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Mental health

How major reforms to the UK’s Mental Health Act could actually help people

The government has opened a public consultation into the 1983 legislation, with the aim of tackling inequalities, empowering individuals, and preventing avoidable detentions

This week, the UK government released its long-awaited response to a review of the Mental Health Act. Officials shared their final report in December 2018, and have now opened a public consultation into the act. “I want to ensure our health service works for all, yet the Mental Health Act is now 40 years old,” health secretary Matt Hancock said in a press release. “We need to bring mental health laws into the 21st century.”

In 2017, former prime minister Theresa May pledged to scrap the “flawed” Mental Health Act, criticising it as responsible for the unnecessary detention of thousands of people. May promised to replace the 1983 legislation with new laws which would tackle these detentions, particularly focusing on discrimination against ethnic minority patients.

Proposed reforms to the act include empowering individuals to have more control over their treatment, and tackling inequalities, particularly the disproportionate detentions of those from Black, Asian, and minority ethnic (BAME) communities, and preventing autism and learning difficulties from being grounds for detention.

In a 2020 government report, it was revealed that Black people are more than four times as likely as white people to be detained under the Mental Health Act, and over 10 times more likely to be subject to a Community Treatment Order (CTO). A CTO means a person who has been hospitalised under the act will have supervised treatment when they leave.

Under the new recommendations, individuals would be assigned culturally-appropriate advocates so those from BAME communities can be better supported – advocates would be assigned to all mental health patients without them having to ask for one. Individuals would also be offered the choice of which friend or family member has a role in decisions about their care.

Speaking to Dazed, Agnes Mwakatuma, the co-founder of Black Minds Matter UK, says: “Over the years, we have seen the ways in which the Mental Health Act has affected Black people in the UK. It is clear that this change is needed to be implemented now more than ever.”

“The ways in which the Mental Health Act’s outcomes have been recorded has fuelled not only our reluctance to seek mental health support, but have created a fear in most of us when it comes to reaching out for help. We hope that this will be the beginning in changing the various Eurocentric models of mental health that have excluded and ignored the needs of the Black community.”

“The ways in which the Mental Health Act’s outcomes have been recorded has fuelled not only our reluctance to seek mental health support, but have created a fear in most of us when it comes to reaching out for help” – Agnes Mwakatuma, Black Minds Matter UK

“Recognising the flaws in the Mental Health Act and committing to addressing the inequalities in healthcare is a great step in the right direction,” Mwakatuma continues. “Black Minds Matter is incredibly proud that we are able to support Black individuals and families access professional mental health services in the UK through 12-week courses of therapy sessions with qualified Black therapists. But our mission requires a lifetime of support and real systemic change to overcome the inequalities in healthcare, and remodel the services to be both accessible and relevant to the Black community.”

Responding to the proposed changes, Sophie Corlett, the director of external relations at mental health charity Mind, said in a statement: “Some communities – particularly Black men – are far more likely than their white counterparts to be held against their will under the act, often subjected to humiliating and life-threatening practices like physical and chemical restraint. That’s why it’s crucial the government hears from people from different Black, Asian, and minority ethnic groups, to make sure any changes work equally well for people from different cultural backgrounds, as well as taking steps to identify, address, and tackle underlying and systemic racism that results in disproportionate detentions and use of force.”

Other recommendations include introducing advance choice documents so people can set out their wishes about future care and treatment, earlier access to a second opinion and a right to appeal against treatments, and a complete end to the use of police cells on detention and police vehicles for transporting individuals to the hospital.

According to Mind, one thing missing from the reforms is a proposed end to CTOs, which the charity says “have not reduced hospital readmissions and are often experienced as intrusive and coercive”.

Addressing the proposal to stop autism and learning difficulties being grounds for detention, the National Autistic Society said: “This will change the law on when autistic people can be sectioned under the Mental Health Act, which we and hundreds of thousands of campaigners have been calling for for years. It’s right that the government has listened and is taking action. But these changes will take years to come into force and, crucially, won’t end this scandal alone. The government and NHS need to stop autistic people reaching crisis in the first place by investing in better social care and mental health services that work for autistic children and adults.”

You can respond to the government’s public consultation into the Mental Health Act here.