Reflections on the Mental Health Act Review

Mental Health Act Review Advisory Group held it’s first meeting following the publication of the review recommendation, 7th May. The second meeting is being held 8th July. 

We continue to share our reflections about the recommendations and will be raising the following at the July meeting.

We welcome the clear attempt to address a number of issues related to the Mental Health Act 1983, not least the recognition of particular issues for people from BME communities, including asylum seekers and refugees, people with learning difficulties and/or autism and children/young people; the emphasis on working to change the current risk averse culture; the recommendation of a statutory basis for treatment choices made by people with lived experience who are judged to have capacity.

However, the National Survivor User Network (NSUN), together with a significant range of other user-led groups and individuals with lived experience, remains concerned. For us, the Review recommendations have fallen short of addressing human rights issues on a more fundamental basis and fail adequately to tackle discrepancies between the commitment which the UK government has made to the United Nations Convention on the Rights of Persons with Disabilities and existing law. For example:

  • There is a continuing focus on a clinical understanding of mental trauma rather than a look, too, at alternatives which many of us find make most sense of our experiences and are more effective in helping us to address the issues we have
  • Whilst it is recommended that a principle of autonomy is enshrined in law, detention in hospital would still be legally permissible. Recommending both also seems a contradiction in terms
  • A two tier system has been put forward in relation to advance choice documents; there would not be the same status for advance choice documentation from people assessed as not having capacity. We would like to see an imaginative use of options which make advance choices a statutory possibility for everyone
  • Although there is a focus on reducing detention, the Review recommendations do not advocate the major increase in non-clinical alternatives and user-led initiatives that many of us strongly want, including the funding vitally needed for these
  • The Review has a lack of emphasis on intersectional factors such as gender, older age, sexual orientation, socio-economic status and other disabilities and on issues for Deaf people and people living with dementia.

Dorothy Gould and Sarah Yiannoullou (NSUN)
June 2019

Read our summary of the recommendations here and a full review of the recommendationshere