MP Calls For Neurodiverse People To Be Protected With Mental Health Reforms
Robert Buckland launched a review earlier this year looking into boosting employment prospects for autistic people (Alamy)
Conservative MP Robert Buckland has urged the government to honour its 2019 manifesto commitment and include the “generational” Mental Health Bill in the King’s Speech next week, in order to end the “injustice” of people with learning disabilities and neurodiverse diagnoses such as autism from being detained in mental health hospitals.
Buckland, who is the Conservative MP for South Swindon and former Secretary of State for Justice and Wales, has been a long-time advocate for improving health and care services for people with autism and learning disabilities.
The Mental Health Act was introduced in 1983 and the draft Mental Health Bill was introduced last year to reform the original legislation, but has since stalled. Buckland, along with numerous campaigners from the National Autistic Society and learning disability charity Mencap, organised an open letter with more than 18,000 signatures to No. 10 last week, calling on the Prime Minister to urgently reform the outdated mental health law.
King Charles III will deliver the King’s Speech on Tuesday, which marks the start of the parliamentary year by setting out the laws the government wants to pass in the coming session.
“There's been so much work on a draft mental health bill in this Parliament that it would be a crying shame if we didn't use the last session to pass what I think is largely non-contentious, non-party political legislation,” Buckland told PoliticsHome.
“This is a manifesto commitment that has been made not just in 2019, but in 2017 as well, and – call me old fashioned – I actually believe that manifestos have a weight to them. If we don't do this, we're missing another opportunity to fulfil the 2019 manifesto, which in large part is still, I think, a valid document and one that we should be following.”
The Mental Health Bill would enshrine in law updated definitions of autism, learning disabilities and psychiatric disorders, and ensure that autistic people and people with learning disabilities cannot be detained in a mental health hospital under the Mental Health Act solely on the basis of their disability. It would also put a strong duty on the government to provide community services to these groups.
“For too long, autism and other lifelong neurodiverse conditions have been wrongly equated with mental health,” Buckland said.
“They are not the same… and to align the two, I think can lead to injustice and it can lead to the incarceration of autistic people in entirely inappropriate surroundings.”
New data from the NHS has shown that in September 2023, 2,045 people – including 205 children – with autism and learning disabilities were being held in mental health hospitals in England.
Under the NHS Long Term Plan, the government committed to reducing the number of inpatients with learning disabilities in mental health hospitals by March 2024, but Mencap has estimated that this is unlikely to be achieved until 2029 at the earliest.
“There's still about 2,000 autistic people, in effect being caged in circumstances that frankly, you wouldn't treat an animal in that way, and it's a scandal,” Buckland continued.
“Unless we get this bill through, I'm worried that we're just not going to make the progress we need to in order to end that sort of abuse.
“Using prisons and police stations as places of safety seems to me to be a cruel irony and when you're in a mental health crisis is going to make it worse, for example. And that's why this legislation will be landmark, it will be generational.”
The NHS and social care services are currently overwhelmed, with basic medical needs not being met in some hospitals – so is it a question of legislating to ensure autistic people receive appropriate care for their needs or is the health and care system just lacking the resources to be able to provide it?
“Hmm… it is a bit of both,” Buckland replied.
“Very often autistic people are left or parked in the NHS system because local authorities do not have the resources to take them on and have an adequate plan for the care system.
“There is no doubt the different pots of money, the different silos definitely cause problems. However, there are always capacity issues in terms of the number of people with specialist training who can support the community to take that on board.
“But unless you have statutory underpinning, then no amount of good practice and guidance will cut it: you'll get a few isolated examples of good practice, but just not enough of an across the board change. No amount of good intentions seems to change the way in which we deal with autistic people or indeed a more humane approach to people with a mental health crisis.”
Asked by PoliticsHome why he thinks such changes to mental health legislation have taken so long to implement, Buckland replied: “I think a sheer lack of time, and I think a sheer lack of, frankly, advocates there to really place priority on it.
“I just haven't seen that sense of urgency really: that’s not a personal criticism of the ministers but unless you've got that political will sometimes these things just don't happen.”
He added that he wanted to use this bill as a “catalyst to reignite the debate” about how to provide healthcare services centred around those using them.
“Sometimes I do feel like I'm banging my head against a brick wall, but we can all see the answers ahead of us… I think it's just a question of will and sort of determination in order to get there.”
For Buckland, the fight is personal: his adult daughter has autism and like thousands of others, his family has had to navigate uncertainties around the level of support she will need throughout her life.
“Like many parents, you go through a period where you hope for the best and then you realise actually, no, we need help and we need a diagnosis,” Buckland said.
“That's not an easy decision. Seeking a diagnosis with an open mind is very important; when you get to diagnosis you have a mixed feeling of relief that there is a proper diagnosis and then a deep sense of sadness.”
The MP for South Swindon said that his family had been “fortunate” and been able to access specialist support for his daughter, but that it was the “next stage” that was a source of worry.
“It's the next stage in their lives that really keeps a lot of parents awake at night,” he said.
“What happens to the young adults as they go into full adulthood? Are they condemned to always having to live at home with mum or dad? Are they condemned to an institution somewhere where they're in effect forgotten?
“Or are they going to have access to the same services and quality of life that everybody else enjoys? That will only happen with increased support and community provision, which at the moment is a massive challenge, we just don't have that sort of provision.”
Buckland said that while people often look at the social care crisis “through the prism of the elderly”, there were many disabled young adults who were being overlooked: “What about the lifelong needs of an adult who's going to need a degree of care through their lives, how do you fund that? That question really keeps turning up in my mind as to how we develop the policy response.”
On Autism Awareness Day in April this year, Secretary of State for Work and Pensions Mel Stride appointed Buckland to lead a review which will look at how the government can work with employers to boost employment prospects for autistic people.
Buckland told PoliticsHome that the aim will be to publish the review in the new year.
“There's a lot of goodwill out there. This project has been largely run by autistic people themselves, which is what I was determined to ensure,” he said.
“I've had the support of businesses, dedicated civil servants in the DWP, as well as a leading autism research charity in the UK. So it's been a very good sort of public-private partnership, a collaboration, and I'm hopeful that this will be the beginning of a cultural change that we so desperately need.”
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