Mental Health Bill 2022

More than three years after the publication of the Wessely Review of the Mental Health Act, the Mental Health Bill 2022 has been laid before Parliament for consideration.  This will be the first substantial update of the Mental Health Act for fifteen years and it does have an impact on those parts of the Act which involve policing in addition to revising many of the main operations of the Mental Health Act’s admission process.  As far as the policing elements are concerned, I was pleasantly surprised because having been involved in Sir Simon’s review, I did wonder whether certain issues which were understandably discussed would make it in to the recommendations and the Bill as a whole.  It looks like they haven’t and I’m going to leave that observations there, in case anybody gets any bright ideas whilst this is working its way through the Parliamentary process!

POLICING & CRIMINAL JUSTICE

The main news for the police:

Police stations will no longer be a Place of Safety under the actever

The Bill proposes to remove the words “police station” from the definition of a Place of Safety for those of us detained under s135 or s136 of the Mental Health Act.  Nobody – literally nobody! – who is detained under those two provisions will be able to be removed to a police station or police custody, thus ending a somewhat medieval practice of jailing the unwell.  The Bill even bothers to specify in s135(7) (the provision which allows “any suitable place” to be used as a Place of Safety) that a police station is not a suitable place.  That’s it – the end.

Even more reassuringly, because it’s often overlooked, the words “police station” and “prison” will be removed from the Part III definition of a Place of Safety (in s55 MHA) – this is a rare provision, but used by criminal courts when unwell defendants are being sentenced to hospital detention but where no secure bed is immediately available.  Unbelievably, the law currently allows people to be locked up with two weeks(!) until a bed is found.  So it looks as if I’ll need a new trick question for the quiz I sometimes run in training about how long a person can be detained in a police station as a place of safety.  Everyone says “24hrs” when in fact the answer is fourteen days but not if this Bill makes it to law – police stations and prisons will no longer be places to jail the unwell, pending a bed being found.

More widely in the criminal justice parts of the reform, there will be a statutory 28-day limit on transferring patients from prison to hospital, where necessary.  Stories abound in recent years about prisoners who need hospital care being detained for months on end because of difficulty in securing secure beds.  You’ll no doubt already be wondering where the new beds are going to come from, because the reason for not transferring prisoners is usually the simple fact there’s nowhere to put them and given the sheer cost of secure MH care (compared to imprisonment), it’s probably legitimate to wonder where the money and additional beds are coming from, given some psychiatrists estimate that almost 10% of prisoners are so mentally unwell at any given time, they require hospital care.

And section 35 MHA will be amended to allow Magistrates to remand a defendant to hospital before a conviction or finding, if that patient consents to it for psychiatric reports before trial.  I’m especially pleased to see this provison within the Bill, having raised it with Sir Simon during the MHA Review in 2018 – seeing it reflected in a bill is personally gratifying.

MHA REVISION

I’m still working my way through this Bill, frankly, so may post again.  It’s going to take me a little longer to get my head ’round the other revisions because I’m not working on this full-time but as recommended by Sir Simon and accepted by the Government, the wording of the criteria for admission to hospital under the Act are changing and various supports and protections for patients are changing, to enhance rights whilst detained.  The currently concept of a “Nearest Relative” (causing such wonderment as “Who is Harry Potter’s Nearest Relative?”) will be replaced by a “nominated person” to undertake certain functions.  This ensures patients have the right to nominate the person they would prefer to take certain decisions on their behalf, preventing the situation where someone to whom the patient objects wins that right by dent of being a more proximate relative.

Detention under s3 MHA (detention for treatment) will change – currently, any patient admitted under this provision can be held for six months, then a further period of six months and then for periods of twelve months until discharged – (6-6-12).  Upon passage of the Bill, this will change to 3-3-6-12 month periods.  It will be further supported by changes in the system of allowing patients to apply to a Mental Health Tribunal more readily and against different criteria for detention under s2 and s3 MHA, it means decisions to detained will be more focussed on patient’s needs and only admitting them where there is a therapeutic benefit to that admission.

Meanwhile, the Government have also announced the funding for ‘mental health ambulances‘, to assist in mental health crisis incidents and I suspect this will be just one aspect that needs considerable increase in resources if it’s to be effective.  One of the obvious risks with all this proposed legislation, is that it will have knock-on consequences and if that is to work, they need to be considered and anticipated.  No police stations as  Place of Safety, ever? – so where do you want the police to take an adult who is agitated and distressed whilst mentally ill?!  Many areas struggle to ensure Place of Safety capacity and a lot of officers end up in Emergency Departments with vulnerable people but only yesterday, I was reading a s136 MHA policy which explicitly states ED in that area will *NOT* receive anyone who does not require ‘physical’ care – whatever that means.  So what happens in ED is refusing, the PoS is full?

This question is not hypothetical and it never, ever was.


Winner of the President’s Medal,
the Royal College of Psychiatrists.

Winner of the Mind Digital Media Award

 

All views expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2022


I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current.  Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.

Government legislation website – www.legislation.gov.uk