Government to draw up new bill to support mental health patients in crisis

The Government will draw up new legislation to transform mental health care for patients in crisis and give them more control of their treatment.

Following the publication of the independent review of the Mental Health Act 1983, the Government has vowed to reform the legislation with a new Mental Health Bill.

The Government announced it was immediately accepting two of the proposals to modernise the Act and will put legislation before Parliament in the new year.

Prime Minister Theresa May said by bringing forward this “historic” new legislation, she was determined to tackle the “burning injustice” that mental health patients do not get the same access to treatment as those with physical conditions.

She added: “I commissioned this review because I am determined to make sure those suffering from mental health issues are treated with dignity and respect, with their liberty and autonomy respected.

“By bringing forward this historic legislation – the new Mental Health Bill – we can ensure people are in control of their care, and are receiving the right treatment and support they need.”

The response comes on the day the review published its report, which includes more than 150 recommendations on how improve the Act.

The proposed new Mental Health Bill will give patients the power to nominate a person of their choice to be involved in their care decisions and make advanced choices about their care, the Government said.

Under current legislation, patients detained under the act are allocated a “nearest relative”, which can lead to distant or unknown relatives being called to make decisions about their care.

The bill will also make advance choice documents a statutory requirement so that patients will be able to set out what future care they want or do not want.

The review said that while psychiatrists can overrule these choices, they will have a duty to say why they chose to deviate from the patient’s wishes, with patients given the right to challenge decisions on their treatment.

But it also said that for some procedures – such as electroconvulsive therapy – only a judge should be allowed overrule a patient’s choice not to have this treatment.

The review was commissioned by Mrs May following her pre-election pledge to rip up and replace the “flawed” Act.

Professor Sir Simon Wessely was appointed to chair the review in October 2017 with a remit to investigate the rising detention rate; the disproportionate use of the Act on black, Asian and minority ethnic groups; and what processes were “out of step” with a modern health system.

The number of people detained under the Act rose by about 30% from 48,600 in 2011-12 to 63,600 in 2015-16, according to NHS Digital figures, while black people are four times more likely to be detained under the Act.

The Government said it will consider the rest of the review’s recommendations and issue a response in the new year before preparing the new legislation.

The review also said major new investment was needed to improve some of the most “dilapidated” estates in the NHS and stressed compulsory treatment must be a last resort and more care should be provided in the community before people reach a crisis point and need to be detained.

It also proposed a new right for patients to challenge the treatment they are being offered at a tribunal.

The review found that it could be “traumatic” and “damaging” to be detained under the Act and that it was normally used on patients when they are at their most vulnerable.

Sir Simon said the recommendations were not about scrapping the existing Act, but modernising to make it fairer.

He added: “If there’s one important theme from the whole thing it is to ensure the voice of patients is heard louder and more distinctly and carries more weight than it has in the past.

“Even when deprived of their liberty, patients will still have a say in their treatment with greater and newer protections than they have had before.”

The authors said the NHS long-term plan – which will set out how the NHS will invest the £20 billion of new funding a year by 2023-24 – was “critical” for implementing its recommendations because it is expected to focus on bolstering crisis and community care.

But Royal College of Psychiatrists president Professor Wendy Burn warned that to reduce detentions under the Act, services need more cash and more staff.

She added: “If the Government is serious about significantly reducing the use of the Mental Health Act, hard-pushed mental health services urgently need further investment and a larger workforce to help people stay well before they reach a crisis point.”

Shadow mental health minister Barbara Keeley said the Government’s record on treating patients at risk of detention was “woeful”.

She added: “The Prime Minister pledged to tackle the burning injustices of mental ill health but unless it takes urgent action to improve services and take action on the inequities facing ethnic minority communities it will squander the opportunity to reform the Mental Health Act and this will only serve to fan the flames of this dire injustice.”

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