Peers’ amendments to bill likely to force government to compromise

The government looks set to be forced into serious concessions over its controversial Mental Health Bill after a series of damaging defeats in the House of Lords.

Peers made three fundamental amendments to the bill this week, including a requirement that compulsory mental health treatment have a therapeutic benefit.

The House of Lords backed an amendment to ensure that a person could only be detained if the treatment would be “likely to alleviate or prevent a deterioration in his condition” by 186 votes to 115.

The bill originally proposed abolishing the need for compulsory treatment to have a therapeutic benefit, principally so that people with a dangerous anti-social personality disorder, sometimes considered untreatable, could be detained.

But peers argued that without a therapeutic benefit test clinicians would be asked to act unethically by providing inappropriate treatment and acting as “turnkeys”.

Community Care understands that parliamentary procedure would prevent the government from forcing a reversal of the changes using its Commons majority (see The cost of not compromising).

Peers also voted overwhelmingly to back an amendment preventing people from being sectioned solely on the basis of their substance misuse, sexual orientation or cultural beliefs.

And a third amendment, requiring that renewal of a detention be agreed by a medical practitioner and a responsible clinician, was agreed by 147 votes to 108. Crossbench peer and former social worker Baroness Meacher suggested the bill as it stood could allow “the rather ludicrous possibility” that an occupational therapist or nurse could renew a detention against the advice of a psychiatrist.

Mental Health Alliance chair Andy Bell said he hoped the therapeutic benefit amendment would be accepted by the government because it would allow people to be detained even if they were not considered “curable”, as long as the treatment brought them some benefit.

The cost of not compromising

Should the government reverse the Lords’ amendments, peers would have the chance to re-introduce them, prompting a “ping-pong” between the two houses. Community Care understands that unless the two houses reach a compromise the bill will fall, which neither the government nor opponents want.

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