The UK government announced Wednesday that it is seeking to reform the Mental Health Act 1983 in order to give patients more control over their treatment. The reforms are based on an independent review carried out in 2017, which looked at the rising number of people being detained under the Mental Health Act as well as at the disproportionate numbers of Black, Asian, and minority ethnic groups being detained.

The Mental Health Act regulates situations where a person may be detained in hospital and treated against their will for a mental health condition.

As such, the government’s white paper is divided into three sections. The first part discusses legislative reforms, while the second part seeks to reform policy and practice to improve the patient experience. The last part covers the government’s response to the Independent Review of the Mental Health Act.

The new reforms place the autonomy of the patient at the very heart of the act. Therefore, the reforms seek to introduce “advance choice documents” that would allow the patients to set out in advance the care and treatment they would prefer and/or the treatments they wish to refuse. These documents would be taken into consideration only if the patient is later too unwell to make these choices by themselves. The reforms also ensure that the patient has enough say in who is involved in their care by introducing the role of the “nominated person.” If a patient wants a nominated person, they will be able to appoint one at the time of the detention or in their advance choice document.

The proposal also sets out that learning disabilities and autism are lifelong conditions, and, as such, they are not considered mental health disorders for the purposes of most powers under the act. Nevertheless, people with a learning disability or autism can be detained under the act for a co-occurring mental disorder.

The government is also committed to making significant changes within the criminal justice system by ending the “outdated practice” of using prison cells as “a place of safety.” Instead, people that are experiencing a mental health crisis will be taken to a healthcare setting. In this respect, Lord Chancellor and Justice Secretary Robert Buckland said: “Prisons should be places where offenders are punished and rehabilitated, not a holding pen for people whose primary issue is their mental health.”