Mental Health Bill: Legislative Scrutiny

Let us be clear, though: the reality of detention under the Mental Health Act is not limited to high-security hospitals or individuals convicted of serious crimes. Many people detained under the Act are not criminals. Many of them are children, young people and adults with autism or learning disabilities who are detained not because they pose a danger to others, but because the support they need in their communities simply is not there. This is not just inefficient, it can often be deeply traumatising and raises significant human rights concerns.

That is why the Committee welcomes the major changes introduced by the Government’s Bill. It will end the detention of individuals under section 3 of the Mental Health Act solely on the basis that they are autistic or have a learning disability; tighten the criteria for detention and require decision makers to consider the nature, degree and likelihood of harm before deciding to detain; introduce the concept of a nominated person to replace the outdated nearest relative system; and remove police stations and prisons as places of safety for individuals in crisis. As stated in the evidence we received from witnesses, those are important, welcomed and long-awaited reforms. They reflect the breadth of the Government’s consultations and prove that the Government listened to the information they received.

While welcoming the Bill’s direction of travel, the Committee believes that there are areas where the Government could go even further to provide enhanced protections for human rights. That is why, based on the evidence we received during the inquiry, we have recommended a few key amendments. First, we recommend a new clause to ensure that children detained under the Mental Health Act are accommodated on adult wards only when that is demonstrably in their best interests.

Secondly, we recommend an amendment to clause 1 to include equity as a fifth guiding principle under the Act. This would refer specifically to addressing inequalities in treatments and outcomes on racial grounds in particular, and I welcome the Health Secretary saying on Second Reading of the Bill on Monday:

“People from ethnic minority communities, especially black African and Caribbean men, are more than three times as likely to be sectioned.”—[Official Report, 19 May 2025; Vol. 767, c. 783.]

In our report, we find that adding equity as a guiding principle would do more to address racial disparities.

Thirdly, we recommend an amendment to clause 32 to shorten the review periods for restricted patients who are discharged into conditions amounting to the deprivation of liberty. The first review will be required within six months, rather than 12, and subsequent reviews will take place annually, rather than every two years.

Those key amendments come amid a range of other recommendations. Recent case law shows that mental health patients in state-commissioned and funded but privately provided care do not come within the protection of the Human Rights Act. That loophole must be closed, and we recommend that the Government do just that.

We also heard evidence that the question of when the Mental Health Act and when the Mental Capacity Act should govern a patient’s deprivation of liberty and treatment is far too complex and raises human rights concerns, not least because depriving a person of their liberty on any ground can be justified only if the legal basis is clear. We therefore recommend that the Government carry out an urgent review and provide the clarity that is currently lacking on this question.

Another crucial area the Bill covers is the rights of children, who are particularly vulnerable when assessed or treated under the Mental Health Act. Many of the proposed changes to the law will be positive for children, including the introduction of an opt-out approach to receiving a report from independent mental health advocates, but we recommend that the Government consult on introducing a statutory test for assessing whether under-16s are competent to consent or to refuse consent to treatment—a cornerstone of compliance with a child’s human rights.

The Committee also deems it vital that prisoners whose mental health makes holding them in prison unsuitable are transferred promptly to an appropriate setting. Keeping them in prison may result in human rights breaches. In our report, we welcome the introduction in the Bill of a statutory 28-day timeframe for hospital transfer. Relevant data should be collected and made available to monitor and help to ensure compliance with that standard.

The Committee welcomes changes to restriction orders placed on a small number of offenders detained under a hospital order, but the Government should consider introducing more prompt and regular reviews by the mental health tribunal, to ensure that any loss of liberty is justified. Witnesses told us that, in the absence of effective support in the community, autistic people and people with learning disabilities could still end up in unjustified detention on other legal bases. The Government have stated that the change in the Bill will come into force only where there are strong community services in place, but it is vital that this does not delay the much-needed reform. We therefore welcome the Government’s commitment to provide a written ministerial statement annually to both Houses of Parliament setting out progress to date on implementation. On what more the Bill could do to improve the prospects of patients receiving timely care in the community, we also ask the Government to consider introducing an English equivalent to the right to a mental health assessment that applies in Wales.

The report makes it clear that much more is needed to fix the broken mental health system in this country, and I know the Government recognise that as well. This is a small, targeted Bill, which will not change everything, but the changes it will introduce are significant and long overdue. The Government have committed to introducing mental health experts in every school, to set up Young Futures hubs and to recruit 8,500 more mental health staff. By focusing on community-based interventions and driving down waiting lists for mental health support alongside the welcome changes in the Bill, we can turn the tide and fix our broken mental health system, so that the human rights of all those with mental health needs are properly protected and they can get the support they need.

I commend this report to the House.