New reforms to the Mental Health Act will ensure that people with a learning disability and autistic people with no co-occurring mental health conditions can only be detained for up to 28 days.
The reforms will also see an increase in the frequency of clinical reviews to ensure that the treatment patients receive is appropriate. It will also make tailored care and treatment plans a legal requirement to ensure patients receive individualised care and that discharge rates are sped up.
In doing so, the Bill aims to ensure patients receive better treatment and discharge planning with more family involvement, improved patient preferences and reduced coercion.
The announcement has been welcomed by charities who say the Bill “can’t come soon enough”.
It follows on from decades of campaigning to reduce the number of people with a learning disability and autism in mental health hospitals. The Transforming Care programme aimed to halve the number of people with a learning disability or autism in inpatient settings by 2019 to 1,700. However, to this day, there are still more than 2,000 people in inpatient beds.
Until now, the initiatives introduced by the government have failed to have any meaningful impact, and these new reforms bring hope to the thousands of people with a learning disability and their families who are battling with long stints in hospital settings. Indeed, the average length of stay for these inpatients is around five years.
Jon Sparkes, OBE, Chief Executive of learning disability charity Mencap, said: “This Bill can’t come soon enough for the 2,000 people with a learning disability and/or autism who are stuck in mental health hospitals right now, as well as those at risk of admission. Reforming the Act is key to ending inappropriate detention and placing new duties on commissioners to ensure the right community support is developed.
“We welcome the inclusion of reforms to stop people with a learning disability and autistic people being detained when they don’t have a mental health condition. The NHS’s own reviews have shown that over 40% of people trapped in mental health hospitals do not need to be there, yet they face an average of nearly five years locked away.”
He added that any reforms to the Mental Health Act must place “strong duties” to develop the right community support, which alongside the Bill’s other reforms “could bring this scandal to an end.”
“We will scrutinise the Bill to make sure it delivers the change we want and need to see for people with a learning disability,” he added.
The government says the new reforms recognise that outdated laws around the treatment of people in a mental health crisis are “no longer tolerable”.
Currently, the law automatically gives a patient’s nearest relative – rather than the person of their choosing such as a partner – a say in decisions about their care. This will change to give patients the right to elect a person to represent their interests and greater access to advocacy when they are detained. The government hopes this will make it more likely for patients to stay in contact with health services and engage in treatments.
The new Mental Health Act will also make changes to the Nominated Person role, strengthening the rights of families and carers. This will require clinicians to consult with others close to the patient as they make decisions around their care, where appropriate, or where the patient wishes.
In addition, police and prison cells will no longer be used to place people experiencing a mental health crisis, and patients will instead be supported to access a suitable healthcare facility that better supports their needs.
The discharge process will also be reviewed; this includes introducing a safety management plan for the patient to keep themselves and others safe. The renewed Mental Health Act will also introduce a new requirement for a Responsible Clinician to consult another person before they discharge a patient.
Secretary of State for Health and Social Care, Wes Streeting, said: “Our outdated mental health system is letting down some of the most vulnerable people in our society, and is in urgent need of reform.
“The treatment of autistic people and people with learning disabilities, and the way in which black people are disproportionately targeted by the act should shame us all.
“By bringing the Mental Health Act in line with the 21st Century, we will make sure patients are treated with dignity and respect and the public are kept safe.”
