When Georgie was diagnosed with anorexia nervosa at 16, she was forced to leave behind her studies and was admitted to a mental health ward. Despite complying with treatment, she was assessed by a clinician and then detained under the Mental Health Act. Georgie described how both she and her parents objected — concerns that fell on deaf ears. Her autonomy was removed and she was left feeling defeated and hopeless. This dehumanising treatment is how patients are too often treated, in this country, in 2024, under the law. Other patients are left feeling ignored and unsupported by clinicians. Some are forcibly treated with antipsychotics without understanding why. Many are powerless over their own care.
The independent review of the Mental Health Act, chaired by professor Simon Wessely, shone a spotlight on rising rates of detention under the bill, with many of those detained feeling more like they were being “processed” than cared for. It highlighted the shocking fact that people from ethnic minority communities — especially Black African and Caribbean men — are more than three times as likely to be sectioned under the act. The legislation is often being used to detain people with learning disabilities or autism, when no decent community care can be found.
This review, commissioned by Theresa May, demanded action. The former prime minister was right to describe shortfalls in mental health services and discriminatory use of the law as “a burning injustice”. But six years on, the legislation governing the treatment of the most severely mentally ill patients remains unreformed. Patients’ wishes can continue to go ignored and dismissed by clinicians, devaluing their past experiences of what does and doesn’t work for them and undermining their self-worth. This only serves to reduce a patient’s trust in the mental health services they ought to rely on.
Current outdated laws do not meet the standards of today and fail to give patients an adequate voice or protect their dignity in times of crisis. Too many people are detained who simply shouldn’t have their liberty taken away from them. At the other end of the spectrum, poor decision-making can lead to patients being discharged who are a danger to themselves and others. The Mental Health Act is as old as I am. In the past 40 years, our society’s understanding of severe mental illness has come on in leaps and bounds. Between episodes, patients can make informed choices about their care, which are ultimately better for them and more likely to lead to successful treatment.
But while attitudes have changed, some of the most important laws that underpin mental health care have remained the same, treating people more like criminals than patients. With the new Mental Health Bill the government is introducing, patients will be given a real say over their own care. They will have opportunities to state their wishes and preferences in advance of their being detained, when they are well enough to do so. Clinicians will be required to give patients’ choices proper consideration. Our reforms will limit the amount of time for which autistic people and those with a learning disability can be detained in hospital — unless they also have a mental health condition for which they need treatment.
We will improve safeguards on patient discharge, so patients, staff, and the public are better protected. We will also end the use of police cells for people in mental health crisis. Police cells should be for people who have committed a crime, not for those in desperate need of medical help. In the Budget, this Labour government demonstrated our commitment to improving mental health services and meeting this urgent challenge of our time. We are providing NHS talking therapies for an extra 380,000 patients, intervening early to prevent patients from reaching crisis point, and investing in building new mental health crisis centres, too. Today we are fulfilling our manifesto promise to reform our outdated mental health legislation. Wes Streeting is secretary of state for health and social care.
The Independent