Dear Colleague

You will have heard on the news yesterday the announcement that the Govt will not be proceeding with the current draft Mental Health Bill [Press notice; written ministerial statement] . Instead the 1983 Act will be amended - only a short list of amendments is planned. The 1983 Act is now seen as a more suitable vehicle for these changes, largely because clinicians have confidence in it.

The proposed amendments are:

1. A community treatment power, to be know as supervised community treatment. This will be restricted to patients who are already detained under section 3 or an equivalent section.

2. The Govt will take an "order-making power" to reduce the time before a detained patient will automatically be referred to the MHRT, if they do not appeal against their section. Currently this is 6 months (ie at the end of a section 3) and the aim will be to reduce it according to assessements of feasibility - in other words, the workforce impact on clinicians. This allows us to keep the principle of universal scrutiny of detained cases, but to proceed at a pace that clinicians can accommodate.

3. A broad definition of mental disorder will be introduced, with exclusions for drug and alcohol dependence and retaining the current partial exclusion of learning disability. The current criteria based on risk and severity will continue, and in the end detention will depend on the judgement of clinicians.

4. The "treatability test" for PD patients will be replaced by a requirement in all cases that appropriate treatment is available, as determined by clinicians.

5. To bring the Act in line with human rights law, the detained patient will be able to apply to displace their nearest relative. "Bournewood" provisions will be brought in as part of the new Bill (though they relate mainly to the Mental Capacity Act).

6. The RMO role will be replaced by a clinical supervisor role and extended to non-medical professions (though in practice this will usually be a psychiatrist, for obvious reasons). The ASW will be replaced by the Approved Mental Health Professional.

7. Safeguards for children, as previously proposed, will still go ahead but through the Children Act rather than the MH Act

Other proposals have either been dropped or will be pursued in other ways. An example of the latter is advocacy which will be supported through training and the Code of Practice.

Feel free to get back to me about this. We will discuss it fully at our meeting in June.

Louis Appleby
National Director for Mental Health