Contribution
In moving Amendment 135, I am grateful for the support of the noble Baronesses, Lady Tyler of Enfield, Lady Bennett of Manor Castle and Lady Neuberger, and I will be a little disappointed if I do not get some support from the noble Lord, Lord Kamall.
This amendment would require that the established and successful procedure, the mental health crisis breathing space, is offered automatically to those detained under longer-term Sections of the Mental Health Act. This is the final one of a set of three amendments to the Mental Health Bill in my name that have addressed the financial implications for people who struggle with their mental health. In these debates I have previously referenced that I am on the advisory board of the Money and Mental Health Policy Institute. This amendment is based on the institute’s work.
I thank my noble friend the Minister for her engagement on my Amendments 59 and 121, which sought to ensure that routine enquiries on financial matters are embedded in care and treatment plans and advance choice documents. I am grateful for the Minister’s acknowledgement and understanding on these issues.
Amendment 135 calls for mental health crisis breathing space to be automatically offered to those detained under Sections 3, 37, 41 or 47 of the Mental Health Act. Of the three amendments in this set on financial issues, this one perhaps has the greatest scope for reducing the financial harms that people experience when they are facing a mental health crisis. The mental health crisis breathing space mechanism is a vital tool that can protect people in a mental health crisis from the impacts of problem debt by pausing enforcement action and contact from creditors, and freezing interest and charges on any debts. These protections are provided for as long as the treatment lasts—plus another 30 days.
When people access this scheme, it can be life-changing. It can be the difference between people leaving hospital after a mental health crisis to find that bills and debts have escalated, thus putting their recovery in jeopardy, and having the space that they need to get back on their feet. I share the words of one of the Money and Mental Health Policy Institute’s research community members who has personal experience of accessing the scheme:
“Breathing space … has totally changed my experience from feeling hounded and persecuted to supported and valued”,
taking away
“much fear and sleepless nights coupled with dire days of depression”.
However, in its current provision, use of the scheme is significantly below its potential and the numbers that were forecast by the Government. When introducing the scheme in May 2021, the Treasury anticipated that 27,000 people would use it in its first year. Yet the most recent figures from last November show that only 4,404 people have accessed it in total. This underutilisation is due not to a lack of demand or need but to how the scheme is designed and delivered.
Existing NHS guidance on acute in-patient mental health care already states that wards should offer mental health crisis breathing space to those who need it. This is well-intentioned but does little to drive take-up of the scheme. In practice, thousands of people who would benefit from the support of this tool are missing out simply because nobody asks. On top of this, awareness of the mechanism is extremely low among mental health care professionals, meaning that, even when financial difficulties are spotted, it does not always result in people accessing the protections that the mechanism affords.
My proposed addition to the legislation would ensure a statutory obligation to offer this mechanism to those who need it most, requiring services to be more thorough in its implementation, with greater levels of accountability. Specifically, automatically offering the breathing space to people detained for potentially longer-term conditions would ensure that those whose incomes are likely to be adversely impacted by extended admissions can be supported. This intervention would target the core group that the mechanism was intended for.
To outline the possible reach of such a targeted intervention, in 2023-24 there were almost 11,000 detentions under the relevant Sections of the Act, representing a fifth of all detentions. Formalising the automatic offer of mental health crisis breathing space to this targeted group would go a long way towards ensuring that the mechanism supports the number of people that the Treasury forecasted it to serve. Crucially, after the breathing space period has ended, people would have the opportunity to be offered formal debt advice, with specialist support for those who need it, to ensure that financial difficulties are resolved on a longer-term basis. Legislating for the scheme to be automatically offered to those detained under the longer-term provisions of the Act would be genuinely transformative in preventing more people from experiencing the acute financial harms that too often accompany a mental health crisis. I beg to move.