This commentary reviews proposals in a white paper published in January 2021 to reform the Mental Health Act 1983 (as amended in 2007) (MHA) in England and Wales. The government launched a public consultation period on the proposals which closed on 21 April 2021. The government published the consultation outcome and its response to it on 24 August 2021. Over 1,700 responses were received to the consultation, which were broadly supportive of the white paper and the need to modernise the MHA. 1 A draft Bill is expected in autumn 2021 with more details of the government’s plans to reform the law. The white paper is the culmination of a relatively lengthy period of review following widespread concerns about the operation of the MHA and recommendations of an Independent Review of the MHA, which reported in December 2018.
The MHA regulates compulsory admission and in-patient treatment of persons with a mental disorder in England and Wales. 2 It empowers mental health professionals to admit a person with a mental disorder (broadly defined in section 1 as ‘any disorder or disability of the mind’) who presents a risk to themselves or others to a psychiatric unit or hospital, for compulsory short-term assessment, or longer term in-patient treatment, of the mental disorder. Currently, persons can be admitted without their consent for a short-term assessment under section 2 (up to 28 days), for assessment in an emergency under section 4, or for longer term treatment under section 3 (initially for up to 6 months, but renewable thereafter). Applications for compulsory admission are usually made by a professional with relevant competence and expertise—known as an Approved Mental Health Professional (AMHP), supported by the requisite medical recommendations. A person’s nearest relative (NR) (identified from a hierarchical list by the AMHP) should be informed, and in some cases consulted on the application, and the NR also has separate powers to object to the admission and apply for discharge in some cases.