New Mental Health Bill: What's included and what's not

After years of campaigning, consulting and amending, the new Mental Health Bill was introduced to Parliament on 6 November 2024.

This is a huge step towards modernising the dated laws that dictate what happens when someone is detained under the Mental Health Act. 

Hasn’t there already been a new Mental Health Bill? 

The short answer is yes, there was a draft Bill created under the Conservative government in 2022, which we have talked about before. This Bill was scrutinised by a Joint Committee of MPs from different political parties but was never introduced to parliament before the 2024 General Election and the formation of the new Government.  

Some of the main changes in the 2022 draft Bill included: 

• The ability to formally challenge detention through more frequent access to Mental Health Tribunals.  
• The introduction of advanced choice documents that will set out a person’s wishes and preferences for care and which must be used by clinicians to guide treatment.  
• Allowing a person to choose their own Nominated Person to support them with decisions while they are detained (something we’ve called for for many years).  
• The introduction of statutory care and treatment plans and the need to record the reasons for compulsory treatment and restrictive practices to improve transparency.   
• Increased access to Independent Mental Health Advocates, including for involuntary patients.  
• Increased threshold for detention and the improvements to care for those in contact with the criminal justice system.  
• Police cells and prisons can no longer be used as ‘places of safety’ for people who have been detained for mental health reasons 
• A 28 day limit on transferring patients from prison to hospital if they need treatment for their mental health  

So, what’s new?  

The 2018 Independent Review of the Mental Health Act, where this journey began, recommended that four “guiding principles” should underpin reform: 

• Choice and autonomy 
• Least restriction 
• Therapeutic benefit  
• The person as the individual 

We are pleased that the new Mental Health Bill will amend the law so that these principles must be considered when writing the Code of Practice that professionals use when applying these laws. We are pleased to see several other changes that show an effort to embed these principles throughout the legislation.  

Overall, the new Mental Health Bill includes more checks and balances for decisions on detention, treatment decisions, discharge and the ability to consent to use of information.  

Advance Choice Documents allow a patient to set out their wishes, feelings, values and beliefs when they are well, to guide clinical decision making when they are unwell. There is significant research which demonstrates the benefits of Advance Choice Documents for all patients, and particularly those from racially minoritised communities.

The new Bill means that people must be informed about Advanced Choice Documents and provided with appropriate help to make one. 

Is anything missing? 

We want all patients detained under the Mental Health Act to have equal access to advocacy, to Mental Health Tribunals and other rights no matter what part of the Act they are detained under.

In its current form, there are some differences depending on whether a person is involved in criminal proceedings. We are particularly concerned that this will have a disproportionate effect on people from racially minoritised backgrounds, who are already significantly more likely to both be detained under and have negative experiences under the Mental Health Act.  

We appreciate that some timeline changes in the new Bill have been made to make sure that services have enough capacity and ability to meet the new legal requirements. However, these changes should still be enacted as soon as possible. This process has taken several years already, and people affected by these laws need to see change.  

There are certain points that have been debated throughout the process of creating this Bill which we have been told will be addressed in the Code of Practice and through implementation.

We are particularly keen that the concerns surrounding the any potential unintended consequences for people with learning disabilities and autism are addressed, and that provisions are put in place to deliver the right community support. We also hope to see strengthening of safeguards for vulnerable children and young people detained under the Mental Health Act. 

All of these changes are a step in the right direction, but absolutely must be backed up with enough resources in the form of money, workforce and training to ensure that they reach their full potential.  

What happens next?  

The Mental Health Bill will now start to progress through Parliament over the course of the next few months, first through the House of Lords and then through the House of Commons. Throughout this journey there will be opportunities for further tweaks and changes to be made to ensure that it is fit for purpose when it does eventually become the law.   

Rethink Mental Illness will be working hard alongside our colleagues in the sector, the civil service and the Government to make sure that the new Mental Health Act works well for everyone it affects and is swiftly implemented so that we can start to see real change for those of us living with severe mental illness.