Mental Health Standards of Care (Wales) Bill
(This was discussed in the Senedd chamber in December, and I was delighted that it received unanimous support giving it leave to proceed)
UPDATES:
JULY 2024: Following the recent election of a Labour Government in Westminster, the King's Speech on 17 July 2024 included their proposals to update the Mental Health Bill. I welcome the intention that their legislation aims to give Mental Health the same attention and focus as physical health, with a particular focus on children and young people – something I have championed since my election to the Senedd in 2021. The move from nearest relative to nominated person is much needed and the consultation responses to my proposed Bill support this move.
Labour’s plans to reform the Mental Health Act picks up many of the ambitions put forward in my private members bill, and that of the Wessely Review undertaken by the past Conservative Government. It will cover both England and Wales. My team and I are looking at the consequences for my Mental Health Bill in Wales to ensure we do not duplicate efforts. We are also in a period of flux in the Welsh Labour Government at the moment, but I am optimistic that the ambitions of my Mental Health Bill will be realised through UK legislation and Senedd legislation and that we will see tangible improvements that will touch the lives of so many people here in Wales.
March 2024: The consultation for my Mental Health Standards of Care (Wales) Bill is now closed. Thank you to everyone who took the time to submit their response.
FEBRUARY 2024: CONSULTATION NOW OPEN - https://business.senedd.wales/mgConsultationDisplay.aspx?ID=545
Closes 22nd March 2024.
I am delighted that this important rights-focused Bill has been tabled, and am keen to work with colleagues across the Senedd in bringing forward mental health reform that will ensure that patients are more empowered, have more choice and influence over their treatment, and receive the dignity and respect they deserve.
The Bill brings forward appropriate changes to the Mental Health Act 1983 (“the Act”) in Wales, and amends elements of the existing Mental Health (Wales) Measure 2010 (“the Measure”).
Content of the Bill
The Bill will enshrine a set of principles throughout mental health services in Wales. These are:
a. Choice & Autonomy,
b. Least Restriction,
c. Therapeutic Benefit, and
d. the Person as an Individual
Under these principles, the Bill will:
- Replace the Nearest Relative (NR) provisions in the Act with a new role of Nominated Person. The intention would be that in place of the NR, a patient would be able to personally select a Nominated Person (NP) to represent them and exercise the relevant statutory functions which the Bill extends. This supports a policy objective of ensuring that the views, experiences and expertise of patients are taken into account more fully and more seriously in their care and treatment, by allowing an individual to express their wishes through someone they know and trust.
- Enshrine a change in the criteria for detention to ensure that people can only be detained if they pose a risk of serious harm either to themselves or to others, and that there must be a reasonable prospect of therapeutic benefit to the patient. Since the Mental Health Act Code of Practice for Wales already sets out that services should be provided in line with the presumption of capacity, be the least restrictive option, serve a person’s best interests and maximise independence, this is likely to be symbolic rather than make a substantive difference in practice, but nonetheless an important one.
- Introduce remote (virtual) assessment under ‘specific provisions’ relating to Second Opinion Appointed Doctors (SOADs), and Independent Mental Health Advocates (IMHA).
The Bill will also:
Amend the Measure to ensure that there is no age limit upon those who can request a re-assessment of their mental health and to extend the ability to request a reassessment to people specified by the patient. Currently the opportunity to request a reassessment is only available to adults, and this change will also seek both a parity within services, and look to address the stigma that’s often felt in receiving mental health support.
Further Detail
- The explanatory memorandum also identifies several areas of potential reform that were given consideration, but not included (paragraph 22), whilst,
- An initial assessment of costs for the implementation of the Bill has also been provided within the explanatory memorandum (paragraphs 26-37).
The development of the Bill has been shaped by a number of significant reviews into Mental Health Act reform (including the Independent Review of the Mental Health Act 1983 (2018), Draft Mental Health Bill (2022) etc), as well as assessments and reviews into the Mental Health (Wales) Measure (2010).
This Bill has also been informed from the views expressed at face to face engagement of public workshops and focus groups from the Independent Review of the Mental Health Act 1983 (2018), as well as the review of Together for Mental Health & Talk to Me 2 Strategies (2023).
Next Steps
Whilst several organisations have given initial thoughts on the development, a more detailed consultation exercise will be undertaken to inform further development of the Bill, should the Senedd give its consent to the proposal progressing to the next stage. To date, I’ve been hugely encouraged by the support of colleagues across the Senedd, mental health charities, and the Royal College Mental Health Expert Advisory Group.