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Disability charities have welcomed the recommendations made by the Joint Committee on the Draft Mental Health Bill in a new report which scrutinises the Bill.
The National Autistic Society (NAS) have said the report is “a huge step forward” to stop the scandal of autistic people being stuck in mental health hospitals and urge the government to act quickly to pass this “vital law”.
The Committee spoke to people with lived experience (as well as charities and other organisations, psychiatrists and NHS workers) and concluded that while the Bill has some good policies and intentions, it could be strengthened.
While the Bill acknowledges that too many autistic people and people with learning disabilities are being detained in inappropriate mental health facilities, the Committee says that removing autism and learning disability as grounds for detention under Section 3 of the Mental Health Act may lead to more detentions under different legal powers.
They are concerned that these detentions could also be enforced with fewer safeguards and could result in more people being detained in the criminal justice system. “This would be the opposite of what the change is intended to achieve,” the report states.
Instead, the Committee says government should focus on implementing community care improvements and strong safeguards against inappropriate detention. This includes introducing stronger duties on health and care bodies to proactively identify those in need of community care and provide it, and developing a specialist Tribunal.
The Tribunal would assess complex cases which may result in detention for an extended period of time (longer than 28 days). The report states that detention should only be continued for longer than 28 days in “tightly defined exceptional circumstances”.
Individuals with an understanding of learning disability an autism should be on the Tribunal, and these individuals will decide on the length of stay, and this time-period should be subject to regular review by the same Tribunal.
The Committee also wants the government to shorten the maximum length of time between Care and Treatment Reviews from 12 months to six months. This would help autistic people and people with learning disabilities to be discharged sooner where appropriate.
Disability organisations have welcomed the report’s recommendations, but Rachael Dodgson, CEO at Dimensions, says the Bill’s success must be evaluated inn Parliament at least once a year to monitor progress.
She said: “We welcome the Joint Committee’s recommendations on the Draft Mental Health Bill. However, there needs to be funding for community support and a statutory duty to report annually to Parliament on the progress against milestones, including the number of detentions and the length of stay. Successive policy interventions such as the ‘Transforming Care plan’ in 2012 and the 2015 ‘Building the Right Support’ plan have failed to reduce the numbers of detentions.
“Too many people with learning disabilities and/or autism remain locked in hospital. The most recent NHS Digital figures show that almost 2,000 people with learning disabilities or autism were detained in hospital in England in August last year, with 350 patients for longer than 10 years. This is a scandal.”
Mencap have also agreed that funding for community services is what is desperately needed and are calling on the government to urgently accept the Committee’s recommendations.
Dan Scorer, Head of Policy and Public Affairs at the learning disability charity Mencap, said:?“We need adequate funding and accountability for local authorities and Integrated Care Boards to build the community services that are so urgently needed. It’s unacceptable that people with a learning disability and autistic people can be sectioned under the Mental Health Act even if they don’t have a mental health problem.
“Mencap is calling for these vital reforms to be enshrined in law as soon as possible, to ensure this national scandal doesn’t continue in plain sight.”
The Committee has also said that the government must publish a workforce plan with clear actions and milestones alongside the Bill. This would help with understanding what extra resources and staff might be needed as well as holding the Government to account and making sure that any changes are effective.
Tim Nicholls, Head of Influencing and Research at the National Autistic Society, said: “Legal change alone is not enough. As the Committee rightly said, we urgently need more social care and mental health services, so that autistic people have the right support in the community and don’t reach crisis in the first place. It can’t wait.”