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The interim report from the independent review of the Mental Health Act (MHA) has outlined a number of areas where service users are being let down.

While noting unprecedented investment in talking therapies for common mental health problems and a general upsurge of interest in mental health, it has seen less attention given to those with severe forms of mental illness – a group most likely to be subject to the MHA.

Act out of step with modern mental health systems

The review, commissioned by the government last October, is tasked with understanding the causes of key issues surrounding mental health and making recommendations to help ministers create a forward-looking plan of changes to legislation and associated practice.

With a broad remit looking at mental health laws and how they interact with services, good practice and the wider care system, it is specifically focussing on the increased MHA use over the last 10 years, rising detention rates, concerns that the act is out of step with modern mental health systems in England and Wales, and the over-detention of people of African-Caribbean and African descent. This should ensure its powers are being used correctly and safely by every from the police to psychiatrists, A&E Doctors and mental health nurses.

Making the MHA better for everyone

Areas earmarked for attention include aftercare, the use of second opinion doctors, issues affecting people aged 16–17, and those with learning disabilities or autism.

Review chair Professor Sir Simon Wessely said: “Our intention is to look at a range of options for reforming the MHA, from large-scale changes to more specific amendments, combined with system and practice changes where these are also needed. Overall, we remain committed to the goal we set out when we began – to make the MHA work better for everyone.”

Priority issues

Priority issues for further examination include: ensuring service users and carers are treated with dignity and respect; greater autonomy for people subject to mental health legislation; greater access to services; improved service user and carer wellbeing with them being as fully involved in treatment as possible; reduced disparities between groups with protected characteristics; greater focus on rights-based approaches; reduced harm and improved safety; and professionals better able to deliver their expertise.

The panel also wants improved in interaction between the MHA and the criminal justice system.

Engaging with service users and carers

The panel, which will produce its final report later this year, aims to engage with as many people as possible. The review has already received over 2,000 survey responses from service users and carers, listened to 320 people at workshops, supported over 30 focus groups, and attended 70-plus meetings.

It has emphasised that improvements to the MHA cannot be achieved by legislation alone and “any changes to the MHA must be underpinned by improvements to mental health services.”

Danielle Hamm from Rethink Mental Illness said the review confirms “there are serious problems with the Mental Health Act” while Mental Health Network chief executive Sean Duggan stressed the need for the government to ensure changes to practice were fully resourced.

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