Reform of the Mental Health Act – workforce implications

The College was disappointed that our calls for more psychiatrists to meet the demands of much needed reforms to the Mental Health Act went unheeded in the Spending Review yesterday.


Earlier this year, the Government published the Mental Health Act White Paper, which set out proposed changes to reform the Act.

We broadly welcome the proposed reforms. They provide an opportunity to modernise mental health law, tackle racial disparities, and improve crisis support. However, they will result in significant changes to the way psychiatrists work and place more demands on their time.

Our work to influence the Spending Review

To influence the 2021 Comprehensive Spending Review (CSR), we commissioned The Strategy Unit to provide an independent assessment of the impact of the proposed changes on the psychiatric workforce.

The research found that the system will need an additional 333 FTE psychiatrists by 2023/24, and a further 161 by 2033/34. These numbers are in addition to the numbers required to deliver NHS Long Term Plan commitments, meet increased demand, fill vacancies, and replace those leaving the profession.

In our response to the research, we recommended that the Government invest a cumulative £82m over the Spending Review period to cover the 349 psychiatrists that are required, and for investment to be accompanied by a workforce plan.

The Government’s response

Chancellor of the Exchequer Rishi Sunak stood in Parliament to deliver the conclusions of the 2021 CSR on Wednesday 27 October. There was not one mention of the proposed changes to the Mental Health Act.

We will continue to lobby

Over the coming weeks, months, and years, we will continue to make the case that the proposed changes cannot be absorbed within the existing workforce.

The impact of taking the reforms forward without investing in the workforce would be significant and, in this instance, we would recommend a phased implementation model.

We have offered to work with the Department of Health and Social Care on this point.

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