In 2017, the government asked Professor Sir Simon Wessely to lead the Independent Review of the Mental Health Act 1983, to examine issues around the use of the Act and to propose recommendations for modernisation and reform.

The final report of the independent review, published in December 2018, concluded that the Act does not always work as well as it should for patients, nor for their families and carers. They said, “when the Act fails people, they become disempowered, are excluded from decisions about their care and treatment, and are treated with neither dignity nor respect”.

Informed by the review’s recommendations, a White Paper has been published. Within this there are four principles that are said to have shaped the approach taken to the new legislation proposals. These are:

  • choice and autonomy – ensuring service users’ views and choices are respected
  • least restriction – ensuring the Act’s powers are used in the least restrictive way
  • therapeutic benefit – ensuring patients are supported to get better, so they can be discharged from the Act
  • the person as an individual – ensuring patients are viewed and treated as individuals

OCD Action’s views on the White Paper

We have spent time speaking with colleagues across the sector, reflecting on our experience and considering what those of you who have been affected by the Act have told us about your experience of it. We are keen to hear more directly from you on the Act before we define and submit our response.

At this point we welcome the White Paper. The Mental Health Act is hugely outdated and is no longer fit for purpose. In its current form, there is clear evidence that under the Act some people’s rights are removed when this should not have been the case, and this happens disproportionately to Black British people, autistic people, and people with learning disabilities. We are aware that some of the people within the OCD community who can find their journey to secure a diagnosis and treatment particularly challenging are those who also have autism, a learning disability or are from a Black, Asian or minority ethnic background. The moves detailed in the White Paper to address some of the disparities autistic people, people with learning disabilities and Black British people face are therefore a step in the right direction.

We feel the work done in the proposals to tighten the detention criteria will help shift thinking in the mental health system towards individual choice and therapeutic benefit as core principles. We also think it will, overall, reduce the length of detentions. However, views are more mixed on whether the changes in the White Paper will reduce inappropriate detentions, an area we are concerned about.

We welcome the proposals made relating to increased opportunities to challenge detention and to expand the role of Independent Mental Health Advocates (IMHA). We are however also concerned that to see the full and successful implementation of the White Paper’s intentions, significant funding will be needed. This will be dependent on the spending review. Furthermore, implementation of much of the change will be reliant on seismic culture change and therefore at a minimum huge multi-agency training role out, so, in many ways the legislation is only the first step.

We also believe that there are areas where the White Paper could have gone further and been braver in making changes that could have brought about a real shift in aligning treatment provision with the reality of living with OCD and other mental health conditions: a shift that may have started to build the foundations of a system where everyone has equality of access to treatment. Specifically we feel there has not been as full an analysis of intersectional factors and how they interplay with the powers of the Act and disparities and longevity of detention and the further investment that may be needed in the mental health system to tackle this at a systemic level. We are also disappointed that the recommendations to put in place a single risk assessment framework, perhaps one based in the Human Rights Act, were not carried forward.  We feel these areas could have been beneficial for all including members of the OCD community. We believe this was a missed opportunity to take an important step towards building a fairer, equal and accessible mental health system that enables everyone affected by OCD to get the treatment they need when they need it.

Providing Feedback on the Review of the Act

The Government is undertaking a consultation and we would encourage you to take part in this if you have been affected by the mental health Act. The full White Paper and consultation form can be found here.

The consultation closes on the 21st April 21.

OCD Action are also completing the consultation. We will be focusing on the areas where we know as an organisation we have more to contribute. We would therefore be particularly keen to understand your views and experiences in each of these areas. While the feedback form gives a limited response space, your views and experiences would be helpful in informing what we say.

We have been working as part of a coalition of mental health charities, to inform responses as well as developing our own to ensure that there is a strong set of feedback being provided across the sector that represents the needs of people with OCD.

If you would like to complete a feedback form, you can download it here.