Government to slow down reform of Mental Health Act

The government has said that it will slow down the implementation of reforms to the Mental Health Act in response to the publication of a report into the treatment received by Valdo Calocane before he killed three people in Nottingham.

Dr Sanjoy Kumar, whose daughter Grace O’Malley Kumar was one of the three victims, said that the health secretary, Wes Streeting, had spoken to him about the planned mental health reforms. “Wes Streeting, secretary of state for health, has promised us that he’s going to slow down the modifications to the Mental Health Act,” Kumar told Sky News. “He has promised that we will be able to work with people who are working with the law. A change is needed. We need to step back a little bit and really see what is safe for the public.”

In the King’s speech in July, the government announced plans to “modernise” the Mental Health Act to give patients “greater choice, autonomy, rights and support”.

The proposals included changing detention criteria so people could only be detained under the act if they posed a risk of serious harm, as well as shortening the period of time for which they could be detained.

The government also said it would “strengthen the voice of patients” by adding statutory weight to their right to be involved with planning their care, and making choices and refusals.

Cross-party support for reform

Reform of the Mental Health Act has been a long time coming.  In 2018, an independent review commissioned by the previous government and led by Sir Simon Wessely, made more than 150 recommendations. Most of these were accepted by the government, which in 2021 published a white paper outlining a set of proposed changes. This was followed by publication of a draft bill in 2022, which had not been passed into law by the time of the general election. The proposals, however, had cross-party support and the new Labour government announced its intention to implement the reforms. These may now be on hold.

Kumar said he wanted to “get the Mental Health Act right” and it was “not about depriving people of their liberty”.

He added: “It’s about holding clinicians responsible who put people like that out on our streets. Any psychiatrist who puts out a dangerous person on our streets has to be held responsible for putting that patient out if he has not done a comprehensive risk assessment. We really hope to be working collaboratively with Wes Streeting, who certainly has the will and the intention to get this right.”

Streeting said he wanted to reform the act in a way that would get the “balance right between recognising there are people whose liberties are being deprived today who could live safely in the community, but also recognising for others there needs to be much better and closer supervision so that people like Calocane are not able to be on the street causing risk or fatalities to others”.

A Care Quality Commission (CQC) review of the mental health care received by Calocane in the years before the Nottingham killings found “a series of errors, omissions and misjudgments” in his treatment.

These included risk assessments that “minimised or omitted” key details such as the seriousness of his risk to others, and not opting to medicate him via depot injection, a slow-releasing form of medication. Calocane frequently refused to take medication when at home and showed “little understanding or acceptance of his condition”, the CQC said.

The report criticised clinicians for not assessing whether Calocane was in a position to make decisions about his care, saying his psychosis symptoms would have “impaired his ability to weigh up the information regarding the need for antipsychotic treatment and the risks of discontinuing it”.

In response to the CQC’s report, Streeting said that he wanted the recommendations of the report to be applied throughout the country so that other families did not suffer the pain that the families of the three Nottingham victims had to live with.