Clause 35, which introduces a formal "debriefing process" for patients after they have been discharged from a mental health unit, was agreed with cross-party support, after young people’s testimonies were central to the debates, according to charity Article 39.
Conservative peer Lord Howe quoted from the vision of Blooming Change, a group of young people with experience of detention under the Mental Health Act 1983, which explains how debriefing goes beyond complaining – with the aim of influencing treatment.
Article 39, which set up Blooming Change in 2021, said young members spent the last year preparing to influence the process, including by considering the implications of the bill for children and young people, and by drawing on their own experiences of mental health detention to ensure this “once-in-a-generation opportunity to reform mental health care is informed by those who know the system first-hand”.
“This marks a major win for children’s rights in ensuring the experiences of children and young people are respected and taken seriously, highlighted not only in the amendment itself but in how it was achieved,” added the charity.
“Debriefing isn’t just complaining," states Blooming Change's vision, adding: “It’s discussing and reflecting on events during admission and the patient’s experience in order to learn from it.
“A complaint is given and then dealt with behind the scenes, whereas a debrief is a reflective discussion between multiple people where the young person is an active participant in discussing their own experience.”
The group hopes that the debriefing process will not only record the experiences of patients and hold institutions accountable but also support patients in healing from their time in mental health units.
This process is “especially vital” in helping child patients feel listened to and validated, supporting them to process their experiences and move forward after discharge, the group believes.
One involved young person said: “I think every single one of us has probably been told that there’s some kind of justification for the awful way that we were treated in mental health units.
“So, then the next time someone in your life might treat you awfully you might think, ‘well maybe it’s not as bad as me being restrained by six men’… it’s going to become a spiral of like justification of mistreatment… So, [the amendment is] almost like a prevention thing as well.”
During the debate, Baroness Barker praised Lord Howe’s amendments which allow the experiences of patients to challenge the “prevailing orthodoxy among the professions”.
Baroness Bennett said: “The phrase ’nothing about us without us’ really stuck in my mind and it is important that we keep that in mind throughout committee.”
While Health Minister Baroness Merron expressed concerns around overburdening staff and preferred to enhance existing systems, she committed to further engagement with the group.
Campaigners argued that current oversight mechanisms such as those managed by the Care Quality Commission (CQC) do not go far enough in terms of ensuring transparency, accountability, or healing for patients and the amendment passed by 209 votes to 143.
Blooming Change and Article 39 are now calling on MPs to protect this amendment and uphold the voices of children and young people as the Mental Health Bill prepares to pass through the House of Commons.
Young people's reflections on the amendment's significance
“For too long, the difficulties faced by young people in inpatient mental health units has remained hidden to those that haven’t seen them first-hand. Giving young people the opportunity to bring these issues to light and influence how they are addressed is vital. Nobody has better knowledge of where the system is failing than those of us it has let down… Introducing a debriefing process that requires patient experiences to be collected, reported on, and used to implement improved practices will not only encourage accountability but help young people to heal by putting down some of the weight of the trauma they carry.” (Abi)
“I’m honestly so happy that our voices are being heard… I genuinely for the longest time felt like I didn’t matter, to anyone or anything, that the universe didn’t need to hear my voice, that what I went through didn’t matter. It took so long to build my confidence and to find my voice and talk about what they did to me… I’m glad I decided to use my experiences to fight for change and I’m so happy our words have made a difference. We will keep fighting for more changes, little by little.” – (Lucy)
“I think this change is essential and am heartened that my experiences have helped bring this about. With this safeguard, my experience could have been completely different… I am hopeful this will allow for others to feel listened to and validated and ensure that they have the opportunity to move forward with their lives after something as traumatic as a mental health unit admission.” – (Danika)
“I think that the voting in of the debriefing amendment is an incredible achievement and one that evidences the importance of acknowledging the impact of detentions on young people whilst providing an opportunity to implement safeguarding mechanisms against the development of further psychological harm.” – (Alaa)
“For so long our voices and experiences have been ignored, dismissed, devalued and denied. For me, this amendment shows the power of young people, and those in positions that are able to create change should note how important it is to listen and act on what we say. Too many young people have been let down and forgotten, all of whom have stories, opinions and voices that deserved to be heard. For me, this is for those children and young people who never got heard or had their voices dismissed and silenced. I hope that they know how powerful their voices are and how capable they are of achieving what they want, despite what the systems around them attempt to confine them to. Years of pain and suffering have led to the moment that we have finally been taken seriously, but I know that this will send a powerful message that young people from all walks of life are here to make a difference; and that we are more than able to do that.” (M)
