Source · Select Committees · Human Rights (Joint Committee)
3rd Report - Legislative Scrutiny: Mental Health Bill
Human Rights (Joint Committee)
HC 601
Published 19 May 2025
Recommendations
2
Accepted in Part
We urge the Government to support the retention of this amendment as the Bill progresses...
Recommendation
We urge the Government to support the retention of this amendment as the Bill progresses through the House of Commons. (Recommendation, Paragraph 14)
Government Response Summary
The government accepts the recommendation in part, committing to monitor and publish data on the number of detentions of people with a learning disability and autistic people under the Mental Capacity Act, as part of their standard publications.
Ministry of Justice
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5
Not Addressed
We are pleased to see that the Government has committed to monitoring the number of...
Recommendation
We are pleased to see that the Government has committed to monitoring the number of autistic people and people with learning disabilities who are detained under the Mental Capacity Act. The Government should report these numbers to Parliament within a …
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Government Response Summary
The government's response discusses the merits of a statutory right to community support and existing healthcare rights, but does not address the recommendation to report numbers on autistic people and people with learning disabilities detained under the Mental Capacity Act.
Ministry of Justice
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8
Not Addressed
The detention of autistic people and people with learning disabilities under the MHA is a...
Recommendation
The detention of autistic people and people with learning disabilities under the MHA is a significant human rights concern. Detention in the absence of individualised, therapeutic treatment risks violating the Article 5 ECHR right to liberty and may even result …
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Government Response Summary
The government's response addresses existing provisions and future guidance regarding placing children on adult wards and CQC notification requirements, failing to engage with the recommendation about the detention of autistic people and people with learning disabilities or the call for investment in community services for these groups.
Ministry of Justice
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9
Not Addressed
To help ensure that mental health needs are properly identified before they reach crisis point,...
Recommendation
To help ensure that mental health needs are properly identified before they reach crisis point, we recommend that the Government considers introducing an English equivalent to the right to a mental health assessment that appears in the Mental Health (Wales) …
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Government Response Summary
The government's response details the extension of independent mental health advocacy rights to informal patients, including children, and mentions cost implications for an opt-out model, but it does not address the recommendation for an English equivalent to the Welsh right to a mental health assessment.
Ministry of Justice
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10
Not Addressed
We recognise the risk that permitting detention on the basis of autism or learning disabilities...
Recommendation
We recognise the risk that permitting detention on the basis of autism or learning disabilities under Part 3 of the MHA whilst prohibiting it under Part 2 amounts to a difference in treatment falling under the prohibition on discrimination in …
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Government Response Summary
The government's response focuses on reasons for not introducing a statutory test for competence for under-16s and commitments to consult on updating guidance in the Code of Practice, entirely failing to address the recommendation for greater community support to divert autistic people and people with learning disabilities from the criminal justice system.
Ministry of Justice
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12
Not Addressed
The Government should, however, carry out an urgent review of the interface between the MHA...
Recommendation
The Government should, however, carry out an urgent review of the interface between the MHA and MCA and take prompt action to provide the clarity that is currently lacking. (Recommendation, Paragraph 78) Children
Government Response Summary
The government's response discusses monitoring and reviewing Community Treatment Orders and the evaluation of culturally appropriate advocacy pilot schemes, but does not address the recommendation to carry out an urgent review of the interface between the Mental Health Act and Mental Capacity Act.
Ministry of Justice
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14
Not Addressed
We agree with submissions made to us that the Mental Health Bill could and should...
Recommendation
We agree with submissions made to us that the Mental Health Bill could and should do more to protect against children being placed on adult wards. The Bill should be amended to include a requirement that a child should not …
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Government Response Summary
The government's response discusses an amendment related to the application of the Human Rights Act to private providers, without addressing the specific recommendation to amend the Bill to prevent children from being placed on adult wards unless demonstrably in their best interests and to require 24-hour CQC notification.
Ministry of Justice
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16
Not Addressed
We welcome the introduction of an “opt–out” system in respect of independent advocacy but call...
Recommendation
We welcome the introduction of an “opt–out” system in respect of independent advocacy but call on the Government to ensure that this system extends to children who are informal patients as well as those who are compulsory patients. (Recommendation, Paragraph …
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Government Response Summary
The government states it is not accepting 'the recommendation' but provides reasons related to the appropriate frequency of Mental Health Tribunal access and safeguards for restricted patients, failing to address the committee's call to extend the opt-out independent advocacy system to children who are informal patients.
Ministry of Justice
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18
Rejected
We support the call from the Joint Committee on the Draft Mental Health Bill for...
Recommendation
We support the call from the Joint Committee on the Draft Mental Health Bill for the Government to consult on the introduction of a statutory test for competency, or “child capacity”, for children aged under 16. (Recommendation, Paragraph 106) Race …
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Government Response Summary
The government rejects the introduction of a statutory test for competency for children aged under 16 due to concerns about unintended consequences, confusion, and undermining Gillick competence, instead committing to consult on updating existing guidance in the MHA Code of Practice.
Ministry of Justice
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21
Rejected
We share the view of witnesses including the Care Quality Commission that the inclusion of...
Recommendation
We share the view of witnesses including the Care Quality Commission that the inclusion of an additional guiding principle of equity in the Bill would be beneficial. While by no means a complete answer, this would emphasise the key need …
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Government Response Summary
The government rejects the recommendation to add 'equity' as a guiding principle to the Bill, stating that the Equality Act 2010 already provides the necessary legal framework. They commit to emphasising compliance with these duties in the Code of Practice and via the NHS Patient Carer Race Equality Framework (PCREF).
Ministry of Justice
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22
Accepted
The Government should carry out a review of the use of Community Treatment Orders, which...
Recommendation
The Government should carry out a review of the use of Community Treatment Orders, which a black person is seven times more likely to receive than a white person. (Recommendation, Paragraph 125) 56
Government Response Summary
The government is committed to monitoring and reviewing reformed Community Treatment Orders (CTOs) and is developing a long-term monitoring and evaluation strategy that will include consideration of changes to CTOs and related data.
Ministry of Justice
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23
Deferred
We look forward to the results of the evaluation of two culturally appropriate advocacy pilot...
Recommendation
We look forward to the results of the evaluation of two culturally appropriate advocacy pilot schemes, which the Government should expand if the results are positive. (Recommendation, Paragraph 126) Other issues
Government Response Summary
The government acknowledges the pilots and is awaiting their evaluation results to consider future options, without committing to expand them even if results are positive.
Ministry of Justice
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25
Accepted in Part
The Mental Health Bill should be amended to ensure that the Human Rights Act, and...
Recommendation
The Mental Health Bill should be amended to ensure that the Human Rights Act, and the protection it provides, applies whenever people receive publicly funded mental health treatment or after–care, or are deprived of their liberty on mental health grounds. …
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Government Response Summary
The government agrees to remedy the issue and has tabled an amendment to the Mental Health Bill to ensure the Human Rights Act applies to publicly funded inpatient care and Section 117 after-care provided by private providers. They acknowledge ongoing questions about the wider scope of 'public authority' but do not commit to a broader review.
Ministry of Justice
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27
Accepted
Monitoring compliance with this standard is important.
Recommendation
Monitoring compliance with this standard is important. Data on hospital transfers should be gathered centrally and made available to the public. (Recommendation, Paragraph 144)
Government Response Summary
The government agrees on the importance of monitoring hospital transfers and has established a Mental Health and Justice Strategic Advisory Group to scrutinise data, committing to include transfer timeliness data in annual reports when ready for publication.
Ministry of Justice
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29
Accepted in Part
The Bill should be amended to ensure that conditions depriving a restricted patient of their...
Recommendation
The Bill should be amended to ensure that conditions depriving a restricted patient of their liberty are reviewed by the Mental Health Tribunal promptly and regularly In particular, the Secretary of State should refer the restricted patient’s case to the …
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Government Response Summary
The government rejects the specific recommendation for restricted patient cases to be referred to the Mental Health Tribunal after 6 months and reviewed every 12 months, but fully accepts and details plans to issue full and detailed guidance on deprivation of liberty conditions.
Ministry of Justice
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Conclusions (14)
1
Conclusion
Rejected
It is crucial that any process of reform to mental health law hears from individuals with direct, personal experience. We welcome the Bill’s proposal to introduce a requirement to offer de–briefing to mental health patients after they have left hospital, so that personal experience can be learned from in future. …
Government Response Summary
While agreeing on the importance of patient experience, the government rejects the need for an additional legislative mechanism for gathering views through post-discharge debriefing, stating that existing feedback systems should be improved instead due to concerns about practicality and potential confusion.
3
Conclusion
Acknowledged
It is particularly troubling that the accounts we heard at the roundtable event in 2025 echoed those the JCHR heard in 2019. This emphasised to us that reform of the Mental Health Act is both pressing and overdue. (Conclusion, Paragraph 18) Detaining autistic people and people with learning disabilities under …
Government Response Summary
The government acknowledges the committee's concern about the need for MHA reform by reiterating its commitment to report annually on the implementation of the Mental Health Bill, including future phases and community service development.
4
Conclusion
Not Addressed
There is an inherent lack of justification for detaining a person for treatment based only on their learning disability or autism, giving rise to clear concerns over compatibility with Article 5 ECHR. We welcome the Bill’s attempts to remove autistic people and people with learning disabilities from the scope of …
Government Response Summary
The government's response, which discusses existing measures to improve community support and funding, does not directly address the committee's conclusion regarding the justification for detaining people solely based on learning disability or autism.
6
Conclusion
Acknowledged
While the evidence we have received supports the view that rushing implementation of the Bill could undermine efforts to improve the treatment of autistic people and people with learning disabilities, we also note that the implementation of other substantial changes in the law in this area have suffered from excessive …
Government Response Summary
The government welcomes the committee's agreement and recognises concerns, discussing appropriate hospital environments for autistic people and those with learning disabilities in the criminal justice system, and the importance of community services, but does not specifically commit to addressing the delays in the Mental Capacity (Amendment) Act 2019 or provide a clearer timeline for the Bill's implementation.
7
Conclusion
Not Addressed
We therefore welcome the Government’s commitment to provide a Written Ministerial Statement to both Houses of Parliament on an annual basis, updating on progress on implementation. (Conclusion, Paragraph 60)
Government Response Summary
The government's response discusses guidance for the Mental Health Act and Mental Capacity Act interface and a separate 'Children Committee View,' but does not address the committee's conclusion welcoming the government's commitment to provide an annual Written Ministerial Statement.
11
Conclusion
Not Addressed
It is disappointing that the Mental Health Bill has not taken the opportunity to provide greater clarity to the interface between the Mental Health Act and the Mental Capacity Act and to make clear when detention and treatment under one or the other should be authorised. In a legislative scrutiny …
Government Response Summary
The government's response focuses on tackling racial inequalities under the MHA, including emphasizing compliance with the Equality Act 2010 in the Code of Practice, and explaining the PCREF, without addressing the committee's concern about the lack of clarity on the interface between the MHA and MCA.
13
Conclusion
Not Addressed
While the recent Government amendment to the Bill, introducing a review of notification requirements in respect of children on adult wards represents a welcome acknowledgement that the status quo may not be satisfactory, it does not guarantee the prompt protection for children’s rights that we have heard is needed. (Conclusion, …
Government Response Summary
The government's response discusses culturally appropriate advocacy pilots and a separate 'Committee View' regarding the Human Rights Act, but does not address the committee's specific conclusion about the adequacy of the Bill's amendment regarding notification requirements for children on adult wards.
15
Conclusion
Not Addressed
We recognise the special importance of advocacy services for children, who may face particular difficulties in understanding and enforcing their legal rights when separated from their families. Independent advocates represent an important method of ensuring the child’s right to be heard, guaranteed by Article 12 UNCRC, is respected. (Conlcusion, Paragraph …
Government Response Summary
The government's response discusses the monitoring and oversight of the transfer process and conditions for restricted patients under the Mental Health Bill, completely failing to address the committee's conclusion about advocacy services for children.
17
Conclusion
Accepted in Part
We agree with witnesses that children under 16 may be denied the opportunity to benefit from the rights provided by the Bill if their ability to make decisions for themselves is not properly assessed. Clarity in such assessments is therefore important. (Conclusion, Paragraph 106)
Government Response Summary
The government rejects introducing a new statutory test for assessing competence in under-16s due to potential confusion, but commits to consulting on updating existing guidance in the MHA Code of Practice to improve the practical application of Gillick competence.
19
Conclusion
Acknowledged
One of the most significant factors that prompted the process of reform that has resulted in this Mental Health Bill was the disproportionate use of compulsory detention and treatment under the MHA on people from minority ethnic backgrounds, particularly black people. Unequal treatment on the basis of race, especially in …
Government Response Summary
The government recognises the issue of inequalities under the MHA, stating the Equality Act 2010 provides the legal framework. They commit to emphasising compliance in the Code of Practice and via the NHS Patient Carer Race Equality Framework (PCREF).
20
Conclusion
Accepted in Part
We recognise that some of the changes proposed in the Bill could help to reduce racial inequity in the application of the Mental Health Act. We also recognise that the causes of differences of treatment and particularly outcomes between people of different races can be varied and complex, and that …
Government Response Summary
The government acknowledges the need to tackle racial inequalities under the MHA, asserting the Equality Act and NHS PCREF provide the framework, and commits to consulting on updating the Code of Practice to include guidance on considering race, culture, and disability.
24
Conclusion
Accepted
The Human Rights Act provides legal protection against, and redress for, human rights violations in the UK. Recent case law has highlighted a gap in that human rights protection for mental health patients in state commissioned but privately provided care. (Conclusion, Paragraph 136)
Government Response Summary
The government agrees this issue should be remedied and has tabled an amendment at Commons Committee to ensure that private providers of state-commissioned mental health inpatient and aftercare are considered public authorities under Section 6 of the Human Rights Act.
26
Conclusion
Accepted
It is crucial that prisoners experiencing serious mental health crises are promptly moved to a hospital environment where they can receive the treatment they need. Delays in such moves risk exposing individuals to inhuman or degrading treatment in breach of Article 3 ECHR. The Bill’s introduction of a statutory 28 …
Government Response Summary
The government agrees that monitoring transfer processes is crucial and has established a Mental Health and Justice Strategic Advisory Group to scrutinise data and identify solutions. They also commit to annual reporting on Bill implementation, including transfer timeliness.
28
Conclusion
Accepted
We can see that in narrow circumstances, where the need to ensure the safety of the public makes deprivation of liberty in the community the least restrictive option available, being able to impose conditions on the discharge of a restricted patient that amount to a deprivation of liberty may be …
Government Response Summary
The government agrees on the need for careful use of the power to impose conditions on restricted patient discharge and for effective safeguards, confirming that more safeguards are in place for this cohort, including more frequent and automatic Mental Health Tribunal referrals. They also commit to producing detailed guidance for the Justice Secretary's functions and for the Mental Health Tribunal to ensure scrutiny.