Government Publishes 'Long Awaited' Response to Review on Mental Health Act

Peter Russell

January 13, 2021

Reforms to the Mental Health Act will give individuals more control over their treatment, the Government has promised.

The Department of Health and Social Care said the plans would "deliver parity between mental and physical health services" and put patients' views at the centre of their care.

The white paper also aims to address the disproportionate detention under the Mental Health Act of people from Black, Asian and Minority Ethnic backgrounds.

Black people are over four times more likely to be detained under the Act and over 10 times more likely to be subject to a community treatment order.

The reform would also address the disproportionate number of people detained who have learning disabilities and autism, ministers said.

New legislation would build on recommendations made by Sir Simon Wessely's 2018 Independent Review of the Mental Health Act. It highlighted concerns over an "inexorable rise in detentions" and called for a modern approach to mental health care with less coercion and restriction of liberties.

Modernising Mental Health Laws

Health and Social Care Secretary for England, Matt Hancock, said: "I want to ensure our health service works for all, yet the Mental Health Act is now 40 years old. We need to bring mental health laws into the 21st century.

"Reforming the Mental Health Act is one of our central manifesto commitments, so the law helps get the best possible care to everyone who needs it."

Ministers have pledged to consult on:

  • Introducing statutory 'advance choice documents' to enable people to express their wishes and preferences on their care when they are well, before the need arises for them to go into hospital

  • Implementing the right for an individual to choose a nominated person to look after their interests under the Act if they aren’t able to do so themselves

  • Expanding the role of independent mental health advocates to offer a greater level of support and representation to every patient detained under the Act

  • Piloting culturally appropriate advocates so patients from all ethnic backgrounds can be better supported to voice their individual needs

  • Ensuring that mental illness is the reason for detention under the Act, and that neither autism nor a learning disability are sole grounds for detention for treatment

  • Improving access to community-based mental health support, including crisis care, to prevent avoidable detentions under the Act

The reforms would also address people with serious mental illness within the criminal justice system by imposing a 28 day time limit for prisoners to be transferred to hospital, so they could get faster treatment.

"Prisons should be places where offenders are punished and rehabilitated, not a holding pen for people whose primary issue is their mental health," said Robert Buckland, the Lord Chancellor and Justice Secretary.

COVID Has 'Intensified Mental Health Challenges'

Sarah Hughes, chief executive at the Centre for Mental Health, commented: "The need to modernise the Mental Health Act could not be clearer. Every year, the number of people who are sectioned grows. While we know this can save lives, the use of coercion can also cause lasting trauma and distress."

The Local Government Association said challenges with the current Act were "indicative of a system that is under strain because of increased demand and reduced funding".

Dr Adrian James, president of the Royal College of Psychiatrists, described the move as "a great opportunity to modernise mental health law and improve safeguards and support for people in a mental health crisis" in "the least restrictive way".

Saffron Cordery, deputy chief executive of NHS Providers, said: "Reforming the Mental Health Act is more important than ever as COVID-19 has accelerated mental health trends and intensified the challenges facing services."

Mental health charity Mind said the Government had waited 2 years to publish its response to the independent review of the Mental Health Act. Sophie Corlett, director of external relations, said: "As we face further restrictions in light of the coronavirus pandemic, we're likely to see more people reach mental health crisis in coming months.

"It's never been more critical to make sure people are properly supported and have their choices and dignity respected."

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