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Mental Health Bill [HL]

I have added my name to the amendments, because I am as concerned as the noble Baroness, Lady Gibson, that the Bill provides no clear link between treating the adult and assessing the needs of any children in the household. Although the framework for the assessment of children in need and their families may be used to determine whether a child is in need under the Children Act 1989, there is no requirement in this Act that such joined up action take place. The children’s charities which the noble Baroness listed are very concerned that, without an explicit requirement in the Bill placing a duty on both health and social services to look into this matter, vulnerable children could—and they do—slip through the net. The amendment would provide an additional safeguard to ensure that joined up working between health and social services professionals takes place and that the needs of any children who may be affected by an adult being detained under this Act are automatically thought about within that process. The Minister may feel that the amendment is unnecessary and that the matter is dealt with by the standards that the noble Earl, Lord Howe, mentioned and other legislation on children’s services, but I shall relate to him a few case histories from real life to illustrate that the current legislation and guidance are not working in every case. I hope he will feel that they back up our feeling that this needs to be made explicit in the Bill. I turn to the first example. Last year, a single mother in a travelling community was seriously depressed. The mental health services and social services were involved with the family. Very sadly, the mother committed suicide at home in front of the children. The two young children were left in that home for two days with their mother’s body before relatives kicked down the door. Nobody knew that there were young children in a household where the mother was so seriously depressed as to be at risk of suicide. In the second example, a mother was sectioned. The father was left at home with the children. When the mother was sent home from hospital, but still under supervision, the father simply could not take any more and left the family. The mother tried to manage, but in the end could not. The professionals were unaware that the children were vulnerable and at risk, so no referral was made. The children could not cope in school and eventually dropped out. One of them is now in youth custody, which indicates what can happen to a child’s life when they do not receive the assessment which the amendment seeks. YoungMinds has told me about a single mother with significant mental health problems whose illness means that she is periodically unwell. She has no support in looking after her seven year-old son who has autism. So the family has double problems. Social services are involved, but they have told the mother not to ring the out-of-hours emergency social work number when she feels that she is becoming unwell. As a result, when she feels that she is becoming unwell, she goes to the accident and emergency department in her local hospital, because she knows that it will make sure that someone goes out to look after her son. Staff in A&E have now told her not to come to them, because they are not the correct place to deal with her, but she continues to go there simply because she knows that somebody will do something about her son. The final example involves a mother who was sectioned. She had two sons, aged 11 and 14. No one made contact with the children or asked her about them. The 14 year-old son had significant mental issues and was extremely violent. The 11 year-old brother was at serious risk of being attacked by him. Both boys were alone for a whole week until an outreach worker discovered them. Social services had been involved with this family, and the boys were on the at-risk register, but social services seemed to be unaware that the mother had been sectioned. The health professionals had not been talking to the social services professionals. These examples make it clear that the joined up approach is not always working as we would like. However, there is nothing like putting a duty on someone to do something to make them do it. We need a clear statement about this in the Bill; it is entirely appropriate to put it in. Besides, it is surely of benefit to the patient and his or her treatment and recovery to know that the children are being well looked after. The second part of the amendment provides for children to be given age-appropriate information about the process of assessment and detention of their parent and about their parent’s illness. Of course, since quite rightly children cannot be considered to be the nearest relative, they do not gain the right to be informed of an application made in respect of a patient. So there is a gap in the Bill for the provision of information to any children who may be affected. The amendment states that that should be provided, in the light of the child’s age and understanding, which is crucial. Nowadays social services must take into account children’s wishes and feelings when decisions are being made about their care, but how can a child adequately express his wishes and feelings if he does not know the truth about his situation in the light of his parent’s mental illness? Proper information, given in an age-appropriate way, will also help a child to deal internally and emotionally with the turmoil that the illness of a near relative causes to him or her. There are many very strong arguments for accepting this amendment, and I hope that the Minister will do so.