Mental Health Act reform will cut number of people with learning disabilities and autism being sectioned

A major reform of the Mental Health Act will reduce the number of people with learning disabilities and autism being sectioned, as they will only be detained for treatment if a ‘co-occurring mental health condition is identified’, according to the government.

The package of reforms also aims to tackle the disproportionate number of people from Black, Asian and minority ethnic communities detained under the Mental Health Act. Black people are over four times more likely to be detained under the Act and over ten times more likely to be subject to a Community Treatment Order.

Patients’ views will be put at the centre of their care and they will have more control and autonomy over their treatment. There will also be an improvement in care for prisoners with serious mental illnesses.

Claire Murdoch, mental health director for NHS England, called the proposed reforms “ a welcome step towards ensuring that people with mental health needs, a learning disability or autism, remain at the centre of decisions about their care, and that longstanding inequalities in experience and outcomes are addressed”.

The wide-ranging new Reforming the Mental Health Act White Paper builds on the recommendations made by Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018.

'We need to bring mental health laws into the 21st century'

Health and Social Care Secretary 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.

“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.”

He added: “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 is to 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

• 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

Patients will be at the 'centre of decisions about their care'

Minister for Mental Health and Suicide Prevention, Nadine Dorries, said: “We know people are too often disempowered and excluded from decisions, which is where the Act, and our ability to successfully support people often fails.

“Informed by Sir Simon’s recommendations, we will transform the Act to put patients at the centre of decisions about their own care.”

A national organisational competency framework for NHS Mental Health Trusts will be introduced. The ‘Patient and Carers Race Equality Framework’ (PCREF) will be a practical tool enabling Mental Health Trusts to understand what steps it needs to take to improve Black, Asian and minority ethnic communities’ mental health outcomes.

The reforms also mean that prisoners with serious mental health problems will be transferred to hospital quicker as a 28-day time limit is being proposed to put an end to unnecessary delays.

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

The Government is also pledging to end the outdated practice of using prisons as ‘places of safety’ for defendants with acute mental illness.

White Paper will ensure patients are 'supported to get better in least restrictive way'

Dr Adrian James, president of the Royal College of Psychiatrists, welcomed the publication of the White Paper and said it will “help ensure that patients are heard, their choices respected and that they are supported to get better in the least restrictive way”.

“We will consult with our members on how the changes will work on the ground and look forward to engaging positively with the consultation over the coming months. This includes exploration of the resources necessary to implement the proposed changes.”

Mark Winstanley, chief executive of Rethink Mental Illness called the publication of the White Paper to reform the Mental Health Act “a hugely significant milestone in a long struggle for change”.

He added it gives “real hope for a more person-centred and principled Mental Health Act which better reflects how a modern society thinks about mental illness”.

To have your say on the consultation click here