Reforming the Mental Health Act – Approaches to Improve Patient Choice: the Parliamentary Office of Science and Technology

Whilst we wait to learn what the next steps may be in relation to mental health reform in England & Wales, the Parliamentary Office of Science and Technology has published the most recent of its ‘POSTnotes’ on , Reforming the Mental Health Act – Approaches to Improve Patient Choice, smmarising proposed reforms to the Mental Health Act (1983) to improve patient choice, highlighting relevant research evidence and stakeholder perspectives.  Its key points include that:

  • The Mental Health Act 1983 has been criticised as being overly restrictive, with inadequate scope for patient choice and autonomy.  
  • The Government’s Draft Mental Health Bill proposes reforms to improve patient choice. A joint parliamentary committee report on the draft Bill recommended further changes to enhance choice, including a statutory duty to offer patients advance choice documents. Reports to date suggest that advance care planning could offer some benefits, but uptake can be low. 
  • Proposals to replace the Nearest Relative who has certain powers under the Act, with a Nominated Person of the patient’s choosing, have been widely welcomed. There are questions about operationalisation and safeguarding. 
  • Alongside the reforms, the Government is piloting ‘culturally appropriate advocacy’, which preliminary findings suggest could help advocates better support patients from ethnic minority backgrounds. 
  • The draft Bill removes learning disabilities and autism as grounds for detention under Section 3 of the Act. Stakeholders have raised concerns about unintended diversion to more restrictive pathways, such as the criminal justice system. A range of stakeholders share the view that careful implementation is needed to maximise the benefits of proposed reforms. 
  • The Government has not announced when the Bill will be introduced. 
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