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The Royal College of Psychiatrists Improving the lives of people with mental illness

Independent review of the Mental Health Act

 

Why has the Prime Minister called this review?

At Conservative Party Conference the Prime Minister restated her commitment to “tackling the injustice and stigma associated with mental health”. The government has noted concern about:

  • rising rates of detention under the act

  • the disproportionate number of people from black and minority ethnicities detained under the act

  • whether some processes relating to the Act are in line with a modern mental health system.

In the last ten years detentions under the Mental Health Act have risen 47% from 43,361 in 2005/6 to 63,622 in 2015/16. (Source: NHS Digital).

Compared to white patients, black patients are 53.8% more likely to be detained under the Mental Health Act and Asian patients are 42.4% more likely to be detained.

Rates of detention across the whole adult population is over four times higher for black people, compared to white people, and around two times higher in the entire BME population. (Source: NHS Digital)

 

What is the remit of the review?

In the Queen’s speech (June 2017) the Government committed to reviewing the mental health legislative landscape and to publish policy recommendations intended to “provide greater rights for those experiencing mental health problems so they can live lives free from discrimination.” 

The Cabinet Office and Department of Health have stated that the review will look at:

  • why rates of detention are increasing and what can be done to reduce inappropriate detention and improve how different agencies respond to people in crisis

  • reasons for the disproportionate number of people from certain ethnic backgrounds, in particular black people, being detained under the act, and what should be done about it.

The review will make recommendations to government which aim to improve the treatment and support received by people experiencing mental ill-health. These recommendations should be practice-based where possible. See the full terms of reference for the review.

 

Who will lead the review?

The Prime Minister confirmed that the independent review will be chaired by Professor Sir Simon Wessely, past president of the Royal College of Psychiatrists, who will have overall responsibility for the review and its outputs. Vice-chairs will also be appointed.

The review will appoint an advisory panel to ensure that service users, carers and other stakeholders are involved in forming its recommendations.

 

Will the review cover all of the UK?

No. The review will consider the functioning of the Mental Health Act 1983, which applies only in England and Wales.

The recommendations made by the review will apply to England (relating to health matters, which are devolved) and to England and Wales (for non-devolved matters, including justice).

 

What is the time frame of the independent review?

The review will produce an interim report with priorities for the review’s work in early 2018, and a final report with detailed recommendations on its priorities, by autumn

 

What is the Mental Health Act and when is it used?

The Mental Health Act provides legal authority for people with mental illness to be admitted to hospital and treated in England and Wales. The current Act was passed in 1983 and was last reviewed in 2007. Use of the Act can save lives but it can mean that people are given treatment against their wishes.

Detentions under the Mental Health Act are made when someone has a mental illness in need of assessment of treatment for the sake of their health or safety or that of others. When someone experiences a mental health crisis like this they are at their most vulnerable.

People who are subject to the Mental Health Act have certain rights including the right to appeal and the right to support from an advocate.

 

Why are detentions rising?

We don’t know for certain why detentions under the Mental Health Act are rising.  We have been concerned about the rising numbers of detention and the disproportionate detentions of people from ethnic minorities and believe the underlying circumstances for this should be thoroughly reviewed.

Providing earlier support can stop people from reaching a mental health crisis in the first place. It is important that the review explores the wider context which the Act operates in and thoroughly considered all the related factors, including the mental health, care and social support system, before actions or legislative change are recommended.

 

How will the College be involved in this review?

The Royal College of Psychiatrists welcomes the Prime Minister’s announcement of a review of mental health law as this can be a significant opportunity to improve mental health care in England and Wales.

The College is keen to work with the review to provide expertise and experience in order to provide better support for those with mental health needs.

Changing mental health law could have a profound impact on the rights of many vulnerable people who have the right to the best possible care and support so it is essential that Government consults widely with patients, carers and clinicians and listens to their views.  The College will work with the Mental Health Alliance, a coalition of patient groups, charities, professional bodies, and civil society organisations to ensure that this happens.

 

Help and advice for those experiencing mental health difficulties and for their friends, family and carers is available.

 

We have set up an email address, MentalHealthActReview@rcpsych.ac.uk, in order for all members to be able to give their thoughts on the review.

 

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