Consultation on Proposed Changes to the Mental Health Act 1983 Code of Practice

Closed 12 Sep 2014

Opened 7 Jul 2014

Results expected 31 Oct 2014

Feedback expected 31 Oct 2014

Overview

This consultation sets out the proposed changes to the Mental Health Act 1983: Code of Practice (‘the Code’), which was last revised in 2008. The Code is a document which provides guidance to mental health professionals and others in respect of the Act, to help them safeguard patient’s rights and ensure that they work within the law. It is also provides people that are detained or treated under the Act, with information about their rights and expectations.

 In Transforming Care, the Department of Health committed to reviewing and consulting on a revised Code and publishing a new version by the end of 2014, which would take account of the findings of the investigations into Winterbourne View. The Care Quality Commission’s (CQC) annual report on the Act identified areas where the safeguards of the Act were either not applied or where there were concerns with the quality and safety of care being delivered. The updates proposed here address these issues and support delivery of a number of actions in Closing the Gap: priorities for essential change in mental health.

This review of the Code does not affect the existing legislation, but aims to address these and other concerns about the practice. Since 2008 there have been changes and updates in legislation, policy, case law, and professional practice that also need to be reflected in the Code. These changes indicate that now is a suitable time to update the Code in order to ensure that it is up to date and fit for purpose.

The Department has been actively engaging with patients, former patients, carers, professionals and stakeholders to identify issues they would like clarified. The major issues identified that can be addressed by the Code, are included in the proposed revisions to the Code.
The draft Code being consulted upon, provides clarity and information to address concerns raised at Winterbourne View, in CQC inspections and Act Annual Reports, including:
i. ensuring reviews happen and patients are discharged as soon as possible
ii. ensuring individuals, especially those who lack capacity, have a say in their care and treatment and can complain
iii. ensuring commissioners, local authorities and other health professionals are clear on their role
iv. ensuring blanket restrictions are avoided
v. ensuring individuals are able to maintain contact with friends and family
vi. reducing restrictive interventions – this complements the new Positive and Proactive Care: reducing the need for restrictive interventions guidance (2014) by providing additional and specific information for patients being treated for mental disorder in hospital and makes clear that the least restrictive principle applies.

The consultation draft includes a significantly rewritten chapter 19 on children and young people – this aims to provide far greater clarity and information for professionals and practitioners.

The consultation draft includes a new chapter on the Act’s interface with the Mental Capacity Act (MCA) including the Deprivations of Liberty Safeguards (DoLS) – this is designed to provide clarity to aid professionals needing to make a choice between treating an individual under the Act, the MCA or both.

Why We Are Consulting

You could ask almost anyone using mental health services what really matters to them and they would say the same: The one thing that makes a difference is knowing that yourvoice is being heard.’Those of us who are service users, or supportsomeone who is, know from personal experience what works well within mental healthservices, and what needs improving. Having the opportunity to share these views in this consultation is very important because it reassures us that the decision makers are listening.

Too many times in the past, people have tried to speak up about their concerns,they are ignored, their concerns are not acted upon and allowed to escalate until a person has the courage to acknowledge what they are saying or blow the whistle and awful failings and abuse are exposed, as in the case of Winterbourne View. The Code of Practice is designed to prevent such atrocities happening and we are hoping that the revised Code will do just that.

There is no doubt that being in a mental health crisis yourself, or trying to support a distressed individual, is incredibly stressful. Knowing what your rights are, and what is being proposed in these circumstances, can save a great deal of distress. However the information needs to be straightforward and presented in a way that everyone understands, especially in acute situations. The inclusion of questions in this consultation about how to make the Code more accessible and available to service users and carers, as well as professionals, is therefore particularly welcome. One of the most common themes for this group has been the issue of practitioner training. We know that best practice, throughout all the different scenarios in mentalhealthcare, is detailed in the Code. These guidelines now need to be enforced, without exception, and for this to happen training has to be consistent and robust across the board.

Finally we have one shared wish for when the new Code of Practice comes into force: Everyone needs to know about the Code and all communication channels — from bottom to top and vice versa — should remain open.’All service users, their families and carers are encouraged to take up the opportunity to make their views known on any aspect of the Code, or its implementation, in the consultation period from 7 July to 12 September 2014. Mental Health Act Code of Practice Expert Reference Group (Consisting of 9 service users and 6 carers with current or recent experience of care and treatment under the Mental Health Act 1983)

What Happens Next

In Transforming Care, the Department of Health committed to reviewing and consulting on a revised MHA Code and publishing a new version by the end of 2014, which would take account of the findings of the investigations into Winterbourne View.  The Care Quality Commission’s (CQC) annual report on the MHA identified areas where the safeguards of the MHA were either not applied or where there were concerns with the quality and safety of care being delivered. The updates proposed here address these issues and support delivery of a number of actions in Closing the Gap: priorities for essential change in mental health.

Audiences

  • Members of the public

Interests

  • Regulation