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Mental health law reform will give patients more rights

Reforms designed to improve patient experience

Adrian O'Dowd

Thursday, 06 December 2018

The government has today announced it will reform existing mental health law so that people will have more say over the care they receive and greater rights.

Following publication of the final report* from the Independent Review of the Mental Health Act 1983, the government said it would introduce a new Mental Health Bill to transform mental health care.

It is accepting two of the review’s recommendations to modernise the Mental Health Act.

Firstly, people detained under the Act will be allowed to nominate a person of their choice to be involved in decisions about their care.

Currently, they have no say on which relative is contacted and this can lead to distant or unknown relatives being called upon to make important decisions about their care when people are vulnerable.

Secondly, people will also be able to express their preferences for care and treatment and have these listed in statutory “advance choice” documents.

The review, chaired by Professor Sir Simon Wessely, Regius Professor of Psychiatry at King’s College London and president of the Royal Society of Medicine, suggests various changes to the existing legislation including:

  • people’s wishes and preferences should carry far more legal weight
  • action is needed for people from ethnic minority communities, children and young people, people in the criminal justice system, and those with a learning disability, autism, or both
  • the use of compulsion should be targeted and justifications should be transparent.
Prime minister Theresa May announced an independent review of the Mental Health Act 1983 in October of last year, saying she wanted to make improvements following rising detention rates, racial disparities in detention and concerns that the Act was out of step with a modern mental health system. The review team was also asked to consider how to improve practice within existing legislation.

Health and social care secretary Matt Hancock said: “I am determined to do everything I can to protect people’s mental health and get them the help they need. The proposed new Mental Health Bill will give patients more control over their treatment and make sure that our mental health laws are fit for the modern age.”

Claire Murdoch, NHS England’s national director for mental health, said: “High-quality support in the community before a person reaches crisis point, coupled with improved crisis services when they are needed, will both help, but the review is also right to argue that anyone who needs to be in hospital should get the best care during and after their inpatient stay.”

British Medical Association's mental health policy lead, Dr Andrew Molodynski, said: “We welcome this review and with it the recognition of the importance of improving the overall patient experience in relation to mental health legislation and the subsequent care they receive.

“Changes to mental health legislation must ensure that any restriction to fundamental rights is both proportionate and necessary with respect to the care that an individual requires.

“This is particularly relevant in the case of community treatment orders (CTOs). While we welcome progress in acknowledging patients’ wishes and preferences and proposals for greater limitations of CTOs, there is a need for further review of their use given that current evidence does not substantiate their viability.

“As well as a significant legislative overhaul, there is a clear need for investment in mental health to ensure effective patient care, with a focus on treatment rather than security.”

*Modernising the Mental Health Act: Increasing choice, reducing compulsion – Final report of the Independent Review of the Mental Health Act 1983. Department of Health and Social Care, December 2018.

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