Independent review of Mental Health Act calls for reform

An Independent Review of the Mental Health Act 1983, chaired by Professor Sir Simon Wessely – Regius Professor of Psychiatry at King’s College London and president of the Royal Society of Medicine, has set out recommendations for government on how the Act and associated practice needs to change.

The review was ordered by the government to consider how the legislation in the Mental Health Act 1983 is used and how practice can improve. In particular, the review looked at the reasons for rising rates of detention under the Act, the disproportionate number of people from black and minority ethnic groups detained and processes that are out of step with a modern mental health care system.

The review sought the views of service users, carers, relevant professionals and affected organisations.

According to BBC News, Kate King, 56, who spent seven years in and out of hospitals in East Anglia after admission in 2004 following a period of post-natal depression, said her detention probably saved her life however in a number of units her experience had been “awful”. She recalled being “abused and ignored” and on one occasion “restrained face down on a mattress.” She said, “one nurse even told me I should kill myself”.

The review reports that there were 49,500 mental health detentions last year, there has been a 40% increase in the number of detentions over the last 10 years and ethnic minorities are four times more likely to be detained. The review stated that the average cost of detention is £18,000.

The review recommended a number of changes including:

• giving patients new rights to legally challenge their treatment and more frequent opportunities to challenge detention
• legally binding advanced care plans so patients can express how they want to be treated in the event they are sectioned
• an end to police cells being used as a place of safety and less frequent use of police cars to transport patients
• a requirement for doctors to record when and why they choose to ignore patient requests
• the right to choose a “nominated person” to have control of a patient’s care if they are sectioned.

Professor Sir Simon Wessely said: “The act needs to help them [patients] more – to make it easier for people to express their choices and preferences about how they want to be treated and harder for them to be ignored.”

As well as reducing the number of detentions, the review group wants to see a reduction in the use of compulsory treatment orders whereby patients are released from hospital under supervision. They say public safety will not be put at risk.

They do acknowledge the changes will require greater investment in community services, particularly crisis care to stop people deteriorating to such an extent that they need hospital treatment.

Mental health charities are overwhelmingly supportive of the recommendations and Prime Minister Theresa May said the review would be used to make changes to the legislation.

A Solicitor in the Medical Negligence team at Ashtons Legal comments: “The Independent Review has demonstrated that a reform of the Mental Health legislation is necessary. Current practices are outdated and mental health treatment needs to improve in line with modern society to protect vulnerable members of the community. It is encouraging that mental health issues are now being discussed more openly and with the review’s clear findings and recommendations, there is no justification for the government to not make the required changes.”