Late on Monday night, in the House of Commons of the UK Parliament, the Mental Health Bill 2025 completed its passage through the legislature and is now finalised by the country’s law-makers. The ceremonial process of Royal Assent is now all that is required to make this Bill law and we will then have a Mental Health Act 2025, assuming the King cracks on to clear his desk before hitting the Christmas sherry and mince pies.
It’s been a long process of work to get here – it’s around ten years since Prime Minister Theresa May, commissioned a review of the Mental Health Act 1983 from Professor Sir Simon Wessely. I was involved in that review, representing the police and it’s was a genuine insight in to how much of this stuff moved from discussion to a group of ideas and proposals for the Government to consider. A White Paper, a proposed Bill from the previous Government and a General Election all contributed to delay until the current Government re-introduced a slightly different Bill to the Commons in 2024 and it has taken some of last year plus all of this year so far to reach the point where we are wondering if the King will take his pen to the legislation ahead of Christmas.
And speaking of ten-year periods, that’s what we are now looking at, in terms of implementation!
ANNUAL UPDATE
In the House of Commons last night, it was made clear it could take a decade for all of the implications of this Bill to become law. The first thing the Government is going to do is draft a new Code of Practice – a mere 8yrs after the current one became out of date by previous amendments to the Act which saw no updates to the Code! – and the process of creating a new Code of Practice will take up to a year, including public consultation on its contents. There has been a commitment given to providing an annual update on how the roll out of the various aspects of the new Act is progressing and what will be happening next.
In addition to training a wide variety of NHS staff in the new Act, there are various projects required about infrastructure, funding for various kinds of services and so on. I started writing a blog post last year about one particular aspect of the new Act which I’m going to publish as a stand-alone next year, but it is about how the threshold for admission is going to change, for section 2 and section 3 patients. It was said during the Mental Health Act review that one objective of the proposals was going to be making it more difficult to justify detention or to justify it for as long as we sometimes see.
This is where I think one of the main challenges of this Act will lie – we know from various pieces of work that admission to hospital is a decision which is sometimes taken because there is no other available option. I was once involved in a piece of work for the Royal College of Psychiatrists which attempted to assess whether there were enough general adult inpatient beds and mentioning this to anyone tends to see them interrupt you to say “No!” as if it’s obvious we don’t have enough. The answer in the report ended up being “it depends” because we found evidence that some areas (in 2015 – of course things have changed) were doing OK, relatively speaking, as long as they had an appropriate amount and variety of community services.
More on all that next year.
PLACE OF SAFETY ISSUES
There was one particular aspect of the Bill’s progress which attracted a lot of attention but did not become law, in the end – the proposal from Baroness May of Maidstone to expand emergency detention powers under s136 MHA beyond police officers to various kinds of health and mental health professionals. The proposal was introduced in the House of Lords and won a vote amongst the peers, so the Commons had to consider it. It was removed at Committee Stage but it’s obvious there have been ongoing discussions about this because it was stated in the Commons that there will be a further review of this by the Government in 2026. I’m not sure the precise drivers for this, except to say that I know the police were supportive of the idea, but many healthcare professionals were not – and everybody had a decent enough point to make about it all.
The issue which has not been discussed very much, because it has been completely uncontentious, is that police stations will be removed as a Place of Safety and I will take personal delight in seeing that happen, because of discussions had during the MHA Review about whether this was possible. No-one in that review thought it was a bad idea in principle – people just questioned how it would work in practice and I think it’s fair enough to wonder about it.
Once it is simply not lawful to use a police station, we need places for well over 30,000 people a year to be assessed whilst detained under s135/136 MHA and the latest data on all this shows that 48% of people detained under the Act are removed first of all to an Emergency Department. And since the 2017 amendments were made which severely restricted the use of police stations as a Place of Safety I’ve always thought many of the occasions where custody was used wouldn’t stand scrutiny against the legal criteria. Most of the people being taken to ED don’t need to go there and there will need to be real thought ahead of implementing the change to remove police stations of where people should be going and how much more capacity the MH system needs to generate to avoid saturating ED at a point where they are busy declaring critical incidents because of the volume of demand they’re facing.
I remember sounding warnings in 2017 when use of police stations was restricted and nothing happened to ensure there wasn’t a quite predictable impact on Emergency Departments and NHS commissioners did almost nothing to ameliorate that – and we now have over 15,000 a year hitting ED, most of whom don’t need to be there at all.
FOR THE LONG HAUL
So strap in – it’s taken ten years to get this far and it will likely take another ten to reach full implementation and by the time we get there, it’s perfectly possible the world will have changed enough to mean we need to think again about reviewing how fit for purpose the legislation is – there are plenty of reason to think this new version of the 1983 Act will remain difficult in practice to operationalise.
Finally, can I make a plea about how we refer to the Act?!
We often see it currently referred to as “The Mental Health Act 1983 (as amended 2007)” or similar. There is simply no need to refer to the amendment unless you’re making some kind of historical comparison with how the Act was and how it changed over the years. The Mental Health Act 2007 is not the only amendment to the 1983 Act – it was amended by the Care Act 2014, by the Policing and Crime Act 2017 and soon by the Mental Health Act 2025 and that’s just three examples of changes over the years.
It’s still just “the Mental Health Act 1983” – and that’s all!
Awarded the President’s Medal, by
the Royal College of Psychiatrists.
Winner of the Mind Digital Media Award
All opinions expressed are my own – they do not represent the views of any organisation.
(c) Michael Brown, 2025
I am not a police officer.
I try to keep this blog up to date, but inevitably over time, amendments to the law as well as court rulings and other findings from inquests and complaints processes mean it is difficult to ensure all the articles and pages remain current. Please ensure you check all legal issues in particular and take appropriate professional advice where necessary.
Government legislation website – www.legislation.gov.uk
Mental Health Cop 