Rachel Fergusson, External Affairs Officer, Money and Mental Health Policy Institute

The Mental Health Act reform we want to see

24 August 2023

  • There are reports that the government is going to drop or delay planned reforms to the Mental Health Act – the laws which oversee the rights and treatment of people detained due to their mental health – ahead of the next session of parliament
  • The proposed reforms are long-overdue and would enable people to have more say over the treatment they receive if they are hospitalised
  • As part of these reforms, we’ve been calling for requirements for practitioners to routinely ask about and address financial matters as part of planning around someone’s care and treatment
  • If shelved, it will be a missed opportunity to improve the treatment people receive, and protect people from the serious financial harm that can occur during in-patient care.

This week it was reported that government ministers could be planning to temporarily shelve the long-awaited reform of the Mental Health Act – the law that regulates when someone can be detained in hospital due to their mental health, and the care and treatment they receive. 

The Draft Mental Health Bill – proposed wide-ranging changes to transform the care patients receive and increase people’s rights, choices and autonomy. If the new plans are dropped by the government in its upcoming King’s Speech, it will be a huge kick in the teeth to the hundreds of campaigners, health professionals and people with lived experience who have fed into the Draft Bill. 

But it would also mean a massive missed opportunity to put individuals at the heart of the Mental Health Act, where their holistic needs – including finances – are considered as part of their care and treatment.

Why we need reform

The Mental Health Act 1983 is outdated – out of step with modern attitudes towards mental health and often risks compromising people’s autonomy, dignity and rights. Our friends at Mind have been leading the charge for reform of the Act, calling for people to have more say over how they are treated and for stronger measures to tackle the racist treatment of people from minoritised ethnic groups (especially people from Black and Black British communities) within mental health services.

Reform of the Act also represents a once in a generation opportunity to focus on the holistic needs of people who have been hospitalised due to their mental health – including addressing someone’s finances as part of their care and treatment. We’ve heard from members of our Research Community about the acute financial harm that can happen when you’re experiencing a mental health crisis and receiving in-patient care. That includes stories like Suzanne’s, who returned from hospital to a pile of debt letters including court summons relating to missed council tax payments. 

Other members of our Research Community have told us about the impact financial problems can have on longer-term recovery, keeping people trapped in a vicious cycle:

It would have been helpful for someone to remind me that my day-to-day life was still going on, and needed attention and servicing. It’s always the same. I go in for treatment and come out to find my financial world is in a bigger mess than when I went in. The resultant terror, shame and guilt undoes all the work of the treatment and I am back in crisis again.” Expert by Experience 

The change we want to see

In the past, we’ve set out policy changes which we want to see off the back of the reformed Mental Health Act, to try and minimise the risk of financial harm for people in mental health crisis. 

This includes giving people a statutory right to make an Advance Choice Document (ACD) – a document that details, in advance, a person’s treatment wishes and preferences. Within that document, we want to see an explicit prompt about how ACDs can be used to support people with their financial affairs. For example, recording someone’s preferences around how important bills like rent will be paid when they’re in hospital, or identifying a third party to deal with financial matters on their behalf. This small but crucial change would help to ensure that people are empowered to plan and put in place arrangements to protect their finances when well, for a time when they may be unwell again in the future or a mental health crisis strikes.

In addition to this, we want to see finances included as an integrated part of Care and Treatment Plans. This will maximise the opportunities for healthcare practitioners to safeguard patients from financial harm – and ensure that people’s holistic needs are considered as part of these plans.

Don’t drop the Bill

Reform of the Mental Health Act is long overdue, and is a vital piece of legislation to ensure that the thousands of people hospitalised each year are treated with the dignity and respect they deserve. 

At a time when financial difficulty is rife, dropping or delaying these plans would be a wasted opportunity to address financial matters as part of mental health care – a small step which could make a huge difference in reducing the risk of financial harm during a mental health crisis, and help people to get back on their feet and focus on recovery.