The Mental Health Act White Paper: a big step towards change

13/01/2021

The government has published the Mental Health Act white paper, setting out their plans to reform the act. Our Social Policy Manager, Will Johnstone, highlights the key areas that the white paper sets out to change and how it impacts people living with severe mental illness.

For Rethink Mental Illness, the Mental Health Act white paper isn’t just the culmination of several years of campaigning, research, and working with our friends across the mental health sector. It’s also the beginning of a transition towards meaningful change in the care and treatment of people living with severe mental illness who are detained under the act.

There are many potential changes to the act that we support, but here are three that we are most looking forward to:

Guiding Principles

The government plan to write guiding principles into the Mental Health Act. These will provide a guide for 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 are as follows:

Choice and autonomy: people should be supported to express what they want and be heard; patients should understand their rights and their relationships should be respected.

Beneficial purpose: care and treatment should be delivered with a view to ending the need for coercion.

Treating patients as individuals: detention should respect the individual circumstances of the detained person, and consider their protected characteristics.

Least restriction: compulsory powers should be used in the least restrictive and least invasive way possible.

Racial inequalities

We also hope that the third principle – treating patients as individuals – will have a positive impact on the experiences of people from Black African and Black Caribbean backgrounds who are statistically more likely to be detained under the act than their white peers. The ‘treating patients as individuals’ principle is intended to reform parts of the law which have a negative impact on the rates of detention and experience of people from diverse backgrounds – including changes to reduce the high rates of Community Treatment Orders and to prefer less restrictive alternatives to detention under the act.

Practical measures, such as pilots for culturally sensitive independent advocacy services, and the Patient and Carer Racial Equality Framework (an initiative which aims to make mental health providers better at measuring and improving the impact their policies have on service users from diverse backgrounds) 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.

Family and carer involvement

The white paper recognises the vital role that carers, families, and friends play in supporting someone who’s 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.

Carers and loved ones play such a vital role in the recovery of people detained under the act that these changes are crucial in ensuring their role is legally recognised and enhanced.

What’s next?

There’s a great deal to look forward to, but it’s worth noting that the white paper’s publication is the continuation of a process, not the end of it. The government are setting out their views on what should change, but we still need to make sure that these changes become law.

If you share our excitement, you can sign up to become a campaigner to help us continue our work on the act.

If you have experience of the act, the government are looking to hear your views on their plans in a consultation.

This white paper has been a long time coming, and it’s cause for celebration. But we still have a long way to before we get a Mental Health Act which we can all be proud of. We look forward to working with the government, people detained under the act, their carers and loved ones, and our campaigners and supporters, to see it delivered in the near future.

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