The direction of travel in the White paper has generally been supported. As I've been saying (eg. see previous post), I think the proposals do need to be taken further forward. I'm particularly pleased that advocacy services will be extended and their quality improved (see previous post) and that Mental Health Tribunal powers will be extended (see another previous post). Even though there was no consultation on reforms to Community Treatment Orders (CTOs), the government says it will work closely with stakeholders to make changes (see previous post). Where I think the government might be missing out is what to do about the abuse in secure learning disability services exposed by BBC’s Panorama programme (see previous post). It does intend to proceed with its proposal to improve the supply of community services for people with a learning disability and autistic people to reduce the number of people being admitted. However, it does not seem to take on board that most of these people do not need to be in secure facilities and that civil detentions should therefore be prohibited to secure facilities (see previous post). The same applies to those with serious mental illness who are difficult to manage or place, who do not need to be in secure facilities unless there is a court order imposed after a crime. Secure psychiatric facilities should primarily be seen as an alternative to prison.
Stakeholders do need to be involved in taking these reforms forward. As the government also says, legislative reform is only part of what’s needed to improve mental health services. They also need to be transformed by work undertaken by NHS England and NHS Improvement (NHSEI) (see previous post).