Government aims to eliminate racial disparities with landmark mental health reforms

PEOPLE experiencing a mental health emergency will be able to access more care in the community, such as through crisis houses and safe havens, and those detained under the Mental Health Act will benefit from landmark reforms which provide patients with more control over their care and treatment.

A £150 million investment over the next three years will bolster NHS (National Health Service) mental health services, better support people in crisis outside of A&E and enhance patient safety in mental health units. These were all recommendations from Professor Sir Simon Wessely’s independent review of the Mental Health Act which will now be implemented to improve patient care.

The funding includes £7 million for specialised mental health ambulances across the country to reduce the use of general ambulance call outs for those experiencing a mental health crisis and prevent the inappropriate use of police vehicles as a way to take people to hospital. This will ease pressure on services, improve response times and outcomes for people in crisis which will help save lives, as well as ensuring patients experiencing a crisis are treated with dignity and respect.

The government has also published its draft Mental Health Bill today setting out wide-ranging reform to the Mental Health Act to ensure greater choice and autonomy for patients in a mental health crisis. They will also aim to tackle the racial disparities in mental health services, better meet the needs of people with a learning disability and autistic people and ensure appropriate care for people with serious mental illness within the criminal justice system.

The draft bill is now subject to pre-legislative scrutiny where a parliamentary select committee will examine the draft in detail before the government publishes a final version.

UK health and social care secretary Sajid Javid said, “This is a significant moment in supporting people with serious mental health issues.

“We’re investing more money to ensure NHS patients have tailored services and support, so people in a mental health emergency get the right care at the right time.

“Our reforms to the outdated Mental Health Act are another important milestone in better supporting those with serious mental health issues and giving people greater control over their treatment, particularly those from ethnic minority backgrounds who are disproportionately detained under the Act.”

Funding will also support local communities to invest in alternatives to hospital admission for people experiencing a mental health crisis, such as ‘crisis houses’ run by the voluntary sector which will ensure people can access the treatment they need within their community.

Increasing local capacity will reduce avoidable hospital admissions and inappropriate out of area hospital placements. This will result in improved patient outcomes as people in crisis will be able to receive specialised treatment in appropriate environments, reducing the risk of readmission to hospital.

Ensuring patients are receiving the appropriate care from the start will help to free up hospital beds, assisting the government's continued mission to bust the Covid backlogs.

Minister of state for care and mental health Gillian Keegan said, “It’s crucial NHS’s mental health care and treatment works for people.

“I’ve heard first-hand the anguish of patients and their families when they have been subject to inappropriate care. Bolstering the mental health support available to people in a crisis will ensure patients are at the centre of decisions about their own care if they’re detained under the Act.

“I look forward to receiving the committee’s feedback on the draft Bill so we can bring the Act into the twenty-first century.”

NHS mental health Director Claire Murdoch said, “This is a significant and welcome milestone towards the much needed reform of the Mental Health Act and I look forward to working with the government on developing a plan for implementing these changes.

“The NHS Long Term Plan is expanding and improving mental health services across the country - from specialised mental health ambulances, opening new buildings, and refurbishing older ones - this much needed funding will modernise facilities and most importantly, ensure mental health patients get access to the best and suitable care when they need it.”

Reforms to the Mental Health Act will help tackle deep seated health disparities, ensuring everyone is treated with the dignity and respect they deserve and ending the stigma of mental illness once and for all. This includes the disproportionate number of people from black, Asian and ethnic minority communities detained under the Mental Health Act. Black people are over four times more likely to be detained under the act and over 10 times more likely to be subject to a community treatment order.

Work is already underway -- improved culturally appropriate advocacy services are being piloted in four areas in England so people from ethnic minority backgrounds can be better supported by people who understand their needs and NHS England are developing a Patient and Carer Race Equalities Framework to provide mental health trusts with practical steps to improve the experience of care within mental health services for people from ethnic minority communities.

The reforms will also change the way people with a learning disability and autistic people are treated in law by setting out that neither learning disability or autism should be considered reasons for which someone can be detained for treatment under section 3 of the Act. Instead, people with a learning disability or autistic people could only be detained for treatment if a mental health condition is identified by clinicians.

The benefits of reform will also be felt by people with serious mental illness within the criminal justice system. A 28-day time limit will speed up the transfer of prisoners to hospital, ending unnecessary delays and ensuring they get the right treatment at the right time and the outdated practice of using prisons as ‘places of safety’ for defendants with acute mental illness will end. Instead, judges will work with medical professionals to ensure defendants can always be taken directly to a healthcare setting from court.

Minister of state for prisons and probation Victoria Atkins, said, “It is essential that those in the criminal justice system get the right mental health support, so we can keep them and the public safe while also cutting crime.

“The new Mental Health Bill will speed up access to treatment, enshrine important protections for vulnerable people and ensure prisons are not used as an alternative to hospital treatment.”

Sir Wessely, chair of the Independent Review of the Mental Health Act, said, “I am delighted to see the draft Mental Health Bill now in print and ready for pre legislative scrutiny. This is a significant milestone on the road to making our recommendations for reform a reality, and takes us one step closer to delivering much needed improvements for patients.

"The draft Bill will support increased equality of experience and outcomes and a much stronger focus on patient choice and autonomy, which we know are key pillars for long-term recovery.”

Reforms will also take steps to ensure parity between mental health and physical health services. The government is already investing over £400 million to eradicate dormitories in mental health facilities as part of its response to Sir Simon’s recommendations so people admitted to hospital can receive care in a modern and genuinely therapeutic environment.

More widely, the government is expanding and transforming mental health services to meet rising demand by investing an additional £2.3 billion a year to expand and transform services in England, which will help 2 million more people to access mental health services by 2023-24.