Disabled campaigners are calling on the government to halt its reform of the Mental Health Act until there is a public inquiry into the “appalling failings, abuse and high levels of deaths” in mental health services across England.
They say that no effective reform can be carried out until the “dreadful state of affairs is both investigated and addressed decisively”.
Last week, a report on the draft mental health bill by a joint committee of MPs and peers was described as “seriously flawed and discriminatory” after it failed to call on the government to deliver immediate “root and branch reform”.
The rights-based organisation Liberation is now leading other disabled-led organisations in a demand for a halt to work on the bill until the failings, abuse and deaths are investigated by an independent inquiry.
They point to a series of scandals relating to care in mental health units.
They include an ongoing independent inquiry into 2,000 deaths linked to mental health wards run by Essex Partnership University Trust over a 21-year period.
Among many other scandals, there have been allegations relating to mental health services for teenagers run by the former Huntercombe Group; claims uncovered by a BBC Panorama documentary about abuse at the Edenfield Centre near Manchester; and the deaths of three teenage girls let down by “systemic failings and dangerous and coercive culture and practice” at services run by Tees, Esk and Wear Valleys NHS Foundation Trust.
Disabled-led organisations supporting Liberation’s call for a halt to work on the draft bill include Disabled People Against Cuts (DPAC), Disability Rights UK, Community Navigator Services and Speak Out Against Psychiatry (SOAP).
Dorothy Gould, founder of Liberation, told Disability News Service this week that evidence from these scandals “fits all too closely with other emerging evidence, experiences of my own and experiences described by peers of mine elsewhere”.
She said: “Unless this dreadful state of affairs is both investigated and addressed decisively, there can be no effective reform of mental health law.”
She said that the recommendations made by the joint parliamentary committee in last week’s report “barely touch on abuse in these services” and that such abuse, neglect and resulting suicides are “all too likely to happen” until people in mental distress, people with learning difficulties and neurodivergent people secure their full human rights.
She said: “By continuing to allow at least some involuntary detention in psychiatric hospitals, forced treatment and community treatment orders, the draft mental health bill does just that.”
This week, the government announced a “rapid review” of patient safety in mental health inpatient settings in England, which it said was “an essential first step in improving safety”.
Gould said the review was “something of a step forward” but would need to be heavily influenced by people with experience of being detained under the Mental Health Act.
Last week, the joint committee called for an “ongoing process” of reform in the long-term that leads in the direction of more rights-based mental health legislation, but it argued against such major reforms in the short-term because key reforms were too urgent to wait.
Gould said: “The flaw with their approach is that, if you adopt half-baked solutions, improvements to abusive services will be half-baked as well.
“At the very least, what we need is a halt to reform plans until the rapid review is complete and its findings have been taken into account.
“This needs to be followed by legal reform which will genuinely give people in mental distress, neurodivergent people and people with learning difficulties the full human rights that are an essential foundation for preventing abuse, the human rights set out so clearly in the UN Convention on the Rights of Persons with Disabilities (UNCRPD).”
Ellen Clifford, a member of DPAC’s national steering group, said: “The government must undertake a public inquiry into the appalling conditions and treatment of people with mental distress within secure facilities at the earliest opportunity.
“Pushing on with the mental health bill will not solve the deep-rooted rot within the mental health system.
“Abuse, mistreatment and gross neglect are all symptomatic of a system that is structured around unequal power dynamics, discriminatory attitudes, coercion and force.
“The bill must be halted for an inquiry to happen and for this to then lead to fundamental reform of the system and a radical shift in how mental distress is understood and treated.
“To stress, DPAC is not saying that improvements in the mental health system should be stopped meanwhile.
“Services should be reviewing how they work and ensuring patient safety and well-being, regardless of where the new bill is up to.”
Cheryl Prax, from SOAP, also supported the call for a halt to work on the mental health bill.
She said: “There needs to be a radical overhaul of the Mental Health Act.
“Small changes cannot be considered urgent if they do not alter the inhumane treatment that so many people suffer from in the mental health system as it has been for many years under the hands of psychiatry.
“Stories of inhumane treatment of patients in the press recently show the urgency of a radical reform.
“The draft mental health bill can and must also be delayed until findings from the rapid review are available.
“The current approach to mental health reform brings to mind the old saying, ‘to put lipstick on a pig’. It is not going to make the pig any prettier, or more useful.
“The fundamental human right of freedom to choose is still not addressed by the changes.
“You can choose whether or not to have physical treatment and criminals cannot be locked up for something they might do but as soon as a psychiatrist decides, in his opinion, that you are incapable of knowing what is best for you, you can be locked up, forcibly given brain- and body-damaging drugs and ECT [electroconvulsive therapy] against your will, and against the will of your relatives, time and time again.
“Some people caught up in this non-compassionate merry-go-round see no way out and kill themselves because of it.
“Absolutely fundamental change is needed.”
Clenton Farquharson, from Community Navigator Services (CNS), a user-led community interest company that works in areas such as advocacy, co-production and inclusion, also supported Liberation’s call.
Farquharson, who is chair of Think Local Act Personal – although not speaking in that capacity – said CNS “supports Liberation very strongly”.
He said the draft bill “falls well short of the fundamental human rights” set out in UNCRPD.
He said that any mental health bill “must start from the assumption that people given a mental health diagnosis, people with learning difficulties and people with autism should have the same human rights as anyone else, including the right to live in the community, with whatever support is needed, free from detention on the basis of disability and institutionalisation”.
Inclusion London said work on the new mental health bill should be halted until it was made compliant with UNCRPD.
It welcomed the announcement of a rapid review, which it said should investigate the failings of patient safety in hospitals, and whether hospitals were safe places, as well as examining alternative community provision, which was “more likely to promote safety and wellbeing”.
An Inclusion London spokesperson said: “The investigation must be led by disabled people with lived experience of hospital detention.
“We hope it will expose how existing system is not fit for purpose and show again how urgently we need a radical reform.”
But it said the rapid review “should not be used as an excuse to do nothing.
“Actions such as redrafting of the bill to make it compliant with UNCRPD, as well as taking steps to fund and put support in the community, could and should be taken now.”
The joint committee on the draft mental health bill was set up to produce the report and so no longer exists, and its chair, the Tory peer Baroness Buscombe, declined to comment this week.
A spokesperson for the Department of Health and Social Care said: “We have announced an eight-week rapid review into patient safety in mental health inpatient settings in England, which is an essential first step in improving safety in mental health inpatient settings.
“It will focus on what data and evidence is currently available to healthcare services, including information provided by patients and families, and how we can use this data and evidence more effectively to identify patient safety risks and failures in care.
“We are reviewing the joint committee’s recommendations for the draft mental health bill and will respond in due course, before bringing forward a revised bill when parliamentary time allows.”
DHSC said it had not ruled out a public inquiry, despite the rapid review.
It said the Essex inquiry would produce recommendations to improve mental health care not only within Essex, but also across the NHS and the wider system.
NHS England has commissioned investigations into the allegations relating to the Tees, Esk and Wear Valleys NHS Foundation Trust and those at the Edenfield Centre.
And it says two hospitals run by Active Care (formerly the Huntercombe Group) are subject to close and ongoing monitoring by the Care Quality Commission and NHS England, while local trusts are working with the two hospitals to improve their services.
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