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Mental Health Patients (Children)

Volume 459: debated on Tuesday 24 April 2007

We have made a commitment to eliminate within two years the use of adult psychiatric wards for children younger than 16. My officials are writing to strategic health authorities informing them that if a child younger than 16 is placed on an adult psychiatric ward, it should be reported directly to the Department so that we can take appropriate action.

Given that the Government’s own commissioner, Professor Sir Al Aynsley-Green, has said that children who go into adult wards for treatment come out in a worse state than when they went in, will she guarantee that the current provisions in the Mental Health Bill that require age-appropriate treatment settings will remain unamended?

No, I will not. One of the problems with the House of Lords amendments to the Mental Health Bill is that, in certain circumstances, they restrict the ability of clinicians to treat 16 or 17-year-olds, for example, who might be better placed on an adult ward. That imposes quite a straitjacket in terms of the clinician’s ability to place people. There is also the issue of emergency treatment and the Lords amendments create further problems in that respect. However, as I said, we are certainly committed to ensuring within two years that children younger than 16 are not treated on adult wards.

As my right hon. Friend is aware, during recent consideration of the Lords amendments to the Mental Health Bill, a number of interesting suggestions and proposals were made. Will she give me a guarantee that she will consider them very carefully?

My hon. Friend is right to say that this is an extremely important issue. I know that he is concerned about it, and he has raised the matter with me separately. As I have said, the problem with the House of Lords amendments is that they would create a clinical and legal straitjacket, but that is not to say that important issues have not been raised, and I am sure that we shall discuss them in Committee.

My constituent, Miss Fiona Gale of Sherston, having been treated in an adult mental health care ward and abused in various ways while she was there, was then discharged against her wishes. Tragically, she committed suicide in front of a train in my constituency shortly afterwards. The coroner agreed that she should have been treated in a separate children’s ward and that there should have been a halfway house between the completion of her treatment and her discharge into the community. I welcome what the Minister has said about under-16s; will she also consider what I have said about the provision of a halfway house?

It is absolutely tragic to hear about such cases. The hon. Gentleman mentioned that the child had been discharged against her will, and that obviously should not happen if a child is still in need of psychiatric help. The hon. Gentleman will be aware of changes made to the Mental Health Bill in the House of Lords that we are seeking to overturn, but one of the provisions that we are seeking to introduce is supervised community treatment. That would enable someone to be discharged but to remain under the care of health care professionals.

What evidence is there that primary care trusts and mental health trusts are discharging their duty of care to the under-18s who need mental health treatment? What proportion of under-18s have access to early intervention provision, which has proved highly successful in treating psychosis among people of that young age group?

I cannot give my hon. Friend the exact number of children using the early intervention teams, but the spending on child and adolescent mental health services—CAMHS—increased from £284 million in 2002 to £530 million in 2005. With that increased investment, we have managed to employ more staff. There were about 7,700 in 2003; that figure went up to 9,800 in 2005. The case load has also risen by about 40 per cent. between 2002 and 2005, however. The extra investment is making a difference, but we certainly accept that there is some way to go, particularly in the development of CAMHS services, and the Under-Secretary of State for Health, my hon. Friend the Member for Bury, South (Mr. Lewis), is continuing to work on further improving those services and, in some instances, integrating them more effectively with the other services.

Yesterday in Committee Room 16, in front of MPs and Members of the Lords, two teenage girls, Lois and Antonia, gave harrowing accounts of their experiences in acute mental wards. Those were adult, often mixed-sex, wards, which contained people who had committed homicides, in which the girls were subjected to sexual abuse and invasion of privacy, and received little or no age-appropriate treatment from inappropriately qualified staff and no help with their education. On behalf of the hundreds of children placed in those wards—the number is growing—they begged for the age-appropriate amendments to the Mental Health Bill to be retained. They do not think that the Lords amendments would prove to be a straitjacket, because they would provide for age-appropriate treatment and allow for emergency admission. Why are they wrong?

They are wrong because—[Interruption.] I am not saying that those girls are not well intentioned, or that we do not want to ensure that the situation improves. At the moment, the number of such bed days—that is, the number of days when a bed in an adult ward is occupied by under-16s and 16 to 17-year-olds—is dropping. We need to ensure that we have more accurate information about that.

The Lords amendments include the proposal that a child should be seen by a specialist practitioner—in this instance, a CAMHS specialist. If they were on an adult ward, that would be difficult to achieve. In that sense, the problem is a real one because the CAMHS specialist would not be assigned to an adult ward. Were it more appropriate for the care of an individual aged 17 to 18 to place them on an adult ward, they would not have access to the specialist. As I have said, however, there are certain problems with the Lords amendments—