Clause 32
Mental Health Bill [Lords]
4:45 pm
Tim Loughton (Shadow Minister (Children), Health; East Worthing and Shoreham, Conservative)
I shall not detain the Committee long. Rather unusually, I seem to be leading on a group including Government amendments, so the length of the debate will depend on how long it takes the Minister to introduce her amendments afterwards.
The amendment goes back to the lobster pot concept that I mentioned earlier, which was raised by Professor Genevra Richardson. It is about time limits being placed on CTOs, and whether somebody can get out of the system having been much more easily scooped into it—the lobster pot. We are questioning the time scale in the Bill. It was a recommendation of the pre-legislative scrutiny Committee that there should be a maximum for CTOs of three years in any five-year period.
The amendment endeavours to insert a maximum time of three years. If someone’s condition had not improved to the extent that he or she can be discharged in the proposed time of three years, surely that would suggest that the CTO has failed to work and therefore needs to be reviewed.
Being a revolving door patient is not a permanent condition. It usually lasts for a short period, while a person comes to terms with a diagnosis, finds out which treatment or combination of treatments is best for them, re-establishes a life in the community—possibly after a lengthy period in a psychiatric hospital, which can involve going from living alone to having to live with strangers with similar conditions—establishes a therapeutic relationship with a community psychiatric team or is referred to and engages with the various resources available, such as day centres, employment support, therapeutic support and housing support. Consequently, CTOs should be seen as a shorter-term option to help patients through a period of crisis when they have become a revolving door patient, not orders that should be renewed indefinitely, which would make them rather more like something from a piece of criminal justice legislation.
There is also a self-fulfilling justification for CTOs, which can validate themselves no matter what the outcome. If an individual’s mental health improves, that could be seen as a reason for their remaining under the order, so as to maintain that improvement. If they deteriorate, that could also be seen as justifying the need to continue. There is a real fear that people will be sucked into the lobster pot and into coercion, but it is not at all clear how they can get out. It is reasonable that a time limit should be imposed. I shall be interested to know why the Government do not agree and why they did not put one in the Bill in the first place.