As we start the new year our team is reflecting on the introduction of new mental health legislation. We share some thoughts below.
The government has introduced an updated draft of the Mental Health Bill. The current round of legislative reform began with the 2018 Independent Review. This was followed by a white paper in 2021 and previous version of a draft Bill in 2022 which was scrutinised by a cross-government Joint Select Committee.
We hope that a new legislative framework will make a positive difference to the lives of those affected by it.
Whilst we welcome the proposed changes to the Act, which are long overdue, it is important to note that many of recommendations from the joint committee have not been taken forward into the current draft.
In addition, for many people, the imperative is a Mental Health Bill that clearly empowers individuals’ rights to an ordinary life in the community with the support they need to thrive, be happy, stay safe, and be healthy.
We must ensure longer term mental health reforms achieve this goal rather than just trying to patch up and improve outdated models of care and support.
We have highlighted some areas below. To succeed they must be resourced properly and implemented in a timely fashion.
Learning disability and autism
We are pleased the Bill no longer recognises people with a learning disability and autistic people as having a mental disorder. Our It’s Not Rocket Science report shows the sensory environment of mental health inpatient settings can have a detrimental impact on the health and wellbeing of autistic people, as well as their recovery journey.
We continue to support staff to understand how, why and what changes can be made. However, legislative changes will need to be implemented in the right way to avoid unintended consequence. For example, there is a risk that with the absence of available community support close to home, too many people may end up in the criminal justice system or with false mental health diagnoses
Community support
Bespoke community support is essential for keeping people out of hospital and living good lives in their communities. The wording in the Bill must be strengthened as the current draft uses words like ‘have regard to’ and ‘seek to ensure’. This isn’t robust enough for appropriate action to be properly implemented.
Learning from our Small Supports programme shows a bespoke, person-centred, community model of care that is committed to supporting people through the toughest times really does work.
Advocacy
We are delighted to see the Bill introduce broader rights to access independent advocacy. However, this must be resourced properly and with an adequate level of national oversight. People with a learning disability and autistic people need advocates/providers to make reasonable adjustments and this must be included in the Bill.
Our review of advocacy for people who are inpatients in mental health, learning disability or autism specialist hospitals highlights a range of recommendations. We are calling for a national advocacy strategy and task force. These reforms are also an opportunity to strengthen the interface between the Mental Health Act, Care Act and Mental Capacity Act to ensure continuity of advocacy support is enabled.
What next?
We urge government to consult, coproduce and involve people, families and the organisations that represent them.
There must be strengthened engagement and consultation with those who draw on mental health services, self-advocates, disabled people’s organisations, as well as with advocacy providers who represent people, in line with the United Nations Convention on the Rights of Persons with Disabilities (UNCRPD). This will be the only way to ensure that the details of these amendments are as effective as possible.
This will be particularly important through the drafting of any regulation and code of practice as well as throughout implementation stages.
We need strong, coproduced implementation plans to:
The Bill will be debated and amended during its passage through parliament before it reaches royal assent in summer 2025.
Reach out to your local MP, disabled people's, and advocacy organisations now to continue these conversations.
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