Some of the UK’s “sickest children” will be put at “unnecessary risk” as a result of the Government’s proposals to overhaul mental health legislation, Parliament has heard.
Baroness Berridge called for greater safeguards to be put in place to protect children experiencing mental illness, as peers scrutinised the Mental Health Bill on Monday.
The Bill proposes that a nominated person be instated by an approved mental health professional (AMHP) when a child “lacks capacity or competence”.
The Conservative peer argued the Bill in its current form could conflict with Family Court orders, as she tabled an amendment that would ensure the nominated person is the child’s special guardian or the parent they currently live with.
Speaking in the House of Lords, Lady Berridge said: “This amendment 34 will ensure that the AMHP, an approved mental health practitioner, appointing the nominated person for a child who lacks competence must appoint as the nominated person, either the special guardian, when the family court has ordered one, or the parent with whom the child lives, under a child’s arrangement order.”
A special guardianship is a Family Court order that places a child or young person in long-term care with someone other than their parents.
Lady Berridge said AMHP’s “don’t want to be foisted” with choosing a nominated person, because “they are not equipped, unlike Family Courts”.
“At 10pm on a Saturday night, how can they assess the daily life of that child? That it’s no longer what was outlined in the special guardianship order,” she added.
Lady Berridge continued: “AMHPs are simply not equipped to delve into complex family issues, already determined by the Family Court. Nor when they are trying to do a mental health assessment of a sick child do they want to be distracted by this.”
“This is not their expertise, and I do hope I am not attaching this Hansard to a letter to a coroner, a CQC (Care Quality Commission) inquiry, or any other inquiry if God forbid a child is harmed or killed in a secure unit by a parent.
“Governing is about deciding and without amendment 34, His Majesty’s Government has in my view decided to take an unnecessary risk with the safety of some of our sickest children.”
Health minister Baroness Merron said the Government had tabled amendments 29-33 “to make it clear who an approved mental health professional must appoint in certain circumstances”.
She added: “For all under 18s lacking capacity or competence, where there is a care order, they must appoint a local authority who has parental protection for them, or if relevant, a competent Court of Protection deputy.
“And where there is no care order, the approved mental health professional can appoint a person who doesn’t have parental responsibility for 16 to 17-year-olds.”
Lady Merron continued: “We don’t agree that a person with residual parental responsibility should always be blocked from being a nominated person.
“A child arrangement order or a special guardianship may be in place for reasons other than the parent being a risk to the child, for example, the parent might struggle with their own health issues, but could still be an effective nominated person.”
Peers voted 218 to 143, majority 75, in support of Lady Berridge’s amendment.
Elsewhere in the Bill’s first day of report stage, the Government was defeated over proposals to expand who can conduct detentions and “remove the need for the presence of police at mental health incidents in the absence of any risk”.
Presenting his amendments, Conservative frontbencher Lord Kamall said: “Almost 95% of calls that police attend, that are flagged as a mental health response, do not require a police presence.”
He called for the powers to be extended “so that healthcare professionals could use them providing they were not putting themselves at risk”.
Peers voted 233 to 157, majority 76, in support of Lord Kamall’s amendments.
Lady Merron had told peers the Government does not support “extending police powers in this way, and understand the police do not support an extension either”.
The Government suffered a further defeat after Liberal Democrat Lord Scriven called for “an absolute firm process” when mental health patients detained in hospital are discharged to receive supervised care in the community.
He said this would “ensure that the individuals who are on a CTO (community treatment order) have certainty about the length of time” they will be supervised for.
Peers voted 272 to 157, majority 115, to introduce a 12-month maximum duration for CTOs, which could only be extended if a second registered psychiatrist gives their written agreement.
“Despite all the words, whenever independent research is done, whether it’s by the CQC, whether it’s by the joint committee, or whether it’s by mental health organisations, the same answer keeps coming back – there is something fundamentally flawed not maybe with the policy but with the implementation of CTOs,” Lord Scriven told the upper chamber.
Lady Merron said in her response to Lord Scriven’s proposal that “it is already the case that CTOs can only be renewed under specific conditions” and added that anybody arranging supervised care must already heed a code of practice under existing mental health law.
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