Reforms to Mental Health Act set to pass into law

Long-awaited updates to the legislation covering the assessment, treatment and rights of people with a mental health disorder are set to become law as the updated Mental Health Act gains Royal Assent.

The reforms follow many years of work by different governments to update the Mental Health Act 2007 to better reflect the modern understanding of mental illness and to reduce detentions and racial inequalities.

A range of changes – including removing the ability to detain people with learning disabilities and autistic people without a co-occuring mental health issue for more than 28 days, and the requirement for care and treatment plans to be created when an individual is detained – will be enacted over a period of up to ten years.

Following lobbying by the NHS Confederation, there will now be an annual written ministerial statement detailing progress over the preceding 12 months and plans for implementation. This provides political accountability to ensure momentum is maintained.

The NHS Confederation, which has been influencing reforms to the legislation since the 2017 Independent Review of the Mental Health Act, largely welcomed the changes.

Community services and racial disparities

The organisation’s influencing activity has centred on the need to build up community services and ensure government accountability for progressing reforms.

The government has stated that once it is confident that sufficient community services are in place, people with learning disabilities and autistic people who do not have a co-occurring mental health disorder will no longer be able to be detained under the Mental Health Act for more than 28 days. The change will be enacted when the government states it is safe to do so; how this will be assessed is yet to be determined.

Throughout its engagement with parliamentarians, the NHS Confederation has also consistently highlighted the stark racial disparities in the use of the Mental Health Act, including in the use of community treatment orders, and the pressing need to address this. This featured prominently in briefings and written evidence, with chair Lord Adebowale raising it in his speech at second reading in the House of Lords. 

Campaign for change

The NHS Confederation has worked closely with the Department of Health and Social Care and other stakeholders to influence the reforms of the legislation since the 2017 Independent Review of the Mental Health Act, through to the publication of the draft bill in 2022 and beyond. 

At the second reading of the bill in the House of Lords in November 2024, Lord Victor Adebowale spoke at length about the issue of detentions, before tabling an amendment ahead of both committee and report stages calling for a costed plan to ensure that integrated care boards and local authorities are able to provide adequate community services for individuals with learning disabilities and autistic people at risk of detention under Part 2 of the 1983 Act. 

Lord Adebowale’s amendment called for such a plan to be informed by a consultation with a range of stakeholders. 

While not voted on, the amendment received support from several peers, including Lord Stevens of Birmingham, former NHS England chief executive, as well as former health ministers Lord Kamall and Earl Howe, who are now shadow minister for health and social care and shadow deputy leader of the House of Lords respectively. 

Before the conclusion of report stage, Baroness Merron, the Parliamentary Undersecretary of State at the Department of Health and Social Care, in referring to Lord Adebowale’s amendment, said that she understood the concerns raised about community support. She then committed: “Within a year of Royal Assent, and each year subsequently, we will lay a written ministerial statement in both Houses. This will include setting out details of the work that has been done over the preceding 12 months to implement this legislation and plans for how we will implement future reforms. It will include progress on the learning disability and autism reforms and plans for community provision.”

The bill then moved to the House of Commons.

At second reading in May 2025, we briefed Jen Craft, Labour MP for Thurrock and member of the Health and Social Care Select Committee, who highlighted in the debate our warning that the 'success of the reforms [in the bill] will be dependent on the wider infrastructure to support' it.

We submitted written evidence to the public bill committee ahead of committee stage. At that point, Lord Adebowale’s amendment from the House of Lords was adopted by Luke Evans, Conservative MP for Hinckley and Bosworth, the Shadow Parliamentary Under Secretary for Health and Social Care.

In the meantime, we began to work with Mencap, the National Autistic Society, the Challenging Behaviour Foundation and VoiceAbility to develop Lord Adebowale’s amendment.

Following this collaborative work, at report stage in the House of Commons in October, Jen Craft tabled a new amendment calling for the government to publish and lay before parliament a roadmap outlining its plans for ensuring sufficient community services to enable the implementation of the act’s provisions on ending the detention of autistic people and people with a learning disability. 

The amendment was co-signed by 18 fellow Labour MPs, including all Labour members of the Health and Social Care Select Committee.

In the ensuing debate, Stephen Kinnock, Minister of State at the Department of Health and Social Care, said that while it wasn’t possible for the government to commit to the specifics of implementation and community support, which depend on factors including the final legislation passed and future spending reviews, the government ‘will work with stakeholders, including people with lived experience, to shape our road map for commencing changes’ in this regard.

He also acknowledged ‘the importance of having a clear plan to resource community provision for people with a learning disability and autistic people to implement these reforms’ and reiterated the government’s commitment to an annual written ministerial statement on implementation of the bill post Royal Assent.

NHS Confederation's response

Responding to the Mental Health Act receiving Royal Assent, Rebecca Gray, mental health director at the NHS Confederation, said:

“The passing through parliament of the mental health bill provides a long-awaited update to mental health legislation. A key driver for reform was to help address race inequity regarding the number of people from black communities detained under the Mental Health Act and placed on community treatment orders.

“We welcome elements of the act that will, over time, reduce detentions of people with learning disabilities and autistic people who do not have a co-occurring mental health disorder. Our members are now focused on ensuring adequate provision in the community for people who might now be detained in hospital. It is positive that the government has agreed to report every year via a written ministerial statement on the progress of all the measures that need to be implemented, including on the learning disability and autism reforms. This follows lobbying by the NHS Confederation on that particular aspect on behalf of our members.

“We also welcome the requirement to ensure patients are aware of advance choice documents which could be a useful tool in improving their treatment. There are areas where we would be keen to see further momentum, including on strengthening the patient and carer race equality framework.

“The focus now turns to updating the Mental Health Act’s Code of Practice and we look forward to working with our members and the government on this.”