The Independent Review of the Mental Health Act 1983, chaired by Sir Simon Wessely, has been published by the Department for Health and Social Care. The report puts forward a series of recommendations aimed at modernising the Mental Health Act and improving the experiences of those detained.
The report recommends that the ‘families of those who have died should receive non-means-tested legal aid’ and is therefore a welcome addition to widespread calls for change on this urgent issue. This follows written and oral evidence by INQUEST to the review team.
The report also recognises the profound structural factors and inequalities that exist for people from ethnic minority communities in accessing treatment, experiences of care, and quality of outcomes following mental health care. The review team report that they “heard repeatedly that black African and Caribbean communities have a real fear of death when interacting with the mental healthcare system”.
Some of the significant recommendations include:
- Clear guidance that a death under Deprivation of Liberty Safeguards/Liberty Protection Safeguards in a mental health setting should be considered to be a death in state detention for purposes of triggering an inquest with a jury, known as Article 2 inquests.
- Wards should not use coercive behavioural systems and restrictions to achieve behavioural compliance from patients, but should develop, implement and monitor alternatives.
- The review team also endorses the recommendation made by the Angiolini report for an Independent Office for Article 2 Compliance.
INQUEST is however disappointed that the review has not recommended independent investigations following a death of someone detained under the Mental Health Act at this stage.
Deborah Coles, Director of INQUEST said: “The recognition of the need to shift away from practices of coercion and control, towards creating therapeutic environments is welcome. The review found, unsurprisingly, that black African and Caribbean communities hold a real fear of death when interacting with mental health services. Our casework reiterates the real dangers of the over use of restraint in mental health settings. This is one example of the extent of cultural change required. The strength of this review depends ultimately on its implementation.
We are glad to see this review adding to the widespread calls for non-means tested legal aid for bereaved families. Access to justice is essential to enable accountability and learning from deaths. INQUEST will continue to push for robust, truly independent investigations following deaths in mental health settings, which are necessary to ensure appropriate scrutiny and prevent future deaths.”
The recommendation for non-means-tested legal aid has been recently supported in a range of reports including the Joint Committee on Human Rights report on their inquiry Enforcing human rights, the annual reports of two Chief Coroners, the Angiolini review on deaths in police custody, and Bishop James Jones' review on the experiences of Hillsborough families.
* Read Modernising the Mental Health Act – final report from the independent review and the associated documents here
* INQUEST https://www.inquest.org.uk/
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