Modernising the Mental Health Act: about time

I’m not the only one who thinks that the way we talk about mental health has changed over the past couple of years – from members of the Royal Family speaking out about their own personal troubles, to politicians and celebrities using public platforms.

The NHS stepped up to the plate prompted by the Five Year Forward View for Mental Health, with NHS England’s implementation plan in summer 2016 setting out a five-year blueprint for the transformation of many vital service areas. But the final report of Professor Sir Simon Wessely’s Review of the Mental Health Act published today sets out a challenge for government, local authorities and society as well as the NHS – what about people with severe mental illnesses in times of greatest need?

What are the rights and protections afforded to people and those closest to them at the most vulnerable times of their – our – lives? How can staff be supported to deliver the best care possible? And why is the Act still somewhat in the shadows, and little thought of, having first been introduced 35 years ago and tweaked a little since?

Within the last seven years, the extraordinary efforts of local NHS, policing and local authority partners has led to a massive 95% reduction in the use of police custody as a place of safety for people detained by the police under section 136 of the Act, accounting for just over 1% of cases in England. As a former policy lead for the Crisis Care Concordat and the legislative changes to these powers that came into effect a year ago, I have seen how joint working towards a powerful shared goal can galvanise different system partners to effect real, positive change.

The Review wants this to go further so that the law prohibits the use of custody for anyone of any age, and so that people are transported far less frequently in stigmatising police vehicles, which at the moment happens in between a third to a half of cases.

It has been a privilege to be part of a process that has sought to involve service users and carers from start to finish within a very challenging timeframe. I pay tribute to all involved. This has allowed for open, often difficult but always necessary conversations to confront some fundamental questions, such as why people from black and minority ethnic groups are so disproportionately overrepresented within detained populations and what can be done to address this complex issue.

The Review argues compellingly that the law needs to catch up with a more modern idea of mental health and mental illness, as does practice, so that anyone who does need to go into hospital is treated compassionately, listened to and respected as an individual with wishes and preferences, and supported to live well in their community as soon as possible. It also chimes with what we have heard through our engagement on the Long Term Plan: that as we move to the next phase of transforming services, we must keep the needs and wishes of those with the most severe mental illnesses at the forefront of our own minds and efforts. It is time to do exactly that.

The #MHAReview final report was published on Thursday 6 December.

Viral Kantaria

Viral Kantaria is Senior Programme Manager in NHS England’s Adult Mental Health Team.

He used to be a policy lead for mental health crisis care and legislation at the Department of Health. He has been a member of the Mental Health Act Review’s Working Group. You can follow him at @ViralKMH.

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  1. Dr Abdul Jaleel FRCPEdin says:

    Welcome to 21st century.

  2. Hannah Quinn says:

    It’s fantastic that conversations about Mental Health and the awareness of it in the modern workplace is improving year on year and even better that is being led through the honesty of public figures. I am pleased to read the Five Year Forward Plan for Mental Health as there is still more that could be done and sadly the gap in service between CAMHS and the Adult Mental Health Service still leaves a lot to be desired for some service users despite the hard work and continuous improvement championed by the Mental Health Trusts, Charities, CCG’s and other support providers. Well done to everyone involved!