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Help reform the Mental Health Act

Last week, the government released its white paper on the Mental Health Act; which details a number of proposed changes that are now out for public consultation.

We take a look at why it needs to change, summarise the new proposals and how you can have your say.

For those who may be unfamiliar with the Act or the actions that lead up to the realise of this new paper, we’ve prepared some background information. If you're ready to read our Advocacy team's white paper analysis, feel free to skip ahead.

What is the Mental Health Act?

The Mental Health Act 1983 describes how and when you can be detained in hospital against your wishes, in the event that your mental health has made you a danger to yourself or others.

People often use the word ‘sectioned’ to describe someone who has been detained, because the circumstances of your hospitalisation and your rights depend on what section of the Mental Health Act you have been detained under.

The sections within the Act also detail how decisions are made about your care, how and where it is given and the treatment you will receive.

Why does the Mental Health Act need to change?

As with all laws and policies, they need to be kept up to date to reflect the society we currently live in. There may also be short-term changes made in an unprecedented emergency, such as those bought in by the Coronavirus Act 2020.

The Act is now 36 years old. Campaigners, mental health professionals and patients alike have voiced how certain parts of the Act bear little resemblance to how we need to support people: from the ambiguity for people who also live with learning disabilities, to the culture of treatment experienced by those from different ethnic backgrounds.

A controversial part of the Mental Health Act is it’s use of restraint, both physical and chemical, which is often disproportionality used on Black males. The Act urgently needs to consider and protect different ethnicities and cultures, to prevent further harm and distrust of the mental health system.

What is a white paper and what will it do?

In 2017 the government asked a range of independent experts (including Mind) and those with lived experience of a mental health issue to review the Mental Health Act and suggest ways it could be improved. This January 2021 white paper is the government’s response to these suggestions, and lists the ones they wish to turn into law.

Before that can happen, the government now wishes to hear feedback through a public consultation, which means you too can have your say. The consultation closes on 21st April 2021, but there is no suggested timeline to make these proposals law, and the pandemic response continues to slow down projects such as this. It’s possible it might even take years, which is an issue when changes are already overdue.

Our Portsmouth Advocacy Service represent the voices of those detained under the act every day. The team have read the white paper in detail and have summarised the proposals and what they may mean for you.

"The general theme of the proposals is the aim to keep you at the centre of decision making, which is very important. Any conversations, records or plans will need to record your views, which could enable you to question or challenge how you are being looked after.

The proposed changes are based on 4 key principles that have been developed with people with their own lived experience of a mental health issue. They are as follows:

  • Choice and Independence – ensuring that your views and choices are respected
  • Least Restriction – ensuring the powers of the Mental Health Act are used in the least restrictive way to you
  • Therapeutic Benefit – ensuring that if you become a hospital patient, you’re supported to get better in order to be discharged from the Mental Health Act
  • The person as an individual – ensuring that your personal views are taken into account

Choice and Independence

This is a key part of the proposed changes, because you may now be supported to ask a Responsible Clinician (like a Psychiatrist or Doctor) what actual choices are being offered to you in terms of your treatment. This will ensure that your views and choices are clearly recorded.

The changes will also empower you to ask important questions such as:

  • How will you ensure that respect is being shown to me and how will that be recorded?
  • What choices are being offered to me in terms of my treatment?
  • What is written in my Care Plan or CPA (Care Program Approach) to support this?
  • How clear are my views in relation to the choices included in my Care or Treatment plan?

The greater sense of choice and independence in these proposals also extend to being able to choose which friend or family member can be given rights and be involved in your care.

Least Restriction 

This is a guiding principle used by psychiatrists or doctors, to ensure the Act is implemented in the least restrictive way and ensure that you have the independence and time to focus on your recovery. For example, if it's possible to treat you safely and lawfully without detaining you under the Act, you shouldn’t be detained.

In these proposals, you could be supported to talk about the restrictions that your Care or Treatment plan may impose upon your life. Decision makers would have to listen and more importantly, record your views.

You could also be supported to challenge the views of the responsible clinician as to what is the least restrictive care or treatment. The psychiatrist or doctor could then be asked to provide you with evidence of how they’ve followed the Least Restriction principle and why they think their course of action is in your best interests.

Therapeutic Benefit

Much like the Least Restriction proposal above, you could also be supported to ask your responsible clinician to explain how and why their choice of treatment provides the best therapeutic benefit to you. Simply put, if you do not agree with your treatment, you may now be able to challenge it.

The Person as an Individual 

If you are detained in hospital, you may find that there are blanket policies in place for whole wards or units. Under this proposal, you could challenge policies in such settings and communicate any personal needs in your Care or Treatment Plan."

Have your say

The white paper now enters the public consultation phase, where they will invite feedback and collect evidence from the public. To ensure the voices of those with lived experience are at the heart of these proposals, we'd like you to share your views. You can:

  • Take part even if you have not been detained before
  • Take part if you care for people living with a mental health issue, either as a loved one or as a profession
  • Submit an organisational response, if you are an employer who often works with the Mental Health Act

You can start the online survey here. You will be asked to answer some questions about yourself for research purposes, but what you submit will be anonymous. If you struggle to fill it in alone, ask a loved one to help you. Remember that your wellbeing comes first, so come back to it later if you need a break. 

If you need some help with the language found inside the online survey, we're happy to help. Email us on: