The Mental Health Act Reforms – 2021 White Paper

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Legally reviewed by: Tim Lumb In: Mental Health Law

In 2017, the UK government asked for an independent review of The Mental Health Act 1983 (MHA). Professor Sir Simon Wessely was chosen to lead the review and to propose recommendations for modernisation and reform. Published in December 2018 the report made over 150 recommendations.

The government published its response in the form of a White Paper, on Wednesday 15th January 2021. This will be followed by a 12-week public consultation. Following consultation, the government plans to draft a revised Mental Health Bill, which will be introduced when parliamentary time allows.

The final report sets out recommendations covering 4 principles that the review believes should underpin the reformed Act:

  • choice and autonomy – ensuring service users’ views and choices are respected
  • least restriction – ensuring the Act’s powers are used in the least restrictive way
  • therapeutic benefit – ensuring patients are supported to get better, so they can be discharged from the Act
  • people as individuals – ensuring patients are viewed and treated as rounded individuals

The review looked at:

  • rising rates of detention under the Act
  • the disproportionate number of people from black and minority ethnic groups detained under the Act
  • processes that are out of step with a modern mental health care system

The Key measures of The Mental Health Act White Paper

  • Putting statutory principles (choice and autonomy, least restriction, therapeutic benefit and the person as an individual) on the face of the legislation to govern decisions.
  • Tightening criteria for detention under the act to reduce its use and disproportionate impact on certain groups.
  • Expanding the role of the Mental Health Tribunal to check whether detention is appropriate.
  • Introducing advance choice documents to enable people to express preferences for treatment should they become subject to the act, which clinicians must take into account.
  • Putting care and treatment plans on a statutory footing, setting clear expectations for treatment.
  • Strengthening safeguards around consent to the use of invasive treatments.
  • Giving people the right to choose a nominated person to support them and challenge decisions rather than have a nearest relative selected for them.
  • Expanding the role of independent mental health advocates including supporting people to take part in care planning, challenging particular treatments and applying to the tribunal on their behalf.
  • Tightening criteria for the use of community treatment orders.
  • Limiting the detention of people with autism or learning disabilities.

Matthew Hancock, Secretary of State for Health, spoke on Wednesday 13th January 2021 in the House of Commons saying that : “The new Act will ensure patients are put at the centre of decisions about their own care, that everyone is treated with respect and the law is only used to compel treatment where absolutely necessary.

“The white paper’s been developed in close consultation with those with the greatest expertise, the Royal College of Psychiatrists, Rethink Mental Illness, Mind, the Centre for Mental Health, and countless practitioners on the front line and I thank them all.”

Consultations on changes that require legislation will run until early spring, with a draft Mental Health Bill published next year.

The closing date for responses is 21st April 2021. The White Paper and consultation documents are available on the

Cartwright King Solicitors, Mental Health Solicitors are approved by the Legal Aid Agency and can provide legal advice and representation and our legal representatives are accredited members of the Law Society Mental Health Tribunal Panel, a dedicated body of solicitors specialising in Mental Health Law.

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All advice is correct at time of publication.