Major reform of Mental Health Act

The Government has announced plans for major changes to the Mental Health Act. The aim is to deliver parity between mental and physical health services and put patients’ views at the centre of their care. It will also tackle mental health inequalities including disproportionate detention of people from black, Asian and minority ethnic (BAME) communities, the use of the act to detain people with learning disabilities and autism, and improve care for patients within the criminal justice system.
This work builds on the recommendations made by Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018. The government will consult on a number of proposed changes, including:
  • introducing statutory ‘advance choice documents’
  • implementing the right for an individual to choose a nominated person who is best placed to look after their interests
  • expanding the role of independent mental health advocates
  • 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,
Including in the proposals is the Patient and Carers Race Equality Framework (PCREF) will enables mental health trusts to understand what steps it needs to take to improve black, Asian and minority ethnic communities’ mental health outcomes.
Where legislation is required there will be consultation until the Spring with a draft Mental Health bill planned for 2021.

Four principles, developed by the review and in partnership with people with lived experience, will guide and shape the approach to reforming legislation, policy and practice. These are:

Choice and autonomy – ensuring service users’ views and choices are respected

Least restriction – ensuring the act’s powers are used in the least restrictive way

Therapeutic benefit – ensuring patients are supported to get better, so they can be discharged from the act

The person as an individual – ensuring patients are viewed and treated as rounded individuals