MP supports Mental Health (Use of Force) Bill in speech to Parliament

I was delighted to support the Mental Health Units (Use of Force) Bill, also known as Seni's Law in a speech to Parliament, please find my contribution on the issues surrounding this Bill and why it is an important step forward below;

It is a pleasure to follow my hon. Friend the Member for Hertsmere (Oliver Dowden), and I congratulate the hon. Member for Croydon North (Mr Reed) on all his work in bringing this Bill to the Floor of the House which, as my hon. Friend the Member for Banbury (Victoria Prentis) highlighted, is an extraordinary feat. I have only been in the House for two years, but it is evident that to beat the systems of the parliamentary process and bring together so many voices to ensure that an important gap in our legislation can be addressed is really impressive, so I am delighted to speak in support of his Bill.

How we view, diagnose and treat mental health has changed dramatically over the past few years. I am delighted that our Conservative Government have taken a lead on this matter now, but we still have a long way to go. Excellent work by health professionals, the royal colleges, many excellent charities, many parliamentarians and citizens from right across society is starting to ensure that mental health is, at last, right up at the top of the Government’s and society’s priorities. Bearing in mind just how much the picture has changed in recent years, it seems somehow incomprehensible that the Mental Health Act has remained unchanged since it was enacted in 1983, which was when I started secondary school—and I am definitely not one of the younger Members in the House.

To think how policy has changed, even over the past decade, reminds us of just how an Act passed three decades ago can no longer be anywhere near fit for purpose. In some ways, it is a good thing that we have moved so far in understanding what mental health means—and, in fact, what mental ill health means. I often find it a strange use of language to talk about mental health when we mean that somebody is unwell, because it is a moment in an otherwise healthy person’s life when they are unwell. As my hon. Friend the Member for Hertsmere said, it is an invisible part of our health and ill health through, for most of us, our now fortunately very long lives.

It is great news that the Mental Health Act review is ongoing, and I look forward to continuing to work with the Government and Ministers to ensure that we get effective reform across the board. This Bill will allow us to address the use of force in mental health units, about which I have had a substantial amount of correspondence from concerned constituents and, interestingly, more widely from family and friends who often say, “I don’t want to bother you, Anne-Marie, because you are very busy in Parliament,” because this is something that really bothers people, and they have dropped me a line to highlight the fact that they want me to speak out.

I thank the hon. Lady for her intervention, with which I absolutely agree. I am pleased that the number of people being held in police cells has fallen dramatically in the past few years, but, as we have seen this week, if people feel that they are suffering injustice, they should always take it to the police or, if that is where the problem or inappropriateness lies, find another outlet to be heard and to get redress. Every citizen of our country should always feel able to stand up and say, “This was wrong, and I am seeking redress for what was done to me.” I encourage the hon. Lady to support her constituent in seeking redress.

Many constituents have written to me with deep concerns about the effect that the undue use of force might have had on their child—and, in three harrowing cases, the effect that it has indeed had. One constituent detailed how the use of unreasonable restraint had a lasting effect on the health not only of the particular family member but on the whole family, which created years of trauma and ongoing illness. The use of excessive force can lead to long-term damage, and, as in the tragic case highlighted by the hon. Member for Croydon North, a death is an absolute travesty. We can never allow such abuses to take place in our civilised society.

It is good that cases of such terrible treatment are rare and that the numbers are coming down, but if we ever treat with force and brutality people who desperately need our help and support when in a state of mental ill health and distress, it is time for those voices to be heard and for action to be taken. These abuses cannot go unanswered or be tolerated any longer. The movement towards understanding mental ill health is progressing, and the Bill will help to change practice.

With that in mind, I will address two specific issues that are extremely close to my heart: autism and young people. There has previously been a lack of cross-Government co-operation on mental health issues. If we are to make a real impact on this issue and to change cultural norms, we need to ensure that the Department of Health, the Home Office, the Ministry of Justice and NHS England have closer working practices to deliver the necessary detention reforms. I hope the Minister will confirm that to the House later today.

The Bill could make a real difference in tackling the inappropriate force that is too often used against patients, many of whom are on the autism spectrum. A recent freedom of information request discovered that there were 66,681 recorded instances of restraint in England ​in 2015-16, an increase on the previous year. The use of physical, mechanical or face-down restraint can undermine an individual’s recovery and increase their risk of injury and long-term harm. As a society, we should be charged with protecting and helping those people to get well again.

I would hope that many in this House have read the National Autistic Society’s recent report “Transforming Care: our stories”. The report follows 13 families with a family member who is on the autistic spectrum or who has a learning disability and who is at risk of being admitted to an in-patient mental health hospital, of which there are still 2,500 across the country. One story spoke of a boy who was, according to a serious case review, “completely failed”:

“A very vulnerable young man suffered a sequence of traumatic experiences which may adversely affect him for…years.”

I am the mother of an autistic young adult—he has just turned 18—and I have other family members who are now diagnosed, and I am constantly concerned that the invisibility of autism in so many sufferers means that their mental health, or mental ill health when it hits them, has completely failed to be understood or, indeed, identified in crisis situations.

I used to have to ask teachers at my son’s school who did not understand how his Asperger’s affected him, “If he had a broken leg, would you ask him to run up the stairs or to join in a football match?” They would look a little bemused, and I would say, “He is in a state of deep stress and trauma at this point. You are expecting him to sit quietly in a classroom and pay attention, as when he is in a state of wellness. This is not possible.”

Teachers committed a huge amount of time to helping him to be in the mainstream system, and it took two or three years to understand that the invisibility not only of autism but often also of mental ill health until a crisis hits means that society cannot see it. Unless we are particularly attuned to the individual sufferer, or indeed to a wider understanding and identification of what that means, we cannot help them. It is important that people charged with looking after those who may be in need have rigorous frameworks and training. Just as we would not ask a boy with a broken leg to play in a football match, we must not have similar expectations of those in mental health crisis.

What can we say when we hear such harrowing stories, which are much more tragic than we should ever have to hear, and have to imagine the tragedy that those families have had to go through? How do we react? The instinct can no longer be to allow things to continue. We need things to improve, but we cannot just make tweaks here and there. The House cannot ignore issues that need urgent attention and reform. I am glad the Government recognise that and are supporting the Bill.

These isolated cases are sadly too common, and NHS Digital figures show that autistic young people still have an increased risk of being unnecessarily and frequently restrained because they cannot express their anxieties and crises in the way that neurotypical people more often can. We cannot continue with outdated practices and restraints that severely endanger the most vulnerable, who need considerate, appropriate and constructive treatment programmes that meet the autistic individual’s needs.

The Bill includes provisions to turn that into reality and to reform practices in mental healthcare, and it highlights a number of concepts that our constituents ​expect of us, of the Government and of our public services right through the system. I will cover a couple of those concepts.

First, on transparency, every time restraining force is used in a mental health unit it will be recorded and fully detailed. This would allow people to know that if this happened when they were in a state of mental ill health, it would be recorded; often people are not able to think clearly in these situations. Where someone has a broken leg or a broken arm, their mental capacities are still functioning fine and they will remember if the cast was put on the wrong arm—they would notice that. However, people in a state of deep mental ill health are not always able to see the world clearly at that point, so to have that fully detailed record will make a big difference to empowering those sufferers to know that they are being properly looked after.

In all our major institutions, such as the police or the NHS, we need accountability in everything that is done for our constituents. That is no mean feat in practice. This Bill will mean that every institution will have to have a named individual responsible for policy on the use of force and implementation. Given the discussions this week in the House, it is perhaps prescient to have a named person to whom those in distress can go, safe in the knowledge that they will be supported, understood and given a fair hearing. That is so important.

I thank the hon. Gentleman for his intervention, and I agree absolutely that we need to get the training right in the first place; understand unconscious bias, which we all invariably suffer from, not only in general life, but within the complex environment of mental ill health; and ensure that de-escalation techniques are learned and constantly reiterated. Such an approach would allow the extraordinary people who work in this sector to be supported, constantly reminded of things and given the right tools to ensure that they can look after our family members and our constituents when they are in these crises.

I thank my hon. Friend for that intervention. She is right: so often the circumstances of patients in the units has meant that people have been able to develop more sophisticated techniques and de-escalation programmes, and this best practice needs to be shared. That is the great challenge, as it so often is in education and in other parts of our public services. We need to find an effective way to share these best practices, so that we can help people who are doing ​their best in units across our constituencies but who are not necessarily using the most effective tools to help patients recover and restore their stability.

These two key policy areas, transparency and accountability, will protect patients, and promote dignity and respect. Everyone who passes through our mental health system should receive dignity in their care and respect for them as an individual in our society. I had a lovely chat with a gentleman on the street last night, not far from here. He was asking for money because he needed £35 for his bed and breakfast last night—this was going to be his night of luxury—and he had with him a sign saying, “This can happen to anyone.” That always makes me stop to chat. His life story was just unfortunate, with a series of unfortunate events, and there he was on the streets. Mental ill health can strike everyone, so to suggest that not everyone is entitled to that dignity would be wrong.

My hon. Friend is exactly right. It is incumbent on us as we go forward with this Bill to set these new markers to ensure that we get a cultural change; we need that understanding that mental ill health is part of our life experience and most of us may well suffer from it in one form or another. For those who are the most vulnerable we absolutely need to ensure that the practices are the best they can be, so that dignity and respect is afforded to every person who needs that support.

Transparency and accountability will also allow health professionals and emergency staff to manage the risks, protecting not only the patient, but our public servants. This can protect them from false allegations and allow us to have that evidence should things go wrong. Body-worn cameras are so important in this regard. The prison in my constituency, HMP Northumberland, was one of the prisons where body-worn cameras were trialled. This has been running for nearly two years now and there has been a dramatic drop not only in the reported cases of argy-bargy between prison officers and inmates, but in poor behaviour, because inmates who might have decided to have a go cannot be bothered anymore because they know it is going to be filmed; the relationship has improved so much as a result. This has created the same thing as we see where a teacher has good discipline in the classroom, understanding that if we provide a framework everyone within it works in a more conciliatory and more constructive fashion.

My hon. Friend is absolutely right. Interestingly, even in the social media world we all live in, a storm of anonymity allows a level of poor behaviour. If the body-worn camera empowers people to remember that anything from good manners and good behaviour to constructive dialogue rather than more violent interventions is the way forward, this must be a tool we should be encouraging across the board. One hopes that behaviour can improve once people remember how these things can be done more constructively and with less violent interventions.

My hon. Friend is exactly right. These common-sense measures could have a dramatic impact on the way our mental health units work, and for the well-being of both staff and those who are there receiving treatment.

Another important aspect of the Bill is the proposal that justice for a potential victim would now become possible. Our country and our values are based on the rule of law, but for justice to be done we need a new and open approach which would allow our public services to learn from past mistakes and ensure that no family or individual has to suffer the tragedy of loss or injustice that has too often been experienced by patients and their families. I have a constituency case in which a young girl had been put in restraint, not within a mental health unit, but within a special school environment, and, as a result of the fits from which she suffered, she hit her head and lost her sight. That is truly tragic, and the family has fought and fought to find a way to get redress and a better educational framework for this child to learn, having developed this entirely avoidable blindness. There is a great challenge in ensuring that we have a system that is open and transparent, and that families can be heard and do not have to fight for years.

I would be happy to work with my hon. Friend on that. Perhaps it is something we need to look at more widely. The extraordinary staff at special schools look after children with a breadth of needs that ​are never the same for two days running or for any two children. We must ensure that they are empowered with the right skills and techniques to support these children, who can lead fulfilling and full lives if we can get them through the education system. As I used to say to my son—I shall namecheck him again; he hates it when I do this, but tough, it is too late—it is really difficult for a child who sits outside the norms to be in the mainstream education system, but if they can make it to adulthood, they are free to be whoever it is that God created them to be and can really flourish. The challenge for our public services, whether for those who suffer from ill health or for children in special needs schools, is not only to ensure that we have a framework that supports them and wraps them with the skills and techniques needed to help them to develop and get well, but to ensure that they are treated with the dignity that everyone would expect for a family member who was in hospital for any other physical ailment.

The proposals in the Bill are really important to me personally and profoundly important to so many of our constituents who have experienced restraint and whose families have lacked a voice on the protection of children or relatives in these situations. Indeed, many have been unable to get any form of justice or restitution for damage to their family members. Legislation can change our practices and, in turn, our attitude towards how we care for those who need it the most. I am delighted that the Bill has been introduced and give it my wholehearted support.