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Mental Health Bill [HL]

moved Amendment No. 27: 27: After Clause 20 , insert the following new Clause— ““Children and young people After section 142 of the 1983 Act insert— ““142A Admission to age appropriate setting In the case of an application for admission for assessment and treatment for a mental disorder, whether voluntary or not, in the case of any child or young person under the age of 18 years, a clinician with specialist training in child or adolescent mental health shall assess the needs of the child or young person and a PCT or equivalent health board shall provide for such services and accommodation as are sufficient for the particular needs of that child or young person. 142B Medical assessment by a CAMHS specialist prior to imposition of compulsion for a child or young person In the case of a minor under the age of 18, who is admitted for assessment under section 2 or admitted for treatment under section 3, one recommendation as specified in these sections shall, except in an emergency where no child or adolescent mental health specialist is available, be made by a qualified child and adolescent registered medical practitioner. 142C Clinical supervisor Wherever under any provision of this Act a responsible clinician is to be appointed if the patient is a minor under 18 that clinician shall, except in an emergency where no child and adolescent mental health specialist is available, be a child and adolescent mental health specialist.”””” The noble Earl said: I should like to continue with the theme of children and young people by proposing a number of further changes to the 1983 Act. The first one relates to the need to admit children and young people to a setting that is appropriate for their age. This is recommended in the National Service Framework for Children, Young People and Maternity Services. It was endorsed by the joint scrutiny committee on the 2004 Bill and acknowledged by the Department of Health in its response to the Bristol inquiry. The amendment would mean that an assessment of therapeutic benefit and safety of a young person would have to be carried out, and a decision made as to whether a place on a CAMHS ward or on an adult ward would be most beneficial. The amendment does not seek to demonise adult wards or staff working on adult wards. I understand that there are occasions when it is more appropriate in developmental terms for a young person to be on an adult ward. However, there is extreme concern among service users, carers and professionals that young people inappropriately placed on adult wards have been subject to harassment, abuse and have suffered significant traumatic stress—all of which has affected their ability to engage with services in future. Young people sometimes hide their symptoms because they are frightened that they will be sent back to an adult ward. The trauma is especially great when the child is under 16, which is why I propose that such children must always be admitted to a CAMHS ward. Admission to a CAMHS unit offers many benefits: the wards tend to be smaller, the practitioners have expertise in working with young people and their families, and the young people have access to education facilities. The next part of the amendment aims to ensure that unless there is an emergency, at least one CAMHS specialist is involved if there is any question of a young person under 18 being detained under the Mental Health Act. This proposal accords with a recommendation by the joint scrutiny committee on the 2004 draft Bill. The reason for it does not, perhaps, need explaining at any length. Children and young people are not the same as adults. The way that they process difficulty and distress is different and therefore they need specialist clinical support and knowledge if their needs are to be met and understood. That means having separate and distinct arrangements whenever assessments have to be carried out. The final part of the amendment is intended to ensure that the clinical supervisor of a child or young person admitted under compulsion is a CAMHS specialist. This proposal picks up a theme in the National Service Framework for Children, Young People and Maternity Services—standard 9—which states: "““The different range and prevalence of serious disorders in childhood compared with adolescence means that services for these two broad age groups have to cater for a different range of needs, which need to be reflected in the specific skills of the staff working with them””." Therefore, I feel very strongly that it would be appropriate for compulsory admissions to be subject to the same rigorous specific skills requirement. A great deal can be done for young people whose illness is diagnosed quickly. Teams working with young people, such as early intervention psychosis teams, with CAMHS staff attached to them, work to try to keep young people integrated into their homes and communities. The whole emphasis is on rehabilitation and recovery, encouraging patients to stay in education or to get a job, rather than the all-too-frequent pattern in adults, where there is a diagnosis of incapacity leading typically to stagnation and inactivity. Government policy is quite clear that CAMHS specialists work with young people aged 16 to 17, but that is simply not happening in parts of the country. Young people fall through the net with neither CAMHS nor adult mental health services owning them; in other areas there is an equally bad situation where adult services are deemed to be appropriate for 16 and 17 year-olds, when they are simply not appropriate. I hope that the Government will use the opportunity provided by the Bill to put in place some clear statutory requirement to protect children and young people who find themselves subject to the mental health system. I beg to move.