Reforming the Mental Health Act 1983: What it means for Wales

Reform of the UK’s Mental Health Act 1983 has been a long time coming. Since the publication of the Independent Review in 2018, it has taken over six years for the UK Government to introduce a Bill to implement the proposed reforms —  a Bill which has still not yet been passed.

While the need for change has long been recognised by the UK Parliament and mental health stakeholders, the process has been slow and complex. Given the seriousness of depriving someone of their liberty, this measured pace reflects the weight of the task. Mental health detention involves one of the most intrusive powers of the state, cutting across health care, human rights, and criminal justice.

This article examines what the proposed reforms mean for people in Wales. At its heart, the Mental Health Bill aims to ensure that individuals are detained only when absolutely necessary, that they have stronger rights and a greater say in their care, and that the law better upholds their dignity, autonomy, and freedom.

Reforming the Mental Health Act

The Mental Health Act 1983 was introduced to protect people in crisis. However campaigners – including Mind, Rethink Mental Illness, the Royal College of Psychiatrists, and the Centre for Mental Health — argue that it is now outdated. They call for reforms that give detained individuals more dignity, choice and control over their treatment.

The reform process began with an Independent Review in 2018, and a White Paper followed in 2021. A draft Mental Health Bill was published in June 2022 for pre-legislative scrutiny. The current Bill was introduced in the House of Lords in November 2024, and in the House of Commons in May 2025.

Key Provisions of the Bill

The Bill seeks to provide stronger legal safeguards by embedding many previously non-binding rights into statute. It aims to align mental health law more closely with human rights principles and social justice values. Key measures include:

• Greater patient autonomy and choice: statutory care and treatment plans will be mandatory for detained individuals, co-produced with patients to set goals, treatment, and discharge steps. People will also be able to nominate someone other than their nearest relative to be involved in decisions about their care.
• Ending inappropriate detention for autistic people and those with learning disabilities: currently, individuals with autism or learning disabilities can be detained under Section 3 of the Act even if they do not have a mental illness. The new Bill will allow detention only where a co-occurring mental health condition requires treatment.
• Addressing the scale of inappropriate detention: The National Autistic Society (NAS) reports that, as of 2023, around 2,040 people with autism or learning disabilities were detained—65% of whom were autistic. Many remain hospitalised for years with limited therapeutic benefit, far from home and with restricted support. The Bill seeks to tackle this issue by removing the legal basis for detaining individuals solely on the grounds of their neurodivergence, ensuring that detention is only used when there is a genuine risk and therapeutic benefit.
• Banning the use of police cells as ‘places of safety’: Under Section 136 of the current Act, people in mental health crisis can be held in police custody. The Bill would ensure they are taken to appropriate health settings instead, promoting dignity and timely care.

Police Powers for Health Professionals

An area of contention is a recent amendment to the Bill, passed by the House of Lords, that would transfer police powers (under Sections 135 and 136) to healthcare professionals, allowing them to detain individuals in crisis in public or private settings without police involvement.

A joint statement by the Royal College of Psychiatrists and eight other health and care organisations have raised concerns about this proposal. They argue that:

• The amendment is based on a flawed assumption that many detentions are risk-free, which is rarely the case.
• Police play a vital role in ensuring safety when entering private homes or managing risk in public spaces.
• Transferring coercive powers to clinicians could damage therapeutic relationships and deter people from seeking help.
• The proposal was not properly consulted on with professionals or service users.

Dr Lade Smith CBE, President of the Royal College of Psychiatrists, warned that such delegation undermines the principles of the 2018 Independent Review, and could disproportionately affect people from minoritised backgrounds. She has emphasised the importance of collaborative planning between police and mental health services to ensure safety and uphold patient rights.

Application to Wales

Although health is a devolved matter, the Mental Health Bill applies to both England and Wales because mental health detention law cuts across devolved and reserved powers.

Wales does have related legislation—the Mental Health (Wales) Measure 2010—which focuses on care planning, advocacy, referrals, and early intervention. However, Welsh ministers have recommended that provisions in the UK Bill should apply to Wales, to ensure coherent cross-border policy and equal legal protections.

The Welsh Government says the Bill supports its Mental Health and Wellbeing Strategy 2025–2035. The Royal College of Psychiatrists Wales has endorsed this approach.

Two Senedd committees — Health and Social Care, and Legislation, Justice and Constitution—have reported on these LCMs. Both committees raised concerns about the use of a UK Bill to introduce these changes in Wales, which allows limited opportunities for Senedd Members to scrutinise provisions.

Nevertheless, the Senedd committees support the Bill in principle, provided the Bill allows Welsh Ministers to retain authority over implementation in Wales, including the development and laying of a Welsh Code of Practice. The Welsh Government will need to lay its own Code of Practice after the UK Mental Health Bill is passed, but the exact timing depends on when the relevant provisions are commenced.

Looking Ahead: Implementation and Risks

Implementation is expected from 2026 onwards, with gradual rollout. However, key concerns remain:

• Risk of Gaps in Support: If detention is restricted for autistic individuals or those with learning disabilities unless they have a co-occurring mental illness, some people may be left without appropriate crisis care. This could result in delays, including prolonged stays in A&E or interactions with the criminal justice system.
• Racial Inequality: A core aim of the reform is to reduce racial disparities in detention. However, campaigners caution that some proposals—such as expanded powers for clinicians—may have the opposite effect.
• Resources and Staffing: Reform alone is not enough. For the system to uphold dignity and person-centred care, the NHS must be adequately staffed and funded. Services must be held to high standards of accountability, and staff empowered to advocate for patients’ rights.

A Senedd debate on whether to grant legislative consent will be held in September.

Article by Sarah Hatherley, Senedd Research, Welsh Parliament.