Mental Health Bill could strip safeguards from those with autism and learning disabilities

Proposals in the Mental Health Bill could lead to unintended and harmful consequences, a new paper published in the British Journal of Psychiatry argues.

The Bill aims to restrict the use of compulsory hospital detention for people with autism and learning disabilities, but academics have warned that the proposals may actually lead to greater risk of criminalisation, homelessness, and reduced access to care.

“Most autistic people or people with a learning disability present no risk to others. But in some cases, risk-related behaviours - such as fire-setting or stalking - require effective and responsive care. Hospital detention is currently a key mechanism to prevent harm and support people’s recovery,” lead author Dr Peter Beazley said.

“The proposed changes mean that autistic people or those with a learning disability, would be more likely to go to prison because they can no longer be detained under the Mental Health Act.

“There are many positive intentions behind these reforms, but the current proposals risk creating more problems than they solve. Compulsory care for people with autism or learning disabilities must improve, but this is not the way to do it.”

Dr Beazley is a clinical associate professor and clinical psychologist at University of East Anglia, with experience working in inpatient mental health settings. He’s one of a group of 25 experts, psychiatrists and carers with significant collective expertise in this area sounding the alarm over the proposals.

“Without access to hospital detention, individuals experiencing crises may face unmanaged escalation of risk in the community, leading to arrest and imprisonment,” he continued.

“If these proposals go ahead, then the group who these changes are intended to protect may in fact be directly and significantly disadvantaged.

“We are at risk of replacing hospital-based detention with deprivations of liberty that are even less transparent, less safeguarded, and more harmful. We are also at risk of sending more people with autism and learning disability to prison.”

Drawing on international comparisons, the paper points to New Zealand’s experience with similar legislative reforms. After changes to its mental health laws, several people with learning disabilities committed serious offences following unsupervised community release.
New Zealand has subsequently rolled back these reforms.

The changes have been criticised for potentially forcing professionals to rely on weaker legal frameworks, such as the Deprivation of Liberty Safeguards (DoLS).

These alternative mechanisms lack key protections, including robust rights to appeal, automatic tribunal review, and funded aftercare support under Section 117 of the current Act.

The authors are now calling for the removal of Clause 3 from the legislation, which allows for detention for treatment, and the retention or expansion of legal routes to care for individuals as an alternative to arrest.