Independent Review of the Mental Health Act

Last year the Prime Minister announced an Independent Review of the Mental Health Act – which sets out when a person can be detained and treated in hospital against their wishes – to look at how it is used and how it can be improved.

Over the course of 2018, the Review has heard from thousands of people who have been detained under the Act, and from their families and carers, about their experiences.

The Independent Review has now published its final report with around 150 recommendations for change. The Prime Minister has welcomed the report and announced that the Government plans to bring forward a new mental health bill.

Derek Caren, Chief Executive of Richmond Fellowship commented:

As Richmond Fellowship approaches its 60th anniversary in 2019, we’re celebrating our history and looking forward to positive changes ahead.

The development of our community based services coincided with a previous Mental Health Act of 1959, which helped establish the pathway for many people to leave hospital and live in the community. We strongly welcome and endorse the recommendations of the Independent Review of the Mental Health Act of 1983.

Strengthening people’s rights and their ability to challenge decisions under the Act when people are at their most vulnerable is a key development and necessary improvement to deliver better mental health services. We want to see these changes enacted by the Government as soon as possible alongside further investment in community based preventative services to reduce the number of people who are being detained.

More information about the final report of the Independent Review of the Mental Health Act

The Review recommends adding principles to the Mental Health Act to guide the way the Act is applied to the care and treatment of people detained under it. The principles recommended by the Review are:

  • Choice and autonomy: people being supported to express what they want and to be heard; patients should understand their rights and their relationships should be respected.
  • Beneficial purpose: care and treatment should be delivered with a view to ending the need for coercion.
  • Treating patients as individuals: detention should respect the individual circumstances of the detained person, and consider their protected characteristics.
  • Least restriction: compulsory powers should be used in the least restrictive and least invasive way possible.

These principles would seek to address some of the current problems with the Act, such as a lack of patient autonomy and choice.

Summary of the Review’s key recommendations:

  • Replacing the ‘Nearest Relative’ role (a family member with particular rights and powers, who is chosen from an inflexible list) with a ‘Nominated Person’, chosen by the person detained
  • Giving patients a legal say over their treatment – doctors will only be able to overrule their wishes in certain circumstances
  • Better oversight of treatment decisions (via independent doctors and tribunals)
  • Extending a right to advocacy to informal inpatients (those who have not been detained under the Mental Health Act but could be threatened with it)
  • More access to tribunals
  • Making care planning statutory for people subject to the Mental Health Act
  • Aiming to substantially reduce the use of Community Treatment Orders

Click here to read the full final report

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