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Mental Health Commissioner Could Offer "Sustained Leadership" For Patients

Many campaigners have voiced concerns that mental health is not being prioritised by government (Alamy)

6 min read

The government should create a Mental Health Commissioner for England role in order to offer “sustained leadership” and to put mental health “at the heart” of policymaking, according to a new report.

A report by research organisation Centre for Mental Health, seen by PoliticsHome ahead of its publication on Wednesday, has compared Mental Health Commissioner roles already in place in other countries and concluded that the position could be created in the UK and enshrined in law. 

Andy Bell, Chief Executive of Centre for Mental Health, said that the report had found that a Mental Health Commissioner might be most useful as a form of strategic leadership for mental health, similarly to the function of the Mental Health Commissioner in New South Wales, Australia. 

“What really interests us is in places like New South Wales, in Australia, where it has very much a strategic role advising and sometimes chiding the government and providing that kind of strategic leadership for mental health,” he told PoliticsHome. 

“That I think we felt the lack of and we believe could make a real difference in England and would add something quite unique and distinctive.”

There are already a number of commissioners for other policy areas in England, for example, the Children’s Commissioner, for whom the purpose is to act as an independent, politically neutral body promoting the rights of children. Many organisations called for the Children’s Commissioner office to be created for years before it became a reality. 

Labour has been exploring the idea of creating such a role for mental health if they get into government, PoliticsHome understands, but have not yet publicly committed to it.

The idea of a Mental Health Commissioner was first floated by the cross-party Joint Committee on the Draft Mental Health Bill. Many members of this committee have since been disappointed by the failure of the government to include the bill in the recent King’s Speech, which would have been the last chance for the legislation to pass during this Parliament during the next general election.

In January, the government also announced it was shelving its 10-year Mental Health and Wellbeing Plan, instead combining mental health with a Major Conditions Strategy to tackle the causes of a number of health conditions.

This has led many campaigners to believe there is a lack of political will behind prioritising mental health, despite the rising prevalence of mental health issues across the UK, and a 2022 survey that found that 18 per cent of children aged 7-16 had a probable mental disorder, up from 12.1 per cent in 2017.

“Mental health hasn't had the political clout it deserves to have and in a sense it's waxed and waned,” Bell said.

“One thing we've noticed is that across governments of all political persuasions, when you have ministers or senior figures in the Cabinet who are really actively promoting mental health as an issue, it's taken seriously, but when you don't have that it very quickly falls down the pecking order. 

“What the Children's Commissioner does is keep the voice and the interest of children there at all times.”

The Centre for Mental Health report stressed the importance of the political independence of a Mental Health Commissioner, with their own resources and ability to determine their own priorities.

“Having that legislative backup is really important, it would need primary legislation to create a Commissioner role,” Bell explained.

“We've certainly seen from examples in other countries the use of soft power: the Commissioner can't tell government what to do, but by providing a combination of sensible advice with the ability to provide information in the public domain and to share their concerns publicly, you've got that balance between being inside and supportive where they can be, but also being prepared to speak out.”

Conservative MP Charles Walker, chair of the Joint Committee on the Draft Mental Health Bill, told PoliticsHome he agreed that having a Mental Health Commissioner for England would be a “really, really good thing” and would help to make mental health care more “patient-focused”.

“I would like to see the Commissioner be the champion of those who suffer the most during a period of ill health, who face being hospitalised sometimes against their will, because people should be able to retain their dignity and have their wishes, as far as possible, respected,” he said.

His concerns echo those of Tory MP Robert Buckland, who previously told PoliticsHome that mental health legislation needed to be reformed to end the “injustice” of people with learning disabilities and neurodiverse diagnoses such as autism from being detained in mental health hospitals.

Walker added that it was important to have a Commissioner who stays in post while ministers “come and go”, in order to instil some continuity in an area that has so much impact on thousands of people. 

“Let's be honest, mental health ministers come and go, and that's the nature of government… but the position of commissioner would be a statutory position,” he said.

“The Commissioner could be appointed for a five year period for example and then you would get continuity, and the appointment of the first Commissioner would be critically important because in a sense, that Commissioner would shape the role.”

Tory MP James Morris, a member of the Health and Social Care Committee, agreed that a Commissioner could be a positive advocate for mental health patients, with a particularly important function in working across departments. 

Morris said it was "extremely disappointing" and a "backward step" that the government had failed to fulfil its 2019 manifesto commitment to introduce the Mental Health Act, and said that if a Mental Health Commissioner was introduced, it could help to clear up legal issues around sectioning and the rights of patients with learning disabilities and severe mental health issues. 

The report will be published on the Centre for Mental Health website on Wednesday 5 December.

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