It is Mental Health Awareness Week this week, the theme for this year is ‘community.’ In honour of Mental Health Awareness Week, we will take a look at one key policy developments aimed at changing the future provision of mental health in the country, the Mental Health Bill.

Originating in the House of Lords, the Mental Health Bill aims to make provisions to amend the Mental Health Act 1983 in relation to mentally disordered persons. This Bill covers the main laws that are used when someone can be ‘detained’ (sectioned), in order to be treated for serious mental health condition. Health Secretary Wes Streeting has stated the act has “saved lives… but it is hugely outdated.’ In line with this statement, Labour have continually promised to update the Mental Health Act, which now stands at more than 40 years old; included as a focus in the parties manifesto ahead of the general election of the summer of 2024.

The Mental Health Bill has moved into the House of Commons, passing 1^st reading and now on to the 2^nd reading which begins on the 19^th of May 2025.

What does the Bill aim to do?

A draft Bill was introduced and underwent pre-legislative scrutiny by the Joint Committee in 2022, which produced a report and a plethora of recommendations. The proposals within this were informed by the four key principles developed by the Independent Review and in partnership with people with lived experience of detention. This included choice and autonomy, namely involving patients in decision making, minimising restrictions on liberty, ensuring that patients receive effective and appropriate treatment and lastly, facilitating treatment that ensures patients are treated with dignity and respect, considering beliefs, values, past experiences, and wider needs.

Since the pre-legislative scrutiny, there was a commitment to tackling several of the recommendations made by the committee:

• Detention Criteria – ‘how soon’ The Bill takes forward the Committee’s recommendation that the proposed requirement for clinicians to consider ‘how soon’ a harm might occur should be removed from the detention criteria revisions that the Bill seeks to make.
• Nominated Person: The Committee supported the Nominated Person provisions but recommended that the Government work with Approved Mental Health Professionals (AMHP) to revise the proposals to address practical concerns. The Bill removes the requirement for the AMHP to see the Nominated Person in person.
• Advanced Choice Documents: The Bill has been updated to take on board the Committee’s recommendations on Advance Choice Documents. The Bill therefore seeks to introduce duties on Integrated Care Boards (ICBs), NHS England and Local Health Boards (Wales) to make arrangements so that people at risk of detention are informed of their ability to make an Advance Choice Document, and (if they accept) supported to make one.
• Principles: In line with the Committee’s recommendation, the Bill amends section 118, which makes requirements for the Code of Practice, the statutory guidance which sits alongside the Act, to include the language of the four principles from the Independent Review. This will apply to both the Code of Practice for England, and the Code of Practice for Wales.
• Discharge: The Bill contains measures for a new requirement for a patient’s responsible clinician (or the responsible authority for the patient) to consult with a second professional involved in the patient’s care when taking the decision to discharge them from certain powers under the Act.^[1]

What role does Mental Health play in ASB?

Mental health both plays a role in both the victim and perpetrator of anti-social behaviour. In a report commissioned by Resolve in 2021, indicated the negative effects of ASB victims’ mental health, of those who had been a victim of ASB:

• 43% say it has affected their mental health.
• 47% say they have considered moving home.
• 54% say they feel unsafe in their local area^[2]

A research report from the Scottish government investigated a variety of issues surrounding ASB, including the impact of poor mental health as a root cause. They found that ‘poor mental health was felt by some people to be a prominent root cause linked to anti-social behaviour,’ and that it was found to be key to recognise that ‘having a lifelong or short-term mental health condition can also make an individual vulnerable themselves.’ It was also stated that mental health conditions could ‘arise with those who are adversely impacted by antisocial behaviour’ and therefore, these individuals need support. Community safety officers also expressed concern that they felt ‘under-resourced and not sufficiently trained’ in order to support and work with those who have challenging mental health problems. ^[3]

The Mental Health Bill and ASB

Any changes that aim to improve mental health provision is welcome and will positively impact ant-social behaviour provision as a result. The key focus is ensuring that those who are treated in detention are treated effectively and fairly in order to ease their transition to living in the community.

Firstly, if the bar for detention is higher, with the fact that there must be evidence that ‘serious harm may be caused to the health or safety of the patient or of another person’, this therefore means detention is only used when necessary, helping to ensure, that mental health care is targeted and that communities are not affected through detention. Many are in agreement that many, particularly those with a learning disability or autism, should not be detained any longer than necessary. The NHS Confederation notes however that there are some concerns that the changes increase the risk of people in these groups falling into the criminal justice system as a result of a lack of ‘community provision’ and the ‘inability to access support through the Mental Health Act.^[4]

Detentions are often found to impact negatively on outcomes for patients and increase the need for, and therefore, cost of, mental health support in the longer-ter. As an organisation focused on prevention and intervention, we recognise the negative outcomes and point therefore to resources such as supported housing that is often vital to ensure people have access to care. Under the revised Bill, patients and their nominated person will have more opportunities and power to challenge their detention and treatment, encouraging a patient-centric focus that helps to modernise mental health care.

The Bill will also mean that Police and prisons cells will no longer be able to be used as a place of safety for adults experiencing a mental health crisis. It is revealed that in 2023/24 police cells were only used in this capacity of a total of 1%.^[5] The freeing of any police space and prison cells is essential, following the well-documented crisis in prisons following on from the SDS40 policy, the targeted use of agencies could help relieve some of the pressures we are aware they are facing in performing day to day duties.

Mental health and anti-social behaviour are often inextricably linked, and that thread must be recognised and understood in order to focus support and change. Of course, with any changes, particularly legislative, resources will be needed, and we of course call for all, particularly community services to be adequately resourced in order to deal with these changes. As the Bill moves swiftly through the commons, and eventually passes through its second reading, and will move to a public bill committee, wherein evidence will be called to help scrutinise the policy provisions included within the Bill.

Therefore, to register interest, or to ask any questions related to this Bill, please contact:

Harrison Box, Policy Officer

This email address is being protected from spambots. You need JavaScript enabled to view it.

^[1] Mental Health Bill Explanatory Notes (2024). Department of Health and Social Care and the Ministry of Justice. https://bills.parliament.uk/publications/56784/documents/5315

^[2] https://www.resolveuk.org.uk/asb-awareness-week/resources-and-media-pack/115-taking-back-our-communities/viewdocument/115

^[3] https://www.gov.scot/publications/reviewing-scotlands-approach-antisocial-behaviour/pages/4/

^[4] https://www.nhsconfed.org/publications/mental-health-bill-2024

^[5] https://www.gov.uk/government/statistics/stop-and-search-arrests-and-mental-health-detentions-march-2024/police-powers-and-procedures-stop-and-search-arrests-and-mental-health-detentions-england-and-wales-year-ending-31-march-2024#detentions-under-section-136-of-the-mental-health-act-1983