A new Reforming the Mental Health Act white paper sets out new measures to ensure people with mental health issues detained under the Mental Health Act have more control over their care and treatment, and delivers a key manifesto commitment.
At the heart of the proposed reforms to the Mental Health Act is greater choice and autonomy for patients in a mental health crisis, ensuring the act’s powers are used in the least restrictive way, that patients receive the care they need to help them recover and all patients are viewed and treated as individuals.
The reforms will ensure parity between mental and physical health services and put patients’ views at the centre of their care. They aim to tackle the disparities in mental health services, to meet the needs of people with learning disabilities and autism better, and to ensure appropriate care for people with serious mental illness within the criminal justice system.
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; and
- improving access to community-based mental health support, including crisis care, to prevent avoidable detentions under the act – this is already underway backed by £2.3 billion a year as part of the NHS Long Term Plan.
The white paper 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.
The proposals aim to ensure parity between mental health and physical health services. The government is already investing over £400 million to eradicate dormitories in mental health facilities as part of its response to Sir Simon’s recommendations and its 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 genuinely therapeutic environment.
The reforms will also change the way people with a learning disability and autistic people are treated in law by recognising a mental health inpatient setting is often not the best place to meet their specific needs. The proposal sets out that neither learning disability nor autism should be considered a mental disorder for which someone can be detained for treatment under section 3 of the Act. Instead, people with a learning disability or autistic people could only be detained for treatment if a co-occurring mental health condition is identified by clinicians.
A national organisational competency framework for NHS mental health trusts will also be introduced, referred as the ‘Patient and Carers Race Equality Framework’ (PCREF). The PCREF will be a practical tool which enables mental health trusts to understand what steps it needs to take to improve black, Asian and minority ethnic communities’ mental health outcomes.
Finally, the benefits of reforms will be felt by people with serious mental illness within the criminal justice system. A 28-day time limit is being proposed to speed up the transfer of prisoners to hospital, ending unnecessary delays and ensuring they get the right treatment at the right time.
