Mental Health Act reform moves forward
By Gemma Raw
The government has promised legislation in this parliament to reform the Mental Health Act, moving a step closer to the first major changes to mental health law since 1983.
The draft Mental Health Act Reform Bill was announced in the Queen's Speech on 10 May. Its purpose is to ensure patients suffering from mental health conditions have greater control over their treatment, and receive the dignity and respect they deserve. The proposed new legislation will also make it easier for people with learning disabilities and autism to be discharged from hospital, as well as addressing the existing disparities in the use of the Mental Health Act for people from ethnic minority backgrounds.
What are the main changes?
The new legislation will revise the definition of mental disorder so that people can no longer be detained simply because they have a learning disability or are autistic. In addition, the assessment criteria for detention will be revised so that it only happens when absolutely necessary, for example where the person is a danger to themselves or someone else.
Other elements of the Bill include: providing patients with better support, including giving everyone the option of having an independent mental health advocate; a 28-day time limit for transfers from prison to hospital for acute patients; a new form of supervised community discharge of restricted patients; more opportunities for appeals against detention; and a statutory care and treatment plan for all patients in detention.
A long time coming
These long-awaited reforms follow years of campaigning by charities and families of those with mental health issues. In 2017 the government commissioned an independent review of the Mental Health Act, chaired by Professor Sir Simon Wessely, a former president of the Royal College of Psychiatrists. This was followed by a white paper and an open consultation, which attracted over 1,700 responses from a variety of sources, including organisations representing those working in frontline mental health roles.
One of the key contributors to the consultation was the Royal College of Nursing (RCN). As the main professional group implementing and delivering care under the Mental Health Act, the RCN considered that it was vital for the voice of nursing staff to be heard throughout the development of the reforms. You can read the RCN responses to the review here.
Reaction to the Reform Bill
The draft Mental Health Act Reform Bill has been broadly welcomed by charities and organisations representing health professionals, although concerns have been expressed about the impact on those working in mental health jobs.
"We urge the government to make the major investment that is still needed in inpatient beds, community services and the mental health workforce so that people whose mental health is deteriorating can be helped before they reach crisis point and the Mental Health Act has to be used," said Marjorie Wallace, Chief Executive of SANE.
In 2021, the Royal College of Psychiatrists (RCP) published an impact assessment of the proposed reforms on the workload of psychiatrists. Responding to the announcement of the draft Bill, RCP President Dr Adrian James commented, "At all points, an individual's dignity, autonomy and human rights must be protected when they are subject to the Act, and we will continue to work to ensure the reforms are successfully implemented. This will rely on the Act being accompanied by a robust workforce plan, along with investment to deliver it."
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