Charles Walker calls for better provision of health-based responses for people suffering a mental health crisis
Charles Walker welcomes the Home Secretary’s commitment to provide £15 million for health-based places of safety so that people suffering a mental health crisis are not detained by the police, but calls for the Bill to go further and impose a duty on the Department for Health to set out the range of crisis responses in each area of the country. He also urged the Government to address the shortage of acute mental health beds.
Mr Charles Walker (Broxbourne) (Con): I am aware that some Bills are driven by the civil service and some are driven by No. 10, but this Bill is driven by the Home Secretary, and I congratulate her on that. I have worked closely with her over the past few years in many of the areas covered by the Bill, and I know that she has held meetings at the Home Office with a variety of interested parties who, in the past, may not have had access to the Home Office. I also know that she has hosted conferences, including, in 2013, a conference with Black Mental Health UK at the QEII Centre to discuss policing in respect of, in particular, African-Caribbean people with mental health problems. Once again—and I am not ashamed to say it—I congratulate the Home Secretary on bringing the Bill to the House.
I also congratulate my hon. Friend the Member for Halesowen and Rowley Regis (James Morris). He is the unsung hero of the debate on mental health, both in the context of the Bill and when the Secretary of State for Health is addressing the House. He is chairman of the all-party parliamentary group on mental health, a job he has done for more than two years, and he has been dogged and determined in pursuit of many of the reforms that are contained in the Bill. He is a great man, and we are all lucky to have him here today.
We need to be clear that we cannot simply will places of safety into being. I know that the Home Secretary understands that. We cannot just shut our eyes and think really hard and hope that it is all going to be all right. There is a need for the political drive and determination to provide them, so that people can be looked after and treated with respect during their time of crisis.
The Home Secretary is absolutely right to say that a police cell is no place for an ill person. Being ill is not a criminal offence. Being ill and black is not a criminal offence, but we know that people of African Caribbean descent who are suffering a mental health crisis are more likely to be subjected to force, to be detained or to be subjected to a community treatment order. That is not right. We need to address these unfairnesses in the system, because they are ensuring that a large number of people who need our help are frightened to engage with those who are able to offer it, because their experience up to this point has been so unsatisfactory. That is one of my pleas today.
We cannot make demands on the police to change the way they do things in providing places of safety unless we actually provide places of safety. My experience of the police is that, in most cases, they want to do the right and proper thing by the people they are protecting and looking after. Most police officers are left distraught at the idea of having to take an ill person or a young person to a police cell as opposed to putting them into the care of healthcare professionals in a hospital or a place of safety that has a bed to offer them.
This is not in the Home Secretary’s gift, but the truth is that there are not enough beds in this country for mentally ill people who are suffering a real crisis. There is nothing more boring than Members of Parliament standing up in this place and saying, “Well, I’ve been warning about this for years”, but I am going to be boring because I and others have been warning about this for the past 10 years. My right hon. Friend the Member for New Forest East (Dr Lewis) and I were warning about it before being joined by my hon. Friend the Member for Halesowen and Rowley Regis in this place six years ago. We need more beds, and I hope that the Home Secretary will be uncompromising in her discussions with colleagues in the Department of Health to ensure that they are in a position to support our police officers in doing the right thing and the best thing.
Bob Stewart (Beckenham) (Con): My hon. Friend is making a great speech. Would he advocate the introduction of interim places of safety in some police stations, so that people can be put somewhere that is not a cell while they are on their way to hospital?
Mr Walker: My hon. Friend is genuinely trying to be constructive and to find a way forward, but I just do not think that police stations are the right place to take ill people. It might be unavoidable in some circumstances, but we need to minimise those circumstances. All too often a police cell is used as a place of safety, but that is not right. However, I entirely accept the spirit in which he made his intervention.
Mr Kevan Jones: Does the hon. Gentleman agree that someone having a heart attack is in crisis and in a life-threatening situation, and that, likewise, someone who is in severe mental torture is experiencing a crisis and in a potentially life-threatening situation as well? Why does he think the two should be treated differently?
Mr Walker: My hon. Friend—for that is what I call him—knows that I do not think that the two should be treated differently, which is why he and I have joined forces on so many occasions in the past and will do so in the future to make sure that the reality changes. There is slow progress, but it is progress none the less. My hon. Friend the Member for Halesowen and Rowley Regis is helping us to make progress, but I do not disagree with my hon. Friend the Member for North Durham (Mr Jones).
As well as a lack of acute beds, the choice of health-based places of safety for an assessment in many places is incredibly limited. I will now draw on the excellent and concise briefing provided by the Royal College of Psychiatrists. According to the Care Quality Commission map, there are no health-based places of safety for under-16-year-olds in many local authority areas, including Devon, Norfolk, Lincolnshire, Bristol or Bath. That is not good and it is not sustainable.
It is not all doom and gloom. There is clear evidence that, where local areas have emphasised long-term preventive measures and put in place crisis outreach and triage teams, they have already improved their services, so they would easily be able to provide the care set out in the Bill. We have heard from the Home Secretary —it is worth repeating—that the crisis care concordat has been a great driver. She also knows that most Department of Health-funded schemes have managed to reduce significantly the number of people being detained under section 136 of the Mental Health Act 1983. For example, in areas where street triage is operating—this is not in the whole force area, but specific parts of a force’s area—pilots have delivered massive reductions in the use of section 136. I recall my hon. Friend the Member for Halesowen and Rowley Regis having an Adjournment debate on that very subject a year ago.
Andy Burnham: I have huge respect for the hon. Gentleman and for his campaigning on these issues over many years. I am listening to his speech carefully. Does he agree with the point that I made that £15 million is not enough, as there is a huge shortage of crisis beds across the country? Does he think that there may be risks in enacting these proposals before major investment is put into mental health crisis services?
Mr Walker: I do agree that we need more beds. It cannot be right that children and adults at a point of crisis are sometimes driven hundreds of miles from their homes to receive treatment. The right hon. Gentleman may recall that one of his predecessors, the right hon. Member for Kingston upon Hull West and Hessle (Alan Johnson), had an Adjournment debate a few months ago on how we treat children who are in mental health crisis, and he pointed out that one of his constituents was being treated 200 miles from his family home. That is not acceptable. The right hon. Member for Leigh did say that, outside the cut and thrust of this place, he had a good working relationship with the Home Secretary. It would be fantastic if, on this matter, the two Front-Bench teams could work closely together, along with the Secretary of State for Health, to make sure we get this right.
Let me look briefly at the successes of triage, of which my hon. Friend the Member for Halesowen and Rowley Regis will be aware. There has been a 20% reduction in Derbyshire; 13% in Devon and Cornwall; 39% in Thames Valley; 31% in Sussex; 27% in the west midlands; and 26% in West Yorkshire. The reductions in the number of people being put under police custody under section 136 in these areas were greater still. For example, there was a 50% reduction in Derbyshire; 85% in Thames Valley; 11% in Devon and Cornwall; and 44% in West Yorkshire. Those are real numbers that have real meaning and that are making a real difference to many people’s lives.
The Royal College of Psychiatrists and other interested parties are calling for the Bill to be amended so that the Secretary of State for Health is obliged to report back to Parliament on the range of crisis responses in each area. That could include street triage teams, availability of acute psychiatric care beds, and health-based places of safety. That sort of information would help the Home Secretary and her team to deliver on their worthwhile pledge, and that pledge needs the support of the Department of Health.
I have spoken for longer than I wanted to, but, in conclusion, I point out that a mental health event is not a criminal event. It is a health crisis. We need to look after people with care and compassion and commitment. It is no good just talking about things. It is no good looking good, as some woman once said to me—it is important that we spend more time being good. We need to be good, not to look good.
Other interventions in the same debate
Mr Charles Walker (Broxbourne) (Con): I thank my right hon. Friend for all the work she has done with Black Mental Health UK in previous years. Will she meet Black Mental Health UK, Rethink Mental Illness, Mind and other interested parties to discuss their continuing concerns about sections 135 and 136 of the Mental Health Act? They all accept that the Home Secretary has made some fantastic strides in the Bill.
Mrs May: My hon. Friend, who has a fine record of campaigning on these issues, is right to raise that point. The organisations he mentions meet Ministers regularly through the crisis care concordat, but I am happy to look at their concerns. I hope that the Bill will go some way to dealing with some of the continuing concerns, notwithstanding the work we have done over the past few years in improving the police response to people who are at a point of mental health crisis.
Mr Charles Walker: The hon. Gentleman is talking about short-term crisis houses, which tend to be run by the third sector. They are community based and people can go to them for between three and five days at that moment of crisis to be sorted out before they go back home or back into the community to stay with friends or relatives.
Mr Jones: Yes. It is time to consider that proposal irrespective of whether such houses are provided by the voluntary sector or the statutory sector. A network of that type of provision across the country would get away from the use of police cells. As the hon. Gentleman knows, they could be commissioned at a local level, and third sector development could provide very good value for money. I welcome the proposed changes, but they need to be amended in Committee.