The Mental Health Act:
The campaign so far
The Mental Health Act was created in 1983 to allow people who need (but do not necessarily want) to go into hospital for mental health care and treatment. As a draft Mental Health Bill has finally been introduced to Parliament, here are some of the changes we have seen so far and some of the changes we hope to see.
Where are we now?
As the world has changed over the last 40 years, the Mental Health Act has not. It’s about time the laws dictating how some of the most unwell people are treated in the UK are updated in line with modern attitudes to mental illness.
Rethink Mental Illness has spent years campaigning to reform the outdated Mental Health Act to create a person-centred approach that involves people in the care they receive as much as possible.
The process of getting the draft Mental Health Bill into Parliament has taken a long time, it started back in 2018 with an Independent Review of the existing Mental Health Act, which formed the basis of the 2022 draft Mental Health Bill under the Conservative government.
What changed in the 2022 Mental Health Bill?
One major achievement of the draft Bill is that people severely affected by mental illness and their carers will have greater control over their care and treatment, and that this will support their sense of respect and dignity during an incredibly challenging and confusing time in their lives. The key changes that should improve choice and autonomy include:
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The ability to formally challenge detention through more frequent access to Mental Health Tribunals.
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The introduction of advanced choice documents that will set out a person’s wishes and preferences for care and which must be used by clinicians to guide treatment.
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Allowing a person to choose their own nominated person to support them with decisions while they are detained (something we’ve called for for many years).
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The introduction of statutory care and treatment plans and the need to record the reasons for compulsory treatment and restrictive practices to improve transparency.
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Increased access to Independent Mental Health Advocates, including for involuntary patients.
We also welcomed the proposed increased threshold for detention and the improvements to care for those in contact with the criminal justice system.
What changes do we still want to see?
A Joint Committee of MPs and Peers from three political parties made recommendations for improving the 2022 draft Bill. We were disappointed that the government chose to reject many key recommendations that have the potential to significantly change the lives of people living with serious mental illness.
The Joint Committee recommended, and we agree, that people should have a statutory right to request an Advance Choice Document and should have the support of a trained, independent person when making one.
It was a huge step in the right direction for the draft Mental Health Bill to create a statutory right to an Independent Mental Health Advocate for all patients whether involuntary (detained under the Mental Health Act) or voluntary (in hospital of their own free will). We believe that all patients should be placed on an opt-out scheme for advocacy once staff capacity allows, to ensure that people’s rights are protected no matter their situation.
A major concern about the draft Bill was that it did not go far enough to address the racial inequalities that are deeply entrenched within the application of the existing Mental Health Act.
To change this, we want the Mental Health Act to:
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Include a statutory right to culturally appropriate advocacy to address the specific challenges racially minoritised people face.
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Take steps towards abolishing Community Treatment Orders, where people are supervised in their community after hospital discharge.
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Commit to improving the monitoring of inequality data and efforts being made to address these inequalities.
Where do we go from here?
We are pleased that a draft Mental Health Bill has finally been introduced to Parliament, especially given the long road it has taken to get here, and the hard work of so many of our supporters and campaigners.
We look forward to continuing to work with the Government as the Bill passes through Parliament and is eventually implemented to ensure that the new Mental Health Act serves all communities and addresses the deeply entrenched existing inequalities.