Mental Health Bill plans to reform mental health care

The government aims to ‘modernise’ mental health care by introducing a new Mental Health Bill. Here’s a summary of the main changes that could be introduced in the next few years.

More and more people are struggling with their mental health. It’s now thought that in England, 1 in 6 adults have experienced a ‘common mental disorder’ such as depression or anxiety in the past week.[1]

It’s also clear that mental health experiences are unequal. For example, in England, men are much more likely to take their own life than women, and people who self-identify as ‘Black’, ‘Mixed & other’ and ‘Asian & Asian British’ are more likely to experience mental health issues than people who self-identify as ‘White British’ and ‘White other’.[2]

At Second Step, we’ve also seen demand for our mental health services and projects grow over the past few years, particularly during the Covid-19 pandemic. But we’ve also seen fantastic results when people are able to access care and support when they need it. For example:

Next Steps – bridging the gap between hospital and community care

Leaving hospital is a big step in many people’s mental health recovery, and hospital leavers often need help adjusting to life at home. Without support, many people end up returning to hospital, or they’re unable to leave at all, even if they feel well enough. Currently, 10-20% of mental health beds are occupied by people who are ready to leave, but don’t have the support they need.[3]

Our Next Steps service in Somerset helps people move from hospital back into the community. Our community navigators and peer volunteers connect with our clients while they’re still in hospital, and after they leave help with things like securing housing, accessing benefits, returning to education, and forming a new daily routine. This makes the transition smoother for our clients and helps them maintain their recovery.

Of the 222 clients Next Steps community navigators and Citizens Advice specialist advisors supported between 2 April 2021 and 26 March 2022, 96% stayed well for at least three months after being discharged from hospital.

This frees up NHS hospital beds, saves the NHS money, and most importantly, it’s the best outcome for our clients’ wellbeing.

We fully believe that reviewing and improving mental health care is the right thing to do to improve availability and access to mental health services, and to address inequalities in mental health experiences and care.

What is the Mental Health Bill?

At the moment, the main laws about mental health are set out in the Mental Health Act 1983 (MHA). For example, the MHA covers how people with mental health problems should be assessed and their rights to make decisions about their own care.

The Mental Health Bill 2022 (the Bill) could reform the MHA and change some of the existing laws around mental health to:

Give people more control over their treatment
Make sure people receive the dignity and respect they’re entitled to
Improve the way people with learning disabilities and autism are treated and supported

What does the Mental Health Bill 2022 cover?

Here are some of the changes that could affect you or your loved one’s mental health care and support if the Bill becomes law:

Changes to hospital detention and treatment

The Bill wants to make sure that people are only sectioned under the Mental Health Act when strictly necessary, for example, where a person’s safety is severely at risk. Changes could be made to the way people are assessed, detained and treated. The Bill also aims to speed up reviews and appeals.

Give patients and representatives more say

Patients’ rights could be increased, allowing them to have more say in their care plans and about treatment, including whether to refuse treatment.

Patients could also be allowed to have more say over who represents them while they’re detained. At the moment, it usually defaults to the patient’s nearest relative. However, under the new Bill, patients could have the right to choose their own ‘nominated person’ and the option to access an independent ‘mental health advocate’ rather than a close relative.

Reform community treatment orders

Community treatment orders (CTOs) are used to provide people with supervised support in the community.

CTOs can be made by ‘responsible clinicians’ who are approved to make decisions about patients’ mental health treatment under the MHA. If your responsible clinician makes a CTO, it means you can receive supervised treatment in the community rather than having to stay in hospital.

Your responsible clinician can add conditions to your CTO, for example, to live in a certain place or to take regular drug and alcohol tests. If you breach the conditions of your CTO, the responsible clinician may make you return to hospital.

CTOs usually last for six months, but they can be renewed for longer.

Although the purpose of CTOs is to support people with their mental health in the community rather than in hospital, the way they’re used in reality has been criticised.

Currently, CTOs are used too much, they often last for too long, and there is severe racial inequality in the way they’re used.

So, the Bill aims to restrict how and when CTOs can be used, for example, there would have to be a ‘therapeutic benefit’ to the patient.

Find out more about community treatment orders.

Police stations and prisons no longer ‘places of safety’

The Bill proposes that police stations and prisons should no longer be considered ‘places of safety’ and that people who need urgent mental health support or have severe mental health needs should be treated somewhere more appropriate.

The Bill also proposes a new 28-day time limit on transfers from prison to hospital for people who need specialist mental health care.

Addressing racial inequalities in mental health care

The Bill aims to address racial inequalities that mean people from some racial backgrounds are detained under the Mental Health Act and are subjected to Community Treatment Orders more than others. NHS England is also working on a Patient and Carer Race Equalities Framework to try to improve mental health care for people who experience inequalities and discrimination.

Improving care for people with learning disabilities

The Bill aims to limit how long people with learning disabilities or autism can be detained for treatment where there is no mental health issue present. The new law could also stop learning disabilities and autism being used as reasons to detain someone for mental health treatment, unless a clinician has also identified a mental health issue that needs support.

Other changes to mental health care

As well as the Mental Health Bill, the government is planning other changes to mental health care following an independent review in 2018.

These changes could include:

More funding for ‘mental health ambulances’ – specialised ambulances that respond to mental health crises, freeing up other ambulances and police cars
More funding for community mental health spaces, such as crisis houses and safe havens
A new Suicide Prevention Plan to tackle rising suicide rates (particularly male suicide rates)

What we think

Reforms to the mental health system are long overdue. Currently, it can be hard to find the right support, it doesn’t involve people enough in their own care, and too many people are disadvantaged in it because of their race or ethnicity.

The new Mental Health Bill is welcome and we’re encouraged to see major issues being addressed such as:

Racial disparities in mental health experiences
The way people are admitted, treated and discharged from hospital
The need for people seeking mental health support to have more influence over their care

We will continue to push with our partners to ensure these proposed changes remain in the Mental Health Bill as it goes through Parliament.

What happens next?

The Mental Health Bill is currently in the ‘pre-legislative scrutiny’ stage. This means that it is still a draft and none of the reforms are set in stone yet. This early draft will be examined and possibly amended by a parliamentary select committee before the final draft is presented to Parliament.

This Bill forms part of the government’s ‘10-year plan’ for mental health and wellbeing in England which will also include a new Suicide Prevention Plan to try and address rising suicide rates across the country.

At Second Step, we’re helping to shape this Plan and have submitted evidence on the positive impact of the Hope Project, our male suicide prevention project in Bristol, North Somerset and South Gloucestershire.

What do you think about the Mental Health Bill 2022?

How do you think mental health care and support could be improved? Send us a message on Twitter or Instagram @wearesecondstep.

More resources

References

[1] Carl Baker, Mental Health Statistics (England) (House of Commons Library Briefing Paper SN06988 CBP-06988) https://researchbriefings.files.parliament.uk/documents/SN06988/SN06988.pdf

[2] Baker, (n1)

[3] NHS England, Guidance on additional 2020/21 winter funding for post-discharge support for mental health patients (NHS England 2020) https://www.england.nhs.uk/coronavirus/wp-content/uploads/sites/52/2020/03/C0894-Mental-health-winter-2021-discharge-funding-supporting-guidance-01-Dec-20-v2.pdf

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