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Legal changes

Mental Health Act 1983 Reforms

The consultation will continue until spring 2021 and a draft Mental Health Bill will be shared next year.

The Department of Health and Social Care has published the much anticipated, ‘Reforming the Mental Health Act’ white paper. The white paper has been produced in response to Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018.

The review identified four principles, which it hoped would be used to guide and shape reform of the legislation, policy and practice. These are:

  1. Choice and autonomy – ensuring service users’ views and choices are respected.
  2. Least restriction – ensuring the act’s powers are used in the least restrictive way.
  3. Therapeutic benefit – ensuring patients are supported to get better, so they can be discharged from the act.
  4. The person as an individual – ensuring patients are viewed and treated as rounded individuals.

Currently 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. To address this, a national competency framework for mental health trusts is to be introduced. This will be referred to as the ‘Patient and Carers Race Equality Framework’ (PCREF) and will support mental health trusts to understand what steps are needed to improve outcomes for black, Asian and minority ethnic communities.

The reforms will also look to address the way people with a learning disability and autistic people are treated, meaning that they could only be detained for treatment if a co-occurring mental health condition was identified by clinicians.

Finally, for those suffering with serious mental illness within the criminal justice system, a 28-day time limit is being proposed to speed up the transfer of prisoners to hospital, ensuring they get the right treatment at the right time.

As part of the Government’s commitment to create greater parity between mental and physical health services, the following funding has been agreed:

  • £2.3 billion a year as part of the NHS Long Term Plan for community-based mental health support;
  • £62 million Community Discharge Grant to support the discharge of people with learning disabilities and autism from in-patient care;
  • £400 million to eradicate dormitories from mental health facilities; and
  • Increased capital spend on the mental health estate so people admitted to hospital can receive care in a modern and genuinely therapeutic environment.

The Government wishes to consult on a number of proposed changes, which include:

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

You can view the white paper online and consultation responses can also be submitted. It is important that those with a working knowledge of the Mental Health Act feed into the consultation helping to shape the reforms.

The consultation will continue until spring 2021 and a draft Mental Health Bill will be shared next year.

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