Reforms to the Mental Health Act welcome, but need scrutiny
The Department for Health and Social Care have today published their draft Mental Health Bill, which will reform the Mental Health Act 1983.
This follows the Independent Review of the Mental Health Act in 2019, which made a series of recommendations to the UK government to overhaul outdated legislation that can cause people with mental health problems to be held against their will (‘sectioned’) in certain circumstances.
Responding to the publication, Paul Farmer, Chief Executive of Mind, said:
“The publication of the draft Mental Health Bill is a watershed moment for mental health in the UK. The 1983 Mental Health Act is an outdated piece of law that far too often enables appalling treatment towards people with mental health problems. It has numerous issues, from widespread inappropriate use of detention and force, to some ethnic groups being disproportionately sectioned. When people’s lives come crashing down in a mental health crisis, they need to be able to rely on the law for the help they need, but right now this just isn’t the case. Changing this crucial piece of legislation is the first step to righting many of these wrongs.
“The Bill contains a number of welcome proposals. We’re particularly pleased to see measures which will give people receiving care under the Act more say over how they are treated and allow a nominated person to exercise certain rights on their behalf. Making sure people with mental health problems have more access to advocacy is particularly important. Access to statutory care and treatment plans will bring more transparency and accountability to clinical decision-making, and put those peoples’ choices first. The new proposed duty on clinicians to consider the person’s wishes and feelings and to involve them in the decision-making process, before deciding whether to treat them under the Act, should help to focus clinical decision-making on a patient's wishes.
“The draft legislation will need scrutiny in some particular areas, where we believe the UK government could go further in addressing issues to make sure the law is fair and equitable for all, especially in reducing racial inequalities. As the Bill goes into Pre-Legislative Scrutiny, we will hope to see these issues addressed.
“In particular, we’d like the UK government to review the use of Community Treatment Orders (CTOs), which are coercive, don't reduce readmissions and are disproportionately applied to Black people.
“We’d also like the guiding principles suggested by the Independent Mental Health Act review to be included, especially as these would strengthen people's rights and help focus decision-makers on eliminating racism.
“Additionally, we would like the Bill strengthened in reforms for young people. The failure to give under 18s the right to make advance decisions to refuse treatment means that they will be unable to access enhanced treatment safeguards in the same way as adults. The lack of a statutory decision-making test for those under 16 could also render many of these reforms ineffective for the youngest people in the system, who are often the most vulnerable.
“Another area that needs scrutiny during the next stage is the new criteria for detention. Ensuring fewer people are inappropriately detained is a crucial intention of the reform and we need to make sure the changes lead to significant reductions in practice.
“Over the next few days we’ll continue to examine the draft Bill, and will look to work closely with UK government and the Pre-Legislative Scrutiny Committee to address our concerns. It is vital we make sure our new Mental Health Act works to protect and support people’s health now and for the generations to come. And finally, alongside this reformed legislation must come the necessary resources and funding needed to deliver this transformation, otherwise even the most well thought out pieces of legislation will not achieve the results we need to see.”