The Government has announced a major reform of the Mental Health Act including speedier transfer of mentally ill prisoners to hospital and greater emphasis on patient autonomy.The Reforming the Mental Health Act white paper, published Wednesday, builds on the recommendations of Professor Sir Simon Wessely in his 2018 Independent Review of the Mental Health Act. Proposed changes include the introduction of ‘advance choice documents’, which would enable people to express preferences on their care prior to hospitalisation, and the expansion of the role of independent mental health advocates.
Individuals detained under the Act will also be able to nominate someone to represent their interests. This marks a significant departure from the current system, which can detain people for mental health treatment without their consent. There were almost 50,000 detentions in 2018, an increase of 47 percent over the past decade.
Reflecting on the ‘unique risk profile’ of individuals who are both mentally ill and incarcerated, the paper also proposes changes to the criminal justice system. These include a 28-day time limit within which prisoners should be transferred to hospital and the ability for defendants to be taken directly from court to healthcare settings. Justice secretary Robert Buckland, who as a barrister practised in criminal law, said that prison officers should be ‘dealing with criminals, not the mentally unwell’.
The reforms will also focus on the disproportionate detainment of people from black, Asian and minority ethnic (BAME) backgrounds under the Act. Black people are over four times more likely to be detained, and ten times more likely to be put on a Community Treatment Order. The Government has proposed the introduction of ‘culturally appropriate’ mental health advocates, as well as the piloting of a Race Equality Framework to be used across mental health trusts.
Mark Rowland, chief executive of the Mental Health Foundation, hailed the publication of the white paper as ‘an incredibly important step’, adding that the reforms should ‘honour patient choice and put restraint and healing at the heart of how we respond to mental distress’. Speaking to The Telegraph on Tuesday night, Nadine Dorries – minister for Mental Health, Suicide Prevention and Patient Safety – said that the Government was ‘determined to expand and transform mental health services. For anyone needing support, you are not alone. Please, reach out.’