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The Government’s White Paper on Reforming the Mental Health Act, published on 13 January 2021, contains wide-ranging proposals to reform the Mental Health Act 1983 (as amended in 2007) in England and Wales.

The White Paper was preceded by an Independent Review which published its final report, Modernising the Mental Health Act, in December 2018. The purpose of the Independent Review was to understand: the rising rates of detention under the Mental Health Act; the disproportionate numbers of people from black, Asian and minority ethnic groups (BAME) in the detained population; and investigate concerns that some processes in the Act are out of step with a modern mental health system.

The Independent Review’s proposals were designed to change the law to make it easier for patients and service users to participate in decisions about their care, to restore their dignity and recognize the importance of human rights in mental health care. The Independent Review made over 150 recommendations and the Government accepted most and incorporated them in the White Paper.

The White Paper includes a range of proposals to reform the Act as well as to bring about improvements in policy, practice, and service delivery. The overall aim is to bring the law in line with modern mental health care and ensure that patients are involved more closely in decisions about their care and treatment.

Included in the proposals for legal change are plans to tighten the admission criteria and raise the threshold for compulsory detention; reduce the use of community treatment orders; strengthen some of the statutory safeguards by giving more frequent access to the tribunal to review detention; bolster support from family members and independent advocates; and enable patients to make advance choices about their future mental health care and treatment. There are also proposals designed to reduce the use of the Act for persons with a learning disability and/or on the autism spectrum, and a range of measures targeted at improving the experiences of persons from BAME groups.

The Government consulted on the White Paper proposals from January to April 2021 and published its response in August 2021. Respondents were broadly supportive of the proposals in the White Paper. The Government said it will continue to work with stakeholders to refine the proposals, to make final policy decisions and develop a draft Bill. 


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