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Mental Health Bill [HL]

This is an extremely difficult issue. The Government’s position—if I do not misrepresent them—is that we gain very much more by having a single and unqualified definition of mental disorder than we would gain by building in various categories of exemption. We will be debating the issue of exclusions in some detail when we reach Amendment No. 4, and I do not want to pre-empt those discussions. The Government’s reason for taking this position is to ensure that clinicians do not get hung up on what diagnostic label may be hanging around someone’s neck, but rather pay attention to what their needs are and what behaviour or symptoms they are exhibiting. In the case of autistic spectrum disorders, I expect that this is the argument we will hear. It is not an argument that can be brushed aside lightly, but I disagree with it. Autistic spectrum disorders are disorders characterised by impaired communication and social interaction. They are not psychotic disorders; nor are they mental illnesses. What the National Autistic Society fears, as the noble Baroness said, is that far from the single definition in the Bill making life simpler and ensuring that only people who have a disorder or disability of the mind are detained, it will cause confusion and result in more people with autistic spectrum disorders being detained than is justified. The behaviour of someone with an autistic spectrum disorder may well resemble that of someone with a mental disorder. We need to be sure that one is not mistaken for the other. If a person is neither mentally ill nor behaving in an abnormally aggressive or irresponsible way, quite simply, they should not be detained compulsorily under the Mental Health Act. It is perfectly true that people with ASDs have a higher than average incidence of mental health problems. We do not want to say that by virtue of having an autistic spectrum disorder they should be excluded from the scope of the Bill altogether. That really would be a mistake. If we imagine an autistic person posing a risk to themselves or to others by reason of mental illness, instead of having the various protections afforded by both the Act and the Bill, they would be left to the mercies of the criminal justice system. There is a way out of this, suggested by the noble Baroness. Unless we add to Clause 2 the words in the amendment, we will have a situation where someone with a learning disability and an autistic spectrum disorder, but without mental illness, could still be detained, even if they were not displaying seriously irresponsible or aggressive behaviour. That surely cannot be what we want. I very much hope that the Minister will be sympathetic to the arguments put forward by the noble Baroness.