Our paralegal, Jessica Hayward, took some time to delve into the new proposals for Mental Health Reform. Here's an insight from Jessica into what may be expected.
King Charles III announced at his 2024 speech “My ministers will legislate to modernise the Mental Health Act so it is fit for the twenty first century”
What does this mean for patients? How will practice differ for professionals involved in their care? This short analysis will offer a preview into the proposals and potential implications within mental health services.
Why does the Mental Health Act need reforming?
Rates of detention increased by over 40% between 2007 and 2016
Detention rates almost doubled since 1983 when Mental Health Act was introduced
The number of autistic people and people with a learning disability detained under the Act has fallen from 2,500 in March 2015 to 1,855 in May 2024
The proportion of autistic patients and patients with a learning disability detained under the Act has risen from 86% in March 2015 to 92% in May 2024
In 2022/23 black people were 3.5 times more likely to be detained under the Mental Health Act than white people AND are 8 times more likely to be placed on a Community Treatment Order
What we know so far about the proposed mental health legislation reforms…
The freshly elected Labour government’s plan to address Britain’s ‘mental health epidemic’ has extended to the proposed modernisation of mental health legislation to give patients greater autonomy, enhanced rights and support, ensuring dignity and respect is maintained. The King’s briefing showcased the following proposals of the Mental Health Bill 2024:
Revision of detention criteria ensuring people can only be detained if they pose a risk of serious harm to themselves or others, and, where treatment will have a therapeutic benefit.
Decreasing the detention period for treatment providing faster and frequent reviews of detention and treatment.
Supporting individuals with a learning disability or autism to live fulfilling lives in the community by limiting the extent of detainment and treatment under the Mental Health Act. This introduces duties on commissioners to ensure adequate community services to prevent inappropriate detentions.
Patients’ rights to be involving in care planning, choices and refusals; on a statutory footing.
Patient will be able to choose a ‘nominated person’, replacing ‘nearest relative’.
Police stations and prisons will no longer be considered places of safety.
Reducing the transfer times from prison to hospital enabling a supervised discharge of restricted patients.
The above proposed changes are not indifferent to the predecessor government’s reform proposals from their draft Mental Health Bill. It remains to be seen if the new government will adopt the previous recommendations of the Joint Committee’s review of the previous Bill. The King’s Speech briefing does not allude to the appointment of a Mental Health Commissioner or abolishing Community Treatment Orders for part 2 patients. Furthermore, other key Joint Committee recommendations were not mentioned, such as plans to replace Deprivation of Liberty Safeguards or an interface with mental capacity statute.
When will these changes take place?
‘These reforms will take a number of years to implement, as we will need to recruit and train more clinical and judicial staff.'
The Labour government echoes the Joint Committee’s timescale, ‘in phases as resources allow’; giving a vague, but realistic timescale expectation of the proposed mental health legislation reform. In practice, sufficient community provisions will need to be implemented to enable those with autism and learning disabilities to be removed from the scope of section 3 detentions.
Next steps?
As promised in the King’s Speech, the next step is for the government to publish the new Mental Health Bill 2024 to be scrutinised in both chambers of Parliament. It can be seen that the proposals are broadly similar to that of the previous draft Mental Health Bill[9] which gave effect to Sir Simon Wesley’s landmark independent review[10] of the Mental Health Act.
‘In this regard, the vulnerability, racism, and fear experienced by service users in hospitals which are intended to be places of safety for those detained under the MHA warrants urgent attention. Participants highlighted lack of compliance with the Human Rights Act 1998 and the Equality Act 2010 (specifically, the Public Sector Equality Duty) and application of the principle of least restrictive practice.’
The reforms are likely to be a lengthy, expensive and an elaborately planned process in view of the provisions and staffing required for such long-awaited changes for the most vulnerable people in Britain.
Updates to follow…
References
Draft Mental Health Bill 2022
Equality Act 2010
Garrat, K., ‘Reforming the Mental Health Act’ (18 July 2024, House of Commons Library)
Human Rights Act 1998
Mental Health Act 1983
UK Government, ‘Joint Committee on the Draft Mental Health Bill: Draft Mental Health Bill 2022’ (19 January 2023, House of Commons, House of Lords) HC 696, HL Paper 128
UK Government, ‘King’s Speech 2024: background briefing notes’,(17 July 2024, Prime Minister’s Office)
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