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Together’s involvement in the independent review of the Mental Health Act

Posted on 07, December 2018

The final report of the independent review of the Mental Health Act has now been launched, after the government first announced such plans back in October 2017.

What does it say, what will the impact be, and how has Together for Mental Wellbeing been involved in the process?

Why has there been an independent review?

The government initiated an independent review of the Mental Health Act to examine how this piece of legislation is used and how its implementation can be improved.

The review specifically aimed to understand the reasons for and address:

  • increasing rates of detention under the Act
  • people from black, Asian and minority ethnic groups being disproportionately detained under the Act
  • processes carried out under the Act that are inconsistent with a modern mental health care system.

Why is Together involved in the independent review?

Since the Mental Health Act’s inception back in 1959, Together has supported many people who have been subject to this legislation. As an organisation that believes that people with mental health issues have the right to lead independent and fulfilling lives and have their choices respected, we strongly support efforts to improve practices that can limit that same independence and choice.

We also firmly believe that any such efforts should entail genuine consultation and engagement with service users and those with lived experience. Their expertise and insight is nothing short of crucial in working together to improve the lives of all people experiencing mental distress.

What has Together’s involvement been?

Our Chief Executive, Linda Bryant, is a member of the independent review’s Advisory Panel, which is made up of a cross-section of stakeholders who have an interest in the Mental Health Act and how its application can be improved. The panel was designed to gather evidence and greater understanding during the course of the review, and to help shape its conclusions and recommendations for the better.

Together also actively engaged with service users and carers with experience of the Mental Health Act, to promote opportunities to be involved in the independent review and support individuals to participate. These opportunities included becoming a member of the review’s Service User and Carer Group, sharing views via the review’s survey, and participating in workshops to feedback thoughts on the recommendations made in the review’s interim report in May 2018.

Linda Bryant, Together’s Chief Executive, said:

“On behalf of Together, I would like to thank all the service users and carers we worked with on this opportunity, who so generously gave their time, energy and insight. It is not easy to share views on an issue that has often had a long-lasting impact on one’s life or the life of a loved one, and for that we are especially thankful to all those who participated.”

What does the independent review’s final report say?

Broadly speaking, the independent review’s final report says that:

  • the Mental Health Act is outdated and needs to be overhauled
  • sectioning” is being misused (when people are detained in hospital against their wishes)
  • the current legislation does not properly protect peoples’ rights
  • people from black, Asian and minority ethnic backgrounds and people with learning disabilities and/or autism are particularly ill-served by the Act.

Among the report’s 154 recommendations are the following key points:

  • There should be four new principles underpinning a reformed Mental Health Act – covering choice and autonomy, least restriction, therapeutic benefit, and seeing the person as an individual.
  • There should be new rights for people to legally challenge their detention and treatment, and to be able to do this more frequently.
  • Doctors should be required to record when and why they make the decision to go against a person’s wishes.
  • People should have the right to choose a “nominated person” to have control of their care if they end up being sectioned (currently this control automatically goes to the person’s nearest relative).
  • There should be legally binding advanced care plans, so that people can express – ahead of time – how they wish to be treated if they were to be sectioned.
  • Mental health services and support that are specifically appropriate for the individual in question should be provided consistently, in particular for people from black, Asian and minority ethnic groups and for people with learning disabilities and/or autism.

What is Together’s reaction to the final report

Together welcomes the final report’s recommendation that the Mental Health Act requires a significant overhaul in order to firmly protect the rights, independence and choice of people who are subject to this legislation.

We wholeheartedly agree that those subject to the Mental Health Act must have further rights enshrined by law and that these rights must be adhered to consistently, regarding the specifics of their treatment and their legal right to challenge this.

Together also particularly welcomes the recognition that people from black, Asian and minority ethnic groups are disproportionately affected and ill-served by the Mental Health Act, and that steps to address this must be taken as a matter of urgency. We are in agreement with the report’s recommendations that a host of measures are required to lower the disproportionate rates of detention for those from black, Asian and minority ethnic groups – such as culturally-appropriate services and support, and training for professionals to tackle implicit bias in decision-making.

For too many years, countless people subject to the Mental Health Act have been on the receiving end of treatment that is at best inconsistent, and at worst traumatising. Experiencing limitations to – and even removals of – one’s independence, choice and control is usually at odds with the right to lead a fulfilling life. Whilst the independent review’s final report cannot wave an instantaneous magic wand, we hope it will provide the momentum needed for the government to proceed urgently with ensuring that the rights of people subject to the Mental Health Act are not just protected but also expanded.