By Kim Moore, Senior Lecturer in Mental Health

Theresa May’s announcement of scrapping the Mental Health Act (1985) and replacing this with a new mental health treatment bill (Savage, 2017) seems to have come out of the blue, but what this actually means for people experiencing mental health issues is unclear.  It is right that we need to look at mental health with new eyes and gain new perspectives, but this should be for the right reasons and not as a means of addressing the increasingly hard to access services, staff shortage or to manage the financial constraints.

The proposed treatment bill seeks to redress the rate of increasing admissions under detention by reducing the way in which people would enter into inpatient services. However, this does not acknowledge the impact of sustained financial cuts to mental health services that has created a shortage of inpatient beds and community staff capable of providing these services (Ford, 2016).  MIND (2014) and the KingsFund (2015) have both argued that recent transformations of mental health services for financial reasons had come at the expense of patient care; the stark reality for many people who need in-patient support is that being ‘sectioned’ under the existing mental health legislation has been the only way to ensure access to mental health beds (Cooper, 2013).  Progressively restrictive thresholds required to access mental health support can be seen as a driving force for increasing mental health detentions under section (Health Select Committee, 2013) so arguably raising these again may not be a solution to this crisis and could create more issues than it solves in the new mental health landscape.

However, developing school based programs will surely be a key development for the future interventions. With schools currently filling in the existing treatment gaps this must seem a sensible approach to address the future mental health of school children and the adults they will become.  While it is admirable to deliver mental health support in schools, there are risks that this has the potential to ‘pathologize normal life events’ (Levine, 2013); creating rather than diminishing the need for mental health interventions.  It could also be argued that the negative messages received by children and adults who are not ‘ill enough’ could have an unanticipated influence in the increasing demands from the already overstretched primary and secondary community services (Smith, 2016). In the face of increasingly problematic access to child and adolescent mental health services, the gap between prevention and treatment seems to be growing ever wider (Campbell, 2016) and it is unclear how the new treatment bill will address this.

One of the most ambitious objectives for new treatment legislation will be to address the discrimination experienced by minority groups.  Government programs (time-to-change, 2014) highlighted greater social discrimination experienced by minority groups; yet investments in anti-discriminatory projects (Time-to-change, 2014) seems to have had limited effects thus far.  Treatment barriers for minority groups have had sporadic attention and with the increasingly diverse society in the UK, it is critical to understand these barriers if mental health services are to be responsive to the needs of these group. NHS providers must understand and incorporate organisation and professional cultural competencies in to the services they offer if this is to be addressed at all (Mernon et al,2016).  But can professional and organisational cultural competence and collaboration with culturally diverse populations be addressed by changing mental health treatment legislation? One can only wait to see how this develops.

The destabilisation of mental health services by sweeping transformational plans (KingsFund, 2015) followed by a radical review of the mental health legislation could be a tipping point in mental health services in the UK.  Health promotion strategies in the longer term may well be an effective approach, however in the immediate and shorter future; this may only enhance the gaps in treatment and it is questionable how educational programs will be funded to achieve these aims.  As mental health nurses it is important that we raise our voices to add to the depth of these consultations and our professional views help to shape this new vision of mental health services.  Let us hope that unlike the amendments to the Mental Health Act made in 2007 the new mental health treatment legislation will not be ‘rushed through’ and a wide consultation informs this process.

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