‘Antiquated’ mental health laws in England and Wales set for overhaul | Health policy

An overhaul of what Boris Johnson described as “antiquated” mental health laws will make it harder to detain people with learning disabilities and autistic people in hospital.

The reforms – which will be part of the Queen’s speech next week and are the first big changes to the Mental Health Act in four decades – are designed to reduce the number of people being detained under current laws in England and Wales. The number of detentions rose by 40% between 2005-06 and 2015-16 and have continued to rise year on year.

Details of the new draft mental health bill were announced on Friday night by Downing Street, which said it met key manifesto commitments.

They include ending a situation in which people with learning disabilities and autistic people can be detained under the act even if the patient does not suffer from any mental health conditions. This practice will be ended by removing learning disabilities and autism as mental health disorders.

While current laws allows treatment to be imposed on patients against their wishes, the draft bill will allow them to voice a preference or refuse a specific treatment where a suitable alternative is available.

Johnson said: “Our mental health laws are antiquated. Every person deserves to be treated with dignity, and it is our duty to ensure the rights and freedoms of our most vulnerable in society are protected and respected.”

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Downing Street said the reforms would help tackle disparities and reduce the number of people from minority ethnic backgrounds, in particular black African-Caribbean communities, detained under the act.

Black people are more than four times more likely to be detained under the act and more than 10 times more likely to be subject to a community treatment order.

The draft bill takes forward recommendations made by Prof Sir Simon Wessely’s 2018 independent review, which looked at how the Mental Health Act is used.

Welcoming the news that the draft bill was being brought forward, Wessely said: “Undertaking pre-legislative scrutiny is a vital step in making sure the bill delivers on our ambitious plans for reform. By strengthening patient rights to influence their care and treatment, and to choose who supports them, we can improve people’s experience of mental health services, address current significant racial disparities and combat rising rates of detention.”

The draft legislation also includes proposals to rebalance the threshold for detention – by ensuring that decisions must balance risk to the public and therapeutic benefit to the patient – and ensuring that all patients receive a timely plan on care and the route to their discharge.

It also proposes reducing the use of community treatment orders, which mean people remain supervised in their community and can be sent back to hospital, and which can include restrictions such as where a person has to live.

The Department of Health and Social Care is running a call for evidence seeking views before a new 10-year mental health plan and updated national suicide prevention plan.

Downing Street said work to reform mental health services continued, after a government investment of £400m to eradicate outdated dormitories in mental health facilities, although health professionals and others recently have also been seeking new investment in mental health services more broadly.

The pandemic has led to a dramatic rise in the numbers of people experiencing mental health problems, with 1.6 million waiting for specialised treatment and another 8 million who would benefit from support unable to get on the waiting list.

By Percy