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https://jonrouse.blog.gov.uk/2014/07/14/code-makers/

Code makers

Posted by: , Posted on: - Categories: Mental health

For legislation to work, we have to know it’s there. More importantly, we have to know how to apply it and be reminded of the consequences if we fail to do so. We also need to recognise the passage of time and make sure legal frameworks and practices are still relevant, beneficial and otherwise fit for purpose. The proposed changes to the Code of Practice: Mental Health Act (1983) are a timely case in point. The current version has not been updated since 2008.

"The consultation... is our opportunity as a sector to make good on the [Act's] promises and commitments . At its heart is the intent to protect the rights and dignity of individuals."
"The consultation... is our opportunity as a sector to make good on the [Act's] promises and commitments. At its heart is the intent to protect the rights and dignity of individuals."
So much has changed since then. In the intervening years, legislation has significantly amended the Act in relation to professional practice, personalisation and case law. More recently, we’ve launched Closing the Gap – our action plan to improve mental health provision, Transforming Care – a robust response to the tragic failings of care at Winterbourne View, the Mental Health Crisis Care Concordat (ensuring appropriate responses and onward treatment for those suffering psychological trauma), not forgetting our review of police powers of detention, and the launch of Positive and Safe – this department’s commitment to eliminating the use of face down restraint and other restrictive practices, where possible, across the health and care system.

The Mental Health Act Code of Practice is the mechanism to deliver these and other changes effectively and consistently. It reminds health and social care professionals of appropriate conduct, patient safeguards and legal compliance. Likewise, patients detained or otherwise affected by the terms of the Act, can refer to the Code to understand their rights, as indeed can their families, carers and anyone else involved in their representation. Even if the Act is not involved, the Code still plays a valuable role in maintaining best practice and making sure society’s most vulnerable citizens receive the help and support they need.

The consultation into proposed changes launched earlier this month is our opportunity as a sector to make good on the promises and commitments made in the initiatives mentioned above. At its heart is the intent to protect the rights and dignity of individuals and to strengthen governance and assessment of health and care professionals as they go about their work. I won’t go into an exhaustive list (you can read all the suggested changes here) but proposed amendments include:

  • five new fundamental guiding principles focusing on cooperation, holistic approaches to care and recovery, making clear that professionals, providers, commissioners and patients, their families and carers all have important roles to play
  • new guidance on appropriate restraint, including when seclusion and segregation can be used
  • guidance on appropriate places of safety, and limiting use of police cells to 24 hours
  • clarification of when use of the Mental Health Act, or Mental Capacity Act Deprivation of Liberty Safeguards is appropriate
  • enhanced professional support for victims of offenders with mental health conditions
  • additional clarity around assessing children and young people under 18 in relation to the Mental Health, Mental Capacity and the Children’s and Families Acts.

I’m also pleased to see that changes to the way we talk about and help those with learning disabilities or autistic spectrum disorders have also been put forward for consideration, with options to promote care closer to home and greater transparency in decisions about discharge and review. With or without the findings of Winterbourne View, the need to demonstrate that our thinking and conduct in this area has evolved is vital. More generally, the rights and autonomies of patients, whatever their status and conditions, must be strengthened and defended.

Equally vital is your contribution to this consultation. If the relatively short consultation window (open now until 12 September 2014) doesn’t concentrate minds, I hope the opportunity to help put the spirit of the Act into action will. As local authorities, commissioners, service providers and those receiving care and treatment, we deserve to know this legislation is being applied in our best interests.

Good mental health care is everyone’s business – please get involved.

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Ways to respond
Online or in writing to: Consultations Coordinator, MHA Code Review Consultation, Department of Health, 313A Richmond House, 79 Whitehall, London, SW1A 2NS
Or e-mail: mentalhealthcode@dh.gsi.gov.uk

Enquiries
By phone: 020 7210 5420 10am-4pm Monday to Friday
e-mail: mentalhealthcode@dh.gsi.gov.uk
Twitter: @MHCodeDH

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