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Mental health policy in England

Briefing Paper Number CBP 07547, 4 September 2018

Author: Elizabeth Parkin

Around one in four people in the UK suffer from a mental health problem each year. The NHS has set out that it wants to achieve “parity of esteem” between mental and physical health, in terms of access to services, quality of care and allocation of resources. While the achievement of parity of esteem has been a long term-policy goal, since 2010 this aim has increasingly featured in legislation and in Government and NHS policy statements.

In February 2016 an Independent Mental Health Taskforce published The Five Year Forward View for Mental Health. This made a series of recommendations for the NHS and Government to improve outcomes in mental health by 2020/21, including ending the practice of sending people out of their local area for inpatient care and increasing access to talking therapies. The Government and NHS England accepted the Taskforce recommendations, and the Government has committed £1billion by 2020/21 to support their implementation.

In October 2017, the Government commissioned a review of the Mental Health Act 1983, in response to concerns about rising rates of detention and the disproportionate use of the Act among people from black and minority ethnic (BAME) groups. An interim report was published in May 2018 and flags several areas for change, such as ‘advance planning’ decisions so patients’ preferences about their care receive suitable consideration. The review is also gathering evidence on the use of the Act among people from BAME groups. The final report is due in autumn 2018.

The briefing also looks at the use of force in mental health units. Current guidance, including the Code of Practice to the Mental Health Act and that published by NICE, provides direction to service providers and healthcare staff about the use of force and restrictive intervention. The Private Members’ Bill Mental Health Units (Use of Force) Bill is currently awaiting Second Reading in the House of Lords. The Bill would place requirements relating to the use of force on a statutory footing, including requiring mental health units to have a written policy and commit to reducing their use of force.

As health is a devolved matter, the Governments of Scotland, Wales and Northern Ireland are responsible for setting their own policies in this area. Links to policies of the devolved administrations are provided in section 6 of this briefing.

Links to Library briefings on more specific areas of mental health policy, such as children and young people’s mental health, suicide prevention, and perinatal mental health, are provided in section 7.