Our hopes for the 2022 Queen's Speech

Next Tuesday (10 May) at the annual State Opening of Parliament, the Queen’s Speech will set out the government’s legislative priorities for the next parliamentary year – the bills it plans to enact in the next 12 months or so. We hope that one of the bills announced will be the long-awaited reform of the Mental Health Act.

The long-awaited reform of the Mental Health Act

The Mental Health Act is the law that allows people to be detained and treated without their consent if they are experiencing a mental health crisis that means that they pose a risk to themselves (in the majority of cases) and/or others (in the minority of cases).

People who have been subject to the Mental Health Act often say that the help that they received saved their lives…but far too often they also say that their rights are not respected, and they are excluded unnecessarily from decisions about their own care. We are also seriously concerned about the fact that people from some minority ethnic backgrounds are far more likely to be detained under the Mental Health 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 than White people.

If a new Mental Health Bill is announced in the Queen’s Speech it will represent a once in a generation chance to improve a law that is at the heart of the way that people experiencing a mental health crisis are treated, by enhancing their rights and increasing their choices around their care and treatment.  

It will be a major milestone in a campaign that we have been working on for several years, working in partnership with people with lived experience of the Act, their carers and loved ones, as well as working closely with politicians and allies in the mental health sector (https://www.rethink.org/get-involved/campaign-with-us/rights-involvement-and-co-production/act-for-mental-health/our-work-on-the-mental-health-act/).

If it is not in the Queen’s Speech, that frankly will be a terrible missed opportunity and a devasting blow to the tens of thousands of people who are detained every year under this outdated Act and their loved ones.  

If reform is announced on Tuesday, we don’t expect to hear the specific details of what the Bill will contain immediately, and we call on the government to bring the Bill forward urgently.

However, we do know that any bill will be shaped by the recommendations of the Independent Review of the Mental Health Act that was published in 2018 (https://www.gov.uk/government/publications/modernising-the-mental-health-act-final-report-from-the-independent-review), and proposals that the Government announced in response last year (https://www.gov.uk/government/consultations/reforming-the-mental-health-act/outcome/reforming-the-mental-health-act-government-response#detention-criteria)

So, what might we see?

There’s not enough space here to talk about all of the important parts of these laws that need reform. But here are three things that we will be looking out for:

When Rethink Mental Illness heard from people who had experiences of being detained under the Act, the majority agreed with the proposed guiding principles.

‘You have to be treated as you and not as every other person…you are detained as you…’

We want to see a Bill that is based on overarching principles, which can guide professionals involved in caring for someone detained under the Act and help service users to know what they should expect from their treatment.

The principles that the Government accepted last year were:

• Choice and Autonomy – ensuring service users' views and choices are respected
• Least Restriction – ensuring the act's powers are used in the least restrictive way
• Therapeutic Benefit – ensuring patients are supported to get better, so they can be discharged from the act
• The Person as an Individual – ensuring patients are viewed and treated as individuals

We want an Act that adequately addresses racial disparities, including the disproportionately high rates of Black men and women detained under the Act, subject to a Community Treatment Order and more frequent use of restraint of Black people.

Practical measures, such as pilots for culturally sensitive independent advocacy services, and the Patient and Carer Racial Equality Framework are meaningful steps towards a Mental Health Act which does not unfairly discriminate against service users who are Black or from other ethnic minorities.

These changes are long overdue but more needs to be done and Rethink Mental Illness will continue to advocate for meaningful change.

Carers, families, and friends play a vital role in supporting someone who is detained under the Act. We’re really pleased that recommendations we called for in previous reports on replacing the Nearest Relative system have been accepted by the Government, and that the method of selection for the new Nominated Person will be through patient choice. This means that the powers and responsibilities for the Nominated Person will carry real weight and have meaning.

 The state opening of Parliament will be broadcast on BBC One & BBC Parliament on Tuesday from 10:30am GMT. To find out more about our work on the Mental Health Act, please visit our Act for Mental Health pages.