One step closer to Mental Health Act reform: Rethink Mental Illness responds to committee's recommendations

19 January 2023

Long-awaited reform of the Mental Health Act, the legislation which allows people experiencing a mental health crisis to be detained in hospital, has moved one step closer. The Joint Committee on the Draft Mental Health Bill has today published a report with its recommendations for the Bill.

The committee, made up of MPs and peers, heard evidence from a range of experts, including Rethink Mental Illness, a diverse range of people with lived experience, clinicians, academics, researchers and lawyers. It has reached a high degree of consensus in how the Bill should address rising numbers of people detained under the Act, improve the level of choice people have in their care and treatment, and tackle unacceptable racial inequality. This builds on the significant consensus obtained as part of the independent review in 2018.

Lucy Schonegevel, Associate Director for Policy and Practice at Rethink Mental Illness, said:

“For too many years, people living with a severe mental illness have not had enough of a say in their treatment, and their voices haven’t been heard. There are so many examples of the poor care received by people enduring some of the most difficult days of their lives when sectioned under the Mental Health Act, and in the last year alone we have heard some shocking reports of abuse and neglect in mental health hospitals. Meanwhile, the racial disparity in the use of the Act is sliding backwards rather than improving. Today’s report comes at a critical moment and we welcome its recommendations.

“It is hugely welcome to see the recommendations for guiding principles – choice and autonomy, the least level of restriction, the ensuring of a therapeutic benefit to care and the treatment of people as individuals – to be placed at the front of the bill. We are also pleased the committee recommended including a principle of ensuring racial equality, given so many Black people encounter unacceptable racist treatment under the Act. But we think this should go even further by recognising equality for all protected characteristics. Setting this out on the face of the Bill will make it clear what individuals should expect and what clinicians should deliver. This is vital when culture change is so desperately needed.

“With the long-standing issues around poor treatment on inpatient wards, most recently highlighted in undercover exposés by the BBC and Channel 4, we strongly agree that the right to an independent advocate should be extended to people receiving treatment voluntarily. A statutory right to culturally-appropriate advocacy will be another crucial way of addressing racial injustice and builds on successful pilots recently carried out by the Department for Health and Social Care.

“We know that Black people are 11 times more likely to be placed on a Community Treatment Order, where people can be discharged from hospital under conditions imposed on them. This is a shameful symbol of the racism built into the system. We are pleased the committee has recommended abolishing CTOs for some people, but we must also ensure the right community services are in place. Only then will we reduce the number of people returning to hospital because they’ve gone home with little to no support, left alone to deteriorate at a critical and fragile point in their recovery.

“We also support the Committee’s recommendations for a statutory right to an advance statement, which gives people the ability to make decisions about their care and treatment if they do become unwell.

“As the report highlights, there are concerns about resourcing the Bill. Yet with the huge consensus reached by the committee, building on the recommendations of the 2018 independent review, it is clear what action must be taken.

“There is a significant opportunity now for the government to improve the way people severely affected by mental illness are detained and cared for. But of course legislation won’t solve everything, and investment and transformation of community services remains crucial to both preventing people from becoming unwell in the first place and helping people leave hospital when it works for their recovery.

“While we wait for reform to be implemented, people continue to suffer the harms of the current Mental Health Act up and down the country. The Mental Health Bill, amended in line with the committee’s recommendations, must be introduced to parliament as soon as possible.

“We thank the committee for its dedication, hard work and collaboration.”