stop, and this is our chance to put a stop to it for good.
Passing Amendment 191, also in this group, would prohibit the use of people’s homes as places of safety. It is unfortunate that this Bill includes the home as a place of safety under the Mental Health Act. While it might seem safe, there is no real way of knowing whether a person’s home would be a safe place for them, and there are many risks. Indeed, it is also important that relatives can feel that their home is a place of safety for them when their relative is having a crisis.
The explicit reference to the home as a place of safety under the Mental Health Act has important and concerning implications for people detained under Section 136. To enter a person’s home remains a major intrusion, especially for mental health patients who do not trust the police anyway. People who have lived with the experience told Mind that:
“I would feel much more vulnerable being detained in my own home … Having a stranger in my home in a time of crisis would destabilise me even further”.
Clearly, there are also safety implications. How do we know about the safety of a person’s own home unless someone has assessed it? Do the police have the ability to judge the safety of a person’s home before arrival? Importantly, a person’s home life or their feelings towards their home may be at the core of their crisis in the first place.
This change will put a lot of pressure on a person who is given the choice to decide if home is a safe option for them, so how will it work? Are we to have a policeman bedding down in the living room while the patient is upstairs self-harming? Would the police mount guard outside so that all the neighbours can see, thinking that the person inside is a criminal? What we really need is health-based places of safety, and a person’s home is no substitute for that. Without adequate services, people’s homes could become the new police cells—the new default for people in crisis. That is a very bad idea.
The noble Baroness, Lady Meacher, who has unavoidably been called away so is not in her place, asked me to say that she is also very supportive of this group of amendments. I beg to move.