Policy paper

Terms of reference: independent review of the Mental Health Act 1983

Published 4 October 2017

This was published under the 2016 to 2019 May Conservative government

1. Background

The government is committed to delivering parity of esteem between mental and physical health. We want to ensure that people with mental health problems receive the treatment and support they need when they need it, are treated with dignity, and that their liberty and autonomy is respected as far as possible.

When considering the functioning of the Mental Health Act 1983, the government notes with concern:

• rising rates of detention under the act
• the disproportionate number of people from black and minority ethnicities detained under the act
• stakeholder concerns that some processes relating to the act are out of step with a modern mental health system, including but not limited to:
  • the balance of safeguards available to patients, such as tribunals, second opinions, and requirements for consent
  • the ability of the detained person to determine which family or carers have a say in their care, and of families to find appropriate information about their loved one
  • that detention may in some cases be used to detain rather than treat
  • questions about the effectiveness of community treatment orders, and the difficulties in getting discharged
  • the time required to take decisions and arrange transfers for patients subject to criminal proceedings

2. Purpose of the review

The purpose of the review is to understand the causes of the issues outlined above, as well as any additional issues with the functioning of the act identified via consultation.

The review will work with stakeholders to make recommendations to government. The recommendations will be aimed at improving the treatment and support people receive when experiencing acute mental ill-health.

Some of the solutions are likely to lie in practice rather than the legislation itself. The review should consider practice-based solutions wherever possible.

The review will help government create a forward-looking plan of changes to legislation and practice, resulting in an enduring legacy of mental health support.

3. Outputs

The review should:

• provide an interim report identifying priorities for the review’s work
• develop a final report containing detailed recommendations on its priorities
• be delivered by autumn 2018

4. Leadership

The government will appoint a chair and vice-chairs of the review.

The chair has overall responsibility for the review and its outputs.

The vice-chairs are responsible for supporting the chair to deliver their responsibilities.

5. Co-production

The review should closely involve service users and carers (both current and past) in all aspects of its work. It should:

• seek to understand practice across different local areas
• engage widely with stakeholders
• make recommendations that have broad support among service users, carers, relevant professionals, and organisations affected

The review period should be used to air differences and find shared solutions.

6. Governance

The review should appoint an advisory panel to ensure that service users, carers and the full range of stakeholders directly shape the recommendations.

7. Devolution

The review is commissioned by and will report to the UK government. Recommendations will extend to England in relation to matters that are devolved in Wales (including health), and England and Wales in relation to non-devolved matters (including justice).

The review should engage with the Welsh Government and stakeholders in Wales, where appropriate, to consider interfaces with Welsh legislation and practice.