The Government has faced a series of defeats in the House of Lords as peers debated key amendments to the Mental Health Bill, aimed at modernising legislation and improving care for patients. The discussions, which took place on Monday, saw significant changes to the draft law, including an expansion of police powers to other healthcare professionals and new safeguards for those receiving mental health treatment.
One of the most notable defeats came as Conservative shadow health minister Lord Kamall proposed an amendment allowing nurses and doctors to carry out detentions under the Mental Health Act without requiring a police presence. Peers backed the proposal by 233 votes to 157, a majority of 76, despite opposition from the Government and police authorities.
Health minister Baroness Merron made it clear that the Government “does not support extending police powers in this way”, adding that police forces themselves were against such a move. However, Lord Kamall argued that almost 95% of calls attended by police flagged as a mental health response did not actually require police intervention, and that extending these powers to healthcare professionals would improve response times and reduce unnecessary pressure on law enforcement.
Calls for debriefing mental health patients after discharge
Peers also voted in favour of an amendment tabled by Conservative peer Earl Howe, which proposed that mental health patients should receive a debriefing session upon leaving hospital. This measure, backed by 209 votes to 143, a majority of 66, aims to provide patients with an opportunity to reflect on their experience and offer constructive feedback on the care they received.
Speaking in the Lords, Earl Howe explained:
“If every patient discharged from a mental healthcare setting were given the opportunity to rate, comment on, and provide constructive feedback on their treatment, the value to the system and the potential benefit to the patient could be very significant.”
He emphasised that debriefing should not be seen as merely a process for complaints, but rather as an opportunity for open and reflective discussion between patients and healthcare providers.
Despite the strong support from peers, Baroness Merron opposed the amendment, stating that ministers preferred “to work to improve existing mechanisms” for capturing patient feedback rather than introducing new requirements.
12-month limit on community treatment orders backed by peers
Another major defeat for the Government came as peers voted to introduce a 12-month maximum duration for Community Treatment Orders (CTOs), a measure designed to give greater certainty to mental health patients about the length of time they will be supervised in the community.
The amendment, tabled by Liberal Democrat Lord Scriven, passed with a significant majority of 272 votes to 157. Under the new proposal, CTOs could only be extended beyond 12 months if a second registered psychiatrist provides written agreement.
Lord Scriven argued that while CTOs were intended to support mental health patients outside of hospital, research by the Care Quality Commission (CQC) and other independent bodies had consistently highlighted flaws in their implementation.
“Despite all the words, whenever independent research is done—whether by the CQC, the joint committee, or mental health organisations—the same answer keeps coming back: there is something fundamentally flawed, not necessarily with the policy, but with the implementation of CTOs.”
The Government pushed back against the amendment, with Baroness Merron arguing that current laws already require specific conditions to be met before a CTO is renewed. However, the Lords ultimately supported Lord Scriven’s calls for tighter regulations.
Changes to mental health protections for children
Another key change came as Conservative peer Baroness Berridge proposed an amendment to improve how approved mental health professionals (AMHPs) nominate guardians for children lacking competence or capacity.
Under existing law, AMHPs may need to appoint a responsible adult for a child undergoing mental health treatment, but there are concerns that they are not equipped to make such decisions, particularly in complex family situations.
Baroness Berridge’s amendment ensures that AMHPs must prioritise appointing either a special guardian (where ordered by a family court) or the parent with whom the child resides under a child arrangement order.
“At 10pm on a Saturday night, how can an AMHP assess the daily life of a child? They are not equipped, unlike Family Courts, to delve into complex family issues already determined by legal orders,” she told the Lords.
The amendment received strong support from peers, passing by 218 votes to 143, a majority of 75.
In response, Baroness Merron acknowledged the need for clearer guidelines and confirmed that the Government had tabled its own amendments (29-33) to clarify who AMHPs must appoint in certain circumstances. These include:
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- For under-18s lacking capacity or competence, the local authority responsible for the child must be appointed where a care order exists.
- Where no care order is in place, an AMHP may appoint an alternative responsible person for 16-17-year-olds.
The road ahead for the mental health Bill
The Government’s defeats in the Lords signal a strong appetite for significant reform in how mental health services operate, particularly regarding police involvement, patient feedback, and supervised care in the community.
Despite opposition from ministers, the amendments passed by peers reflect growing concerns that current mental health laws fail to adequately protect vulnerable patients and place unnecessary burdens on police and healthcare professionals.
The Bill will now return to the Commons, where MPs will have the opportunity to accept, amend, or reject the changes made by the Lords. However, with cross-party support for many of these amendments, ministers may struggle to overturn them without facing backlash from mental health advocates and medical professionals.
As the UK seeks to modernise its mental health legislation, the coming weeks will be crucial in determining how much of these proposed reforms make it into law.
