Mental health patients to have stronger protections, government says

New laws will give patients sectioned under the Mental Health Act more dignity and say over their care, the government has said.

Announcing the long-awaited reforms to the 1983 Mental Health Act, the government said that current laws do not meet modern standards and fail to give patients an adequate voice. People experiencing severe mental illness can be placed in police cells, and the law automatically gives a patient’s nearest relative, rather than a person chosen by the patient, a say in decisions about their care.

Black people are more than three times more likely to be detained under the Act, while people with autism or a learning disability are sometimes detained inappropriately, the government said. Patients currently have little say over their care and treatment should they be detained, or over who should be involved in making decisions related to their care.

The new draft Mental Health Bill aims to improve patients’ experiences of hospital and mental health outcomes, while also introducing stronger protections for patients, staff and the general public.

Tailored care and treatment plans

Under the proposed reforms, it will be a legal requirement for each patient to have care and treatment plans tailored to their individual needs, making clear what is needed to progress them to discharge. The bill will also give patients the right to nominate a person to represent their interests and give them greater access to advocacy when they are detained. Together, these reforms will make it more likely that patients will stay in contact with health services and continue to engage with treatment, the government said.

The reforms also recognise the critical role that families and carers can play in keeping patients safe. The bill will strengthen the rights of families and carers through changes to the nominated person role, and require clinicians to consult with others close to the patient as they make decisions about their care where appropriate or where the patient wishes.

The act will also place a limit of 28 days for which people with autism or a learning disability can be detained unless they have a co-occurring mental health condition.

Police and prison cells will no longer be used to hold people experiencing a mental health crisis. Instead, patients will be supported to access a health care facility that will better support their needs.

Making sure patients are treated with dignity

Wes Streeting, the secretary of state for health and social care, said: “Our outdated mental health system is letting down some of the most vulnerable people in our society, and is in urgent need of reform. The treatment of autistic people and people with learning disabilities, and the way in which black people are disproportionately targeted by the act should shame us all. By bringing the Mental Health Act in line with the 21st century, we will make sure patients are treated with dignity and respect and the public are kept safe.”

The announcement of the draft bill was broadly welcomed by mental health organisations. Dr Sarah Hughes, chief executive of Mind, said that the bill had the potential “to be an historic moment for people with the most serious mental health problems and their loved ones, as well as the clinicians and experts who have fought tirelessly to bring the outdated Mental Health Act 1983 into the twenty-first century.”

She added: “The introduction of statutory care and treatment plans and the removal of police and prison cells as ‘places of safety’ are vital in creating a step change in how people are supported at times of crisis and as they live with enduring mental illness.”

Emma Paveley, interim assistant director of the NHS Confederation’s Mental Health Network, said: “These reforms are essential if we are going to start to address the unacceptable disparities in rates of detention for people from some ethnic minority backgrounds. We know black people are more than three times more likely to be detained under the Act, whilst those with a learning disability and autistic people have also been found to have been inappropriately sectioned and often detained for long periods of time.”

She added: “The Bill should stop people with learning disabilities and autistic people being detained long-term unless they also have a serious mental health condition, but only when there is sufficient and appropriate community care in place to support them instead. A plan on how this capacity will be built up is vital, otherwise people will continue to be detained inappropriately.”