People with a learning disability or autistic people could only be detained for mental health treatment if a mental health condition is identified by clinicians, according to new draft reforms.

The draft Mental Health Bill aims to provide patients with more control over their care and treatment with those experiencing a mental health emergency being able to access more care in the community, such through as crisis houses and safe havens.

The government said that too many autistic people and people with a learning disability are admitted into institutional settings when they will be better served in the community.  

The new bill limits the scope to detain people with learning disabilities and autistic people for treatment unless they have a mental illness that justifies a longer stay or if they are admitted through the criminal justice system. 

Mencap said that the changes to the Mental Health Act are an important step, but there is still have much campaigning left to do with people with a learning disability and families and other partners, including: 

  • To make sure the Mental Health Bill is strong enough to deliver the change needed for people with a learning disability and/or autism. 
  • To make sure the government’s upcoming action plan for homes not hospitals delivers on the government’s promise to ensure people with a learning disability and/or autism get the right support in the community and are not inappropriately detained in inpatient units. The government has committed in the NHS long term plan to close 50% of inpatient beds for people with a learning disability and/or autism by 2024. 

Mencap CEO, Edel Harris, said: “Current safeguards under the Mental Health Act are not working, given that more than 2,000 people with a learning disability and autism currently locked away in inpatient units, with most detained under the Mental Health Act. Often this is due to a lack of the right support in the community, not because they need inpatient mental health treatment. 

"Mental Health Act reform is a key part of tackling the inappropriate detention of people with a learning disability and autism and building the community support that is desperately needed.  We look forward to being part of the conversation around this bill to ensure it delivers the change needed.”  

Funding for specialised mental health ambulances

The government is investing £150 million in a range of measures over the next three years including helping better meet the needs of people with a learning disability and autistic people and ensure appropriate care for people with serious mental illness within the criminal justice system.

The funding includes £7 million for specialised mental health ambulances across the country to reduce the use of general ambulance call outs for those experiencing a mental health crisis and prevent the inappropriate use of police vehicles as a way to take people to hospital.

This will ease pressure on services, improve response times and outcomes for people in crisis which will help save lives, as well as ensuring patients experiencing a crisis are treated with dignity and respect.

Milestone to stop autistic people being wrongly detained

Caroline Stevens, Chief Executive of the National Autistic Society, said: “This is a milestone in the campaign to stop autistic people being wrongly detained and stuck in mental health hospitals. We and hundreds of thousands of campaigners have been calling for the law to be changed for years, so that it respects autistic people’s rights.

“This is an important first step, but it won’t end this scandal on its own. Autistic people need investment in the right local social care and mental health services – so they don’t reach crisis in the first place.”   

The draft bill is now subject to pre-legislative scrutiny where a parliamentary select committee will examine the draft in detail before the government publishes a final version.

Other measures include introducing a duty for councils, NHS England and local health decision makers to provide enough of the right community services to prevent autistic people reaching crisis point, and having to stay in an institution because there is nowhere else to go. 

This is in addition to making Care and Treatment Review actions enforceable, helping people with a learning disability and autistic people get discharged from hospitals sooner.

According to the National Autistic Society, 2,010 autistic people and people with learning disabilities are in inpatient mental health hospitals in England.

Despite some progress in moving people with a learning disability out of hospital and into the community, the number of autistic people in inpatient facilities has increased. In 2015, autistic people made up 38% of the number in hospital – now it is 61%.

Kirsty Matthews, CEO of learning disabilities charity Hft, added: “At present, people with a learning disability and/or autism can be admitted to in-patient units under the Act, even if they don’t have a mental health condition. Learning disabilities and autism are not mental health conditions, and the removal of this definition from the Act should go some way to reducing the number of people being unnecessarily detained in in-patient units.

“However, if the Government is truly committed to ‘transforming care’, they must go further by getting the care right and ensuring everyone with a learning disability and/or autism has his or her support needs met and can live where and how they want to. This would play a vital part in drastically reducing any inappropriate admissions to in-patient units in the first place.

“There are currently more than 2,000 people with a learning disability/autism trapped in in-patient settings, where the average time spent is 5.6 years. We want to see a significant reduction in any inappropriate admissions to in-patient units and a commitment to provide the resources to ensure people are discharged in a timely manner. People with a learning disability and/or autism should be able to live with the support they need, where they want and to be closer to family and friends."