Our response to the Independent Review of the Mental Health Act published today

18 November 2018

Today, 6 December, the Independent Review of the Mental Health Act published its final report with around 150 recommendations for change. We are really pleased to hear that the Prime Minister has welcomed the Review and that the Government plans to bring forward a new mental health bill.

Rethink Mental Illness has been campaigning for over two years to reform the Mental Health Act. Read on to find out the latest develo---pments and how you can be part of the campaign to improve the rights of people detained under it.

Mark Winstanley, CEO at Rethink Mental Illness, said:

“Rethink Mental Illness has long campaigned for reform of the vital but outdated Mental Health Act. Countless people have told us how they felt disrespected and lost all control of their care while treated under the Act.  The Review’s recommendations can change that.  By giving people more rights to shape their own treatment, choose how to involve loved ones, and more power to challenge decisions, the Review shows how mental healthcare can respect people’s rights while they are very unwell. We are ready to work with the Government, Parliament and the NHS to now take these recommendations forward.”

Last year the Prime Minister announced an Independent Review of the Mental Health Act - which sets out when a person can be detained and treated in hospital against their wishes - to look at how it is used and how it can be improved.

Over the course of this year, the Review has heard from thousands of people who have been detained under the Act, including carers and loved ones. We have been told by countless people detained under the Act how it failed to protect their rights and dignity; excluded them from decisions about their own treatment, and from carers who were left in the dark about their loved ones’ care.

Principles of the Mental Health Act

There are currently no principles on the face of the Mental Health Act. The Review recommends adding principles as it would contribute overarching values to guide the way the Act is applied to the care and treatment of people detained under it. The principles recommended by the Review are:

  • Choice and autonomy: people being supported to express what they want and to 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.

These principles would seek to address some of the current problems with the Act, such as a lack of patient autonomy and choice.

Here is a summary of the Review's key recommendations:

  • Replacing the ‘Nearest Relative’ role (a family member with particular rights and powers, who is chosen from an inflexible list) with a ‘Nominated Person’, chosen by the person detained

  • Giving patients a legal say over their treatment - doctors will only be able to overrule their wishes in certain circumstances

  • Better oversight of treatment decisions (via independent doctors and tribunals)

  • Extending a right to advocacy to informal inpatients (those who have not been detained under the Mental Health Act but could the threatened with it)

  • More access to tribunals

  • Making care planning statutory for people subject to the Mental Health Act

  • Aiming to substantially reduce the use of Community Treatment Orders

 The Reviews recommendations mark a milestone for everyone wishing to improve this important but outdated legislation.

The response from the Government has been positive…but there is still a long way to go before we get the law changed and funding committed. Please follow us on Facebook and Twitter to get details on how you can support us.

If you would like to be put in touch with spokespersons or case studies please get in touch with our media team at 0207 840 3138 or email media@rethink.org