Last reviewed 13 January 2021

The Government has announced landmark reforms to be set out in its Mental Health Act (MHA) White Paper, which will provide more control over individuals’ care and treatment.

The White Paper builds on the recommendations made by Sir Simon Wessely’s Independent Review of the Mental Health Act, which was accepted by the Government at the time of its publication in 2018.

Legislative reform of the Mental Health Act will deliver parity between mental and physical health services and put patients’ views at the centre of their care, and tackle mental health inequalities including disproportionate detention of people from black, Asian and minority ethnic (BAME) communities, the use of the MHA to detain people with learning disabilities and autism, and improve care for patients within the criminal justice system.

The Government announced that it will consult on a number of proposed changes, including introducing statutory “advance choice documents” to enable people to express their wishes and preferences on their care when they are well, before the need arises for them to go into hospital. The consultation will also look at implementing the right for an individual to choose a nominated person who is best placed to look after their interests under the Act if they are not able to do so themselves.

The reform will expand the role of independent mental health advocates to offer a greater level of support and representation to every patient detained under the Act, and there will be pilots for culturally appropriate advocates so patients from all ethnic backgrounds can be better supported to voice their individual needs. Neither autism nor a learning disability will be grounds for detention for treatment.

Access to community-based mental health support will also be improved, including crisis care, to prevent avoidable detentions under the MHA. The Government said this was already underway, backed by £2.3 billion a year, as part of the NHS Long Term Plan.

Professor Sir Simon Wessley said: “Since the introduction of the MHA back in 1959 attitudes towards mental illness have changed dramatically. It was time for our legislation to catch up, so two years ago I presented my recommendations to modernise the Mental Health Act, so that it works better for those it protects. Today the government is taking the next steps to making these changes a reality. The Mental Health Act white paper proposes changes which address amongst others rising rates of detention under the act, the disproportionate number of BAME individuals detained, and allows the patient voice to be heard better than in the past.”