A package of reforms has been set out in a wide-ranging White Paper that builds on recommendations made by Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018.
The Reforming the Mental Health Act White Paper is designed to tackle the racial disparities in mental health services, better meet the needs of people with learning disabilities and autism and ensure appropriate care for people with serious mental illness within the criminal justice system.
Health and Social Care Secretary Matt Hancock (pictured) 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.
“These reforms will rightly see people not just as patients, but as individuals, with rights, preferences, and expertise, who are able to rely on a system which supports them and only intervenes proportionately, and which has their health and wellbeing as its centre.
“This is a significant moment in how we support those with serious mental health issues, which will give people more autonomy over their care and will tackle disparities for all who access services, in particular for people from minority ethnic backgrounds.”
The government will consult on a number of proposed changes, including:
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’ who is best placed 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 mental illness is the reason for detention under the Act, and that neither autism nor a learning disability are grounds for detention for treatment of themselves; and
Improving access to community-based mental health support, including crisis care, to prevent avoidable detentions under the Act. This is already underway backed by £2.3bn a year as part of the NHS Long Term Plan.
Consultations will continue until early spring 2021 for changes which require legislation and a draft Mental Health Bill will be shared next year.
Dan Scorer, Head of Policy and External Affairs at the learning disability charity Mencap, said: “We welcome these proposals to reform the Mental Health Act so that people with a learning disability and/or autism cannot be detained if they do not have a mental health condition. Currently, thousands of children and adults are locked away in modern day asylums even when they do not have a treatable mental health condition.
“It is the right thing to do to require commissioners to develop community support, but this new duty must be properly funded, not left to cash-strapped local authorities who are already struggling to fund social care. While putting Care and Treat review recommendations on a statutory footing looks good on paper, this makes no sense unless the reviews themselves are also a statutory requirement – otherwise it risks reviews simply not happening.
“Ultimately, changes to the Mental Health Act must be backed by a cross-government strategy to deliver on Government promises to get people with a learning disability and/or autism out of in-patient mental health units. The Government also needs to commit funding to develop the right housing and social care support to truly transform care and close inpatient beds for good. People with a learning disability have a right to live in their own homes, not in hospitals.”
While welcoming the White Paper’s publication, Professor Martin Green OBE, CEO of Care England, questioned whether the consultation period and delivery timescales were realistic given the ongoing pandemic.