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Last week, the government responded to important recommendations made by the Joint Committee on the Mental Health Bill. The urgency of the reforms needed was highlighted by the publication of the CQC’s annual report, Monitoring the Mental Health Act.

We are pleased that the government agree to use both legislative and non-legislative approaches ensuring an appropriate level and range of community support is available before commencing those parts of the bill which will remove the power to detain people with a learning disability and autistic people without a co-occurring mental health condition under section 3.

We also welcome the Joint Committees recommendations that Community Treatments Orders (CTOs) are abolished for patients under part II of the MHA, and echo the Joint Committee’s call for clear actions from the government, NHS and CQC to prevent the practice of the concept of ‘capacity’ being misused to deny treatment to people voluntarily seeking help when they are very unwell and potentially suicidal.

In these areas the government’s response does not go far in enough: there is insufficient evidence that the use CTO’s is beneficial but it is clearly evidenced that these orders are being disproportionately used for persons of colour and diverse ethnicities. The government say that greater scrutiny and oversight will address the inordinate use of CTO’s and that they will work with professional bodies to investigate whether they can improve the way that clinicians communicate and engage with patients about capacity and suicide.

These actions are inadequate in light of current and historical failures to use best practice in application of existing legislation in Mental Health. Marginalised groups are not receiving equitable treatment under existing laws and guidelines. Relying on the Equality and Diversity Act 2010 as an addition to current practice has not addressed inequalities.

The CQC’s monitoring report raises practical areas of concern that inform and perpetuate inequalities such as workforce retention, closed cultures and restrictive practice. The CQC also state: More work is needed to address the over-representation of Black people detained under the MHA (and) prolonged detention in hospital for people who need specialist support.

This work must be founded on legislative reform that challenges professionals and organisations to change cultures that oppress and exclude. The Mental Health Act is in desperate need of reform and every day we support people in our services who have been failed by an archaic system. We call on all political parties to include in their election manifestos a commitment to passing the legislation within their first 12 months in office.

The External Affairs Team

Government Response to the Joint Committee for the Draft Mental Health Act

QCQ Monitoring the Mental Health Act Report