Reform of the Mental Health Act must be properly funded

Proposed changes to the mental health system must be properly funded to be effective, the Law Society of England and Wales warned following publication of the Mental Health Act White Paper.

“It is clear the current system means that all too often compulsory detention and treatment is, or feels like, a first and not a last resort,” said Law Society president David Greene.

“Every person who has mental health issues should be treated in the least restrictive way possible and should only be detained against their will as the very last option if their health, safety or public protection depends on this.

“In October 2020, there were nearly 15,000 people detained in hospital under the Mental Health Act. Anyone who is formally detained under the Mental Health Act – often referred to as being sectioned – must be effectively safeguarded and have greater involvement in decisions about their care and treatment.

“Reform must be backed up by proper funding to meet the rising pressure on services and to address the poor state of infrastructure in many hospitals. This is vital to ensure the safeguards for people detained under the Act are sustainable, effective, and enforceable.

“Without adequate investment into the mechanisms upholding the law, such as the mental health workforce, public health and social care, community-based support and the tribunals, these changes will result in exponential demand that cannot be met, and consequentially, collapse.

“These services are already under severe strain due to the COVID-19 pandemic, and it is important that they are regarded as a priority by the government if there is to be sustainable, long-term change.”

Many of the proposed reforms would need a substantial injection of resources to succeed:

  • reducing compulsory detention depends upon more accessible and responsive crisis and community-based services
  • transferring prisoners to secure hospitals within a 28-day time limit may require extra beds within the secure estate
  • extending tribunals’ powers and increasing opportunities to appeal would require more hearings, and so more judges, panel members and tribunal staff
  • increasing the role of independent mental health advocates to support patients throughout their journey will require funding
  • there will be a greater demand for aftercare services, with an emphasis on enhanced provision for community-based support and treatment, together with statutory care plans
  • hospital environments will need to be modernised and refurbished to provide truly therapeutic environments for patients

David Greene said: “As well as facing higher rates of detention, Black British people experience poorer outcomes.

“Data indicate that Black patients are subject to a level of restraint that is three times higher than White British patients. The Law Society welcomes the commitment to develop culturally appropriate advocacy for people of all ethnic backgrounds and communities. The steps proposed to address the significant under-representation of people of Black African and Caribbean descent across the mental health professions at more senior levels are also positive, although this is unlikely to be a quick fix.

“The plan to reduce the number of community treatment orders (CTOs) overall is promising, but as Black or Black British people are at least ten times more likely to be placed on a CTO than White British people, it will be important to monitor whether any reduction in their use does in fact result in a reduction in this disparity.”

“There are also devolved issues, which means that the white paper will be need to be considered by the Welsh government for application there, but it is important that the changes link up, given the high number of cross-border matters.”

Notes for editors

Department of Health and Social Care: Reforming the Mental Health Act white paper

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