New Mental Health Bill introduced for England and Wales

The UK Government has introduced a Mental Health Bill to the House of Commons which will reform the Mental Health Act to “improve treatment of patients and address disparities”. 

The Bill comes more than two years after the previous government introduced the Draft Mental Health Bill which was scrutinised by a pre-legislative committee of MPs and Lords. BASW fed into the call for evidence launched by the committee with a written submission, and later our Chief Executive Dr Ruth Allen gave oral evidence. The committee then made recommendations on how to improve the Bill, and we now have a Bill that will go through the formal parliamentary stages. 

Key parts of the Mental Health Bill are:

• Statutory care and treatment plans
• End the use of police and prison cells to place people experiencing a mental health crisis 
• End the inappropriate detention of autistic people and people with learning disabilities, implementing a limit of 28 days for which they can be detained unless they have a co-occurring mental health condition  
• Greater involvement of patients, families, and carers 

These are welcome changes, but the Bill does not address a number of issues that BASW raised during the pre-legislative process. For example, there are practical challenges for implementing the legislation such as no mention of early intervention to prevent admission in the first place, the interface of mental health and mental capacity legislation, strains on the workforce, and no acknowledgment of the importance of the social model to look at social factors that may impact a person’s mental health. 

We are particularly concerned about how this legislation will work in practice alongside the Mental Capacity Act. The replacement of Deprivation of Liberty Safeguards (DoLS) with Liberty Protection Safeguards (LPS) remains uncertain and this does not create confidence in these processes. 

On the face of the Bill, the government has acknowledged racial disparities in how people are treated, but further consideration needs to be made on stigma, unconscious bias, and culturally appropriate advocacy. 

For autistic people and people with a learning disability, a limit on detention is a positive step but BASW’s Homes not Hospitals campaign advocates ways of working to avoid admission altogether if a person does not have a co-occurring mental health condition. 

The workforce is also a serious concern for BASW as there is already an insufficient number of staff to deal with current challenges in the form of increasing demand and the existing backlog. The Approved Mental Health Professional (AMHP) role is one of the most important in the application of the mental health statutory framework. AMHPs have the power to apply for a person to be detained under the mental health legislation if the legal criteria are met. AMHPs are also responsible for coordinating assessments and admissions under the mental health legislation, as well as working to identify alternatives to compulsory detention. Existing data suggests up to one third of the current AMHP workforce are approaching retirement age, will little uptake from other professionals outside of social work to quality to carry out this role. Reforms cannot focus upon what happens without considering the implications for other parts of the support system.

Unless the system as a whole is properly resourced and able to support people in the community, we may see greater levels of hospital admission if that is the only place where resource is available.

Commenting, BASW Chief Executive Dr Ruth Allen said:

“The Mental Health Act needs reform, and we welcome that this government has decided to make it a priority in the first parliamentary session. But as we said when the draft Mental Health Bill was published, any reform needs to be properly resourced and must be implemented in ways that promote human and social rights.

“BASW thoroughly supports the move towards an approach based upon principles relating to least restrictive intervention and therapeutic benefit, but we remain concerned that the approach taken in the Bill still risks over-medicalising issues where societal factors are the dominant factors contributing to mental health distress. This Bill cannot stand in place of action on public, preventive and community mental health measures for a healthier society overall.

“We also urgently need clarification on what the government’s plans are on mental capacity.  This legislative change must be implemented to give confidence to professionals, individuals and their families that processes, procedures and experiences under the Mental Health Act will improve. This must include one of the most important reasons for the reform – tackling racism in the mental health system.”