Government publishes first draft of reforms in new Mental Health Bill

The Department of Health and Social Care has set out its plans to reform the Mental Health Act with a new bill, presented to Parliament.

It says people experiencing a mental health emergency will be able to access more care in the community and that those detained under the Mental Health Act will benefit from landmark reforms which provide patients with more control over their care and treatment.

The reforms were proposed in a white paper in January last year, following Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018, ordered by then Prime Minister Theresa May.

Secretary of State for Health and Social Care Sajid Javid said it is “a significant moment in supporting people with serious mental health issues.”

The Government says the reforms aim to tackle racial disparities in mental health services, better meet the needs of people with a learning disability and autistic people and ensure appropriate care for people with serious mental illness within the criminal justice system.

“Our reforms to the outdated Mental Health Act are another important milestone in better supporting those with serious mental health issues and giving people greater control over their treatment, particularly those from ethnic minority backgrounds who are disproportionately detained under the Act,” Javid said.

The draft bill is now subject to pre-legislative scrutiny where a parliamentary select committee will examine the draft in detail before the government publishes a final version.

The Government has allocated £150 million over three years to improve NHS mental health services, including £7 million for specialised mental health ambulances to reduce the use of general ambulance call outs for those experiencing a mental health crisis and “prevent the inappropriate use of police vehicles as a way to take people to hospital”. It says this will ease pressure on services, improve response times and outcomes for people in crisis which will help save lives, as well as ensuring patients experiencing a crisis are treated with dignity and respect.

The reforms also hope to tackle deep-seated health disparities and ensuring everyone is treated with dignity and respect. Currently, Black people are over four times more likely to be detained under the act and over 10 times more likely to be subject to a community treatment order.

Culturally appropriate advocacy services are currently being piloted in four areas in England so people from ethnic minority backgrounds can be better supported by people who understand their needs. NHS England are developing a Patient and Carer Race Equalities Framework to provide mental health trusts with practical steps to improve the experience of care within mental health services for people from ethnic minority communities. It will also expand the role of independent mental health advocates (IMHAs) to informal patients.

The Bill will implement 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, replacing the ‘nearest relative’ role.

The reforms will also change the way people with a learning disability and autistic people are treated in law by setting out that neither learning disability or autism should be considered reasons 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 mental health condition is identified by clinicians.

The Bill also sets out a 28-day time limit to speed up the transfer of prisoners to hospital and end the ‘outdated’ practice of using prisons as ‘places of safety’ for defendants with acute mental illness. Judges will now work with medical professionals to ensure defendants can always be taken directly to a healthcare setting from court.

Prisons Minister, Victoria Atkins, said: “The new Mental Health Bill will speed up access to treatment, enshrine important protections for vulnerable people and ensure prisons are not used as an alternative to hospital treatment.”