A Bill that would empower mental health patients with more control over their case and treatment is inching closer to becoming law. The groundbreaking Mental Health Bill seeks to amend a 1983 Act that established the legal framework for the detention, assessment and treatment of people with a mental disorder who are perceived as a risk to themselves or others.
The proposed legislation would, officials say, ensure that detention and compulsory treatment are only implemented when absolutely necessary, with provision for more regular reviews and appeals. It also aims to impose restrictions on the detention of autistic people and those with a learning disability.
The Mental Health Bill has passed the report stage and third reading in the House of Commons, and amendments made in the public bill committee will now be considered by the House of Lords.
Minister of State for Care, Stephen Kinnock, gave the Bill its third reading, sharing that attitudes towards mental health have ‘shifted dramatically’ since the Mental Health Act 1983 and its update in 2007. He said: “Our understanding has grown but the law has been neglected.
“It’s clear that adults and young people with mental health issues have been let down for years, which is why we are transforming the current mental health system through our 10-year health plan, including recruiting over 8,500 additional mental health workers, delivering more NHS talking therapy appointments than ever before, increasing the number of mental health crisis centres and providing access to a specialist mental health professional for every school in England.
“Today, we are another step closer to delivering on the reforms around dealing with people with severe and acute mental health disorders. A step closer to strengthening and clarifying the criteria for detention, to better supporting clinicians in making the right decisions around appropriate care and treatment.
“We want to make sure that patient choice and patient needs are at the heart of decision-making.”
Mr Kinnock described the Bill as the culmination of years of dedicated work that began before Labour took office. He praised former Conservative Prime Minister Baroness Theresa May for initiating an independent review that ‘paved the way for this legislation’.
He also thanked those who have shared their experiences of mental health services and said he hopes the House of Lords will agree to the changes to ensure it can make ‘swift progress to royal assent’.
At the report stage, the Government saw off Conservative and Liberal Democrat bids to amend the Bill in three key ways. Shadow health minister Luke Evans put forward amendment 40, which would require care and treatment plans to include an assessment of the level of risk to public safety posed by the patient in the community.
He said: “Modernisation must go hand in hand with public confidence. The public and patients themselves must know that every plan for treatment and discharge is rooted not only in care, but in safety… As far as I can see in the Bill, there remains no explicit requirement for clinicians to assess and record the level of risk posed to those in the public.”
However, MPs rejected this by 339 votes to 163, majority 176. Mr Evans also put forward amendment 41, which would require the nominated person for a patient under the age of 16 to have parental responsibility, unless there are safeguarding concerns.
He said: “The Government are right that the Bill modernises the old nearest relative system, which was too rigid, too bound by bloodlines and, at times, blind to the complexities of family life. Under the Bill as drafted though, a current 16 deemed competent could nominate any adult – that could be a 19-year-old boyfriend or peer – as someone exercising control.” The amendment was rejected by 333 votes to 164, majority, 169.
Finally, Liberal Democrat health spokesperson Danny Chambers put forward new clause 16, which would ensure that every hospital has a dedicated liaison service for the carers of patients detained under the Mental Health Act.
He said: “This is a vital step to support carers during what can be an unimaginably difficult time, and to close blind spots that too often exist when someone is caring for a loved one with serious mental illness. We know that parental mental health concerns are now the most common factor in children’s social care assessments, and that those children are at much higher risk of developing mental ill health themselves.
“And yet, only around a third of mental health professionals in inpatient settings ask whether a patient is a parent.” The amendment was rejected 327 to 78, majority 249.
The Bill will now return to the Lords where peers will consider the amended legislation, and if the final draft is agreed by both Houses, it will become law.