The reform of the Mental Health Act of 1983 has been broadly welcomed, but questions still remain about support for individuals with autism and learning disabilities.
Just before Christmas, the new Mental Health Act received royal assent. It is intended to reform the Mental Health Act of 1983, which provides the legal framework to detain and treat people in a mental health crisis who are at risk of harm to themselves or others.
For years, the government says, patients have been let down by a mental health system that needs reform. Those detained under the Mental Health Act have had too little say over their care and treatment and who should be involved in it.
It pointed out that Black people are 3.5 times more likely to be detained than their White counterparts. Autistic people and those with learning disabilities who don’t have a mental health condition have often been inappropriately detained.
The new Act will ensure patients have stronger rights and greater control over their treatment through new statutory care and treatment plans. Families and carers will have more involvement in decisions around treatment, giving them a real say in supporting their loved ones.
Racial disparities in treatment will be addressed through clearer guidance for mental health professionals. The act will also strengthen the rights of children and young people to make their wishes and feelings more central to decision-making, ensuring they, and those close to them, are consulted and involved where appropriate with decisions around their care and treatment.
“Mental health patients are among the most vulnerable in our society and their safety and rights must be protected. Both patients and staff have been calling for a twenty-first-century Mental Health Act that supports both those receiving and those delivering modern mental health care,” said Parliamentary and Health Service Ombudsman Paula Sussex.
Significant step forward
“When I chaired the Independent Review of the Mental Health Act, I met a service user who told me that she was certain that being sectioned had saved her life, but she added, ‘why was it such a terrible experience?’ Why indeed,” said Simon Wessely, chair of psychological medicine at King’s College London and who proposed the reforms in a review in 2018.
“Our review proposed giving patients more of a say over their care, to ensure they were treated with greater dignity and respect, but without jeopardising the safety of others,” he said.
The Act was broadly welcomed.
“The new Mental Health Act is a major step towards ensuring that people in mental health crises get care that is safe, effective and centred on their needs,” said Adrian James, medical director for mental health and neurodiversity at NHS England.
“It will give every detained patient a real say in their treatment and a timely care plan, with any period of detention focused on therapeutic benefit and kept as short as possible.”
“This is a landmark moment and a vital step towards ending the inappropriate detention of people with a learning disability and autistic people in mental health hospitals,” agreed Jon Sparkes, chief executive of learning disability charity Mencap.
Rebecca Fitzpatrick, partner and head of health advisory and inquests at law firm Browne Jacobson, called the Act a “significant step forward” in modernising mental health legislation and placing patient choice and autonomy at the heart of the system.
Though for her, concerns still remained. “Robust community services must be available to support individuals with autism and learning disabilities, underpinned by an appropriate legal framework to safeguard their welfare,” she said.