Mental Health Act

There will be major changes to the Mental Health Act Code of Practice, which will come into force on 1 April 2015.

Five new overreaching Principles will be introduced, which should always be considered when taking decisions on matters covered by the Act. Although each of the principles is of equal importance the weight given to each principle in reaching a particular decision will vary depending on the context and nature of the decision being made.

Principle one is the least restrictive option and maximises independence. This is where a patient can be treated safely and lawfully without detention under the 1983 Act, the Code is clear: the patient should not be detained. Wherever possible, the focus should be on promoting the patient’s recovery and independence.

Principle two is empowerment and involvement. Patients should be fully involved in decisions about their treatment, care and support, and able to participate in decision-making as far as they can. Where appropriate, the views of the patient’s family and carers should also be considered.

A patient’s views, wishes and feelings (including present, past and those expressed in advance) should be considered so far as they can be ascertained. With this in mind, the Code encourages professionals to support patients to develop advance statements of their feelings and wishes so that, during periods of wellness, they may express views about their future treatment and care.

The third principle is respect and dignity. Not only should patients be treated with respect and dignity but these principles should also apply to the treatment of their families and carers.

Principle four is about purpose and effectiveness. Decisions about a patients' care should: have clear therapeutic aim; promote recovery and be performed to current national and/or best practice guidelines.

Principle five is efficiency and equity. The organisations involved in providing care and treatment to patients should work together to ensure that mental healthcare services are of high quality and are given equal priority to both physical health and social care services.

Other key changes.

These include additional chapters on equality and health inequalities, care planning, victims and human rights. There is new guidance on when to use the 1983 Act and when to use the Mental Capacity Act 2005 and Deprivation of Liberty Safeguards (DoLS).

Additional guidance is included on blanket restrictions; immigration detainees; supporting patients (including young people) with autism and learning disabilities; supporting patients with dementia; and physical health care. There are also revisions to the chapters on restrictive interventions (including seclusion and long-term segregation).

The Trust has set up a task and finish sub-group of MHA good practice. This group includes representatives from services lines, training, communications and legal. The group have agreed to produce a video about the changes, which will be available to all staff. All relevant policies will be reviewed to reflect changes, however, if you are in doubt please refer directly to the code. E-learning will be updated with University of Greenwich Training and Training updates to be delivered. The Trust will adopt a joint approach with Kent County Council and the Clinical Commissioning Groups as recommended by the Care Quality Commission.

Any questions, please refer to your local Mental Health Act administrator or Legal Services.

For more information and to download the Mental Health Act Code of Practice, visit the Mental Health Act page on the GOV.UK website.