The Mental Health Bill: Initial Analysis
The publication of the new Mental Health Bill on 6 November 2024 marks a significant milestone in the ongoing process of reviewing and reforming the 1983 Act, a journey that began in 2017.
These introductory comments serve as a prelude to a more detailed analysis that my colleagues and I will undertake in the coming weeks and months. We will delve into the history, examine the aspirations, and comment on the actual changes as the Bill progresses through Parliament.
There is still a long way to go. The second reading of the Bill is scheduled for 25 November, with all subsequent Parliamentary stages to follow. The speed at which the Government will push this process remains uncertain, but extensive debate is anticipated. Additionally, the timeline for implementing any changes is unclear. Resource issues may arise, and a new Code of Practice will likely be needed. The experience of implementing the Liberty Protection Safeguards suggests that these factors can significantly delay the enactment of new legislation.
The Proposed Legislation
The first thing to note is that the Bill will amend the Mental Health Act 1983, rather than replace it entirely. This makes the Bill itself somewhat challenging to read and understand, as it involves removing and adding parts to existing sections of the 1983 Act. In future comments, we will explore each of the proposed changes in more detail.
Sources
The original text of the Bill and its future path through Parliament can be found here.
A fact sheet and comments made when introducing the Bill into the House of Lords can be found here and here.
Read our ‘Mental Health Bill in Numbers’ infographic:
Initial comment
There is no doubt that the aims of the Bill and the proposed changes will impact the delivery of mental health services. Here are my initial thoughts on some of the main issues, categorised into three broad areas. We will provide more detailed analysis as the Bill progresses.
Changes reflecting good practice
Some changes are essentially making a statutory requirement of what should already be standard practice. The impact on specific services will largely depend on how closely they currently align with the new provisions:
- Mandatory care and treatment plans, with increased patient input
- Greater patient choice in representation and advocacy
- Increased involvement of families and carers, especially in discharge arrangements
Changes with resource implications
These features are likely to have significant resource implications and may lead to more complaints or challenges if there is disagreement on what should be done:
- Avoiding the use of police or prison cells as places of safety and meeting expected timescales for prison transfers. Given the high level of mental health issues in the prison population, disagreements between prison services and health services are expected, along with significant challenges regarding secure capacity in the health system.
- Avoiding the admission of autistic people and those with learning disabilities, focusing instead on improved community provision. Existing disputes between local authorities and health services over whether individuals should be cared for in the community or hospital are unlikely to disappear. Emphasising community provision without suitable resources may lead to increased litigation. More generally, there will be greater pressure on health services to provide additional specialist community support.
- Requiring a second opinion before discharge and compulsory safety management plans. This will mean more work and administration. While the benefits could include increased safety and fewer readmissions, the discharge process is likely to take longer initially, frustrating both patients and services.
Changes dependent on ethos rather than legislation
These broad aims of the reforms are very positive but are unlikely to be achieved through legislation alone. Success will depend on how the legislation is interpreted and applied, which in turn depends on the overall environment, including resources and ethos:
- Reducing the overall number of detentions
- Addressing ethnic disparities in the application of statutory powers
Contact us
Stephen Evans is a partner in our healthcare advisory team. If you have any questions or concerns relating to the issues raised in this article, contact us today.