Mental Health Bill
“My ministers will legislate to modernise the Mental Health
Act so it is fit for the twenty first century”
- The Mental Health Bill will deliver our manifesto commitment
to modernise the Mental Health Act 1983 which is woefully out of
date. The Bill will make it fit for the 21st century so that
patients have greater choice, autonomy, rights and support, and
make sure all patients are treated with dignity and respect
throughout their treatment.
- This Bill, along with our wider plans to tackle the mental
health crisis, will help deliver the Government's mission to see
people living healthier for longer, including reversing the
rising trend in the rate of lives lost to suicide.
What does the Bill do?
- The Mental Health Bill takes forward the vast majority of
Professor Sir Simon Wessley's 2017 recommendations for
legislative reform and includes a wide range of changes to shift
the balance of power from the system to the patient, putting
service users at the centre of decisions about their own
care.
- The Mental Health Bill will amend the Mental Health Act 1983
to give people detained greater choice and autonomy, enhanced
rights and support, and ensure everyone is treated with dignity
and respect throughout treatment by:
-
ensuring that detention and treatment under the
Mental Health Act takes place only when necessary,
by revising the detention criteria to ensure that people can
only be detained if they pose a risk of serious harm either
to themselves or to others, and where there is a reasonable
prospect that treatment would have a therapeutic benefit. It
will also revise and shorten the period that a patient may be
kept in detention for treatment and provide faster, more
frequent reviews and appeals of both detentions and
treatment.
-
further limiting the extent to which people with a
learning disability and/or autistic people can be detained
and treated under the Mental Health Act and
supporting such individuals to live fulfilling lives in their
community. It will do this by introducing duties on
commissioners to improve understanding of the risk of crisis
amongst people with a learning disability and/or autistic
people in their local area and also ensure an adequate supply
of community services to prevent inappropriate detentions.
-
strengthening the voice of patients by
adding statutory weight to patients' rights to be involved
with planning for their care, and to make choices and
refusals regarding the treatment they receive.
-
strengthening and improving the statutory
roles which protect and support those who
are detained by introducing a new statutory role – the
nominated person – who is chosen by the patient, to replace
the nearest relative and extend access to Independent Mental
Health Advocates to informal patients and introduce an
opt-out system for formal patients.
-
removing police stations and prisons as places of
safety under the Mental Health Act to ensure
people experiencing a mental health crisis or with severe
mental health needs are supported in the most appropriate
setting.
-
supporting offenders with severe mental health
problems to access the care they need as
quickly and early as possible, and improve the management of
those patients subject to a restriction order
(for the purposes of public protection).
- These reforms will take a number of years to implement, as we
will need to recruit and train more clinical and judicial staff.
We plan to introduce these reforms in phases as resources allow,
and we will not commence new powers unless we have sufficient
staff in place that means it is safe to do so.
Territorial extent and application
- The Bill will extend and apply to England and Wales.
Key facts
- The Mental Health Act 1983 has not been fully updated for
over 40 years. It was last amended in 2007. In 2017 there was an
Independent Review of the Mental Health Act, chaired by Professor
Sir Simon Wessely, commissioned to consider the reasons for the
rising number of detentions under the Mental Health Act, and
disproportionate detentions of people from black and minority
ethnic groups, as well as processes in the Mental Health Act that
are out of step with a modern mental health care system.
- Rates of detention under the Mental Health Act have nearly
doubled since 1983, and between 2007 and 2016 the number of
detentions rose by over 40 per cent. In 2022/23 there were
around 51,000 new recorded detentions under the Mental Health Act
in England. This is an estimated 7.7 per cent fall in detentions
from 2021/22, continuing a 5.7 per cent decrease estimated for
the previous year.
- A total of 1,746 restricted patients were admitted to
hospital for treatment under the Mental Health Act in 2023 in
England and Wales, a 5 per cent increase from 2022. As of 31
December 2023, there were 7,833 restricted patients, of which
4,648 were detained in hospital and 3,185 conditionally
discharged. Restricted patients are offenders subject to special
controls by the Secretary of State for Justice, for example after
a court sentence or transfer from prison.
- In 2022/23, 997 detentions were recorded for children and
young people aged 17 and under - over two-thirds (680) of these
were aged 16 or 17. In the same period, black people were three
and a half times more likely than white people to be detained
under the Mental Health Act, and over eight times more likely to
be placed on a Community Treatment Order.
- Care Quality Commission research has found that the
environment of mental health hospitals was often not therapeutic,
and that the noisy and chaotic nature of the wards could add to
people's distress, particularly for autistic people.
- The number of learning disability and autistic inpatients
detained under the Mental Health Act has fallen from 2,500 in
March 2015 to 1,855 in May 2024. However, a larger proportion of
learning disability and autistic inpatients are now detained
under the Mental Health Act – 92 per cent in May 2024 compared to
86 per cent in March 2015.
- Leading mental health charity Mind supports reform of the
Mental Health Act saying: “The
Mental Health Act is outdated. It's not fit for purpose. Mind has
been pushing for reform to the Act for many years. And we can't
wait any longer.”
