Intended Mental Health Act Reforms

Reforming the Act – Legal Changes

The White Paper: Part 1 – Legislative Changes

Part 1 of the White Paper - proposals for reform of the Mental Health Act - plans for legislative change.

New Guiding Principles
Clearer Stronger detention criteria
Giving patients more rights to challenge detention
Strengthening the patients right to choose and refuse treatment: Introduce Advance choice document (ACD)
Strengthen-expand the roles of Independent Mental Health Advocacy (IMHA)
Improving the support for people who are detained: Add a new “Nominated Person” role to replace the “Nearest relative role”
Revise, tighten and limit use of Community Treatment Orders (CTOs)
Speed up, revise, strengthen governance of the statutory Care and Treatment Plan (CTP) for detained patients
Amend the consent and refusal of treatment frameworks
Increase access to and roles of the Tribunal of the Mental Health Act
The interface between the Mental Health Act and the Mental Capacity Act
Caring for patients in the Criminal Justice System
People with a learning disability and autistic people: Affirm the Government’s commitment to reducing the reliance on specialist inpatient services for people with a learning disability and on the autism spectrum, and to developing community alternatives
Children and young people
The experiences of people from BAME backgrounds: Tackle racial inequalities and acknowledged the wider structure of existing systems needs to change, including culture change, to bring about improvements in the overall quality of services and patient experiences
Interface with the criminal justice system-clarify and specify how the new Mental Health Act proposals will be applied differently to this group of patients due to the need to protect the public from those who have committed serious offences

Implementation of the Reforms

The White Paper: Part 2 - Implementation

Proposals and ongoing work to reform policy and practice to support implementation of the new Mental Health Act to improve patient experience

Transforming mental health services: the NHS Long Term Plan
A new national quality improvement programme:
1. to do this, a comprehensive implementation support plan will be developed in partnership with NHSEI and HEE. This will include a national quality improvement (QI) programme led by NHSEI, which will look specifically at care under the Act to enable and support this system-wide drive for change. The QI programme will support the system to address issues around quality, patient experience, leadership and culture. The scoping phase will identify the specific reforms to the Act which are most likely to benefit from a QI approach; potential areas of focus may include improved care planning, reducing inequalities, improved partnership working, improved assessment processes, greater levels of safety, and the dignity and respect experienced by service users.
2. Once developed and tested, subject to funding, the programme will be rolled out nationally to support all mental health providers and local systems.
Inpatient safety and risk
Restrictive practice
Suicide
The physical ward environment
The role of the Care Quality Commission
Supporting people in the community
Care planning in the community
Section 117 national guidance
Supporting people in a mental health crisis
Use of police custody
Ambulance conveyance
The mental health workforce
Diversity of the workforce
Improving staff morale
Data and digital
Impact assessment
Annex A: proposed changes to part 4 of the Mental Health Act
Category 1 treatments: most invasive
Category 2 treatments: invasive
Category 3 treatments: all other medication

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