Autistic people less likely to be detained under ‘landmark’ mental health reform proposals

Autistic people who are “locked up” under the Mental Health Act will be less likely to be detained under “landmark” legal proposals mooted by Government officials.

The Mental Health Act 1983 is set to be reformed to make it harder to detain people who are autistic or have learning difficulties, and to bring the Act “into the 21st century”.

A package of measures has been set out in a wide-ranging new Reforming the Mental Health Act White Paper, which builds on the recommendations made by Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018.  

Under new plans, mental health patients will have more control over their treatment and the reforms will deliver parity between mental and physical health services. 

Furthermore, inequalities such as: the disproportionate detention of people from BAME communities, the use of the Act to detain people with learning disabilities and autism, and the level of care for patients within the criminal justice system will also be addressed.

However, among the most radical departures from current practice, the White Paper proposes that mental illness is the sole reason for detention under the Act, and that neither autism nor a learning disability are grounds for detention for treatment of themselves.

The proposals come following the shocking and high-profile case of Bethany. The autistic teenager was sectioned under the Mental Health Act when she was 15 years old because she was deemed a risk to herself and others. She was locked up for almost three years in a "cell" where food was served to her by sliding it across the floor.

Her case drew national attention to the detention of hundreds of young people with autism or learning disabilities in Britain, and prompted an inquiry into the mental health system by a committee in Parliament. The conditions were so dire, the committee said, that the lawmakers had “lost confidence” in the system and its regulators.

The case prompted the Health Secretary, Matt Hancock, to publicly apologise to Bethany, who cannot be identified for legal reasons, last year. She has since been moved to more “appropriate” accommodation.

Following the announcement of the new proposals Jeremy Hunt, the Conservative chairman of the health and social care select committee, called for all mental health units to be closed so that vulnerable people can be looked after "more humanely".

The former Health Secretary told the House of Commons that more than 2,000 people with autism and other learning disabilities are still "locked up in mental health units, often supposedly temporarily, sadly sometimes with terrible breaches of human rights".

Mr Hunt added: "So will (Mr Hancock) use this landmark moment to follow what Italy have done and close down all such units so that these highly vulnerable people can be looked after more humanely in the community?"

Mr Hancock told MPs that the 2,000 figure is "a significant reduction" on when Mr Hunt set the target as Health Secretary, adding: "I want to see that number continue to fall”.

He continued: "Of course, where there is a criminal justice element or restriction, that can be more difficult. But what we must do is ensure that the treatment and the setting is appropriate for each and every person.

"And very often a mental health setting is not appropriate for somebody with learning disabilities or somebody with autism for whom it can be in fact the opposite of appropriate – it could be much the worse place."

Nadine Dorries, minister for mental health, added: “We committed in our Manifesto to improve the way that people with a learning disability and autistic people are treated in law.

“We are proposing reforms to limit the scope to detain people under the Act where their mental disorder is a result of a learning disability or autism alone. 

“In future, there would be a limit of 28 days for such detentions, which would be used to assess clinical need, and not to allow for medium- to long-term detention and treatment for learning disability and autism alone. We believe these proposals are the right ones.”

Over the weekend, The Telegraph revealed new measures ahead of Wednesday’s announcement, and reported that people who are detained under the Mental Health Act will be given a greater say over how they are treated, and allowed to nominate someone to represent them in the biggest overhaul of mental health laws in 40 years.

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Currently, the Mental Health Act can be applied to force people to undergo treatment for a mental health condition without their consent, and even detain people for treatment to take place, a process known as "sectioning".

However, BAME people are disproportionately detained under the existing law. Black people are over four times more likely to be detained under the Act, and ten times more likely to be put on a Community Treatment Order.

Under the proposals, a new funded pilot scheme aims to “contextualise advocacy” to the needs of Black or Asian people. 

It aims to provide advocacy across three broad areas where BAME people are “over-represented,” for example: in community settings regarding Mental Health Act detentions, via Community Treatment Orders, in the criminal justice system and within inpatient facilities.

It is expected that a draft Bill will be brought to Parliament around this time next year.

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