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Mental Health Act undergoes landmark reforms

Individuals are set to benefit from greater control over their treatment following major reform to the Mental Health Act being set out by the UK Government.

Under the landmark reforms, people with mental health issues who are detained under the Mental Health Act will receive more appropriate care which they need to recover and be viewed and treated as individuals.

A wide-ranging new whitepaper, Reforming the Mental Health Act, sets out the package of reforms, which have been developed building from the recommendations made by Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018.

Alongside greater choice and autonomy for patients in a mental health crisis, the reforms aim 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 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
  • 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 annually as part of the NHS Long Term Plan

The whitepaper sets out the path towards the government’s commitment to introduce the first new Mental Health Bill for 30 years, and end the stigma of mental illness once and for all.

Minister for Mental Health and Suicide Prevention Nadine Dorries added: “I am committed to improving people’s experience under the Mental Health Act, and most importantly to making sure their care and treatment works for them.

“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.”

Decisive action will be taken to help tackle the disproportionate number of people from black, Asian and minority ethnic communities detained under the Mental Health Act. Black people are over 4 times more likely to be detained under the act and over 10 times more likely to be subject to a community treatment order.

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NHE May/June 2024

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