Strengthen Mental Health Bill, say MPs

The government should strengthen its draft Mental Health Bill to address the rising numbers of people who are detained under current legislation, a committee of MPs and peers has said.

The joint committee on the draft mental health bill, whose job it is to scrutinise the bill, also called for it to tackle the problem of racial inequality. “Community treatment orders are 11 times more likely to be given to black people than white people and this figure is rising,” the committee noted in its report. “The evidence we heard suggests they are ineffective for most patients.”

Baroness Buscombe, who chairs the committee, said members welcomed the reform proposed under the draft bill and that ministers must now act swiftly to bring it before parliament. “We believe stronger measures are needed to bring about change, in particular to tackle racial disparity in the use of the Mental Health Act. The failure to date is unacceptable and inexcusable,” she said.

Another recommendation in the committee’s report is to create a new mental health commissioner to monitor the implementation of the bill and speak up for patients, families and carers.

The report also recommends that health organisations should appoint a responsible person to collect and monitor data on detentions under the Mental Health Act (MHA), broken down by ethnicity, with annual figures published by government, and to implement policies to reduce inequalities.

The committee’s report welcomed the government’s proposal to end the inappropriate long-term detention of people with learning disabilities or autism. However, it recommended that integrated care boards and local authorities should be given strengthened duties to ensure an adequate supply of community services for these groups to avoid long-term detention.

Strengthen patient choice

Another recommendation in the report was that patients detained or previously detained under the MHA should have a statutory right to request that an advance choice document, setting out their preferences for care and treatment, is drawn up. This would strengthen “both patient choice and their voice” Buscombe said.

She added: “The existing shortfall in community care must also be addressed or these reforms risk being derailed, with worse outcomes for those that the bill is intended to help.”

The committee welcomed the removal of prisons and police custody as places of safety, and the introduction of appropriate places of safety as a way of reducing detentions and pressures on A&E and the police.

The draft bill was published in June 2022, following the 2018 Independent Review of the Mental Health Act. The bill amends the Mental Health Act 1983, the main legislation regulating the compulsory detention or treatment of a person with a mental disorder in England and Wales.