Landmark reforms of mental health laws need to transform care for people with a learning disability and/or autism

The Department of Health and Social Care today (13 January) published its response to the Mental Health Act White Paper.

In a landmark movement, people with mental health issues who are detained under the Mental Health Act will benefit from landmark reforms, which provide more control over their care and treatment, the government has announced today.

Previously, people with a learning disability and/or autism could have been detained under the Mental Health Act, despite learning disability or autism not being a mental health condition.

The reforms will also ensure neither autism nor a learning disability are grounds for detention under the act and improve access to community-based mental health support, potentially preventing avoidable sections.


A package of reforms has been set out in a wide-ranging new Reforming the Mental Health Act White Paper, which builds on the recommendations made by Sir Simon Wessely’s Independent Review of the Mental Health Act in 2018.  

At the heart of the proposed reforms to the Mental Health Act is greater choice and autonomy for patients in a mental health crisis, ensuring the Act’s powers are used in the least restrictive way, that patients receive the care they need to help them recover’ and all patients are viewed and treated as individuals.

“I want to ensure our health service works for all, yet The Mental Health Act is now 40 years old. We need to bring mental health laws into the 21st century,” states health and social care secretary Matt Hancock.

“Reforming the mental health Act is one of our central manifesto commitments, so the law helps get the best possible care to everyone who needs it. 

“These reforms will rightly see people not just as patients, but as individuals, with rights, preferences, and expertise, who are able to rely on a system which supports them and only intervenes proportionately, and which has their health and wellbeing as its centre.”


The White Paper sets out the path towards the Government’s commitment to introduce the first new Mental Health Bill for 30 years, and end the stigma of mental illness once and for all.

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 £2.3bn a year as part of the NHS Long Term Plan. 


“We welcome these proposals to reform the Mental Health Act so that people with a learning disability and/or autism cannot be detained if they do not have a mental health condition,” comments Dan Scorer, head of policy and external affairs for Mencap.

“Currently, thousands of children and adults are locked away in modern day asylums even when they do not have a treatable mental health condition.

“Ultimately, changes to the Mental Health Act must be backed by a cross-government strategy ​to deliver on Government promises to get people with a learning disability and/or autism out of in-patient mental health units.

“The Government also needs to commit funding to develop the right housing and social care support to truly transform care and close inpatient beds for good. People ​with a learning disability have a right to live in their own homes, not in hospitals.”

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