Mental Health Act review: White Paper

View: Reforming the Mental Health Act

Related papers

In December 2018, an independent review of the Mental Health Act (MHA) made recommendations for improving this legislation.

Many individuals with learning disabilities and/or autism can currently be detained under the MHA (because they meet the criteria for detention) when they do not have an underlying Mental Health issue. In contrast to the protection the MHA was intended to provide, for this group of children and adults it means that they are trapped in a system that causes them significant distress and harm. This has been evidenced in numerous reports including the Joint Committee of Human Rights inquiry into the Detention of Young People who are Autistic and/or have Learning Disabilities (2019) and CQC’s report Out of sight- Who Cares? (2020).

On the 13th January 2021 the government’s proposed reforms to the Act were published in a White Paper.

The CBF welcomes the plans to reform the Act but stresses that commitment to additional funding and regulation is also necessary to deliver change.

Issues addressed

The White Paper addresses several of the CBF’s long-term campaign issues and proposes:

1)    Learning disability and autism will no longer be considered a mental disorder for which someone can be detained for treatment under section 3 of the act.

In line with the general population, people with a learning disability or autistic people will only be detained for treatment if a co-occurring mental health condition is identified by clinicians. This would end the use of the Act to detain people with a learning disability or autism (other than for assessment for up to 28 days) where there is no evidence of a co-occurring mental health condition.

2)    There will be a duty on health and social care commissioners (NHS and local government) to collaborate to ensure provision of community-based support and treatment for people with learning disabilities and autistic people.

Commissioners will be obligated to provide sufficient services to meet assessed needs and ensure an adequate supply of community services. However, this will only be possible if commissioners have the right skills and knowledge (they are currently unregulated and have no professional body, code of conduct or professional standards), if adequate funding is provided and there is significant investment in discharge and community services. The CBF are concerned that the £62 million Community Discharge Grant is not sufficient to move children and adults into appropriate support in the community.

3)    Care and Treatment Reviews and Care, Education and Treatment Reviews will be placed on a statutory footing.

It will be a statutory requirement for the responsible clinician to consider the findings and recommendations made as part of care and treatment reviews in the patient’s care and treatment plan. There are loopholes in this section of the legislation, and we will raise this in our consultation response to the White Paper.

This White Paper is undoubtedly a step in the right direction, but it is also only the start of the much wider statutory reform that is needed to improve outcomes for people with learning disabilities and their families.

Legislative change is slow and these changes may not appear on the statute books until 2023. The reform of the Mental Health Act must be supplemented with immediate measures to improve the quality of life for people with learning disabilities and autistic people and their families.

What next?

The government will now publish a consultation on the proposed changes and plan to publish the reformed Mental Health Bill in 2022. The CBF, working with family carers, will respond to the consultation.

View: Reforming the Mental Health Act