---

Mental Health Bill [Lords]

That is not a ringing endorsement of CTOs, nor does it endorse the Government position. I do not want us to return to the situation that arose in Committee, when the Minister read out a brief that she had received but which no one else had, and it turned out to be a rather interesting misinterpretation of the position of certain groups. The fact is that she has been unable to produce any ringing endorsement of CTOs from any members of the MHA or any respected professional body, and neither has she been able to cite any reviews conducted anywhere else in the world that have found that they are efficacious. Professor Thorneycroft of the Institute of Psychiatry was one of the co-authors of the Churchill report. He said:"““There are real risks not just of the unamended Bill having neutral effects but causing actual harm. The key such areas of harm, would be increased treatment avoidance by people with mental health problems, perpetuation, at least, of current disparities with respect to people from black and ethnic minorities who, as you know, are much more likely to be detained, and huge transaction costs from the implementation of CTOs. Without the evidence that CTOs work, not only would the money be ill-spent, but the opportunity to invest the relevant funds wisely in effective services would be lost.””" We are all greatly concerned about the impact on black and minority ethnic communities. The hon. Member for Hackney, South and Shoreditch has greater experience of that than many of us because of the particular problems in her constituency among the BME community. A recent letter from the director of policy and public sector of the Commission for Racial Equality does not pull its punches. He says that the concerns it has"““primarily relate to the widening of the definition of ‘mental illness’, the impact of supervised Community Treatment Orders and the role of Approved Mental Health Professionals. It is our view that in each instance there is the potential for negative impact””" for mental health users from different ethnic minority communities. Interestingly, he also mentions in that letter the Minister’s selective use of available research. We have certainly seen instances of that. My hon. Friend the Member for Tiverton and Honiton mentioned existing section 25A powers and section 17 supervised discharge powers. Section 17 leave of absence powers allow a compulsory patient to leave hospital and live back in the community, while still being subject to the powers of the Act. A section 17 patient can be recalled any time a clinician wishes, without the need for formal re-sectioning and the imposition of compulsory treatment. The provision is widely used. As the King’s Fund said, this raises the question of whether a better understanding of section 17 powers might negate the need for supervised community treatment. So the point is that many existing powers are not being used. We should be investigating why they are not being used first, before bringing in a whole raft of new powers that are potentially very off-putting to people coming to the mental health service.