Mental health bill ‘will not stop us being locked up’, say disabled activists

A long-awaited new mental health bill falls far short of the fundamental reforms needed to ensure full human rights for disabled people, and will not stop them being subjected to forcible detention and degrading treatment, activists have warned.

The government yesterday (Wednesday) introduced its mental health bill into parliament, although it is based on a draft piece of legislation drawn up by the last Conservative government.

But one disabled activist said the new bill would not prevent disabled people being “locked up, abused, tortured, treated inhumanely and left to die through neglect”.

Other campaigners said many of the reforms would be “meaningless” in a system where community care was “chronically under-resourced”.

The last government’s draft bill fell “well short” of compatibility with the UN Convention on the Rights of Persons with Disabilities (UNCRPD), activists warned at the time.

The new bill, which will reform the “outdated” Mental Health Act 1983, includes measures to end the use of police and prison cells as “places of safety” for people in mental health crisis; stop the “inappropriate” detention of autistic people and people with learning difficulties; and introduce statutory care and treatment plans.

The bill also gives patients more say over how they should be treated if they are sectioned under the act, and offers “stronger protections” for patients, staff and the public, the government says.

It also offers patients the right to choose a person to represent their interests and “greater access to advocacy” when they are detained, and reforms the use of community treatment orders so they are only used “when appropriate and proportionate”.

Disabled people’s organisations welcomed some aspects of the reforms, but they warned that the new bill would not comply with the UN Convention on the Rights of Persons with Disabilities (UNCRPD).

National Survivor User Network (NSUN), a user-led network of groups and people with experience of mental ill-health, distress, and trauma, said some of the proposals in the last government’s draft bill had “the potential to improve the experiences of people who are detained under certain circumstances”, if they were properly resourced and implemented.

But NSUN said the draft bill had not shifted far enough “towards truly rights-based care” and failed to provide “real alternatives to detention and properly-resourced community care”.

An NSUN spokesperson said: “Black people are over three times more likely to be detained under the Mental Heath Act and 11 times more likely to receive an inappropriate community treatment order, but the [government] press release fails to elaborate on steps toward addressing and reforming what we know to be a structurally oppressive system which further marginalises racialised communities.”

NSUN also said that measures to prevent people in mental health crisis being placed in prison, and ensure patients had as much control over their care as possible, were “ultimately meaningless in a system where community care is chronically under-resourced”, with significant question-marks over any additional funding.

Simone Aspis, project manager for Inclusion London’s Free Our People Now project, which is led by autistic people and people with learning difficulties, said the new bill “focuses on keeping people in psychiatric hospitals against their wishes”.

She said: “We don’t think this bill will stop us from being locked up, abused, tortured, treated inhumanely and left to die through neglect in psychiatric hospitals.”

Although the new bill introduces a 28-day limit for detention for autistic people and people with learning difficulties who do not also have a mental health diagnosis, many of those with another diagnosis or label would not have the same protection.

Aspis said: “We don’t think this will stop us from being locked up.

“Having statutory care and treatment plans for us will have limited impact if mental health professionals still have the power to lock us up, for years on end, without a release date.

“Increasing numbers of young people are being detained and we face widespread prejudice.

“It will take more than just involving more patients, families and carers to change this.”

Aspis said Free Our People Now “would welcome a mental health bill that is in line with our UN human rights as disabled people.

“This would focus on stopping us being locked up in the first place, and keeping us out of psychiatric hospitals for good.

“We need a bill that focuses on giving people with learning difficulties and autistic people the right to the support we need, to live great lives in the community.”*

Fazilet Hadi, head of policy for Disability Rights UK, said the bill would provide “some patient-centred improvements to existing practices and services” but “in no way upholds the civil and human rights of disabled people” under the UN convention.

She said: “Under the convention, disabled people have the right to liberty, the right not to be subjected to degrading and inhuman treatment, and the right to live independently in the community.

“The bill isn’t built on these principles and those in mental distress will continue to be forcibly detained against their will and to be subjected to degrading treatment.

“Whilst the bill promotes increased support in the community, the current underfunding of mental health services makes such a shift unlikely.”

Dorothy Gould, founder of the user-led, rights-based organisation Liberation, said the government’s announcement was “devastating news” because the bill appeared to be “in fundamental breach of full human rights for those of us given a mental health diagnosis”.

She said: “Information released about the bill demonstrates all too clearly that it is thought acceptable for us just to have ‘improved’ rights.

“Why should people experiencing acute trauma not have full human rights?

“Why are we continuing to be treated as second-class citizens like this?

“This is not a bill which brings the Mental Health Act ‘in line with the 21st century’.

“On the contrary, the UK government is continuing to breach our basic rights under the UNCRPD.”

She added: “The government has argued that continuing provision for disability-based detention and forced treatment is needed because of times when we are a risk to ourselves and others.

“However, this does not even seem to be based on adequate research evidence.”

She said: “What is true is that many of us are being traumatised further by the use of involuntary detention and forced treatment at the very times when we most need warm, human and genuinely healing approaches, and that the mental health system has resulted in death levels among us that are at horrific levels.

“It’s a national disgrace, a huge stain on past governments and now on the current government as well.”

She said the bill represented “a blatant failure to tackle the main causes of acute mental distress: discrimination, abuse and hate crime, inequality, poverty, the misery caused by the current welfare benefit system and the failure to provide adequate support for those of us who can work combined with intolerable pressures on those of us who cannot”.

Health and social care secretary Wes Streeting said in a statement announcing the bill: “Our outdated mental health system is letting down some of the most vulnerable people in our society, and is in urgent need of reform.

“The treatment of autistic people and people with learning disabilities, and the way in which black people are disproportionately targeted by the act should shame us all.

“By bringing the Mental Health Act in line with the 21st century, we will make sure patients are treated with dignity and respect and the public are kept safe.”

The government told DNS yesterday that the new bill contains “a number of measures that go further than the previous draft bill”.

The Department of Health and Social Care (DHSC) did not clarify how many new measures there were in the new bill, but it provided two examples.

One change from the draft bill is that advance choice documents, which allow patients to set out their choices and wishes on their future treatment, will be written into law.

DHSC said the bill will also strengthen “safeguards for public safety”, for example by requiring clinicians to consult at least one other mental health practitioner before discharging a patient after they have been sectioned.

*Free Our People Now’s Bring People Home from Psychiatric Hospital network has created a list of requests (PDF) which represent “what we want the government to do to stop locking us up in hospital”. It has been signed by 27 organisations

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