Contribution
My Lords, I rise to speak in support of Amendment 2, to which I have added my name, but first I declare my interests as listed in the register, especially as honorary vice-president of the Royal College of Speech and Language Therapists and as an honorary fellow of the same organisation. I am able to speak briefly as a result of the excellent explanation of these amendments by my noble friend Lady Whitaker, which I am pleased to support.
As we have heard, the lead amendment would place a requirement in the statement of principles to specify in the table the communication needs of the individual and recognise the disability, difficulty or difference to ensure they will be identified and supported. This requirement then flows throughout the Bill—as evidenced by the number of amendments to which I have also added my name—ensuring a thread of consistency for this vital area of support. These include, as we have heard, Amendments 49, 60, 112, 118 and 126, but I will not speak specifically to each of those and test the patience of the Committee.
The importance of Amendment 2 is clearly laid out in the excellent briefing, as we have heard, prepared by the Royal College of Speech and Language Therapists and endorsed by at least 46 related organisations representing this crucial area of work and service.
As we know, communication is fundamental and foundational to human life. It is central to how we express ourselves, how we understand others and how we interact. It is also fundamental and foundational to the aims of this Bill. It underpins the principles to inform decisions and is key to the matters to be addressed. Crucially, it ensures the individual is properly involved in the decisions taken as a consequence of this legislation. As we know, many people accessing mental health services have some form of communication disability, difficulty or difference. This can affect whether they are able to make themselves understood, understand what is being said to them, and how they interact with people. Left unidentified and unsupported, it can subject people to a range of negative outcomes, including inaccessible referrals, assessments, treatment and care and, potentially, unnecessary detentions and detentions longer than necessary.
I first recognised this issue when I undertook my independent report for the then Government, published way back in 2009, about people with mental health problems or learning disabilities in the criminal justice system. At that time, I identified appropriate adults as a key group to support people with communication issues and recommended that they should receive specific training to ensure the most effective support. They still play an invaluable part in such communication. I also recommended the establishment of liaison and diversion services, and I am pleased that in the subsequent years they have been rolled out across the country and we now have 100% coverage for that service.
These liaison diversion teams, placed in police stations and the courts, identify, assess and support people with complex needs, including mental health problems, to try to divert them away from the criminal justice system and support them along the criminal justice pathway. I recognised during this rollout that certain key additional services should be connected to the teams, including speech and language therapists, to enhance the support required for these people with communication difficulties in a variety of settings and circumstances. As the speech and language therapists who I have met over the years themselves identified, these many situations and settings include significant unmet communication needs among individuals on mental health wards, challenging behaviour relating to communication needs, lack of staff knowledge and skills in relation to communication needs in people with mental health conditions, and many more.
Although it is welcome that the Bill’s Explanatory Notes highlight that a care and treatment plan
“may also contain other information, for example, how the patient’s communication needs will be met”,
clearly this is not sufficient. The Bill must therefore be strengthened to make it explicit both that communication is central to the Bill’s aims and that
“communication disability, difficulty, or difference”
must be identified and supported. This would help to ensure that people receive the best possible treatment and care to support their recovery, including through the necessary reasonable adjustments that should be made. It would also help to reduce the risk to them, including of their being unnecessarily detained, and to assure the wider public. These issues must also be fully covered in the code of practice. I hope therefore that the Government will recognise the importance of such communication being in the Bill and look forward to the Minister’s response on these points.