What’s just happened?
On January 13th, 2021, the government released a White Paper in response Sir Simon Wessely’s proposed recommendations made in a 2018 report on reforming the Mental Health Act 1983 (MHA). [1] This will be followed by 12-weeks of public consultation, with a draft of a revised Mental Health Bill to be introduced when government time allows. [2]
What does this mean?
An Independent Review of the Mental Health Act 1983 (MHA) conducted in 2018 which prioritised modernisation and reform to patient care made over 150 recommendations to the government. [3] Proposed changes emphasise the need for greater patient autonomy, tackling racial inequalities, and to better meet the needs of people with learning disabilities and autism. [4]
In 2020 alone there were 50,893 new detentions under the Mental Health Act. [5] Too often people are being detained without their consent or rights being advocated for and receive insufficient therapeutic input on their wellbeing. However, individuals detained under the revised Mental Health Act will be able to nominate someone to represent them if they are unable to do so themselves, which will in turn provide patients with greater involvement in decisions about their care and treatment. [6] [7] The government have stated that the revised MHA will only intervene “proportionately, and which has their health and wellbeing as its central organising principle”. [8]
“We know people are too often disempowered and excluded from decisions […] we will transform the act to put patients at the centre of decisions about their own care” [9]
There are also significant disparities in current mental health services for people of BAME backgrounds who are over 4 times more likely to be detained under the act and subjected to poorer treatment options based on clinicians’ negative racial bias which must be immediately addressed and improved. [10] [11]
The government has also highlighted numerous cases of quality failings in the care of people with learning disabilities and autism in inpatient settings. This will be addressed through a separate legal approach which will act on their manifesto pledge to the Joint Committee on Human Rights (JCHR) made last year stating that “individuals within this group should only be in inpatient care for as short a time, as close to home and in the least restrictive setting possible, with a clear, therapeutic benefit, not as a last resort due to lack of appropriate community support”. [12]
This will ensure that mental illness is the sole reason for detention under the act which will prevent the abhorrent experiences of individuals such as Alexis Quinn who was detained without her consent and received treatment she described as “sub-human” simply because she has autism. [13]
However, there are some concerns over the longevity of these proposed reforms. David Greene, president of Law Society expressed concerns that new safeguards for people detained under the act must be sustainable, effective, and enforceable. [14] The government needs regard the legal and mental health mechanisms that will ultimately uphold the reform’s new services as a constant priority, without which there will be an “exponential demand that cannot be met, and consequentially, collapse”. [15]
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Written by Connie Barnes
References:
[1] 'Reforming the Mental Health Act' (GOV.UK, 2021) https://www.gov.uk/government/consultations/reforming-the-mental-health-act/reforming-the-mental-health-act
[2] 'Changes That the Government Wants to Make to A Law Called the Mental Health Act' (GOV.UK, 2021) https://www.gov.uk/government/consultations/changes-that-the-government-wants-to-make-to-a-law-called-the-mental-health-act-easy-read
[3] Tim Spencer-Lane, ‘How the government proposes to reform the Mental Health Act’ (Community Care, January 13th, 2021)
[4] Matt Roberts, ‘Mental Health Act undergoes landmark reforms’ (National Health Executive, January 14th, 2021)
[5] 'Mental Health Act Statistics, Annual Figures 2019-20 - NHS Digital' (NHS Digital, 2021) https://digital.nhs.uk/data-and-information/publications/statistical/mental-health-act-statistics-annual-figures/2019-20-annual-figures
[6] Ibid
[7] Christopher Hope, ‘Mental Health Act overhaul to allow sectioned people to choose family to represent them’ (The Telegraph, January 9th, 2021)
[8] Ibid
[9] Alex Turnbull, ‘” Landmark” reform to mental health laws’ (Independent Nurse, 13th January 2021)
[10] Ibid
[11] ‘Discrimination in mental health services’ (Mind, June 2019)
[12] Ibid
[13] Alexis Quinn, ‘Autism is not a mental health issue, yet I was sectioned’ (Metro, January 18th, 2021)
[14] ‘Reform of the Mental Health Act must be properly funded’ (Law Society, January 15th, 2021)
[15]Ibid
Disclaimer: This article (and any information accessed through links in this article) is provided for information purposes only and does not constitute legal advice.