The second day of committee in the House of Lords on the Mental Health Bill took place on Monday 20 January. This stage allows peers to scrutinise the detail of a Bill, but traditionally no votes are taken. See summary below (plus a link to the full debate in Hansard).
Grouping 1 - definitions
Concerns were raised by peers about the definition of “serious harm”, the content of the risk factors regulations for the purposes of the dynamic risk register and the availability of community-based resources.
For the Government, Baroness Merron confirmed that serious harm will be explained in the Code, the risk factors will include previous hospital admissions and presentations at A&E and pointed to NHSE pilots of 24/7 mental health services.
Grouping 2 - learning disability and autism: implementation
There were calls for clear plans over the timing and funding for the implementation of the Bill. Peers raised specific concerns about the LD/A mandatory training not being rolled out at tier 3 level.
The minister stated that the detention of people with LD/A in hospital was “unacceptable” but confirmed that definitive implementation plans are not possible due to uncertainly of future funding arrangements. She agreed to write to the House about Tier 3 training.
Group 3 - detention criteria
Peers were concerned that predicting harm was inexact for detention criteria and that appropriate treatment should include consideration of the setting of the treatment provided.
The minister argued that the current detention criteria were too vague and the new criteria were not based on predictions but individual circumstances. She confirmed that setting should be part of therapeutic benefit.
Group 4 - Roles & responsibilities at the point of detention
Baroness May called for extending the range of professionals who can detain patients and the reduction of police attendance at mental health incidents.
The minister challenged claims that health and social care professionals supported being given additional powers, and argued this would be a major shift in professional roles. She confirmed that the Code would be used to clarify hand-over procedures at A&E.
Group 5 - Community Treatment Orders
A range of views were expressed on CTOs including calls for their abolition. There were also calls for reporting on racial disparities regarding the use of CTOs.
The minister confirmed said government will be monitoring the effectiveness of CTOs and noted the new requirement of therapeutic benefit to justify their use and increased access to tribunals.
Group 6 – Advocacy
There were calls for CTO patients to be informed of their right to an IMHA. There was some concern about the availability of resources to expand advocacy and the evidence base to support this.
The minister confirmed that patients will be informed of their right to an IMHA and that the annual costs of advocacy will be £6/7m per year.
Committee starts again on Wednesday 22 January.