Dimensions response to the Draft Mental Health Bill

We welcome the recommendations in the report by the Joint Committee on the Draft Mental Health Bill.  It warns that a deficit in community care provision has the potential to derail reform of the Bill, leading to worse outcomes for people with learning disabilities and autism.

The proposed reform of the Mental Health Act means that people with a learning disability and/or autism cannot be detained if they do not have a mental health condition.

Dimensions is committed to using its experience of supporting individuals out of hospital into the community to influence change and this is why we are contributing to the funding of the secretariat for a new all-party group on the inappropriate institutional care of autistic people and people with learning disabilities.

The Joint Committee has examined the extent to which the draft Bill would ensure fewer people are detained against their wishes and end the inappropriate long-term detention of people with learning disabilities and autistic people under the Act.

The most recent NHS Digital figures show that almost 2000 people with learning disabilities or autism were detained in hospital in England in August last year, with 350 patients for longer than 10 years. Currently, 93% of people with learning disabilities or autistic people in Assessment and Treatment Units are detained under the Act.

Rachael Dodgson, Chief Executive of Dimensions said:

“We welcome the committee’s recommendations but there needs to be funding for community support and a statutory duty to report annually to Parliament on the progress against milestones, including the number of detentions and the length of stay. Successive policy interventions such as the ‘Transforming Care plan’ in 2012 and the 2015 ‘Building the Right Support’ plan have failed to reduce the numbers of detentions. This is a scandal.”

MPs and Peers urge the Government to publish a comprehensive implementation and workforce plan alongside the Bill with clear actions and milestones. We are campaigning for effective workforce planning in social care, not just in the NHS, and you can read more in our Workforce Manifesto.

Jemima Burnage from the CQC told the Committee that they support the aims of the Bill but “we do not feel that the impact assessment and the range of resourcing are sufficient to meet the ambitions of the Bill”. Peter Devlin from ADASS echoed this assessment, and said that ADASS do not believe the expansion of community services has been factored in, but only “implied”. The Government has told the Committee that an Impact Assessment will be “revised and updated” in anticipation of the Bill’s formal introduction to Parliament, but does not specify whether this updated version will include more detailed costs for community care.

The Joint Committee calls for agreed milestones on service provision to be met before the reforms are fully implemented. Based on our experience, Dimensions has a practical plan: “Broken system, broken lives,” which we are sharing widely across government. You can help too by sharing this with your MP.