Mental Health Bill Update

The Mental Health Bill passed its second reading in the House of Lords, moving closer to becoming law. While broadly supported, key concerns include:

• Reviewing the use of Community Treatment Orders (CTO)
• Ensuring children aren’t placed in adult wards or far away from home
• Giving patients the right to Advance Care Directives
• Managing the rise in A&E visits as police stations are no longer used as a place of safety.

Baroness Barker and Baroness Keeley highlighted worries about changes to the Care Act. This followed a court ruling that the Human Rights Act didn’t cover mental health patients receiving aftercare in private settings.

Wider took place in the House of Lords, including:

• A new Mental Health Commissioner role and measures to tackle racial inequalities
• Better support for people in the community with learning disabilities and autism
• Replacing “nearest relatives” with “nominated persons” for patient advocacy
• Shorter detention periods, easier tribunal access, and tighter CTO criteria.

Other proposed measures that the Bill includes are:

• New statutory Codes of Practice for England and Wales
• Removal of learning disability and autism from Section 3 of the Mental Health Act (1983)
• Statutory care and treatment plans for all patients
• Wider access to advocacy, second opinions, and tribunals.

Roll out will be gradual, with smaller changes to criminal justice starting soon after the Bill passes. Major reforms are slated for 2027, though the full extent of the Act, including expanded tribunals, may take until 2032.

Government Plans New Accommodation for Children at Risk of Deprivation of Liberty

The Government is developing a new type of care home for children with complex needs and trauma. Addressing the growing use of unregistered placements under High Court orders. These homes will be registered with Ofsted but not classified as Secure Children’s Homes (SCH).

Key recommendations from the Children’s Commissioner include:

• Deprivation of liberty is a last resort and regularly reviewed
• Any deprivation of liberty should be reviewed by a judge every three months
• The child must have a legal representative (a Cafcass guardian) during any court proceedings
• Children should be able to tell the judge their views in a way that’s comfortable for them
• The Education Secretary and Ofsted must be informed if a child is deprived of liberty and not in a registered home
• Children should have access to advocacy, to include those who are unable to speak for themselves.

To reduce deprivation of liberty, the focus will be on creating more therapeutic, safe homes. The Department for Education, in partnership with NHS England, plans to pilot a programme offering community-based care and housing – via collaboration with social care, health, education, and justice sectors.

Terminally Ill Adults (End of Life) Bill

The Terminally Ill Adults (End of Life) Bill, published on 11 November 2024, proposes a legal framework for the terminally ill to seek assisted dying under strict safeguards. Currently, the Suicide Act 1961 criminalises assisting someone to complete suicide. However, the European Court of Human Rights allows countries to legalise assisted dying with safeguards, to ensure the person’s decision is voluntary and free from coercion.

Eligibility is for people:

• Aged 18+ and been a resident in England or Wales for at least 12 months
• With a terminal illness, with less than six months to live
• Who can demonstrate the mental capacity to make the decision

The process for assisted dying has three stages:

• The person must make a formal declaration, which is assessed by two independent doctors to confirm eligibility.
• The High Court reviews the case to confirm that all criteria have been met.
• After a minimum of 14 days (or 48 hours if death is imminent), the person must reaffirm their decision through a second This ensures thorough evaluation and respects the person’s autonomy.

The Bill includes robust safeguards to protect all parties involved. This process is entirely voluntary for healthcare professionals, with legal protections ensuring they don’t face discrimination for not participating. Legal oversight is strict, with criminal penalties for anyone found guilty of coercion or making false declarations. Additionally, the law will undergo regular reviews to ensure it remains fair, effective, and aligned with its intended purpose.

The Bill offers terminally ill people dignity and autonomy at end of life. With robust safeguards to protect against abuse or coercion. If passed, it will mark a significant shift in end-of-life rights in the UK.