Agenda Alliance responds to reform of the Mental Health Act

The government has announced their intentions to provide ‘better care for mental health patients’ through reform to the Mental Health Act.

We welcome this news, which we and many of our alliance members, have been pushing for across years; we most recently voiced our concerns to Rishi Sunak at the omission of similar reforms from the King’s Speech last year (7 Nov 2023).

The Mental Health Act in its current form is seriously outdated and has significant negative impacts for women and girls, especially those from Black, Asian, minoritised and migratised backgrounds, or with experience of poverty, and gendered abuse.

Black people are over three times more likely to be detained under the act, while those with a learning disability and autistic people are frequently inappropriately sectioned – this is unacceptable. We know that Black women, in particular, young Black women, are more likely to be punished or seen as ‘aggressive’ when expressing distress, and less likely to be offered support, despite studies showing higher rates of self-harm amongst this group. The focus on resolving racial disparities in care is therefore critical.

The end to the use of police and prison cells as a ‘space of safety’ for those in mental health crisis is long overdue and hopefully, life-saving. Skyrocketing rates of self-harm and self-inflicted deaths amongst women in prison, especially young women, demonstrate prison will never be a space of safety; instead of sanctuary, police and prison cells trigger pre-existing trauma and worsen mental distress. Police and prison staff are not appropriately equipped to support those experiencing mental health crisis, and too frequently cause serious further harm by failing to provide adequate care, or through traumatic practices such as strip-searching.

An end to this practice must be paired with investment in specialist support so that alternative spaces of safety exist. With recognition that patients deserve increased voice, and more tailored care shaped by their individual needs, must come with acknowledgement of the gendered drivers of women and girls’ mental ill-health. Resolving an epidemic of violence against women and girls, and a whole-society approach to prevention, is fundamental to suicide prevention. It is therefore critical that women and girls are able to access age-appropriate, culturally-responsive, trauma-informed, mental health support which can keep them safe and meet their needs, especially before they ever reach crisis point.

To succeed, the Department of Health, and  the Government, must work in effective partnership across departments. It must make sure that the new legislation is shaped by experts in delivering gender- and culturally-responsive support, as well as those with lived experience of mental health difficulty. We hope that this provides a turning point in the care and supported of women facing mental health challenges, many of whom will have faced significant violence, abuse and trauma.

Key statistics:

• Our research found that Black and minoritised women were over-represented in the 32 women who were detained under the Mental Health Act and died after the use of restraint, across 2012-17.
• Girls are more likely to be detained under the Mental Health Act than boys and young men. In 2021-22, 71% of young people placed in secure hospitals were girls.
• Our analysis found women who have experienced intimate partner violence (IPV) are three times more likely to have made a suicide attempt in the past year
• The rate of self-harm in women’s prisons is 8x higher than in men’s. 73% of women in prison have experienced domestic abuse, and 53% have experienced abuse as a child (Women in Prison)