Has the 1983 Mental Health Act been ripped up?

In May 2017, Theresa May pledged to “rip up the 1983 Act” by commissioning an independent review into the Mental Health Act with a view of modernising it. In December 2018 the Independent Mental Health Act Review published its final report.

Proposed changes for patients: The review focused on promoting patient choice. It has made a number of recommendations to increase patient involvement with their care and to provide a clear framework for those detained under the Mental Health Act.

The final report can be read in full here.

We have chosen to look at a few of the recommendations in more detail.

These recommendations include:

• For those detained under section 2 there should be a further clinical assessment after 14 days. As well as an extension of the 14 day limit to appeal to the Tribunal.
• A strengthening of the criteria for detention. This would create a higher threshold for the clinical team to demonstrate that detention is necessary.
• The initial duration of detention under section 3 to be reduced from 6 months to 3 months.
• Improvements to be made to crisis and community mental health teams to make them more accessible and responsive.

So how does it affect you?

If you are a patient detained in hospital under the Mental Health Act or subject to a Community Treatment Order (CTO) or if you are the relative of a patient then these new recommendations will be of interest to you.

The proposals would introduce tougher criteria for detention in hospital. One of the changes includes the condition that there must be a “substantial likelihood of significant harm” to the health and safety of the patient or the safety of others. This is remarkably different to the current criteria that detention must be “necessary for the health and safety of the patient or for the protection of other persons”. The new condition is a much higher threshold for the professionals to satisfy.

This would hopefully prevent people being detained under the Mental Health Act unless it is absolutely necessary and the only option available. It would also mean that when there is no longer a substantial likelihood of significant harm the section must be discharged.

The reduction in the initial period of detention under section 3 from 6 months to 3 months would ensure that there is an earlier review of the patient’s detention and the necessity for it. This would decrease the number of patients who remain in hospital for up to 6 months without any review of their detention.

Improvements and greater access to the community and crisis teams would be aimed at helping and supporting patients in the community to prevent further admissions to hospital.

The purpose of all the recommendations made by the review is to even out the balance of power between the professionals and the patient. However, at this stage these are just recommendations and it will remain to be seen whether the Government chooses to act on any of them. And even if it does the timescale for implementation it likely to be years!

There is still a long way to go before Theresa may can declare that she has been successful in ripping up the 1983 Act!