COMMENTING on proposed reforms to the Mental Health Act, POhWER’s Chief Executive Helen Moulinos said:

“It is wonderful to see some progress in reforming the Mental Health Act particularly where it strengthens relationships, empowers individuals, further upholds human rights and builds dignity for people supported by public services or in government-run institutions.

“However, there are still many concerns POhWER has about the proposed changes to the Mental Health Act which we hope are addressed ahead of legislation being proposed in Parliament.”

Under the Act, people with a mental disorder may be formally detained in hospital (or ‘sectioned’) in the interests of their own health or safety, or for the protection of other people. They can also be treated in the community but this is subject to recall to a hospital for assessment and/or treatment under a Community Treatment Order (CTO). 

While POhWER welcomes reform of the Mental Health Act, and in particular the increased scope of advocacy, it says there is a need for more formal statutory duties to be stipulated for public sector bodies to mandate along with increased information outlining an individual’s human rights when they are detained.

In particular, POhWER points to the revised Act needing:

• More investigative and regulatory oversight for non-natural deaths which occur in a mental health setting: The charity is concerned about the suitability of the support offered in the proposals, and say that there is a need for a more comprehensive review of the use of restraint or excessive force related to the deaths.

• More work to understand discrimination in how the Act is applied: POhWER points to the disproportionate application of the Mental Health Act for black British people who, according to the NHS, were 8 times more likely than white people to be detained under the Act between 2018-2019. Men are also far more likely to be detained. The report goes on to confirm known gender-based inequalities in the use of Community Treatment Orders, for example, the rate for males (11.2 per 100,000 population) is much higher than the rate for females (6.1 per 100,000 population).

• More clarity on funding: The Mental Health Act reform emphasises the increased role for independent advocacy in order to uphold human rights, particularly in underfunded settings such as prisons and immigration detention centres, but does not provide clarity on where this funding, or the skilled people to fulfil these roles, will come from.

• More safeguards for patients being treated informally with consent: The changes to the Mental Health Act seem to propose treating inpatients informally with consent whenever possible. This is due to evidence suggesting that patients who feel that their admissions are consensual will be more likely to respond positively to treatment than those who are formally detained. However, POhWER says there is a concern that this approach could be open to abuse.

• More thought given to the needs and circumstances of people living with Learning Disabilities and Autism: POhWER says that more empathetic empowering options are needed, outside of detention.

• More clarity as to how often, and in which situations, Community Treatment Orders (CTOs) are used: POhWER is calling for suitable community-based options and alternatives to detention.

• More reform on the need for unethical use of blanket restrictions.

Helen added:

“We would welcome more dialogue on these proposals to make any changes as effective as they can be. Many of the advocacy providers, including POhWER, are predominantly Civil Society organisations with limited resources to scale or expand further without investment. We’d like to see some recognition of the important role advocates play in keeping checks and balances in wider society, and ensuring a level playing field for all.”

POhWER has vast experience working in settings where the Mental Health Act (MHA) is applied – supporting individuals who are subject to the powers and entitled to the rights enshrined within the Act.

From 1^st April 2019 to 31^st March 2020, POhWER’s Independent Mental Health Advocacy (IMHA) service supported 9,451 clients with 19,605 support issues. It is one of the key duties of an independent mental health advocate to support those who are subject to the act in understanding and accessing their rights.

For more information about POhWER or to access support, please visit: www.pohwer.net or call 0300 456 2370.