Mental Health Act Reform - Children and Young People

DOI: https://doi.org/10.58248/PN685

The Mental Health Act (MHA) 1983 regulates compulsory detention and treatment of people with a mental disorder in England and Wales. The UK Government has published a draft Mental Health Bill to amend the MHA 1983. The proposed changes focus on increasing patient autonomy and reducing assessment and detention under the MHA.

A Joint Committee on the Draft Mental Health Bill was established in July 2022 to scrutinise the draft Bill. Further information on the White Paper, the consultation and the draft Bill is available in the Commons Library briefing on Reforming the Mental Health Act.

This POSTnote is focused on children and young people (CYP) aged under 18 years. It covers how and when the MHA is used to treat CYP aged under 18, rates of MHA use and outcomes for CYP and how it interacts with other legislation. It also covers stakeholder perspectives on the potential impact of the reforms on CYP and further policy considerations.

It complements the POSTnote on MHA Reform – Race and Ethnic Inequalities. As healthcare policy is devolved, the reforms described here apply only to England and Wales.

• Data on CYP detained under the MHA 1983 are limited.
• A shortage of specialist inpatient beds has contributed to CYP being detained in inappropriate settings, such as adult wards.
• Complex overlapping legal and ethical frameworks apply to medical treatment and decision making for those aged under 18. Many stakeholders argue that this is not adequately addressed in the draft Bill.
• Key reforms in the draft Bill that impact CYP include: new detention criteria; removing autism and learning disabilities as a reason for detention under section 3; a new duty on professionals to consider explicitly the patient’s wishes and feelings; the ability to choose a ‘Nominated Person’; and extending the statutory right to advocacy.
• Many stakeholders argue that realising the benefits proposed through MHA reform will require improved access to CYP mental health services and better data collection.

POSTnotes are based on literature reviews and interviews with a range of stakeholders and are externally peer-reviewed. POST would like to thank interviewees and peer reviewers for kindly giving up their time during the preparation of this briefing, including:

Members of the POST Board*

Kadra Abdinasir, Centre for Mental Health*

Dr Philip Anderson, Belfast Health and Social Care Trust

Children’s Commissioner for England*

Helen Clark, Child Mental Health Charter*

Professor Gavin Davidson, Queen’s University Belfast

Dr Catherine Dennison, Nuffield Foundation*

Department of Health and Social Care*

Professor Ann Hagell, Association for Young People’s Health*

Danielle Hamm, Nuffield Council on Bioethics

Lisa Harker, Nuffield Family Justice Observatory*

Dr Dan Hayes, South London and Maudsley NHS Foundation Trust*

Mat Kinton, Care Quality Commission*

Professor Judy Laing, University of Bristol*

Dr Emily Lowthian, University of Swansea

Racheal McKeown, Association for Young People’s Health*

NHS England, Specialised Commissioning*

Sophia O’Neil, Child Mental Health Charter and Play Therapy UK*

Dr Camilla Parker, Just Equality*

Charlotte Rainer, Children and Young People’s Mental Health Coalition (CYPMHC)*

Alice Roe, Nuffield Family Justice Observatory*

Martha Scanlon, University of Bristol*

Dr Kevin Stone, University of Plymouth*

Dr Jacinta Tan, University of Oxford

Dr Sarah Vicary, Open University*

Dr Thomas Webb, University of Lancaster

* denotes people and organisations who acted as external reviewers of the briefing.