Independent Review of the Mental Health Act 1983 by Simon Wessely (2018)

MHA reform Extract from website: "The review was set up to look at how the legislation in the Mental Health Act 1983 is used and how practice can improve. The purpose of the review is to understand the reasons for: (a) rising rates of detention under the Act; (b) the disproportionate number of people from black and minority ethnic groups detained under the Act; (c) processes that are out of step with a modern mental health care system. The review will seek the views of service users, carers, relevant professionals, and affected organisations in producing recommendations. It will produce a report with recommendations for change in autumn 2018."

Pre-report

Wessely review. Department of Health, 'Terms of Reference - Independent Review of the Mental Health Act 1983' (policy paper, 4/10/17) — Extract from website: "The independent review of the Mental Health Act will: (a) look at how the legislation is currently used; (b) look at its impact on service users, families and staff; (c) make recommendations for improving the legislation and related practices. The review will be chaired by Professor Sir Simon Wessely, a former President of the Royal College of Psychiatrists. He will produce an interim report in early 2018 and develop a final report containing detailed recommendations, by autumn 2018."

Wessely review response. Law Society, 'Mental Health Act 1983 Independent Review: Call for Evidence: Law Society response' (22/1/18) — The Law Society's response notes that the MHA/MCA interface, and UNCRPD compatibility, need to be considered, and contains proposals under the following sub-headings: (a) Giving informal admission statutory force; (b) Period of detention under Section 3; (c) Treatment without consent under the MHA 1983; (d) Automatic referrals to the tribunal; (e) Statutory requirement to discharge where detention criteria are not met; (f) Managers Hearings for patients who lack capacity; (g) The need for an express requirement of tribunals to have regard to ECHR Rights; (h) Transfer of Prisoners to Hospital; (i) Inadequacy of tribunal powers in respect of transferred patients; (j) Community Treatment Orders; (k) Lack of access to aftercare for patients detained under section 2 and informal patients; (l) Learning Disabilities & Autism; (m) Under 18s; (n) Nearest Relative Rule; (o) Our views on mental health service provision.

The Wessely report

MHA reform report. Independent Review of the Mental Health Act 1983, 'Modernising the Mental Health Act: Increasing choice, reducing compulsion' (final report, 6/12/18) — The report states that "[a] purpose and a set of principles should be included in the Act itself" and makes recommendations under the following headings: (1) Principle 1 - Choice and autonomy: (a) Making decisions about care and treatment; (b) Family and carer involvement; (c) Advocacy; (d) Complaints; (e) Deaths in detention. (2) Principle 2 - Least Restriction: (a) Tackling the rising rates of detention; (b) Criteria for detention; (c) A statutory Care and Treatment Plan; (d) Length of detention; (e) Challenging detention; (f) Deprivation of liberty: MCA or MHA?; (g) Community Treatment Orders; (h) Coercion and restrictive practices within inpatient settings. (3) Principle 3 - Therapeutic Benefit: (a) Care planning/aftercare; (b) Hospital visitors; (c) Inpatient social environments; (d) Inpatient physical environments. (4) Principle 4 - The Person as an Individual: (a) Person centred care; (b) Recognition of patient individuality at the tribunal; (c) The experiences of people from ethnic minority communities; (d) Children and young people; (e) People with learning disabilities, autism or both; (f) Policing; (g) Patients in the criminal justice system; (h) Immigration Detention; (i) Victims. (5) System wide enablers: (a) Data; (b) Digital enablers; (c) Quality Improvement (QI); (d) Staffing; (e) Improving staff morale.

Post-report

White Paper on MHA reform. SSHSC, LC and SSJ, 'Reforming the Mental Health Act' (CP 355, 2021, consultation from 13/1/21 to 21/4/21) — "It is two years since Professor Sir Simon Wessely delivered his landmark Independent Review of the Mental Health Act. ... We accept, and we will take forward, the vast majority of its recommendations for change. ... The changes are based on 4 principles that have been developed with people with lived experience of the MHA. They are: (1) choice and autonomy - ensuring service users’ views and choices are respected; (2) least restriction - ensuring the MHA’s powers are used in the least restrictive way; (3) therapeutic benefit - ensuring patients are supported to get better, so they can be discharged from the MHA; (4) the person as an individual - ensuring patients are viewed and treated as individuals."

Response to MHA review. SSHSC, LC and SSJ, 'Reforming the Mental Health Act: Government response to consultation' (CP 501, July 2021) — This is the main report, but the easy-read version's headings are: Introduction; Four principles; Reasons for keeping people in hospital; Your right to go to a tribunal; People who have gone back into hospital; Giving tribunals more power; Hospital manager’s panel hearings; Choosing your care and treatment; Making sure your choices are listened to; Care and treatment plans; Refusing treatment; Asking a tribunal to stop your treatment; Agreeing to go into hospital; Nominated person; Advocacy; The Mental Capacity Act; Accident and emergency departments; Going to a mental health hospital from prison; People who have been in trouble with the law; The Social Supervisor; People with a learning disability and autistic people; People with a learning disability who get into trouble with the law; Care (Education) and Treatment Reviews; The Care Quality Commission (CQC); Community Treatment Orders (CTOs).