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The future the Mental Health Act

In October 2017 the government announced an independent review of the Mental Health Act, chaired by Professor Sir Simon Wessely. To help inform the debate of how mental health law might evolve, the Policy Institute at King's College London brought a group of stakeholders together for a "policy lab" to consider what approaches the review could take to six areas of tension that were indenftified as relevant.

The discussions drew on the latest data and evidence, combined with an assessment of the overall direction the mental health system might take into the future. From this, a number of principles and proposals emerged for the review to consider:

1. Protections and prevention should be balanced with a more person-centred approach.

2. The concept of risk should take more account of risks the individual prioritises and avoid the ‘slippery slope’ towards a wider set of risks prioritised by the state.

3. The MHA should evolve towards a framework that places greater emphasis on the ability of people to make their own decisions about care and treatment.

4. To minimise detentions, alternative approaches are needed.

The government responded to the final report from the Independent Review in December 2018, by accepting the review’s recommendations to modernise the Mental Health Act by introducing a new Mental Health Bill to transform mental health care.

Read the report


The future of Advance Decision Making in the Mental Health Act

One aspect highlighted by the Independent Review of the Mental Health Act, was the inequality that exists between the provision for advance decision-making for patients with physical health problems and those with mental health problems. Currently, people living with mental illness in England and Wales are unable to make decisions about their own future mental health treatment. The report recommended the statutory provision of mental health advance decision making in the form of "Advance Choice Documents" (ACDs), which were drawn from a report submitted by the Mental Health and Justice Project and summarised in a policy briefing compiled by the Policy Institute and the Institute of Psychiatry, Psychology & Neuroscience at Kings College London. The briefing was discussed at an evidence session in the House of Lords.

Read the policy briefing