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The Mental Health Act Review (England and Wales): will we see any meaningful changes?



There is a growing consensus that mental health legislation across the Western world represents crude human-rights violations, as well as acting as an engine room for the often-damaging biomedical approach to human suffering. In the autumn of 2017, the United Kingdom government initiated an ‘Independent Review of the Mental Health Act (1983) that aims to publish its priority recommendations by autumn 2018. In light of this development, how optimistic should we be that the urgently-required radical revision of the discriminatory Mental Health Act (MHA) is imminent?


Taken at face value, the comments of the Prime Minister, Theresa May, in the run up to the review were encouraging. Appropriately, she referred to the ‘burning injustices’ associated with a ‘discriminatory use of a law passed more than three decades ago’, and pledged to ‘rip up the 1983 act’ and replace it with ‘a new law which finally confronts the discrimination and unnecessary detention’ (Savage, 2017). The Queen’s Speech following the Conservative Party’s election victory in June 2017 retained the commitment to ‘reform mental health legislation’. So maybe we are on the cusp of meaningful – perhaps even ground-breaking – change to mental health legislation?


Alas, closer inspection of the review’s terms of reference and the chairperson’s introductory comments dampens any optimism.


The review is chaired by Professor Simon Wessely – a psychiatrist and former president of the Royal College of Psychiatry – and, predictably, his intention seems to be to steer the range of stakeholders away from anything that might disturb the status quo. In a blog about the review for The Huffington Post, he regurgitates the language of biomedical psychiatry – ‘serious mental illness’, ‘very unwell’ – thereby showing no recognition of the desirability of capacity-based laws (applicable to all and requiring no explicit reference to the dubious construct of ‘mental disorder’) as an alternative to the existing discriminatory legislation. In the same blogpost, Wessely also suggests that changing the legislation may be less important than changing ‘the way we deliver care’ – an ominous sign that he sees the MHA as broadly fit for purpose in its present form.


Reading the terms of reference strengthens my scepticism. In describing the purpose of the review it states: ‘Some of the solutions are likely to lie in practice rather than the legislation itself.   The review should consider practice-based solutions wherever possible.’ Clearly, despite the explicit human-rights violations within it, there is an assumption from the outset that the MHA per se requires little revision; instead, the review group should focus on how psychiatric professionals oversee its implementation.


So I await the review’s report later this year (autumn 2018). For those who recognise the fundamental flaws inherent to existing mental health laws, now might be an appropriate time to canvass politicians about the need for radical revision – I’m currently engaged in correspondence with my local Member of Parliament urging him to use his influence to try to shape the review. However, in light of the above, it is difficult not to anticipate that subsequent recommendations will be cosmetic, failing to address the cornerstones of the prejudicial detention process. I hope I am proved wrong.



Photo courtesy of winnond at




3 thoughts on “The Mental Health Act Review (England and Wales): will we see any meaningful changes?

  1. Amanda Kemp / Reply 31st July 2018 at 4:07 pm

    I have written to the Review and my belief is that the Fusion of The Mental Health Act and the Mental Capacity Act is the only option for a humane society. In Northern Ireland this is already the Law. However I am writing to you because I noticed a Petition on the Government Petitions website entitled “Stop Treatment without Consent – Mental Health”. This has only 10 signatures (showing how much people care). 1,000 of people are being murdered by inappropriate drugs. Psychosis is a cycle people will get better on their own. Hope you can sign the petition. Pointless as it all seems because society cares more about 13 Thai footballers than 1,000 dying needlessly in our country.

    • Gary Sidley / Reply 10th August 2018 at 10:44 am

      Hi Amanda
      Thank you for your interest and response. I, too, have been proactive in trying to shape the work of the review, with written submissions and lobbying my local MP. I appreciate you drawing my attention to the petition – which I have now signed, making a total of 17!. It’s good to hear from an ally in this ongoing struggle to overcome the institutionalised prejudice against people deemed to have mental health problems.

  2. Pingback: National Survivor User Network (NSUN) Bulletin – 28 August 2018 - Altering Images of Mentality

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