The Mental Health system is a step nearer to undergoing significant changes, to remove the aspects of the current system which are discriminating against black people. A white paper has been released detailing proposed changes, which will undergo consultation, and become law in 2022.

Ministers say changes to how people are sectioned in England and Wales will see them treated “as individuals, with rights, preferences, and expertise”.

Black people are over four times more likely to be detained under the Mental Health Act, relative to population.

NHS data shows that in 2019-2020 there were at least 50,893 detentions recorded under the Mental Health Act (although there are more that were not submitted to the data collection). Of these 5,336 people were black or black British. This shows that there were 321 detentions per 100,000 population for people who were black or black British – while there were 73 detentions per 100,000 for white people.

With the act disproportionately used against black people, the reforms will see a Patient and Carers Race Equality Framework introduced across all NHS mental health trusts – which the government describes as a practical tool to improve the outcome for BAME communities.

The reforms will also ensure that autism or a learning disability cannot be a reason for detaining someone under the act.

In future, a clinician will have to identify another psychiatric condition to order their detention.

The Government’s press release on the white paper says:

  • Major reform of Mental Health Act will empower individuals to have more control over their treatment and deliver on a key manifesto commitment.
  • Reforms will deliver parity between mental and physical health services and put patients’ views at the centre of their care.
  • Plan will tackle mental health inequalities including disproportionate detention of people from black, Asian and minority ethnic (BAME) communities, the use of the act to detain people with learning disabilities and autism, and improve care for patients within the criminal justice system.

BBC article, press release on the White paper from the Government


The government will consult on a number of proposed changes, including:

  • introducing statutory ‘advance choice documents’ to enable people to express their wishes and preferences on their care when they are well, before the need arises for them to go into hospital
  • implementing the right for an individual to choose a nominated person who is best placed to look after their interests under the act if they aren’t able to do so themselves
  • expanding the role of independent mental health advocates to offer a greater level of support and representation to every patient detained under the act
  • piloting culturally appropriate advocates so patients from all ethnic backgrounds can be better supported to voice their individual needs
  • ensuring mental illness is the reason for detention under the act, and that neither autism nor a learning disability are grounds for detention for treatment of themselves
  • improving access to community-based mental health support, including crisis care, to prevent avoidable detentions under the act – this is already underway backed by £2.3 billion a year as part of the NHS Long Term Plan

You can respond to this consultation through the Government’s website – the full version of the White Paper, and how you can respond are in their Consultations section.
This consultation closes at 11:59pm on 21 April 2021