Mental Health Bill [HL]

We have heard some compelling speeches in this debate. The noble Baroness, Lady Wilkins, and the noble Lord, Lord Williamson, are to be applauded for all that they said in support of their respective amendments. In a policy context it is always problematic to talk in terms of a completely demand-led service available as a right to whoever asks for it. That appears to be the effect of the noble Baroness’s amendment, and I suspect the Minister is likely to balk at it. In his shoes, I probably would as well. Even if I cannot support her amendment quite as worded, however, I am definitely with the noble Baroness in spirit. I am also definitely with the noble Lord, whose amendment seems to me to have the edge over that of the noble Baroness. There are several things that both the noble Lord and the noble Baroness said that bear underlining. The first is that all too often the only reason that someone ends up being subject to powers of compulsion under the Mental Health Act is the lack of available outreach or early intervention services appropriate to their needs at an earlier stage. I was staggered to see the figure from Rethink that 50 per cent of people subject to compulsory treatment have previously asked for help and been turned away. That chimed in with the story that the noble Baroness, Lady Murphy, told us, and it is a terrible indictment of the way mental health services are configured. If anyone supposes that it can be better or more cost effective to treat someone as an in-patient under conditions of coercion than to provide treatment to the person informally when they are much less severely ill, I will be amazed. Time after time, though, that is what the service ends up doing to people. The Sainsbury Centre for Mental Health has put the total cost of mental illness to the economy at over £77 billion a year. A figure like that is a salutary reminder that an approach to mental health that adopted a much broader and more imaginative model for assessing cost effectiveness could well prove highly beneficial. Like the noble Baroness, I think straight away of the proposals put forward by the noble Lord, Lord Layard, who, as she said, has argued persuasively that a substantial investment in talking therapies for those with depression would repay itself in savings of incapacity benefit. I hope that the Government will give that idea the support it deserves and take it forward. That is only one example of the savings that could undoubtedly be made across the piece, if only we were able to deal earlier and better with mental illness and get people who are ill back into employment. Therefore, I hope that the Minister will listen carefully to his noble friend and to the noble Lord who, as I am sure he agrees, know a thing or two about disability matters. They are absolutely right to move our attention away from issues to do with detention and compulsion and on to issues to do with better and more timely service delivery, which are the things that really matter to the vast majority of service users.