Learning Disabilities & Autism Opinion

Changing mental health law

Felicity Stephenson, Policy and Parliamentary Officer (Mental Health)​ at the National Autistic Society

The Government recently published a promising plan to change mental health law in England and Wales. This will change the law on when autistic people can be sectioned under the Mental Health Act, which we and hundreds of thousands of campaigners have been calling for for years. It is a huge step forward in the fight to stop the scandal of autistic people being stuck in mental health hospitals. But much more still needs to be done.

The problem

Currently, the Mental Health Act allows people to be sectioned because they’re autistic – even though autism isn’t a mental health problem. This is one of the reasons that hundreds of autistic people are stuck in inpatient mental health hospitals, instead of being supported to live full lives in their community, close to their family and friends.

It’s right that the Government is taking action. But these changes will take years to come into force and, crucially, won’t end this scandal alone. The Government and NHS need to stop autistic people reaching crisis in the first place, by investing in better social care and mental health services that work for autistic children and adults.

What’s changing

The proposals are part of the Government’s ‘White Paper’ on the Mental Health Act. They include:

Changing the definition of ‘mental disorder’ in the Mental Health Act. The White Paper proposes that mental illness must be the reason for sectioning someone under ‘section 3’, meaning autism alone is no longer grounds for detention for treatment.

Autistic people could still be detained in two circumstances:

  • For ‘assessment’ for up to 28 days (sometimes called a ‘section 2’). If, during the assessment period, a mental health condition is not identified, then there would no longer be grounds for detention.
  • In cases where otherwise it would mean someone would go to prison (sometimes called ‘criminal justice’ or ‘Part 3’ sections). This would mean that autistic people could still be diverted away from prison to get more support.

Making Care and Treatment Review (CTR) actions enforceable. Currently, CTR recommendations and actions aren’t followed often enough. The proposals would make them enforceable by law. This means they could be scrutinised at mental health tribunals.

Introducing a duty to provide adequate community services. Too many autistic people get stuck in mental health hospitals because there aren’t the right services to support them in their homes. The White Paper states that there will be a duty for councils, NHS England and local health decision makers to provide enough services for autistic people in their area. This could include: mental health services, supported housing or social groups.

Changing ‘detention criteria’. The White paper sets out some key changes to the detention criteria someone has to meet to become sectioned. The Government proposes it must be demonstrated that:

  • The purpose of the care and treatment has a clear ‘therapeutic benefit’
  • The same treatment cannot be done in the community.
  • That there is a ‘substantial likelihood’ of harm – it will have to be clear how serious this harm must be or how likely it is that the harm will occur in order to justify someone being sectioned.

There are other important proposals including: more frequent reviews of the decision to be detained, more choices available to people over their treatment and improved support for those who are sectioned with better access to help from advocates.

This will make a huge difference to the number of people being wrongly sectioned and has been welcomed by our charity, many autistic people and their families. But the proposals will take time to become law. In the meantime, it’s vital that the Government and NHS invests in better social care and mental health services that work for autistic children and adults. Only then will this crisis end.

Find out more: autism.org.uk


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