'Outdated' Mental Health Act Must Give Power Back To Patients, Says Review

More and more people are being sectioned, but their voices are being lost.

People who are sectioned because of mental illness can become powerless once they step foot in hospital – and a new review of how the system works is calling for change.

The independent review of the Mental Health Act 1983, which means people can be sent to hospital to receive treatment for mental illness against their will, has issued suggestions on how the “outdated” system could better respect people’s rights.

Almost 50,000 people were sectioned in the UK between 2017 and 2018. The figure rose by 40 per cent between 2005 and 2016. Patients should be given more legal weight when it comes to their future, the review said.

Among its suggestions was that patients should be able to choose a relative to advocate for them. Currently the system gives default power to a patient’s next of kin, without taking into account if they are estranged – or abusive.

Professor Sir Simon Wessely, Chair of the Review, said it should be easier for patients to express their choices and preferences about how they want to be treated – and harder for them to be ignored.

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The review suggests a number of ways in which the Mental Health Act could be brought up to speed, with a focus on patients being given more power over their future.

Currently, a person who has been sectioned or is at risk of being sectioned can express views about how they want to be treated when they are detained. But there is little in place to ensure that their views are respected.

Under proposed changes, documents would be created enabling people to make a range of choices and statements about their future inpatient care while they were well. These would include a patient’s medication preferences.

People should get earlier access to second opinions about their treatment, the review said, and should be able to challenge decisions they disagree with at a tribunal.

They should also be able to choose a ‘nominated person’ to have power over their care while sectioned, rather than being allocated a ‘nearest relative’.

In starling findings, black people are four times more likely to be detained under the Mental Health Act. The review suggested mental health services should be better equipped to respond to a local population’s ethnic and cultural demographics.

Additionally, it recommended that parents of detained children and young people should receive better information and support. Use of the Act for people with a learning disability or autism was often inappropriate, it added.

The review also called for better hospital facilities and access to long-term support to keep people well after they’ve been discharged.

Paul Farmer, chief executive of Mind, said thousands of people have been left too long without support, become severely unwell and then experience poor treatment under the Act, only to be left living with the consequences.

“The recommendations to strengthen people’s rights, empower them to question decisions about their care, choose their treatment and involve friends and family have the potential to make a real difference to those who are in an extremely vulnerable situation,” he said.

“The government now needs to take this forward as soon as possible so that people with mental health problems get the support they need.”

Useful websites and helplines:

  • Mind, open Monday to Friday, 9am-6pm on 0300 123 3393
  • Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill.)
  • The Mix is a free support service for people under 25. Call 0808 808 4994 or email: help@themix.org.uk
  • Rethink Mental Illness offers practical help through its advice line which can be reached on 0300 5000 927 (open Monday to Friday 10am-4pm). More info can be found on www.rethink.org.