The Labour government has introduced a long-anticipated mental health bill aimed at ending the use of prison cells for individuals in crisis and placing limits on detaining people with autism or learning disabilities.
This bill proposes updates to the Mental Health Act 1983, last revised 17 years ago and now considered outdated. The Act currently establishes the legal framework for detaining and administering compulsory treatment to individuals with mental health disorders who may pose a risk to themselves or others, a practice often referred to as "sectioning." However, concerns have grown that the current law is overly restrictive and affords patients minimal control over their treatment.
Additional issues include significant racial disparities like black individuals and more than three times as likely to be detained and instances of unfair treatment for people with learning disabilities or autism.
Efforts to reform the bill began in 2017 when then-Prime Minister Theresa May requested a comprehensive review of the Act, led by Professor Sir Simon Wessely. Sir Simon’s report, published in December 2018, forms the foundation of this new bill, which is built around four key principles of-enhancing patient choice and autonomy, minimising restrictions on freedom wherever possible, ensuring that detention and treatment provide a “therapeutic benefit,” and treating each individual affected by the Act with respect and dignity.
The proposed changes introduce a higher threshold for detention, requiring a risk of “serious harm” rather than just “harm.” This same standard would also apply to community treatment orders, which allow for supervised care in the community rather than in a hospital setting.
Another key aspect of the bill mandates that all detained patients have individualised care and treatment plans outlining steps toward recovery and discharge. Importantly, it prohibits the use of prison or police cells as “places of safety” for individuals in a mental health crisis, requiring instead that they be cared for in appropriate healthcare settings.
Reform alone is not enough
Leading experts have urged the Labour Party to commit to a dedicated funding plan for mental health, amid concerns that current government ministers may reduce the investments previously promised by the Conservative administration. Charities are warning that the mental health crisis, compounded by the cost-of-living pressures, could escalate into a widespread “pandemic in the making.”
Many people are experiencing heightened anxiety, stress, and hopelessness due to financial strains and critics argue that the recent budget, instead of offering relief, has actually impede growth for small enterprises. Proposed increases in National Insurance are expected to affect both businesses and employees negatively, putting further strain on communities already grappling with financial instability. As people struggle to manage these financial burdens, affording or prioritising mental health support becomes even more challenging, despite reforms intended to improve access to care. Experts warn that without a solid funding plan, these reforms risk being out of reach for many who need them most. Additionally, the NHS crisis is something that will also affect how things progress.
Rohit Sagoo, a children’s nurse, PhD student at the University of Bedfordshire, and founder of British Sikh Nurses, is of the opinion that this shift offers greater freedom, choice, and understanding for those seeking mental health support, paving the way for a more compassionate approach. However, he believes that the reforms alone are not sufficient. “It aims to give individuals more say over their care, reduce hospital stays unless necessary, and focus on providing personalised care that genuinely benefits each person”, he said.
On the other hand, Andrew Molodynski, mental health lead at the British Medical Association (BMA), while welcoming the over-due reform, also pointed out that, “Many people with severe mental illness might never have reached the point of needing crisis care if they had been able to access better care sooner. Without adequate and sustainable funding for mental healthcare we will still be far from being able to meet all our patients' needs, and some will continue to fall through the cracks.
“Over the last few years, need from patients has increased faster than funding has, resulting in longer waiting lists, people having to be moved far away from their homes and loved ones, and crumbling facilities. We are also facing a recruitment and retention crisis, and need far more mental health doctors and other professionals to meet the needs of our patients."
Royal College of Nursing chief nursing officer Lynn Woolsey said, “Modernising the Mental Health Act is welcome, but these long overdue reforms won’t be successful unless we address the crisis in the workforce.
“A third of all nursing vacancies are in mental health services, meaning vulnerable people are routinely denied access to timely and appropriate care.” She added that it was “crucial” that the nursing profession was involved in shaping and rolling out these changes.
Chief Executive of Mental Health First Aid England, Sarah McIntosh also pointed out that, “Reform alone is not enough though. Robust funding is crucial to making these changes effective and sustainable. Adequate resources are needed to address the backlog of patients waiting for care, fund mental health crisis hubs, and ensure 24/7 access to emergency mental health support. Without the proper funding, this reform will fall short of its transformative potential, risking continued inequalities and delays in care.
“Furthermore, early intervention must be a top priority. By investing in preventative services and mental health hubs for young people, we can support individuals before they reach crisis points, reducing the overall demand on mental health services and improving outcomes across generations. The government’s commitment to early intervention in schools and workplaces is essential to preventing mental health issues from worsening and empowering people to manage their mental health proactively.
“We also need continued commitment from the government to address the societal factors that often underlie mental health issues, including poverty, inequality, racism, and injustice. Tackling the root causes will be key to reducing disparities in mental health treatment and outcomes and ensuring that support is available to those who need it most.”
A step towards compassionate care
For individuals with learning disabilities or autism, the bill establishes a 28-day detention limit unless a concurrent mental health condition is diagnosed. Additionally, it introduces a new right for patients to select a “nominated person” as their advocate, rather than defaulting to their nearest relative.
Clinicians will also be required to follow a “clinical checklist” in treatment decisions, ensuring they consider the patient’s personal values, past and present wishes, and actively involve both the patient and their close contacts in the decision-making process. This legislative reform aims to create a more compassionate, inclusive, and effective mental health care framework that prioritises patient rights and dignity while addressing the unique needs of vulnerable groups.
Reacting to the proposed reforms, Tim Nicholls, Assistant Director of Policy, Research and Strategy at the National Autistic Society, said, “This is a once in a generation chance to end the human rights scandal of autistic people being inappropriately detained in mental health hospitals.
“Autism is not a mental health condition, but currently 1,385 autistic people are held in mental health hospitals when many could be better supported in their homes surrounded by their loved ones. Instead, they face detention for an average of five years, and risk being subject to unnecessary restraint, overmedication, and solitary confinement.
“We have campaigned for years to reform the outdated Mental Health Act and protect autistic people’s human rights. That is what this Bill must do. But changing the law is just part of what’s needed. Without investing in making sure the right support is available everywhere, autistic people will still face this inequality.”
Strong network of friendship and family is crucial for well-being
The conversation around mental health and well-being is incomplete if the taboo around the topic is not addressed, especially in context of the South Asian communities. Cultural norms around mental health often discourage open discussion of mental illness in the community, and stigma surrounding mental health may prevent individuals from seeking professional help. In such cases, the role of family and friends becomes even more important.
Dr Santosh Bhanot, Director and Head of Peepul Health at the Peepul Centre, highlighted the persistent silence around mental health issues like depression, anxiety, and low self-esteem within South Asian communities, often due to cultural stigma. "Discussing mental health can be difficult in these communities, where terms like ‘Pagal’ (meaning ‘crazy’) are used dismissively, discouraging open conversations,” she explained.
She stressed the importance of a strong support network of friends and family, noting that the first step to well-being is recognising mental health symptoms. “Awareness is crucial. Once we recognise the signs, sharing our feelings with trusted friends or family can offer relief and fresh perspective,” she added. Dr Bhanot also underscored the value of positive friendships, noting, “Friends can boost self-esteem through simple activities like walks, which reduce stress. They may even encourage healthier lifestyle choices, like reducing alcohol or adopting positive habits.”
While friends and family can be essential, Dr Bhanot also emphasised that complex challenges like financial stress, relationship issues, or grief often need professional intervention. “Friends provide empathy and guidance, but they may lack the resources or expertise to address specific issues. Combining personal support with professional help when needed allows for a more comprehensive approach to mental health,” she explained.
