Government to reform outdated mental health laws

The draft Mental Health bill is expected to be featured as part of the government’s new legislative programme, unveiled in the Queen’s Speech next week.

The Mental Health Act 1983 covers the assessment, treatment and rights of patients who are treated or detained for a mental health disorder. The Act is outdated and can currently be too easily used to deprive the liberty and autonomy of some of the most vulnerable people in society, with powers that do not exist in any other aspect of healthcare.

The draft bill will overhaul the Act for the first time in four decades, levelling up mental health treatment for all patients and preventing the unnecessary detention of patients who should be treated elsewhere.

Reforms aim to reduce the number of people detained under the Act. The number of detentions increased by 40% between 2005/06 and 2015/16 and continue to rise year on year.

Prime Minister, Boris Johnson said:

“Our mental health laws are antiquated. Every person deserves to be treated with dignity, and it is our duty to ensure the rights and freedoms of our most vulnerable in society are protected and respected.

“Our reforms to the Mental Health Act are the first in four decades, and will make sure that every patient receives the treatment they deserve and no patient is detained unnecessarily.”

The draft bill will deliver on two key manifesto commitments. People with learning disabilities and autistic people can currently be detained under the Act even if the patient does not suffer from any mental health conditions. This can result in patients being kept under lock and key in psychiatric units, which may not be an appropriate places for their care.

The draft bill will end this practice by removing learning disabilities and autism as mental health disorders warranting compulsory hospital treatment, so patients can be supported more appropriately elsewhere.

Treatments for severe mental health conditions often have significant side effects. The Act currently allows treatment to be imposed on patients against their wishes, even when they are able to voice a preference, or object. The draft bill will allow patients to voice a preference or refuse a specific treatment where a suitable alternative is available.

Supporting people to get better and be discharged to communities quicker will also free up valuable beds and support the NHS as they work tirelessly to clear the covid backlog.

The draft bill will deliver on the governments mission to eradicate deep seated health disparities, ensuring everyone is treated with the dignity and respect they deserve and ending the stigma of mental illness once and for all.

By giving individuals more of a say in their care and treatment, reforms will help tackle significant disparities which exist to reduce the number of people from ethnic minority backgrounds, in particular black African-Caribbean communities, detained under the Act.

Health and Social Care Secretary Sajid Javid said:

“The Mental Health Act is now 40 years old. We need to bring mental health laws into the 21st century so everyone who needs help can get the best possible care.

“Our proposed legislation will ensure people from ethnic minority backgrounds, people with learning disabilities and autism and people in the criminal justice system receive the mental health care they need to support them to get better.

“This is part of my mission to tackle disparities and level up healthcare across the country ensuring everyone has the ability to live healthier, happier lives.”

Professor Sir Simon Wessely said:

“I welcome the news today that the government is bringing forward a draft bill to modernise mental health legislation. Undertaking pre-legislative scrutiny is a vital step in making sure the bill delivers on our ambitious plans for reform.

“By strengthening patient rights to influence their care and treatment, and to choose who supports them, we can improve people’s experience of mental health services, address current significant racial disparities and combat rising rates of detention.” 

The draft Bill includes proposals to: 

• Rebalance the threshold for detention – decisions on detention must balance both risk to the public and therapeutic benefit to the patient. 
• Strengthen the rights of patients to express a treatment preference, for example based on experience of side-effects.
• Limit the extent to which the Act can be applied to people with learning disabilities and autistic people by removing the ability to detain someone who does not have a mental health condition for treatment, unless they have been sentenced to a hospital stay via the courts. 
• Legislate so that all patients receive, and input into, a timely plan on their care and the route through to their eventual discharge.
• Reduce the use of Community Treatment Orders, which mean people remain supervised in their community and can be sent back to hospital, and can include restrictions like where a person has to live.

The draft bill takes forward the majority of the recommendations made by Professor Sir Simon Wessely’s 2018 Independent Review which looked at how the Mental Health Act is used in practice, and made recommendations to address processes that are out of step with a modern mental health care system.

Work to reform mental health services is ongoing following a government investment of £400 million to eradicate outdated dormitories in mental health facilities. This forms part our commitment to level up access to mental health services and rebuild better than before, so people admitted to hospital can receive care in a modern and therapeutic environment.

The introduction of the draft bill follows the Mental Health Recovery Action Plan, backed by a one-off targeted investment of £500 million last year, ensured additional support for members of groups most impacted by the pandemic including those with severe mental illness.

The draft bill will be subject to pre-legislative scrutiny before beginning its formal parliamentary passage. This follows the successful model to scrutinise important and complex reforms used for the Domestic Abuse Act and Building Safety Act.  

The Department of Health and Social Care is running a Call for Evidence seeking views to inform a new 10-Year Mental Health Plan and updated National Suicide Prevention Plan which will build on current progress, assessing how local services can work together to prevent mental ill health to level up mental health across the country and put mental and physical health on an equal footing.