People have been traumatised by the Mental Health Act for decades the government’s reform plan is welcome – iNews

The Mental Health Act confers unique powers on the state: allowing police, health and social services to detain a person on the basis of their mental state.

We know that the Act saves lives, providing vital health care in an emergency to people who need urgent help, but we also know that the use of coercion to treat mental illness can be frightening and traumatic. For too many people, powers that exist to protect them have ended up causing lasting harm, and the use of these powers is far from equal across society.

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This is why the publication of the governments plan to reform the Act this week is so welcome.

The current legislation was written in 1983, and partially updated in 2007. In that time, the way mental ill health is understood and treated has changed but the law has not kept up. Now, with the publication of a government reform plan, based largely on an independent report written two years ago by Sir Simon Wessely, we have a chance to bring mental health law into the 21st century. The changes will give patients more control and autonomy over their care, ensure that the needs of those with learning disabilities and autism are better met, and work towards making the system less discriminatory towards Black people.

Every year since the Act was last updated, the use of coercion has risen. That means more people are sectioned, often with the involvement of the police. And since 2007, compulsory powers can be extended once people leave hospital, through community treatment orders which require people to comply with treatment or face a return to hospital.

Use of these powers is not spread evenly. Black people in England and Wales are four times more likely to be sectioned than white people, and even more likely again to be given a community treatment order. These inequities may partly relate to higher rates of mental illness, but they cannot be explained away without understanding Black peoples experiences of racism, oppression and injustice that begin early in life and are too often reflected in how they experience mental health care.

The reforms aim to stop discrimination and racism within the mental health system using a Patient and Carer Race Equality Framework (a tool designed to improve care and race equality,recommended in the 2018 Independent Review).It is vital that this is properly resourced and given the time it needs to make a real difference in communities and services nationwide.

The Mental Health Act doesnt just provide a legal basis for people to be detained in hospital. It also sets out the ways in which peoples rights can be protected during that time. For example it sets limits on how long a person can be detained and what for, and it provides protections such as a right to independent advocacy and aftercare.

The Governments plans seek to boost those protections: including enabling people to write Advance Choice Documents to say how they would like to be treated when they are unwell. And it pledges to boost advocacy services so that more people get advice and support about their rights. This will mean people will get the care and dignity they desire when unwell.

The Government also pledges to end the use of mental health law to detain people solely because they are autistic or have a learning disability. If this is accompanied by investment in better community support, it should prevent the inappropriate use of mental health legislation to keep people in hospitals and care homes for months and years at a time.

While the changes proposed by government will not happen quickly, we hope that in time they will mean that peoples rights and dignity are respected at every turn

Reforming the Mental Health Act will rebalance a system that too often leaves people traumatised and treated without dignity when they are at their most unwell. But it will not on its own be enough to tackle the injustices and inequalities that lie beneath the letters of the law.

Deeply ingrained racism and discrimination in society must be tackled to prevent mental ill health in communities. Investment in community mental health support is also vital: years of austerity, especially in social care, have eroded the services that support people living with a mental illness, putting them at greater risk of relapse and hospitalisation.

And the hospital buildings used for mental health support are in urgent need of modernisation: in some cases, the places people are detained when they are most unwell are some of the poorest and most dated parts of the NHS estate. And in last years hospital upgrade plan, just two of the 40 sites chosen by government for modernisation were for mental health care.

Reform of the Mental Health Act is long overdue. While the changes proposed by government will not happen quickly, we hope that in time they will mean that coercion is used only where it is necessary, for as short a time as possible, respecting peoples rights and dignity at every turn. The Governments plans are now out for consultation, with plans for new legislation to be introduced later this year.

Andy Bell is deputy chief executive at Centre for Mental Health and was a member of the working group for the Independent Review of the Mental Health Act in 2018

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People have been traumatised by the Mental Health Act for decades the government's reform plan is welcome - iNews