Mental Health Bill [HL] 2024-26

NC38

To move the following Clause— "Duty of co-production with autistic people and people with learning disabilities (1) The Mental Health Act 1983 is amended as follows. (2) After section 23 (discharge of patients) insert- "23A General duty of co-production with autistic people and people with learning disabilities on discharge from hospitals (1) The Secretary of State must, within 12 months of the passing of the Mental Health Act 2025, and in consultation with— (a) integrated care boards, (b) local authorities, and (c) providers of services for autistic people and people with learning disabilities, establish an advisory committee on the discharge of autistic people and people with learning disabilities from hospitals. (2) The advisory committee under subsection (1) must be made up of— (a) autistic people, (b) people with learning disabilities, and (c) representatives of autistic people and people with learning disabilities. (3) The advisory committee must publish guidance on the discharge of autistic people and people with learning disabilities from hospitals including advice on- (a) accommodation, (b) local services, (c) safe spaces and crisis facilities, (d) education, (e) work, and (f) leisure and social opportunities. (4) Guidance under subsection (3) must be developed in consultation with— (a) autistic people, (b) people with learning disabilities, (c) national and local organisations managed by autistic people, (d) national and local organisations managed by people with learning disabilities, and (e) any other relevant persons or organisations, and must comply with- (a) co-production standards as set out by disabled people's organisations, (b) Equality Act 2010 sections 20, 21 and 149, and (c) UN Convention on the Rights of Persons with Disabilities implementation standards. (5) Each body under subsections (1)(a)-(c) shall be required to— (a) publish a five-year plan, within 18 months of the passing of the Mental Health Act 2025, to reduce the number of autistic inpatients and inpatients with learning disabilities under this Act or the Mental Capacity Act 2005, and (b) review and evaluate its progress against the plan under paragraph (a) every two years. (6) The Secretary of State shall be under a duty to make available sufficient funding for the advisory committee, guidance and plan implementation under this section.””

38

Clause 4, page 9, line 32, after “125D(3)(d)” insert “and 125DA(3)”.

<p>Amendments 37 and 38 are consequential on amendment 36 and would ensure that integrated care boards and local authorities have regard to reports from care and treatment review meetings with people on their registers when commissioning services.</p>

NC24

To move the following Clause—<br> <b>“Report: Mental health services for children and young people</b><br> (1) The Secretary of State must, within 18 months of passing this Act, prepare and lay before Parliament a report on the provision of specialist mental health services for patients aged under 18.<br> (2) The report under subsection (1) must include an assessment of—<br> (a) the number of patients aged under 18 receiving specialist mental health services;<br> (b) the availability of specialist mental health services based outside of hospital settings;<br> (c) any gaps in care and support experienced by patients aged under 18;<br> (d) the Secretary of State’s conclusions as to whether there are sufficient resources to deliver mental health services for patients aged under 18;<br> (e) the views of children, young people and families with experience of receiving specialist mental health services.<br> (3) For the purpose of this section—<br> (a) “specialist mental health services for patients aged under 18” means—<br> (i) inpatient mental health services specifically designed for individuals aged under 18 years, including specialist eating disorder services;<br> (ii) community-based mental health services specifically designed for individuals aged under 18 years as an alternative to inpatient care.<br> (b) “resources to deliver mental health services” include—<br> (i) finances;<br> (ii) appropriate trained medical professionals;<br> (iii) appropriate facilities for patient care.”

<p>This new clause would require the Secretary of State to review and report on the availability of specialist mental health services for patients under 18.</p>

NC25

To move the following Clause—<br> <b>“Determination of competency for persons under 16</b><br> (1) For the purposes of this Act, a person aged under 16 (referred to in this section as a child) is able to make a relevant decision if they can—<br> (a) understand the information relevant to the decision;<br> (b) retain that information;<br> (c) use or weigh that information as part of the process of making a decision; and<br> (d) communicate their decisions (whether by talking, using sign language or any other means).<br> (2) Where a child is able to make a relevant decision in accordance with paragraph (1) above, that child will be competent for the purposes of this Act.<br> (3) A child is not to be regarded as unable to understand the information relevant to a decision if he is able to understand an explanation of it given to him in a way that is appropriate to his circumstances (using simple language, visual aids or any other means).<br> (4) A person determining a child’s ability to make a relevant decision under this section must—<br> (a) have due regard to Article 12 of the United Nations Convention on the Rights of the Child, and<br> (b) be able to show reasonable grounds for their belief that the child is or is not able to make a relevant decision.”

<p>This new clause inserts a competency test for determining a child’s ability to make a relevant decision.</p>

NC26

To move the following Clause—<br> <b>“Duty to establish carer liaison service</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In Part X (Miscellaneous and Supplementary), after section 133 insert—<br> <b>“133A</b> <b>Duty to establish carer liaison service</b><br> (1) The managers of every hospital providing services under this Act must establish and maintain a dedicated carer liaison service.<br> (2) A service established under this section must provide—<br> (a) support to unpaid carers when a patient for whom they provide care is—<br> (i) awaiting admission to hospital for treatment under the Act;<br> (ii) receiving treatment in hospital under the Act;<br> (iii) set to be discharged from a hospital where they had been receiving treatment under this Act;<br> (b) timely and accessible information regarding the discharge of the patient they care for, including details of—<br> (i) the patient's discharge plan; and<br> (ii) aftercare arrangements under section 117 of this Act;<br> (c) support for unpaid carers to identify their own needs and connect to relevant local services for post-discharge support, including local authority adult social care services, general practitioners, and local carers' centres;<br> (d) facilitation of effective communication and collaboration between unpaid carers and the patient's multidisciplinary clinical team regarding the discharge process;<br> (e) assistance to unpaid carers in developing or updating a carer's support plan in the context of the patient's discharge, including guidance on—<br> (i) their rights to assessment and support as carers<br> (ii) their participation in education or employment;<br> (iii) available counselling services;<br> (iv) support in planning for emergencies in relation to the patient;<br> (v) benefits for the carer and patient; and<br> (vi) other forms of local support; and<br> (f) services to ensure that the perspective of the unpaid carer, as a key provider of support, is considered during discharge planning, where appropriate and with due regard to patient confidentiality and consent.””

<p>This new clause would require hospitals to establish a dedicated liaison service for the carers of patients detained under the Mental Health Act.</p>

NC27

To move the following Clause—<br> <b>“Duty to identify children of patients receiving treatment</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In Part X (Miscellaneous and Supplementary), after section 133 insert—<br> <b>“133B</b> <b>Duty of managers of hospitals to identify children of patients</b><br> (1) Where a patient liable to be detained under this Act is in a hospital or registered establishment, the managers of the hospital or registered establishment shall take such steps as are practicable to identify children of the patient.<br> (2) The managers must ensure, where children of patients are identified, that—<br> (a) information is provided to the family about support available for the child;<br> (b) the appropriate practitioner consider whether the child might be a young carer and whether they might benefit from additional support including—<br> (i) a Young Carers’ Needs Assessment under section 17ZA of the Children Act 1989, or<br> (ii) additional support from their local authority or local young carers service.””

<p>This new clause would require hospitals to identify children of patients and provide support or provide guidance on available support to them, particularly if they are a young carer.</p>

NC28

To move the following Clause—<br> <b>“Duty to mitigate adverse effect of compulsory measures on parental relations</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) After section 131A, insert—<br> <b>“131B</b> <b>Duty to mitigate adverse effect of compulsory measures on parental relations</b><br> (1) Subsection (2) below applies—<br> (a) where—<br> (i) a child is subject to any measures authorised by virtue of this Act; and<br> (ii) the measures will or will be likely to impair the personal relations or diminish direct contact between the child and any person with parental responsibilities in relation to the child; or<br> (b) where—<br> (i) a person with parental responsibilities in relation to a child is subject to any measures authorised by virtue of this Act; and<br> (ii) the measures will or will be likely to impair the personal relations or diminish direct contact between that person and the child.<br> (2) Every person having functions by virtue of this Act shall take such steps as are practicable and appropriate to mitigate the impairment or diminution referred to in this section or, as the case may be, the likelihood of that impairment or diminution.<br> (3) In this section—<br> “child” has the meaning given by section 105 of the Children Act 1989; and<br> “parental responsibilities” has the meaning given by section 3 of the Children Act 1989.””

<p>This new clause would create a duty to mitigate the adverse effect of compulsory treatment under theMental Health Act 1983 on relations between parents and their children, mirroring provisions in theMental Health (Care and Treatment) (Scotland) Act 2003.</p>

NC29

To move the following Clause—<br> <b>“Age-appropriate treatment for children</b><br> (1) Section 131A of the Mental Health Act 1983 is amended as follows.<br> (2) After subsection (1), insert—<br> “(1A) A patient to whom this section applies must not be detained in, or admitted to, an adult ward unless the managers of the hospital consider that—<br> (a) there are exceptional circumstances which justify the patient’s detention in, or admission to, an adult ward; and<br> (b) the decision is in accordance with the best interests of the child.”<br> (3) After subsection (3), insert—<br> “(3A) Where a patient to whom this section applies has been detained in, or admitted to, an adult ward, the managers of the hospital must record in writing the reasons for the admission, including—<br> (a) the reason, or reasons, why other options for accommodation were not available or suitable for the patient;<br> (b) details of the measures to be taken by the hospital to ensure that, while the patient is detained or otherwise accommodated in the adult ward, the patient is provided with care in a safe environment; and<br> (c) unless it has been determined that an adult ward is the most appropriate environment for the patient in accordance with subsection (1A), the steps being taken by the hospital to transfer the patient to more appropriate accommodation.<br> (3B) Where a patient to whom this section applies is—<br> (a) detained in, or admitted to, an adult ward or in a local authority other than the local authority in which the patient was ordinarily resident; and<br> (b) the detention or admission is of more than 24 consecutive hours' duration, the managers of the hospital must notify the regulatory authority immediately, setting out why they consider that the requirements under subsection (1A) above are met and providing the information set out in subsection (3A).<br> (3C) Subsection (3D) applies when—<br> (a) the managers of a hospital accommodate a patient to whom this section applies in an adult ward for a consecutive period of at least 28 days; or<br> (b) detain or admit a patient to whom this section applies who—<br> (i) was ordinarily resident immediately before being detained or admitted in the area of a local authority other than the local authority within whose area the hospital is situated, or<br> (ii) was not ordinarily resident within the area of any local authority.<br> (3D) Where this subsection applies, the managers of the hospital must immediately inform the appropriate officer of the responsible local authority—<br> (a) of the patient's detention or admission, and<br> (b) when the patient's detention or admission ceases.”<br> (4) Leave out subsection (4) and insert—<br> “(4) In this section—<br> (a) “adult ward” means a ward in a hospital to which persons aged 18 or over are detained in or admitted to;<br> (b) “the appropriate officer” means—<br> (i) in relation to a local authority in England, their director of children's services, and<br> (ii) in relation to a local authority in Wales, their director of social services;<br> (c) “hospital” includes a registered establishment; and<br> (d) “the responsible authority” means—<br> (i) the local authority appearing to the managers of the hospital to be the authority within whose area the child was ordinarily resident immediately before being detained or admitted, or<br> (ii) where it appears to the managers of the hospital that the patient was not ordinarily resident within the area of any local authority, the local authority within whose area the hospital is situated.””

<p>This new clause seeks to ensure that children are only placed on adult wards where there are exceptional circumstances, and it is in their best interests. It includes procedural safeguards for determining the reasons behind (and suitability of) admitting a child to a hospital environment in which adults are simultaneously accommodated or in an out of area placement, along with notification requirements.</p>

NC30

To move the following Clause—<br> <b>“Application in respect of patient already on hospital grounds</b><br> (1) Section 5 of the Mental Health Act 1983 (Application in respect of patient already in hospital) is amended as follows.<br> (2) In subsection (1), after “or,” insert “that the patient has attended a hospital or been brought to a hospital to seek help or admission as a patient or,”.<br> (3) After subsection (2), insert—<br> “(2A) If, in the case of a patient who—<br> (a) is an outpatient in hospital; or<br> (b) has attended hospital to seek treatment as an outpatient; or<br> (c) has attended hospital to seek admission as an inpatient,<br> <span class="wrapped">it appears to the registered medical practitioner assessing the patient that an application ought to be made under this Part of this Act for the admission of the patient to hospital, the registered medical practitioner may furnish to the managers a report in writing to that effect; and in any such case the patient may be detained in the hospital for a period of 72 hours from the time when the report is so furnished.”</span><br> (4) In subsection (3), after “(2)” insert “or (2A)”.”

<p>This new clause would allow people who have attended or been brought to a hospital to seek help or admission as a patient to be detained for assessment under the Mental Health Act.</p>

NC31

To move the following Clause—<br> <b>“Costed plan to ensure community provision for individuals with learning disabilities and autism who are at risk of detention</b><br> (1) Within 18 months of the day on which this Act is passed, the Secretary of State must publish a fully costed plan for how Integrated Care Boards and local authorities will ensure provision of adequate community services for individuals with learning disabilities and autistic people who are at risk of detention under Part 2 of the Mental Health Act 1983.<br> (2) As part of the development of that plan, a formal consultation process must take place to determine how the decision to enact the relevant parts of this Act will be made.<br> (3) The consultation must include input from relevant stakeholders, including—<br> (a) individuals with learning disabilities and autistic people;<br> (b) carers for people with learning disabilities and autistic people;<br> (c) healthcare professionals; and<br> (d) advocacy groups.”

<p>This new clause would require a costed plan to ensure that ICBs and local authorities are able to provide adequate community services for individuals with learning disabilities and autistic people at risk of detention under Part 2 of the 1983 Act, informed by a consultation with a range of stakeholders.</p>

NC32

To move the following Clause—<br> <b>“Mandatory Independent Care (Education) and Treatment Reviews for patients detained in long-term segregation</b><br> In the Mental Health Act 1983, after section 142D (inserted by section 52 of this Act) insert—<br> <b>“142E</b> <b>Mandatory Independent Care (Education) and Treatment Reviews for patients detained in long-term segregation</b><br> (1) A notification of any use of long-term segregation for a patient detained under this Act must be issued to the Care Quality Commission, the hospital’s Board of Directors and the relevant NHS Commissioner within 72 hours of the person being placed in long-term segregation.<br> (2) Upon receipt of a notification under subsection (1), the Care Quality Commission must appoint a qualified professional to conduct an Independent Care (Education) and Treatment Review.<br> (3) The independent reviewer must—<br> (a) conduct a face-to-face assessment of the patient,<br> (b) consult with the patient’s family or carers, where appropriate,<br> (c) review the patient’s care and treatment plan, including the rationale for continued segregation, and<br> (d) assess whether alternatives, including ward or community-based alternatives, were considered prior to the implementation of long-term segregation.<br> (3) Where the assessment under subsection (3)(d) reveals that alternatives were not adequately considered, the independent reviewer may require the detaining organisation to—<br> (a) provide justification for this omission, and<br> (b) outline steps to ensure that alternative options are considered in future cases.<br> (4) The independent reviewer has authority equivalent to a second opinion appointed doctor to—<br> (a) confirm the appropriateness of the long-term segregation,<br> (b) recommend amendments to the treatment plan, and<br> (c) require alternative interventions if long-term segregation is deemed inappropriate.””

<p>This new clause requires independently chaired reviews for any person detained in long-term segregation, in line with the recommendations of Baroness Hollins’ report on solitary confinement for people with autism and learning disabilities.</p>

NC33

To move the following Clause—<br> <b>“Mandatory Independent Care (Education) and Treatment Reviews for patients with autism or learning disability detained for more than 5 years</b><br> In the Mental Health Act 1983, after section 142D (inserted by section 52 of this Act) insert—<br> <b>“142E</b> <b>Mandatory Independent Care (Education) and Treatment Reviews for patients with autism or learning disability detained for more than 5 years</b><br> (1) Where a person with autism or a learning disability has been subject to compulsory detention under this Act, including by virtue of a community treatment order, for a continuous period of 5 years or more, the Care Quality Commission must appoint a qualified professional to conduct an Independent Care (Education) and Treatment Review (ICETR) of that person’s care and treatment.<br> (2) The independent reviewer must—<br> (a) conduct a face-to-face assessment of the patient,<br> (b) consult with the patient’s family or carers, where appropriate,<br> (c) review the patient’s care, education (where applicable), and treatment plan, including the rationale for continued detention or the continuation of a community treatment order, and<br> (d) assess whether alternatives to continued compulsory detention, including community-based or less restrictive options, have been adequately considered.<br> (3) The Care Quality Commission must ensure that a further ICETR is conducted at intervals of not more than 12 months for so long as the person remains subject to compulsory detention under this Act or to a community treatment order.<br> (4) Where the assessment under subsection (2)(d) reveals that alternatives to continued detention or community treatment were not adequately considered, the independent reviewer may require the detaining organisation or responsible commissioner to—<br> (a) provide justification for this omission, and<br> (b) outline steps to ensure that alternative options are fully considered in future reviews.””

<p>This new clause provides for a new process with independently chaired reviews for any patient with autism or a learning disability subject to detention or community treatment orders for long periods of time.</p>

NC34

To move the following Clause—<br> <b>“Grounds for detention</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In section 2 (admission for assessment), in subsection (2)—<br> (a) omit the “and” at the end of paragraph (a);<br> (b) for paragraph (b) substitute—<br> “(b) there is a risk of serious harm to the health or safety of the patient or of another person; and<br> (c) given the nature or degree of the harm, the patient ought to be so detained.”<br> (3) In section 3 (admission for treatment)—<br> (a) in subsection (2), for paragraphs (c) and (d) substitute—<br> “(b) there is a risk of serious harm to the health or safety of the patient or of another person unless the patient is so detained,<br> (c) it is necessary, given the nature or degree of the harm, for the patient to receive medical treatment,<br> (d) the necessary treatment cannot be provided unless the patient is detained under this Act, and<br> (e) appropriate medical treatment is available for the patient.”<br> (b) in subsection (3)—<br> (i) in paragraph (a), for “(d)” substitute “(e)”;<br> (ii) in paragraph (b), for “(c)” substitute “(b) to (d)”<br> (4) In section 5(4) (detention for six hours pending application for admission), for paragraph (a) (but not the“and” at the end) substitute—<br> “(a) that there is a risk of serious harm to the health or safety of the patient or of another person unless the patient is immediately restrained from leaving the hospital;”<br> (5) In section 20 (renewal of authority for detention of patient detained in pursuance of application for admission for treatment etc), in subsection (4), for paragraphs (c) and (d) substitute—<br> “(b) there is a risk of serious harm to the health or safety of the patient or of another person unless the patient receives medical treatment,<br> (c) it is necessary, given the nature or degree of the harm, for the patient to receive medical treatment,<br> (d) the necessary treatment cannot be provided unless the patient continues to be liable to be detained, and<br> (e) appropriate medical treatment is available for the patient.”<br> (6) The amendment made by subsection (5), so far as relating to persons who are liable to be detained by virtue of Part 3 of the Mental Health Act 1983, applies in relation to such a person whether the person became so liable before or after the coming into force of this section.”

<p>This new clause is intended to replace Clause 5 (see Amendment 43). It would remove from the criteria for detention any reference to ‘likelihood’ or ‘may be caused’, replacing those words with language related to an individual’s risk, in order to simplify a psychiatrist’s assessment of a patient’s levels of risk.</p>

NC35

To move the following Clause—<br> <b>“Community treatment order: conditions</b><br> (1) Section 17B of the Mental Health Act 1983 (Conditions) is amended as follows.<br> (2) After subsection (7) insert—<br> “(8) The responsible clinician must ensure that a community treatment order complies with the code of practice as set out in section 118(2B) of this Act.<br> (9) A community treatment order has a maximum duration of 12 months, unless the conditions set out in subsection (10) apply.<br> (10) The responsible clinician may extend the duration of a community treatment order beyond 12 months only after the responsible clinician has—<br> (a) consulted the patient, the patient’s nominated persons, and any relevant mental healthcare professional involved in the patient’s treatment or care planning;<br> (b) undertaken a review to evaluate the ongoing necessity and therapeutic benefit of the community treatment order; and<br> (c) consulted a General Medical Council registered psychiatrist regarding the conditions of the community treatment order and obtaining their written agreement that an extension is necessary and in accordance with the principles set out in section118(2B).<br> (11) A tribunal may recommend that the responsible clinician consider whether to extend, vary, or terminate the duration and conditions of a community treatment order.<br> (12) A community treatment order with a duration of less than 12 months is not subject to the conditions set out in subsection (10).<br> (13) Where a community treatment order is extended beyond a period of 12 months, the order must be reviewed at intervals not exceeding six months from the date of the extension, in accordance with the requirements set out in subsection (10).<br> (14) At the conclusion of the initial 12 month period or of any extended period, the responsible clinician must undertake a review to assess the effectiveness of the community treatment order at complying with the code of practice set out in section 118(2B) of this Act.””

<p>This new clause would set out conditions for the extension of a community treatment order beyond 12 months, and would require such an order to comply with the Mental Health Act’s code of practice.</p>

NC36

To move the following Clause—<br> <b>“Age appropriate treatment for children</b><br> (1) Section 131A of the Mental Health Act 1983 is amended as follows.<br> (2) After subsection (1), insert—<br> “(1A) A patient to whom this section applies must not be detained in, or admitted to, an adult ward unless the managers of the hospital consider that—<br> (a) there are exceptional circumstances which justify the patient’s detention in, or admission to, an adult ward, and<br> (b) the decision is in accordance with the best interests of the child.”<br> (3) For subsection (3), substitute—<br> “(3) For the purpose of deciding how to fulfil the duty under subsection (2) above, the managers must consult—<br> (a) someone with parental responsibility for the child, unless it is not deemed in the best interests of the patient for someone with parental responsibility to be consulted; and<br> (b) a person who appears to them to have knowledge or experience of cases involving patients who have not attained the age of 18 years which makes the person suitable to be consulted.”<br> (4) After subsection (3), insert—<br> “(3A) Where a patient to whom this section applies has been detained in, or admitted to, an adult ward, the managers of the hospital must record in writing the reasons for the admission, including—<br> (a) the reason, or reasons, why other options for accommodation were not available or suitable for the patient;<br> (b) details of the measures to be taken by the hospital to ensure that, while the patient is detained or otherwise accommodated in the adult ward, the patient is provided with care in a safe environment; and<br> (c) unless it has been determined that an adult ward is the most appropriate environment for the patient in accordance with subsection (1A), the steps being taken by the hospital to transfer the patient to more appropriate accommodation.<br> (3B) Where a patient to whom this section applies is detained in, or admitted to, an adult ward, and the detention or admission is of more than 24 consecutive hours’ duration, the managers of the hospital must notify the regulatory authority and the responsible authority within 48 hours of the patient’s admission, setting out why the managers of the hospital consider that the requirements under subsection (1A) above are met and providing the information set out in subsection (3A).<br> (3C) Subsection (3E) applies when the managers of a hospital accommodate a patient to whom this section applies on an adult ward for a consecutive period of at least 28 days.<br> (3D) Subsection (3E) also applies where the managers of a hospital detain or admit a patient to whom this section applies who—<br> (a) was ordinarily resident immediately before being detained or admitted in the area of a local authority other than the local authority within whose area the hospital is situated, unless the hospital is less than 20 kilometres from the patient’s ordinary residence; or<br> (b) was not ordinarily resident within the area of any local authority.<br> (3E) Where this subsection applies, the managers of the hospital must inform the appropriate officer of the responsible local authority without delay—<br> (a) of the patient's detention or admission, and<br> (b) when the patient's detention or admission ceases.”<br> (5) Leave out subsection (4) and insert—<br> “(4) In this section—<br> “adult ward” means a ward in a hospital to which persons aged 18 or over are detained in or admitted to<br> “the appropriate officer” means—<br> (a) in relation to a local authority in England, their director of children’s services, and<br> (b) in relation to a local authority in Wales, their director of social services;<br> “hospital” includes a registered establishment; and<br> “the responsible authority” means—<br> (a) the local authority appearing to the managers of the hospital to be the authority within whose area the child was ordinarily resident immediately before being detained or admitted, or<br> (b) where it appears to the managers of the hospital that the patient was not ordinarily resident within the area of any local authority, the local authority within whose area the hospital is situated.””

<p>This amendment would restrict the circumstances in which a child can be admitted to or detained on an adult ward for treatment under the Mental Health Act 1983, require the hospital to notify the local authority when they have done so, or when they have placed a child in a ward outside their local authority, and require that the parents or legal guardians of the child have access to their child and are consulted about their admission to an adult ward.</p>

NC37

To move the following Clause—<br> <b>“Roadmap for the provision of sufficient services for autistic people and people with a learning disability</b><br> (1) Within six months of the passing of this Act, the Secretary of State must prepare and lay before Parliament a roadmap to outline the Government’s plans for ensuring sufficient community services for autistic people and people with a learning disability to facilitate the operability of section 3 of this Act.<br> (2) When developing the roadmap under subsection (1), the Secretary of State must engage with relevant stakeholders, including—<br> (a) autistic people and people with a learning disability;<br> (b) carers for autistic people and people with a learning disability;<br> (c) health and care professionals; and<br> (d) advocacy groups.<br> (3) Within twelve months of the publication of a roadmap under subsection (1) above and annually thereafter,the Secretary of State must publish a monitoring statement on progress made towards implementing the roadmap, including its targets and milestones.”

<p>This new clause would require the Government to publish a roadmap outlining its plans for ensuring sufficient community services to enable the implementation of the Act’s provisions on ending the detention of autistic people and people with a learning disability.</p>

33

Clause 1, page 1, line 19, at end insert—<br> “(2BA) The Secretary of State shall ensure that each of the following matters is addressed—<br> (a) the provision of access to advocacy services for patients who have not attained the age of 18, including patients admitted to, or who remain in, hospital in pursuance of such arrangements as are mentioned in section 131(1);<br> (b) the assessment of “competence” in relation to patients who have not attained the age of 16;<br> (c) the preparation of care and treatment plans for patients who have not attained the age of 18, including patients admitted to, or who remain in, hospital in pursuance of such arrangements as are mentioned in section 131(1);<br> (d) matters to be taken into account by an approved mental health professional when deciding who to appoint as a nominated person in circumstances in which the patient has not attained the age of 18 and paragraph 7 of Schedule 2 of this Act applies;<br> (e) steps to be taken by managers of the hospital when section 131A of this Act applies including—<br> (i) matters to be taken into account when determining whether the patient’s environment in hospital is suitable having regard to the patient’s age (including article 3(1) of the UN Convention on the Rights of the Child (“the best interests of the child”));<br> (ii) measures to be taken in cases where a patient who has not attained the age of 18 has been admitted to an environment that provides care and treatment to patients who have attained the age of 18, including—<br> (A) safeguards to ensure that the patient is provided with care in a safe environment; and<br> (B) action to be taken to ensure that the patient is transferred to a more age-appropriate environment as soon as reasonably practicable;<br> (f) matters to be taken into account when determining whether a patient who has not attained the age of 18 should be admitted to a hospital for the purpose of treatment (or assessment, or assessment followed by treatment) of mental disorder which is located in an area falling outside the local authority in which the patient was ordinarily resident, or otherwise living in, prior to such detention or admission and the safeguards to be followed if the patient is so admitted;<br> (g) an explanation of the arrangements for the commissioning and provision of community and inpatient mental health services for those who have not attained the age of 18.”

<p>This amendment inserts commitments related to children and young people which the Government made in the House of Lords into the section on principles to inform decisions on the Code of Practice.</p>

36

Clause 4, page 9, line 20, at end insert—<br> <b>“125DA Registers: reviews</b><br> (1) Each integrated care board must make arrangements for ensuring that care and treatment review meetings take place in relation to a person included in that board’s register under section 125D if either—<br> (a) the person consents to meetings taking place and to the disclosure of information in accordance with the arrangements, and to the use of the information in accordance with this Act, or<br> (b) the person lacks capacity to give that consent but the board considers that it is nonetheless in the person’s best interests for the meetings to take place, and information to be disclosed and used, as mentioned in subsection (a).<br> (2) In this section “care and treatment review meeting” means a meeting, convened by the integrated care board, for the purpose of reviewing a person’s case in order to—<br> (a) identify any needs of the person for—<br> (i) social care provision,<br> (ii) medical treatment, or<br> (iii) financial support, and<br> (b) make recommendations about—<br> (i) whether and how any such needs can be met,<br> (ii) how the person’s safety can be ensured while they are at risk of detention, and<br> (iii) how to reduce any risk of the person being detained in a hospital or registered establishment.<br> (3) The arrangements under subsection (1) must include arrangements for—<br> (a) the preparation of a report (whether by the board or another person) setting out the needs identified, and recommendations made, at each meeting, and<br> (b) the provision of a copy of the report, within the period of 14 days beginning with the day on which a meeting takes place, to each of the following persons (other than any who prepared the report)—<br> (i) the responsible commissioner,<br> (ii) the person’s responsible clinician,<br> (iii) the integrated care board, and<br> (iv) the local authority in whose area the person is ordinarily resident.<br> <span class="wrapped">(The arrangements may also include provision authorising or requiring a copy of the report to be given to other persons.)</span><br> (4) The integrated care board shall arrange appropriate provision within 28 days of receipt of a report under subsection (3) to address any needs identified and recommendations made.<br> (5) The arrangements under subsection (1) must include arrangements for ensuring that—<br> (a) the first meeting in relation to the person takes place within the period of 28 days from their inclusion in the register under section 125D, and<br> (b) a further meeting takes place at least once in each successive period of 24 months for which the person remains on the register, beginning with the day on which the first meeting takes place.<br> (6) A person may withdraw consent to the taking place of meetings and to the disclosure of information in accordance with arrangements under subsection (1).<br> (7) The arrangements under subsection (1) must include provision about—<br> (a) how consent to the taking place of meetings or the disclosure of information may be withdrawn;<br> (b) what is to happen when consent is withdrawn (which may include provision about who is to be informed).”

<p>This amendment replicates the provisions for care and treatment reviews for patients under sections 125A and 125B but for people with autism and learning disabilities who are at risk of detention, in order to identify needs and ensure that those needs can be met without detaining them.</p>

37

Clause 4, page 9, line 26, after “125D(3)(c)” insert “and 125DA(3)”.

43

Page 11, line 15, leave out Clause 5

44

Clause 6, page 12, leave out lines 26 to 29 and insert—<br> “(b) there is a risk of serious harm to the health or safety of the patient or of another person unless the patient receives medical treatment,”

<p>This amendment is linked to NC34</p>

45

Clause 6, page 12, line 29, for “degree and likelihood” substitute “or degree”

<p>This amendment is linked to NC34</p>

40

Clause 21, page 29, line 30, at end insert—<br> “(c) containing an assessment of the levels of risk to public safety posed by the patient in the community.”

<p>This amendment would require consideration to be given to public safety in care and treatment plans.</p>

39

Clause 21, page 30, line 26, at end insert—<br> “(vii) for a relevant patient who has not yet reached the age of 18, the parents or legal guardians of the relevant patient, unless that is not deemed in the best interests of the patient.<br> (5A) Any care plan prepared under this section, if prepared for a relevant patient who has not yet reached the age of 18, must include provision for the parents or legal guardians of the patient to be directly involved in the care and treatment of the relevant patient, unless such involvement is not in the best interests of the patient.<br> (5B) For the purposes of subsection (5A), the parents or legal guardians must be given regular access to the relevant patient through attendance on the hospital ward.”

<p>This amendment would require a practitioner to consult the parents or legal guardians of a child patient when preparing the patient’s care and treatment plan, require parental involvement in patient care through the plan, and enable those parents (or guardians) regular access to the patient on the hospital ward.</p>

34

Page 64, line 34, leave out Clause 51

<p>This amendment omits Clause 51. It is no longer necessary because of the general data protection override in section 183A of the Data Protection Act 2018, which was inserted by section 106(2) of the Data (Use and Access) Act 2025 and came into force on 20 August 2025.</p>

35

Schedule 2, page 76, line 37, leave out from “patient”” to end of line 38 and insert “means—<br> (a) a person by whom a nominated person is appointed under Part 1 of Schedule A1, or<br> (b) a person for whom a nominated person is appointed under Part 2 of that Schedule.”

<p>This amendment corrects the definition of “patient” in new section 30B(7) (which inadvertently goes too wide since in certain cases it would cover an approved mental health professional).</p>

41

Schedule 2, page 77, line 21, at end insert—<br> “(3) Where the patient has not yet reached the age of 16 (the “child patient”), the nominated person must be a person with parental responsibility for the child patient, unless the factors set out in sub-paragraph (4) below apply.<br> (4) A person who has parental responsibility for a patient under the age of 16 (‘the parent’) must not be the nominated person if—<br> (a) the parent is subject to a prohibited steps order under section 8 of the Children Act 1989;<br> (b) a local authority is taking action under section 47(8) of the Children Act 1989 to safeguard the child patient or otherwise protect the child patient’s welfare due to concerns about the parent; or<br> (c) the local authority has made enquiries under section 47(1) of the Children Act 1989 and concluded that the child patient is suffering, or is likely to suffer, harm at the hands of the parent (within the meaning of section 31(9) and (10) of that Act).”

<p>This amendment would stipulate that the nominated person for a patient under the age of 16 must have parental responsibility for the patient, unless there are safeguarding concerns.</p>

42

Schedule 2, page 80, line 13, after “2(2))” insert “, has parental responsibility for the patient, subject to conditions (see paragraphs 2(3) and 2(4)),”

<p>This amendment is connected to Amendment 41; it would stipulate that the nominated person for a patient under 16 must have parental responsibility for the patient, unless there are safeguarding concerns about that parent.</p>

NC25

★ To move the following Clause— "Determination of competency for persons under 16 (1) For the purposes of this Act, a person aged under 16 (referred to in this section as a child) is able to make a relevant decision if they can— (a) understand the information relevant to the decision; (b) retain that information; (c) use or weigh that information as part of the process of making a decision; and (d) communicate their decisions (whether by talking, using sign language or any other means).(4) A person determining a child's ability to make a relevant decision under this section must- (a) have due regard to Article 12 of the United Nations Convention on the Rights of the Child, and (b) be able to show reasonable grounds for their belief that the child is or is not able to make a relevant decision.

Gov 34

★ Page 64, line 34, leave out Clause 51

Gov 35

★ Schedule 2, page 76, line 37, leave out from “patient”” to end of line 38 and insert "means— (a) a person by whom a nominated person is appointed under Part 1 of Schedule A1, or (b) a person for whom a nominated person is appointed under Part 2 of that Schedule."

NC24

To move the following Clause— “Report: Mental health services for children and young people (1) The Secretary of State must, within 18 months of passing of this Act, prepare and lay before Parliament a report on the provision of specialist mental health services for patients aged under 18. (2) The report under subsection (1) must include an assessment of- (a) the number of patients aged under 18 receiving specialist mental health services; (b) the availability of specialist mental health services based outside of hospital settings; (c) any gaps in care and support experienced by patients aged under 18; (d) the Secretary of State's conclusions as to whether there are sufficient resources to deliver mental health services for patients aged under 18; (e) the views of children, young people and families with experience of receiving specialist mental health services. (3) For the purpose of this section- (a) "specialist mental health services for patients aged under 18" means— (i) inpatient mental health services specifically designed for individuals aged under 18 years, including specialist eating disorder services; (ii) community-based mental health services specifically designed for individuals aged under 18 years as an alternative to inpatient care. (b) "resources to deliver mental health services” include- (i) finances; (ii) appropriate trained medical professionals; (iii) appropriate facilities for patient care.”

33

Clause 1, page 1, line 19, at end insert— "(2BA) The Secretary of State shall ensure that each of the following matters is addressed- (a) the provision of access to advocacy services for patients who have not attained the age of 18, including patients admitted to, or who remain in, hospital in pursuance of such arrangements as are mentioned in section 131(1); (b) the assessment of “competence” in relation to patients who have not attained the age of 16; (c) the preparation of care and treatment plans for patients who have not attained the age of 18, including patients admitted to, or who remain in, hospital in pursuance of such arrangements as are mentioned in section 131(1)); (d) matters to be taken into account by an approved mental health professional when deciding who to appoint as a nominated person in circumstances in which the patient has not attained the age of 18 and paragraph 7 of Schedule 2 of this Act applies; (e) steps to be taken by managers of the hospital when section 131A of this Act applies including- (i) matters to be taken into account when determining whether the patient's environment in hospital is suitable having regard to the patient's age (including article 3(1) of the UN Convention on the Rights of the Child (“the best interests of the child")); (ii) measures to be taken in cases where a patient who has not attained the age of 18 has been admitted to an environment that provides care and treatment to patients who have attained the age of 18, including- (A) safeguards to ensure that the patient is provided with care in a safe environment; and (B) action to be taken to ensure that the patient is transferred to a more age-appropriate environment as soon as reasonably practicable; (f) matters to be taken into account when determining whether a patient who has not attained the age of 18 should be admitted to a hospital for the purpose of treatment (or assessment, or assessment followed by treatment) of mental disorder which is located in an area falling outside the local authority in which the patient was ordinarily resident, or otherwise living in, prior to such detention or admission and the safeguards to be followed if the patient is so admitted; (g) an explanation of the arrangements for the commissioning and provision of community and inpatient mental health services for those who have not attained the age of 18.”

NC22

To move the following Clause—<br> <b>“Veterans’ Mental Health Oversight Officer</b><br> After section 142B of the Mental Health Act 1983 insert—<br> <i class="text-centre">“Veterans’ Mental Health Oversight Officer</i><br> <b>142C</b> <b>Veterans’ Mental Health Oversight Officer: establishment</b><br> (1) The Secretary of State shall appoint a Veterans’ Mental Health Oversight Officer ("the Officer") to oversee the treatment and care of veterans under this Act.<br> (2) The Officer shall—<br> (a) oversee the cases of veterans who are—<br> (i) at risk of detention under this Act;<br> (ii) currently detained under this Act; or<br> (iii) following detention under this Act, subject to community or outpatient treatment or other post-discharge mental health provisions;<br> (b) advocate for mental health assessments and care tailored to veterans' service-related experiences;<br> (c) collaborate with mental health professionals, veterans' services, legal representatives, and third-sector organisations to safeguard veterans' rights and well-being within relevant treatment settings;<br> (d) promote diversion from detention where clinically appropriate, including the use of veteran-specific support services; and<br> (e) submit an annual report to Parliament detailing—<br> (i) detention rates of veterans under this Act;<br> (ii) outcomes and recidivism rates for veterans detained under this Act;<br> (iii) recommendations for service improvement.<br> (3) In this section—<br> “veteran” refers to a person who has served or currently serves in the armed forces of the United Kingdom or a Commonwealth nation;<br> “relevant health authority” includes NHS England, regional NHS boards, or their successors.””

<p>This new clause introduces a dedicated oversight role for veterans within the framework of the Mental Health Bill, recognising that service personnel have unique needs and experiences that need to be considered in mental health care and detention decisions.</p>

NC23

To move the following Clause—<br> <b>“Mental Health Act: interim support for a child or adolescent at risk of detention</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) After section 33, insert—<br> <b>“33A</b> <b>Interim support for child and adolescent patients</b><br> (1) Where a child or young person (“P”) is referred to Child and Adolescent Mental Health Services and—<br> (a) P has not yet attended their first appointment, and<br> (b) P is at risk of detention under this Part, in the opinion of a family member or close associate,<br> <span class="wrapped">the responsible authority must ensure that interim support is available.</span><br> (2) Interim support under this section must include at least one of—<br> (a) regular contact with a family support worker;<br> (b) access to GP appointments;<br> (c) regular contact with a school nurse or equivalent healthcare professional; or<br> (d) access to a peer support group, youth group, or youth club offering appropriate emotional support.””

<p>This new clause would ensure adequate interim support for children at risk of detention under Part II the Mental Health Act while awaiting an appointment with Child and Adolescent Mental Health Services (CAMHS).</p>

32

Clause 45, page 58, line 2, at end insert—<br> “(2A) After subsection (3), insert—<br> “(3ZA) After-care provision under subsection (3) above may include, for patients who have not yet reached the age of 16, appropriate Early Help services in the community.””

<p>This amendment would ensure that, when a tribunal is discharging a child who has experienced a mental health crisis, the tribunal may recommend that they are referred to appropriate Early Help services as part of their after-care planning.</p>

29

Clause 46, page 59, line 10, at end insert—<br> “(4) After subsection (6), insert—<br> “(6A) After-care services under this section may include provision for authorised community pharmacies to dispense emergency and ongoing medication in line with after-care plans.<br> (6B) Community pharmacies providing services under subsection (6A) must be—<br> (a) given access to suitable training and resources;<br> (b) integrated into the local primary care team, with appropriate access to prescribing professionals and multidisciplinary support; and<br> (c) given appropriate remuneration and reimbursement for providing after-care services.<br> (6C) Responsible bodies must carry out due diligence of any pharmacy operator before authorising them to provide after-care services under this section.<br> (6D) Due diligence checks under subsection (6C) must include ensuring that—<br> (a) the operator is not in significant arrears in respect of staff wages, supplier payments or other financial obligations;<br> (b) the operator can demonstrate the financial capacity to sustain additional locations without compromising existing services; and<br> (c) the operator has an established record of compliance with relevant regulatory and contractual requirements.<br> (6E) Where due diligence checks under subsections (6C) and (6D) determine that a pharmacy operator is failing in its existing financial obligations, the pharmacy operator must not be authorised to take on new after-care service locations.””

<p>This amendment would allow community pharmacies to be reimbursed for dispensing medication under the aftercare provisions of the Mental Health Act 1983, and would ensure that they have access to relevant training, that they are integrated into the primary care team, and that the responsible body carries out due diligence checks on their financial health.</p>

30

Clause 46, page 59, line 10, at end insert—<br> “(4) After subsection (6), insert—<br> “(6A) After-care services provided under this section must include the availability of family support workers.””

<p>This amendment would require the provision of family support workers as part of the after-care provisions under the Mental Health Act 1983.</p>

31

Clause 46, page 59, line 10, at end insert—<br> “(4) After subsection (6), insert—<br> “(6A) When determining the adequacy of after-care services for a specific patient, responsible bodies must take into account—<br> (a) whether the patient lives in a rural or urban area;<br> (b) associated travel times between the patient’s residence and after-care services;<br> (c) the patient’s levels of contact with others in their community; and<br> (d) the views of local transport authorities and operators and relevant community transport or volunteer groups on levels of accessibility to after-care services.<br> (6B) The responsible body must ensure the provision of outreach or visiting services to isolated individuals eligible for after-care under this section, including to those in remote or agricultural areas.””

<p>This amendment would ensure that the needs of individuals living in rural areas are accounted for when providing after-care services under the Mental Health Act 1983, and that local transport operators are consulted on how easy it is to access these services.</p>

NC21

To move the following Clause—<br> <b>“Assessment for admission: clinicians with outstanding complaints</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In Part II (Compulsory Admission to Hospital and Guardianship), after section 6 insert—<br> <b>“6a</b> <b>Assessment for admission: clinicians under investigation</b><br> (1) For the purposes of the written recommendations required under sections 2(3) or and 3(3) of this Act, a recommendation may not be made by a medical practitioner who is, at the time of the assessment or written statement—<br> (a) under investigation by the General Medical Council or the hospital due to concerns relating to the medical practitioner’s care of the patient being assessed; or<br> (b) subject to a complaint to the General Medical Council or the hospital by the patient or the patient’s close associates.<br> (2) The Secretary of State may by regulations make further provision under this section.””

<p>This new clause would prevent a patient from being assessed to be detained by a doctor under investigation by the GMC or hospital trust, or subject to a complaint, in relation to their care of that patient.</p>

NC20

To move the following Clause—<br> <b>“Duty to establish carer liaison service for discharge</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In Part X (Miscellaneous and Supplementary), after section 133 insert—<br> <b>“133A</b> <b>Duty to establish carer liaison service for discharge</b><br> (1) The managers of every hospital providing services under this Act must establish and maintain a dedicated carer liaison service.<br> (2) A service established under this section must provide—<br> (a) support to unpaid carers when a patient for whom they provide care is discharged from a hospital where they had been receiving treatment under this Act;<br> (b) timely and accessible information regarding the discharge of the patient they care for, including details of—<br> (i) the patient's discharge plan; and<br> (ii) aftercare arrangements under section 117 of this Act;<br> (c) support for unpaid carers to identify their own needs and connect to relevant local services for post-discharge support, including local authority adult social care services, general practitioners, and local carers' centres;<br> (d) facilitation of effective communication and collaboration between unpaid carers and the patient's multidisciplinary clinical team regarding the discharge process;<br> (e) assistance to unpaid carers in developing or updating a carer's support plan in the context of the patient's discharge, including guidance on—<br> (i) their rights at work;<br> (ii) available counselling services;<br> (iii) support in planning for emergencies in relation to the patient;<br> (iv) benefits for the carer and patient; and<br> (v) other forms of local support; and<br> (f) services to ensure that the perspective of the unpaid carer, as a key provider of support, is considered during discharge planning, where appropriate and with due regard to patient confidentiality and consent.<br> (3) The Secretary of State may issue guidance under this section about the establishment and operation of services under this section, and hospital managers must have regard to this guidance.””

<p>This new clause would require hospitals to establish a dedicated liaison service for the carers of patients detained under the Mental Health Act.</p>

None

Clause 21, page 30, line 26, at end insert- "(g) following the patient turning 18 years of age during the course of a care and treatment plan."

25

Clause 4, page 10, line 5, at end insert—<br> <b>“125FA</b> <b>Assessment: provision of services for autistic people and people with a learning disability</b><br> (1) Each financial year, an integrated care board must—<br> (a) conduct an assessment of the availability and adequacy of services within its area for autistic people and people with a learning disability who have specified risk factors for detention under Part 2 of this Act;<br> (b) publish the results of the assessment; and<br> (c) publish an action plan to address any gaps in provision identified.<br> (2) The assessment under subsection (1) must include consideration of—<br> (a) the availability of appropriate crisis accommodation;<br> (b) the availability of appropriate community support services;<br> (c) the adequacy of training for responsible bodies and individuals to carry out support, diagnostic and treatment plans; and<br> (d) the experiences of autistic people and people with a learning disability who have specified risk factors for detention under Part 2 of this Act and their families or carers.<br> (3) The integrated care board must consult the following in conducting the assessment—<br> (a) autistic people and people with a learning disability who have specified risk factors for detention under Part 2 of this Act and their families or carers;<br> (b) the relevant local authority or authorities;<br> (c) providers of relevant services; and<br> (d) such other persons as the integrated care board considers appropriate.<br> (4) The Secretary of State must issue guidance about the conduct of assessments under this section, and integrated care boards must have regard to this guidance.”

<p>This amendment would require integrated care boards to conduct and publish annual assessments of the provision available for autistic people and people with learning disability at risk of detention and to prepare action plans to address any identified gaps.</p>

26

Clause 4, page 10, line 5, at end insert—<br> <b>“125FA</b> <b>Report: services for autistic people and people with a learning disability</b><br> (1) The Secretary of State must, within 12 months of this section coming into force and annually thereafter, prepare and lay before Parliament a report on—<br> (a) the availability of appropriate accommodation for autistic people and people with a learning disability detained under this Act;<br> (b) the number of instances where appropriate accommodation could not be found within statutory timeframes;<br> (c) the progress towards implementation of sections 3 and 4 of the Mental Health Act 2025 and the impact of any delays to implementation on autistic people and people with a learning disability; and<br> (d) progress made towards meeting the needs of autistic people and people with a learning disability without detaining them under Part 2 of this Act.<br> (2) In preparing the report, the Secretary of State must consult—<br> (a) autistic people and people with a learning disability who have specified risk factors for detention under Part 2 of this Act and their families or carers;<br> (b) integrated care boards;<br> (c) local authorities; and<br> (d) such other persons as the Secretary of State considers appropriate.”

<p>This amendment would require the Secretary of State to report annually to Parliament on the availability of appropriate placements for autistic people and people with learning disability and on progress implementing the relevant provisions of the Act.</p>

28

Clause 4, page 10, line 5, at end insert—<br> <b>“125FA</b> <b>Training standards</b><br> (1) The Secretary of State must by regulations make provision about training standards for responsible bodies and individuals working with autistic people and people with a learning disability in—<br> (a) mental health hospitals;<br> (b) places of safety designated under sections 135 or 136 of this Act;<br> (c) crisis accommodation; and<br> (d) such other settings as the Secretary of State considers appropriate.<br> (2) Regulations under subsection (1) must—<br> (a) specify minimum training requirements;<br> (b) require training to be co-produced with autistic people and people with learning disability and their families or carers;<br> (c) require regular refresher training; and<br> (d) include training on de-escalation techniques and alternatives to restraint.<br> (3) The Secretary of State must publish guidance about the standards set out in regulations under subsection (1).<br> (4) A statutory instrument containing regulations under this section is subject to annulment in pursuance of a resolution of either House of Parliament.”

<p>This amendment would require the Secretary of State to produce guidance on minimum training standards for staff working with autistic people and people with learning disability in mental health settings and require that training be co-produced with people with lived experience and their families.</p>

27

Clause 21, page 30, line 41, at end insert—<br> “(4A) Where a patient has autism or a learning disability, the care and treatment plan must—<br> (a) identify specific crisis prevention strategies appropriate to the patient's individual needs;<br> (b) identify suitable crisis accommodation options in the event that the patient's current placement becomes unable to meet their needs;<br> (c) specify how the patient's sensory needs will be met;<br> (d) specify communication approaches appropriate to the patient's needs; and<br> (e) record the views of the patient's family members or carers, where appropriate and with the patient's consent.”

<p>This amendment would ensure that care and treatment plans for patients with autism or learning disabilities include specific components addressing their particular needs, including crisis prevention strategies and identification of suitable crisis accommodation options.</p>

24

Clause 4, page 9, line 38, at end insert—<br> <b>“125ZF</b> <b>Crisis accommodation: duty to assess and provide</b><br> (1) In exercising its functions under section 125E, an integrated care board must assess the need for appropriate crisis accommodation for autistic people and people with a learning disability within its area.<br> (2) Where such need is identified under subsection (1), the integrated care board must ensure appropriate crisis accommodation is available, either—<br> (a) within its area, or<br> (b) through arrangements with other integrated care boards for regional provision.<br> (3) For the purposes of this section, "appropriate crisis accommodation" means accommodation which—<br> (a) is designed to meet the specific needs of autistic people and people with learning disability during periods of acute mental health crisis;<br> (b) is staffed by persons with specialist training in supporting autistic people and people with learning disability;<br> (c) provides a safe alternative to detention under section 136 of this Act;<br> (d) is developed through co-production with autistic people and people with learning disability.<br> (4) The Secretary of State must issue guidance about the assessment of need and provision of crisis accommodation under this section.”

<p>This amendment requires ICBs to assess need and ensure provision of appropriate crisis accommodation, either locally or regionally, designed specifically for autistic people and people with learning disability in crisis.</p>

17

Clause 18, page 26, line 22, at end insert—<br> “(1A) Regulations under subsection (1) may only be made to provide for circumstances where—<br> (a) the treatment is immediately necessary to save the patient’s life,<br> (b) obtaining a second opinion would cause a delay that places the patient at a significant and imminent risk of death or serious physical harm, and<br> (c) the treatment is reversible.”

<p>The amendment limits the power to dispense with a second medical opinion for urgent electro-convulsive therapy to exceptional, life-threatening cases, introduces periodic reviews of its use, and ensures transparency by prohibiting retrospective application.</p>

1

Clause 21, page 29, line 41, at end insert—<br> “(4A) For the purposes of preparing a plan under this section, a discharge planning meeting must be held.<br> (4B) A meeting under subsection (4A) must include—<br> (a) the patient;<br> (b) the patient’s nominated person;<br> (c) any independent mental health advocate acting for the patient;<br> (d) a representative of the integrated care board;<br> (e) a local housing officer;<br> (f) a local authority social worker;<br> (g) a representative from the Department for Work and Pensions; and<br> (h) any other person or agency involved in the patient’s care or likely to support recovery in the community.<br> (4C) A care and treatment plan under this section must include—<br> (a) actions agreed by relevant agencies to support the patient’s recovery;<br> (b) provisions to address clinical, financial, housing, and social needs;<br> (c) steps to reduce the likelihood of readmission or further detention under this Act; and<br> (d) a record of any points of disagreement and how they are to be resolved.<br> (4D) Where an agency listed under subsection (4B) fails to attend a discharge planning meeting, the responsible clinician must take reasonable steps to obtain their input in writing and record it in the plan.<br> (4E) For the purposes of subsections (4A) to (4D), the Secretary of State must issue guidance on best practice for discharge planning meetings and multi-agency collaboration.”

<p>This amendment would require the clinician preparing a care and treatment plan to hold a multi-agency planning meeting to inform it, and specifies what must be included within the plan.</p>

NC2

To move the following Clause—<br> <b>“National strategy on mental health units</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In Part VIII (Miscellaneous Functions of Local Authorities and the Secretary of State), after section 118 insert—<br> <b>“118A</b> <b>National strategy on mental health units</b><br> (1) The Secretary of State must, within 12 months of the passing of the Mental Health Act 2025, publish a national strategy to set out how the Government will ensure that all relevant mental health units meet or exceed “good” safety standards as assessed by the Care Quality Commission (CQC).<br> (2) A strategy issued under this section must address the following matters—<br> (a) recruitment, retention and training of mental health staff,<br> (b) patient-to-staff ratios, and<br> (c) safe staffing levels during crises and night shifts.<br> (3) Following publication of the strategy, a report on implementation progress must be laid before Parliament annually.<br> (4) For the purposes of this section, a “relevant mental health unit” is a facility used for treatment under this Act.””

<p>This new clause would require the Secretary of State to publish a strategy, followed by an annual progress report, on how the Government will ensure that all mental health units used for treatment under the Mental Health Act 1983 are rated “good” or above by the CQC.</p>

NC3

To move the following Clause—<br> <b>“Impact assessment: children and young people in temporary foster care</b><br> (1) The Secretary of State must, within 18 months of the passing of this Act, publish and lay before Parliament an impact assessment on the impact of this Act on children and young people who are in temporary foster care.<br> (2) The impact assessment under this section must consider—<br> (a) whether the ordinary residence provisions result in delays or inequities in accessing treatment or after-care under this Act;<br> (b) the effect of transitions between placements on continuity of treatment under this Act; and<br> (c) any unintended consequences for children and young people in temporary foster care arising from the application of subsections (3) to (5) of section 125G of the Mental Health Act 1983.”

<p>This new clause would require the Government to publish an impact assessment on the impact of this Act on children and young people in temporary foster care.</p>

NC4

To move the following Clause—<br> <b>“Adequacy of accommodation: review</b><br> (1) The Mental Health Bill 1983 is amended as follows.<br> (2) After Section 131A (Accommodation etc. for children) insert—<br> <b>“131B</b> <b>Adequacy of accommodation</b><br> (1) The Secretary of State must, within 12 months of the passage of the Mental Health Act 2025, publish a review of the quality of accommodation for any patient who is—<br> (a) liable to be detained in a hospital under this Act;<br> (b) admitted to, or remains in, a hospital in pursuance of such arrangements as are mentioned in section 131(1) above.<br> (2) The Secretary of State must, within six months of the publication of the review under subsection (1), publish a strategy to implement the recommendations of that review.””

<p>This new clause would require a review of the quality of accommodation for people detained or admitted to hospital under the Mental Health Act 1983 and require the Secretary of State to publish a strategy to implement the recommendations of this review.</p>

NC5

To move the following Clause—<br> <b>“Review of impact of this Act on detention</b><br> (1) The Secretary of State must, within a period of 12 months following the day on which this Act is passed, commission an independent review into the impact of relevant provisions on reducing the number of people detained under Part 2 of the Mental Health Act 1983.<br> (2) In subsection (1), “relevant provisions” include—<br> (a) sections 4, 5 and 6,<br> (b) section 8,<br> (c) section 21, and<br> (d) sections 46 and 47.<br> (3) The Secretary of State must, within 12 months of the publication of the review in subsection (1), publish a strategy to implement the recommendations of that review.”

<p>This new clause would require the Secretary of State to commission a review into the impact of relevant provisions in the Act in reducing the number of people detained, in particular the provisions relating to people with autism or a learning disability, on grounds for detention and for community treatment orders, medical treatment, care and treatment plans, and on after-care, and to implement any recommendations within 12 months of the publication of the review.</p>

NC6

To move the following Clause—<br> <b>“Transfer of patients: out of area placements</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) After section 19 (transfer of patients), insert— <br> <b>“19A</b> <b>Transfer of patients: out of area placements</b><br> (1) The Secretary of State must reduce to zero, within five years of the passage of the Mental Health Act 2025, the number of patients transferred to a hospital outside of the area in which the patient is ordinarily resident.<br> (2) The Secretary of State must publish, within six months of the passage of the Mental Health Act 2025, a report to outline how the duty under this section will be met, including how provision for treatment under this Act will be increased.””

<p>This new clause would require the transfer of patients to hospitals outside of their area to be reduced to zero within 5 years, and for the Secretary of State to produce a report on how this will be achieved.</p>

NC7

To move the following Clause—<br> <b>“Children detained on adult wards</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) After section 131A (Accommodation, etc. for children), insert—<br> <b>“131B</b> <b>Children detained on adult wards</b><br> (1) The Secretary of State must reduce to zero, within five years of the passage of the Mental Health Act 2025, the number of children detained on adult wards.<br> (2) The Secretary of State must publish, within six months of the passage of the Mental Health Act 2025, a report to outline how the duty under this section will be met, including how provision for treatment under this Act will be increased.””

<p>This new clause would require the number of children detained on adult wards to be reduced to zero within 5 years, and for the Secretary of State to produce a report on how this will be achieved.</p>

NC8

To move the following Clause—<br> <b>“Report on the impact of this Act on patients with eating disorders</b><br> (1) Within a period of 12 months following the day on which this Act is passed, the Secretary of State must publish a report on the impact of relevant provisions in this Act on patients with eating disorders.<br> (2) In subsection (1), “relevant provisions” include—<br> (a) section 5 (Grounds for detention),<br> (b) section 11 (Making treatment decisions),<br> (c) section 17 (Urgent treatment to alleviate serious suffering),<br> (d) section 21 (Care and treatment plans), and<br> (e) section 47 (After-care services).”

<p>This new clause would require the Secretary of State to report on the impact of this Bill on patients with eating disorders within 12 months of the passage of this Bill.</p>

NC9

To move the following Clause—<br> <b>“Report and Guidance: Improving Outcomes for LGBT Patients</b><br> (1) The Secretary of State must, within 12 months of the day on which this Act is passed, prepare and lay before Parliament a report on the mental health outcomes of patients who are treated under the Mental Health Act 1983 and who identify as lesbian, gay, bisexual, or transgender (LGBT).<br> (2) The report under subsection (1) must include an assessment of—<br> (a) any differences between non-LGBT patients and LGBT patients in—<br> (i) the extent of the use of detention measures under the Mental Health Act 1983; and<br> (ii) treatment outcomes following detention, and<br> (b) the availability and accessibility of "culturally competent" mental health treatment under the 1983 Act for LGBT patients.<br> (3) Following publication of the report under subsection (1), the Secretary of State must publish guidance for responsible bodies and individuals working with patients under the Mental Health Act 1983, including but not limited to those working in—<br> (a) mental health hospitals;<br> (b) places of safety;<br> (c) crisis accommodation; and<br> (d) relevant community mental health services.<br> (4) The guidance under subsection (3) must include—<br> (a) provisions about updated training standards for staff regarding the specific mental health needs and experiences of LGBT individuals, including training on non-discriminatory practice and inclusive communication approaches;<br> (b) steps to improve safety for LGBT patients in relevant mental health settings, with particular regard to addressing discrimination and harassment; and<br> (c) a definition of “cultural competent mental health treatment” for the purposes of subsection (2).<br> (5) Responsible bodies and individuals working with patients under the Mental Health Act 1983 must have regard to guidance published under subsection (3).<br> (6) In preparing the report under subsection (1) and the guidance under subsection (3), the Secretary of State must consult—<br> (a) patients with a mental disorder who identify as LGBT;<br> (b) the families or carers of patients with a mental disorder who identify as LGBT;<br> (c) relevant professional bodies;<br> (d) integrated care boards;<br> (e) local authorities;<br> (f) providers of mental health treatment; and<br> (g) such other persons as the Secretary of State considers appropriate.<br> (7) The Secretary of State must update the guidance under subsection (3) at regular intervals, and no less frequently than every three years.”

<p>This new clause would require the Secretary of State to report on mental health outcomes and disparities for LGBT patients in treatment under the Mental Health Act 1983 and publish guidance covering training and safety for this specific group.</p>

NC10

To move the following Clause—<br> <b>“Report and Guidance: Transition to Adult Mental Health Treatment</b><br> (1) The Secretary of State must, within 18 months of passing of this Act, prepare and lay before Parliament a report on improving provision for patients transitioning from treatment in a hospital environment for children and young people to one for adults when they attain the age of 18.<br> (2) The report under subsection (1) must include an assessment of—<br> (a) the current pathways and outcomes for young people transitioning between hospital environments for children and for adults;<br> (b) any gaps in care or support experienced by patients during this transition;<br> (c) best practices for ensuring safe and effective transitions.<br> (3) Following the report under subsection (1), the Secretary of State must publish guidance for integrated care boards, local authorities, and providers of mental health treatment on improving outcomes and ensuring continuity of care for patients transitioning to a hospital environment for adults.<br> (4) The guidance under subsection (3) must include—<br> (a) specific steps to guarantee continuity of care for patients transitioning between treatment in a hospital environment for children and young people and one for adults;<br> (b) measures to identify young people requiring transition support at an appropriate stage;<br> (c) provisions for joint working and information sharing between providers of treatment for children and young people and for adults;<br> (d) requirements for the review and updating of care and treatment plans to reflect the needs of patients transitioning to a hospital environment for adults.<br> (5) Integrated care boards, local authorities, and providers of mental health treatment must have regard to guidance published under subsection (3).<br> (6) In preparing the report under subsection (1) and the guidance under subsection (3), the Secretary of State must consult—<br> (a) young people with experience of transitioning between children and young people’s and adult mental health services, and their carers and guardians;<br> (b) relevant professional bodies;<br> (c) integrated care boards;<br> (d) local authorities;<br> (e) providers of mental health treatment;<br> (f) such other persons as the Secretary of State considers appropriate.<br> (7) The Secretary of State must update the guidance under subsection (3) at regular intervals, and no less frequently than every three years.”

<p>This new clause would require the Secretary of State to review and report on the transition of patients from children's to adult mental health settings for treatment at age 18 and publish guidance for relevant bodies on improving provision and ensuring continuity of care during this transition.</p>

NC11

To move the following Clause—<br> <b>“Reporting: racial disparities relating to community treatment orders</b><br> (1) Within a period of 12 months following the day on which this Act is passed, the Secretary of State must undertake a review of racial disparities which relate to the use and administering of community treatment orders.<br> (2) The review under subsection (1) must include, but is not limited to—<br> (a) an assessment of whether certain racial or ethnic groups are disproportionately represented among individuals subject to community treatment orders compared to their representation in the general population;<br> (b) a review of the outcomes and effectiveness of community treatment orders across different racial groups, including health outcomes, and patient experiences.<br> (3) The Secretary of State must lay a report of the findings of the review before Parliament within 18 months of the day on which this Act is passed.”

<p>This new clause seeks to gauge the Government’s view on prevalent racial disparities as they relate to the use of community treatment orders under the Act.</p>

NC12

To move the following Clause—<br> <b>“Mental Health Crisis Breathing Space</b><br> (1) Any person detained under sections 3, 37, 41 or 47 of the Mental Health Act 1983 must be offered support from the mental health crisis breathing space debt respite scheme.”

<p>This new clause ensures that MHCBS, a debt respite scheme, is offered and available to patients detained under sections 3, 37, 41 and 47 of the Mental Health Act 1983.</p>

NC13

To move the following Clause—<br> <b>“Addressing and reporting on racial disparities and other inequalities in the use of the Mental Health Act 1983</b><br> After section 120D of the Mental Health Act 1983, insert—<br> <b>“120E</b> <b>Mental health units and services to have a responsible person</b><br> (1) A relevant health organisation that operates a mental health unit or community mental health service for qualifying patients must appoint a responsible person for that unit or service for the purposes of addressing racial disparities and other disparities based on protected characteristics related to functions discharged under the Mental Health Act 1983.<br> (2) The responsible person must—<br> (a) be employed by the relevant health organisation, and<br> (b) be of an appropriate level of seniority.<br> (3) Where a relevant health organisation operates more than one mental health unit or service, that organisation must appoint a single responsible person in relation to all of the mental health units or services operated by that organisation.<br> (4) A patient is a qualifying patient if they are—<br> (a) liable to be detained under this Act, otherwise than by virtue of section 4 or 5(2) or (4) or section 135 or 136;<br> (b) subject to guardianship under this Act;<br> (c) a community patient.<br> <b>120F</b> <b>Policy on racial disparities and other disparities based on protected characteristics</b><br> (1) The responsible person must publish a policy on how the unit plans to reduce racial disparities and other disparities based on protected characteristics in that unit or service.<br> (2) The policy published under subsection (1) must cover the following topics—<br> (a) the application of the guiding principles to all aspects of operation of this Act;<br> (b) staff knowledge and competence in connection with promoting equality and anti-discriminatory practice in relation to this Act;<br> (c) workforce demographics, recruitment, retention and progression;<br> (d) implementation of the patient and carer race equality framework (England only) and any other requirements of relevant national policies;<br> (e) care planning and decision-making in the use of this Act including section 56A (making treatment decisions);<br> (f) the availability of alternatives to detention and involuntary treatment;<br> (g) take-up of independent mental health advocacy;<br> (h) the cultural appropriateness of independent mental health advocacy;<br> (i) access to and use of advance choice documents;<br> (j) what steps will be taken to reduce racial disparities and other disparities based on protected characteristics in that unit or service.<br> (3) Where a responsible person is appointed in relation to all of the mental health units operated by a relevant health organisation, the responsible person must publish a single policy under subsection (1) in relation to those units or services.<br> (4) Before publishing a policy under subsection (1), the responsible person must—<br> (a) consult any persons that the responsible person considers appropriate;<br> (b) have regard to the following matters—<br> (i) the views, wishes and feelings of people from ethnic minority communities who have been detained;<br> (ii) the views, wishes and feelings of people with other protected characteristics who have been detained.<br> (5) The responsible person must keep under review any policy published under this section.<br> (6) The responsible person may from time to time revise any policy published under this section and, if this is done, must publish the policy as revised.<br> (7) If the responsible person considers that any revisions would amount to a substantial change in the policy, the responsible person must consult any persons that the responsible person considers appropriate before publishing the revised policy.<br> <b>120G</b> <b>Training in racial disparities and other disparities based on protected characteristics</b><br> (1) The responsible person for each mental health unit or service must provide training for staff that relates to addressing racial disparities and other disparities based on protected characteristics in that unit or service.<br> (2) The training provided under subsection (1) must include training on the topics covered in section 120F(2).<br> (3) Subject to subsection (4), training must be provided—<br> (a) in the case of a person who is a member of staff when this section comes into force, as soon as reasonably practicable after this section comes into force, or<br> (b) in the case of a person who becomes a member of staff after this section comes into force, as soon as reasonably practicable after they become a member of staff.<br> (4) Subsection (3) does not apply if the responsible person considers that any training provided to the person before this section came into force or before the person became a member of staff—<br> (a) was given sufficiently recently, and<br> (b) is of an equivalent standard to the training provided under this section.<br> (5) Refresher training must be provided at regular intervals whilst a person is a member of staff.<br> (6) In subsection (5) “refresher training” means training that updates or supplements the training provided under subsection (1).<br> <b>120H</b> <b>Annual report by the Secretary of State</b><br> (1) As soon as reasonably practicable after the end of each calendar year, the Secretary of State must conduct a review in consultation with relevant bodies with commissioning functions on the use of treatment and detention measures contained in the Mental Health Act 1983 broken down by race and other demographic information.<br> (2) Having conducted a review under subsection (1), the Secretary of State must publish a report on the progress made in reducing inequalities in treatment outcomes and the use of detention measures in the use of this Act on people who have protected characteristics under the Equality Act 2010.””

<p>This new clause requires mental health units and services to appoint a responsible person tasked with addressing racial disparities related to functions discharged under the Mental Health Act 1983.</p>

NC14

To move the following Clause—<br> <b>“General duty to secure sufficient resources for services in the community</b><br> (1) It is the general duty of integrated care boards to ensure, insofar as is reasonably practical, that services in the community responsible for delivering care, treatment, or detention provisions under the Mental Health Act 1983 and this Act have the necessary resources, including financial support, to meet service demands.<br> (2) Additional forms of resource may be determined by integrated care boards in consultation with relevant local authorities or health care service providers and may include—<br> (a) sufficient numbers of trained medical professionals;<br> (b) purpose-built facilities for patient care;<br> (c) community services responsible for out-patient care.<br> (3) Each Integrated Care Board must conduct an assessment of its resources every two years to evaluate its ability to deliver services in the community effectively.<br> (4) Each Integrated Care Board must publish a report outlining its findings upon completing the assessment in subsection (3). The first reports must be published within one year of the passage of this Act.”

<p>This new clause places a general duty on integrated care boards to ensure that services in the community have the necessary level of resource to meet demand on services to ensure that the provisions of the Bill function as intended and to assess and report on this every 2 years.</p>

NC15

To move the following Clause—<br> <b>“Report: statutory competency test for under-16s</b><br> Within 12 months of day on which this Act is passed, the Secretary of State must undertake a review of whether a statutory competency test for under-16s in determining their ability to make a relevant decision would be expedient for the purposes of this Act or the Mental Health Act 1983.”

<p>This new clause requires the Secretary of State to undertake a review of whether a statutory competency test for under-16s would be expedient for the purposes of this Bill and the Mental Health Act 1983.</p>

NC16

To move the following Clause—<br> <b>“Duty to promote mental health wellbeing</b><br> After section 142B of the Mental Health Act 1983, insert—<br> <b>“Duty to promote mental health wellbeing</b><br> (1) It is a general duty of local authorities and anybody in carrying out functions under this Act or the Mental Health Act 2025 to promote mental health wellbeing.<br> (2) In carrying out the duty under subsection (1), local authorities and commissioning bodies must have regard to—<br> (a) the prevention of mental illness,<br> (b) the promotion of positive mental health,<br> (c) the reduction of stigma and discrimination associated with mental health conditions, and<br> (d) the provision of accessible and appropriate support services to individuals experiencing mental health challenges.<br> (3) Local authorities and commissioning bodies must publish an annual report outlining the steps taken to discharge their duty under subsection (1), including an assessment of—<br> (a) progress in improving mental health wellbeing in their area for persons affected by the provisions of this Act, and<br> (b) any barriers to promoting mental health wellbeing for such persons and proposed actions to address them.<br> (4) The Secretary of State may issue guidance on the discharge of the duty under subsection (1), and local authorities and commissioning bodies must have regard to such guidance.””

<p>This new clause would require local authorities and commissioning bodies to promote and report annually on mental health wellbeing, with regard to any guidance published by the Secretary of State.</p>

NC17

To move the following Clause—<br> <b>“Funding and reporting</b><br> (1) For each financial year until all sections of this Act have come into force, of the total health service expenditure by the bodies (taken together) in subsection (2), the proportion which relates to mental health spending—<br> (a) under the Mental Health Act 1983, and<br> (b) under this Act or which, in future, would be made under provision inserted into the Mental Health Act 1983 by this Act,<br> (taken together) must not decrease.<br> (2) The bodies are the Department of Health and Social Care, NHS England and integrated care boards.”

<p>This new clause would require that mental health spending as a proportion of health service expenditure must not decrease in the implementation period of the Act.</p>

NC18

To move the following Clause—<br> <b>“Mental Health Commissioner</b><br> After section 142B of the Mental Health Act 1983, insert—<br> <i class="text-centre">“Mental Health Commissioner</i><br> <b>142C</b> <b>Independent Mental Health Commissioner: establishment</b><br> (1) There is to be an office known as the Office of the Mental Health Commissioner.<br> (2) The Office in subsection (1) must be established by the Secretary of State three months after the day on which the Mental Health Act 2025 is passed.<br> (3) The Office of the Mental Health Commissioner will be led by an individual appointed by the Secretary of State titled the “Independent Mental Health Commissioner”.<br> (4) The role in subsection (3) is referred to as the “Mental Health Commissioner”.<br> (5) The Mental Health Commissioner may appoint staff to the Office of the Mental Health Commissioner they consider necessary for assisting in the exercise of their functions in section 142D.<br> <b>142D</b> <b>Functions of the Commissioner</b><br> (1) The Mental Health Commissioner is responsible for overseeing the implementation and operability of functions discharged by relevant bodies and persons under the provisions of this Act, the Mental Health Act 1983, and the Mental Capacity Act 2025 particularly regarding the provision of treatment, care, and detention of people with a mental disorder.<br> (2) The Mental Health Commissioner must publish an annual report on the use of functions discharged under this Act, which must assess—<br> (a) the quality of mental health care treatment provided by relevant services;<br> (b) the accessibility of mental health care treatment services;<br> (c) the relationship between mental health and the criminal justice system;<br> (d) inequalities of mental health care provision regarding protected characteristics under the Equality Act 2010;<br> (e) the use and effectiveness of detention measures under this Act, including but not limited to Community Treatment Orders, for the purposes of therapeutic benefit outlined in section 1(2B);<br> (f) challenges surrounding stigma of mental health conditions;<br> (g) the accessibility of advice and support to mental health service users, their families and carers on their legal rights;<br> (h) other issues deemed appropriate by the Mental Health Commissioner.<br> (3) In fulfilling their duties under subsection (1), the Mental Health Commissioner may review, and monitor the operation of, arrangements falling within subsection (1), (2) and (3) for the purpose of ascertaining whether, and to what extent, the arrangements are effective in promoting the principles in section 118(2B) of this Act.<br> (4) Subject to any directions from the Secretary of State, the Commissioner may take action necessary or expedient in connection for the purposes of their functions.<br> (5) This may include—<br> (a) collaborating with health services, public authorities, charitable organisations, and other relevant entities, including NHS bodies, the Care Quality Commission, and the Parliamentary and Health Service Ombudsman;<br> (b) ensuring enforcement authorities and public bodies under the Mental Health Act 1983 have the necessary capacity and resources to adequately discharge duties under the Mental Health Act 1983 and this Act.<br> <b>142E</b> <b>Appointment, Tenure, and Remuneration of the Mental Health Commissioner</b><br> (1) The Secretary of State may by regulation make provision for the appointment, tenure, removal, and general terms of appointment of the Mental Health Commissioner.<br> (2) The Secretary of State may also by regulation determine the Commissioner’s remuneration, allowances, and pension entitlements.<br> <b>142F</b> <b>Examination of cases</b><br> (1) The Secretary of State may, by regulations, make provision for the examination by the Mental Health Commissioner of the cases of those who are detained under this Act receiving treatment by authorised mental health care providers.<br> (2) The Secretary of State may, by regulations, provide for the Office of the Mental Health Commissioner to access and examine relevant data on mental health treatment provision held by NHS England and any other authorities the Secretary of State considers appropriate.<br> <b>142G</b> <b>Regulations</b><br> A statutory instrument containing regulations under sections 142E and 142F may not be made unless a draft of the instrument has been laid before and approved by a resolution of each House of Parliament.””

<p>This new clause establishes the office of the Mental Health Commissioner and makes provisions for relevant duties and responsibilities.</p>

NC19

To move the following Clause—<br> <b>“Duty to provide advice and support to families and carers</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) After section 117B insert—<br> <b>“117C</b> <b>After-care: provision of support and advice to families and carers</b><br> (1) The responsible integrated care board must ensure that, as part of the provision of after-care services under section 117 of this Act, advice and support is offered to the family or carers of the person discharged where the person consents.<br> (2) This support must include—<br> (a) information about the person’s condition and recovery;<br> (b) guidance on how to support their recovery at home and avoid relapse;<br> (c) access to financial, housing, and social care advice services relevant to the situation of the person’s family; and<br> (d) procedures for family members or nominated persons to notify the integrated care board of concerns that the person is at future risk of detention under Part 2 of this Act.<br> (3) Where a concern is raised under subsection (2)(d), the integrated care board must—<br> (a) consider whether the individual meets criteria to be included on the register of persons at risk under section 125D of this Act; and<br> (b) take reasonable steps to involve the family or nominated person in planning of subsequent support, subject to—<br> (i) the person’s consent; or<br> (ii) if they lack capacity, the person’s best interests.<br> (4) The Secretary of State must publish guidance under section 125B of this Act on the format and provision of support under subsection (3)(b).””

<p>This new clause would require the integrated care board, as part of the aftercare services offered under the Mental Health Act 1982, to offer support and advice to the family or carers of the person being discharged from treatment.</p>

2

Clause 4, page 4, line 41, at end insert—<br> “(iv) accommodation and relocation, and”

<p>This amendment ensures the impact of accommodation and relocation is considered in care and treatment reviews for patients with autism or learning disabilities.</p>

6

Clause 4, page 5, line 23, at end insert—<br> “(v) the patient,<br> (vi) the patient’s nominated person, and<br> (vii) the patient’s independent mental health advocate.”

<p>This amendment would ensure that nominated persons and independent mental health advocates receive copy of a care, education, and treatment review meeting report for children and young people with autism or a learning disability.</p>

7

Clause 4, page 5, line 31, for “12” substitute “six”

<p>This amendment would shorten the length between care and treatment reviews from 12 months to six months.</p>

8

Clause 4, page 7, line 6, at end insert—<br> “(iii) housing, and”

<p>This amendment ensures that housing needs are considered as part of care and treatment review meetings.</p>

9

Clause 4, page 7, line 32, at end insert—<br> “(v) the patient,<br> (vi) the patient’s nominated person, and<br> (vii) the patient’s independent mental health advocate.”

<p>This amendment ensures that nominated persons and independent mental health advocates receive a copy of a care and treatment review meeting report.</p>

10

Clause 4, page 7, line 40, for “12” substitute “six”

<p>This amendment would shorten the length between care and treatment reviews from 12 months to six months.</p>

11

Clause 4, page 8, line 12, leave out “must have regard to” and insert “have a duty to carry out”

<p>This amendment ensures that integrated care boards and local authorities responsible for a patient's treatment and care have a duty to implement recommendations arising from a care and treatment review.</p>

12

Clause 4, page 8, line 27, at end insert—<br> “(ba) the person is under 18 years old and satisfies the conditions in (b)(ii).”

<p>This amendment inserts a new subsection that extends the duty on integrated care boards to establish and maintain a register for those at risk of detention to all children and young people under the age of 18.</p>

3

Clause 4, page 9, line 20, at end insert—<br> “(6) The risk factors specified in regulations under subsection (5) must include—<br> (a) homelessness;<br> (b) addiction;<br> (c) domestic abuse;<br> (d) miscarriage and traumatic birth;<br> (e) experience of armed conflict; and<br> (f) bereavement.”

<p>This amendment would specify risk factors for detention for people on the register of people at risk of detention under Clause 4.</p>

13

Clause 4, page 9, line 29, at end insert—<br> “(c) seek to ensure that the needs of children and young people can be met without detaining them under Part 2 of this Act.”

<p>This amendment extends the duty on integrated care boards and local authorities to exercise their marketing functions in a way that seeks to ensure that children and young people’s needs can be met without detaining them.</p>

14

Clause 4, page 10, line 5, at end insert—<br> “<b>125FA Report: sufficient commissioning services for people with autism or learning disability</b><br> (1) Within four months of the day on which the Mental Health Act 2025 is passed, the Secretary of State must lay before Parliament a plan to allocate sufficient resources for commissioning services regarding the treatment and detention of autistic people and people with learning disabilities to ensure operability of provisions in this Act.<br> (2) The plan must include—<br> (a) revised assumptions of the number of autistic people and people with learning disabilities who may require detention under this Act;<br> (b) the actions that the Secretary of State will take to ensure community services are available to meet demand after the 28-day detention period;<br> (c) plans for data collection to support commissioning sufficient services;<br> (d) plans to allocate appropriate resource to ensure operability of services, including, but not limited to, financial resource;<br> (e) plans to ensure that responsible bodies and individuals receive the necessary training to carry out support, diagnostic, and treatment plans.”

<p>This amendment requires the Secretary of State to present a plan within four months to ensure sufficient services, resources, data, and training are in place to support autistic people and those with learning disabilities under the Act.</p>

15

Clause 6, page 12, line 40, at end insert—<br> “(c) after subsection (6) insert—<br> “(6A) Any person subject to a community treatment order must be informed orally and in writing at the time of the making of the order of their right to an independent mental health advocate under section 130A of this Act.””

<p>The amendment would ensure that people who are to be subject to a community treatment order would receive information about their right to advocacy.</p>

16

Clause 8, page 14, line 13, after “treatment” insert “including the setting in which treatment takes place,”

<p>This amendment ensures that the definition of appropriate medical treatment includes the setting in which treatment takes place.</p>

4

Clause 21, page 29, line 28, at end insert—<br> “ <span class="sub-para subsection"><span class="sub-para-num">(ab)</span><span class="sub-para-text">containing steps to alleviate social and financial stressors contributing to the patient’s risk of requiring detention in future; and”</span></span>

<p>This amendment would require social and financial stressors be addressed in care and treatment plans.</p>

18

Clause 21, page 29, line 39, at end insert—<br> “(iii) the discussion of the person’s finances and financial situation.”

<p>This amendment ensures that the care and treatment plan includes matters relating to the patient’s financial circumstances.</p>

19

Clause 21, page 29, line 41, at end insert—<br> “(4A) The information authorised or required to be included in, or attached to, a care and treatment plan by virtue of regulations under subsection (3) must include provision to protect the patient's housing and accommodation during and immediately after they are subject to a care and treatment plan.”

<p>This amendment ensures that protection of housing and accommodation are considered as part of care and treatment plans.</p>

20

Clause 21, page 30, line 26, at end insert—<br> “(g) following the patient turning 18 years of age during the course of a care and treatment plan.”

<p>This amendment ensures that individuals turning 18 during a care and treatment plan have their plans reviewed to maintain continuity of care while transitioning from child to adult services.</p>

21

Clause 21, page 30, line 29, leave out from “so” and insert—<br> “(a) consult the persons mentioned in subsection (5)(f),<br> (b) ask whether there are children in the family and take actions to respond if the children need help or protection from harm.”

<p>This amendment seeks to deliver earlier identification of children who might be in need of information, support, or protection from potential harm.</p>

22

Clause 45, page 56, line 37, at end insert—<br> “(3A) An “advance choice document” under subsection (3) should include consideration of the person’s financial circumstances.”

<p>This amendment ensures that the advance choice document includes matters relating to the patient’s financial circumstances.</p>

5

Schedule 2, page 86, line 38, at end insert— <br> “(18A) In section 130B (arrangements in relation to independent mental advocates: England), after subsection (3)(d), insert—<br> “(e) support the patient’s carer and family members to prepare for the patient’s discharge from hospital treatment, and<br> (f) support the patient to access help with social and financial stressors that might otherwise increase their likelihood of future detention.””

<p>This amendment extends the support offered by Mental Health advocates to cover social and financial stressors and support for family carers and other members of the household when the patient is discharged.</p>

23

Schedule 3, page 90, line 32, after “patient” insert “or English qualifying informal patient under 18”

<p>This amendment extends the provision of opt-out advocacy services in England to informal inpatients under 18.</p>

NC26

To move the following Clause—"Use of restraint and restrictive intervention (1) The Mental Health Act 1983 is amended as follows. (2) In Part II (Compulsory Admission to Hospital and Guardianship), after section 7, insert—"7A Use of force in connection with admission for assessment or treatment (1) A relevant organisation that operates a hospital must appoint a responsible person for the purposes of this section. (2) The responsible person must— (a) be employed by the relevant health organisation, and (b) be of an appropriate level of seniority. (3) The responsible person must keep a record of any use of force by staff who work in that hospital against a person (“P”) who— (a) has been admitted for assessment or treatment under sections 2 to 5 of this Act; or (b) is on the hospital premises and is at risk of detention under this Act. (4) The Secretary of State must by regulations provide for the risk factors to be considered under subsection (3)(b). (5) A record kept under this section must include— (a) the reason for the use of force (b) the place, date and duration of the use of force (c) whether the type or types of force used on the patient formed part of the patient's care plan; (d) the name of the patient on whom force was used; (e) a description of how force was used; (f) the patient's consistent identifier; (g) the name and job title of any member of staff who used force on the patient; (h) the reason any person who was not a member of staff in the hospital was involved in the use of force on the patient; (i) the patient's mental disorder (if known); (j) the relevant characteristics of the patient (if known); (k) whether the patient has a learning disability or autistic spectrum disorders; (l) a description of the outcome of the use of force; (m) whether the patient died or suffered any serious injury as a result of the use of force; (n) any efforts made to avoid the need to use force on the patient; and (o) whether a notification regarding the use of force was sent to the person or persons (if any) to be notified under the patient's care plan. (6) The responsible person must keep the record for three years from the date on which it was made. (7) The Secretary of State must ensure that, at the end of each year, statistics are published regarding the use of force by staff who work in hospitals under the conditions set out in this section.””

Gov 26

Clause 5, page 11, line 22, leave out "by a constable or other authorised person"

Gov 27

Clause 5, page 11, line 33, leave out "by a constable or other authorised person”

Gov 28

Clause 5, page 12, line 6, leave out "by a constable or other authorised person"

Gov 29

Clause 5, page 12, line 23, leave out subsection (7)

Gov 30

Clause 6, page 13, line 7, leave out subsection (3)

NC25

To move the following Clause—<br> <b>“Deaths in detention: independent investigations</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In Part X (Miscellaneous and Supplementary), after section 139, insert—<br> <b>“139A Death in detention</b><br> (1) If an approved clinician in charge of the treatment of a patient is made aware that a patient has died while in detention under this Act, the approved clinician must, as soon as reasonably practicable, commission an independent investigation into the patient’s death.<br> (2) An investigation under this section—<br> (a) must be conducted by a legal or medical professional with no personal or professional connection to—<br> (i) the facilities in which the death occurred, or<br> (ii) a clinician supervising the patient’s care at the time of death;<br> (b) must be concluded within 12 months of the date of death; and<br> (c) must result in a report to be submitted to—<br> (i) the approved clinician,<br> (ii) the local authority,<br> (iii) the local integrated care board, and<br> (iv) the patient’s next of kin.<br> (3) The Secretary of State may by regulations make further provision under this section.””

<p>This new clause would require an independent investigation to take place whenever a patient dies while in detention under the Mental Health Act 1983.</p>

46

Clause 45, page 57, leave out lines 5 to 11 and insert—<br> “(1) All eligible patients shall have a right to create an advance choice document.<br> (1A) For the purposes of this section, an “eligible patient” is a patient who—<br> (a) has previously been detained under Part 2 or Part 3 of this Act,<br> (b) has been diagnosed with a mental disorder which may lead to the possibility they will be detained under this Act in the future, or<br> (c) is an English qualifying informal patient (see section 130CA).<br> (1B) NHS England and each integrated care board must make such arrangements as it considers appropriate for—<br> (a) ensuring that all eligible patients for whom it is responsible for the purposes of this section are informed of their right to create an advance choice document, and<br> (b) helping an eligible patient to create an advance choice document.”

<p>This amendment gives all eligible patients the statutory right to create an advance choice document if they so wish.</p>

54

Schedule 2, page 77, line 21, at end insert—<br> “(3) Where the patient has not attained the age of 16 years, a nominated person must have parental responsibility for the patient.”

<p>This amendment would stipulate that the nominated person for a patient under 16 must have parental responsibility for the patient.</p>

55

Schedule 2, page 80, line 13, after “2(2))” insert “, has parental responsibility for the patient (see paragraph 2(3))”

<p>This amendment would stipulate that the nominated person for a patient under 16 must have parental responsibility for the patient.</p>

49

Schedule 2, page 87, line 13, at end insert— <br> “(18A) In section 130B (arrangements in relation to independent mental advocates: England), after subsection (3)(d), insert—<br> “(e) support the patient’s carer and family members to prepare for the patient’s discharge from hospital treatment, and<br> (f) support the patient to access help with social and financial stressors that might otherwise increase their likelihood of future detention.””

<p>This amendment extends the support offered by Mental Health advocates to cover social and financial stressors and support for family carers and other members of the household when the patient is discharged.</p>

NC11

To move the following Clause—<br> <b>“Costed plan to ensure community provision for individuals with learning disabilities and autism who are at risk of detention</b><br> (1) Within 18 months of the day on which this Act is passed, the Secretary of State must publish a fully costed plan for how Integrated Care Boards and local authorities will ensure provision of adequate community services for individuals with learning disabilities and autistic people who are at risk of detention under Part 2 of the Mental Health Act 1983.<br> (2) As part of the development of that plan, a formal consultation process must take place to determine how the decision to enact the relevant parts of this Act will be made.<br> (3) The consultation must include input from relevant stakeholders, including—<br> (a) individuals with learning disabilities and autistic people;<br> (b) carers for people with learning disabilities and autistic people;<br> (c) healthcare professionals; and<br> (d) advocacy groups.”

<p>This new clause requires a costed plan to ensure that ICBs and local authorities are able to provide adequate community services for individuals with learning disabilities and autistic people at risk of detention under Part 2 of the 1983 Act, informed by a consultation with a range of stakeholders.</p>

NC12

To move the following Clause—<br> <b>“Age-appropriate treatment for children</b><br> (1) Section 131A of the Mental Health Act 1983 is amended as follows.<br> (2) After subsection (1), insert—<br> “(1A) A patient to whom this section applies must not be detained in, or admitted to, an adult ward unless the managers of the hospital consider that—<br> (a) there are exceptional circumstances which justify the patient’s detention in, or admission to, an adult ward; and<br> (b) the decision is in accordance with the best interests of the child.”<br> (3) After subsection (3) insert—<br> “(3A) Where a patient has been detained in, or admitted to, an adult ward, the managers of the hospital must record in writing the reasons for the admission, including—<br> (a) the reason, or reasons, why other options for accommodation were not available or suitable for the patient;<br> (b) details of the measures to be taken by the hospital to ensure that, while the patient is detained or otherwise accommodated in the adult ward, the patient is provided with care in a safe environment; and<br> (c) unless it has been determined that an adult ward is the most appropriate environment for the patient in accordance with subsection (1A), the steps being taken by the hospital to transfer the patient to more appropriate accommodation.<br> (3B) Where a patient to whom this section applies is—<br> (a) detained in, or admitted to, an adult ward or placed out of area; and<br> (b) the detention or admission is of more than 24 consecutive hours' duration,<br> the managers of the hospital must notify the regulatory authority immediately, setting out why they consider that the requirements under subsection (1A) above are met and providing the information set out in subsection (3A).<br> (3C) Subsection (3D) applies when—<br> (a) the managers of a hospital accommodate a patient to whom this section applies in an adult ward for a consecutive period of at least 28 days; or<br> (b) detain or admit a patient to whom this section applies who—<br> (i) was ordinarily resident immediately before being detained or admitted in the area of a local authority other than the local authority within whose area the hospital is situated, or<br> (ii) was not ordinarily resident within the area of any local authority.<br> <span class="sub-para subsection"><span class="sub-para-num">(3D)</span><span class="sub-para-text">Where this subsection applies, the managers of the hospital must immediately inform the appropriate officer of the responsible local authority—</span></span><br> (a) of the patient's detention or admission, and<br> (b) when the patient's detention or admission ceases.”<br> (4) Leave out subsection (4) and insert—<br> "(4) In this section—<br> (a) “adult ward” means a ward in a hospital to which persons aged 18 or over are detained in or admitted to;<br> (b) “the appropriate officer” means—<br> (i) in relation to a local authority in England, their director of children's services, and<br> (ii) in relation to a local authority in Wales, their director of social services;<br> (c) ”hospital” includes a registered establishment; and<br> (d) ”the responsible authority” means—<br> (i) the local authority appearing to the managers of the hospital to be the authority within whose area the child was ordinarily resident immediately before being detained or admitted, or<br> (ii) where it appears to the managers of the hospital that the patient was not ordinarily resident within the area of any local authority, the local authority within whose area the hospital is situated.””

<p>This new clause seeks to ensure that children are only placed on adult wards where there are exceptional circumstances, and it is in their best interests. It includes procedural safeguards for determining the reasons behind (and suitability of) admitting a child to a hospital environment in which adults are simultaneously accommodated or in an out of area placement.</p>

NC13

To move the following Clause—<br> <b>“Duty to review the functions of the regulatory authority</b><br> (1) Within the period of one year from the passage of this Act, the Secretary of State must carry out a review of the regulatory authority’s role under the Mental Health Act 1983.<br> (2) The review under subsection (1) must include an assessment of the effectiveness of the regulatory authority’s role—<br> (a) in carrying out its duties under the Mental Health Act 1983, and<br> (b) in regulating the provision of mental health services under the Mental Health Act 1983.<br> (3) The review under subsection (1) must also include an assessment of whether the regulatory authority will be able to effectively carry out its duties under this Act.<br> (4) The Secretary of State must publish the results of the review in a report and must lay that report before both Houses of Parliament.”

<p>This new clause would require the Government to carry out a review of the effectiveness of the regulatory authority for the Mental Health Act 1983 (the Care Quality Commission) at carrying out its duties under that Act.</p>

NC14

To move the following Clause—<br> <b>“Adequacy of accommodation: review</b><br> (1) The Mental Health Bill 1983 is amended as follows.<br> (2) After Section 131A (Accommodation etc. for children) insert—<br> <b>“131B</b> <b>Adequacy of accommodation</b><br> (1) The Secretary of State must, within 12 months of the passage of the Mental Health Act 2025, publish a review of the quality of accommodation for any patient who is—<br> (a) liable to be detained in a hospital under this Act;<br> (b) admitted to, or remains in, a hospital in pursuance of such arrangements as are mentioned in section 131(1) above.<br> (2) The Secretary of State must, within six months of the publication of the review under subsection (1), publish a strategy to implement the recommendations of that review.””

<p>This new clause would require a review of the quality of accommodation for people detained or admitted to hospital under the Mental Health Act 1983 and require the Secretary of State to publish a strategy to implement the recommendations of this review.</p>

NC15

To move the following Clause—<br> <b>“Review of impact of this Act on detention</b><br> (1) The Secretary of State must, within a period of 12 months following the day on which this Act is passed, commission an independent review into the impact of relevant provisions on reducing the number of people detained under Part 2 of the Mental Health Act 1983.<br> (2) In subsection (1), “relevant provisions” include—<br> (a) sections 4, 5 and 6,<br> (b) section 8,<br> (c) section 21, and<br> (d) sections 46 and 47.<br> (3) The Secretary of State must, within 12 months of the publication of the review in subsection (1), publish a strategy to implement the recommendations of that review.”

<p>This new clause would require the Secretary of State to commission a review into the impact of relevant provisions in the Act in reducing the number of people detained, in particular the provisions relating to people with autism or a learning disability, on grounds for detention and for community treatment orders, medical treatment, care and treatment plans, and on after-care, and to implement any recommendations within 12 months of the publication of the review.</p>

NC16

To move the following Clause—<br> <b>“Transfer of patients: out of area placements</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) After section 19 (transfer of patients), insert— <br> <b>“19A</b> <b>Transfer of patients: out of area placements</b><br> (1) The Secretary of State must reduce to zero, within five years of the passage of the Mental Health Act 2025, the number of patients transferred to a hospital outside of the area in which the patient is ordinarily resident.<br> (2) The Secretary of State must publish, within six months of the passage of the Mental Health Act 2025, a report to outline how the duty under this section will be met, including how provision for treatment under this Act will be increased.””

<p>This new clause would require the transfer of patients to hospitals outside of their area to be reduced to zero within 5 years, and for the Secretary of State to produce a report on how this will be achieved.</p>

NC17

To move the following Clause—<br> <b>“Children detained on adult wards</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) After section 131A (Accommodation, etc. for children), insert—<br> <b>“131B</b> <b>Children detained on adult wards</b><br> (1) The Secretary of State must reduce to zero, within five years of the passage of the Mental Health Act 2025, the number of children detained on adult wards.<br> (2) The Secretary of State must publish, within six months of the passage of the Mental Health Act 2025, a report to outline how the duty under this section will be met, including how provision for treatment under this Act will be increased.””

<p>This new clause would require the number of children detained on adult wards to be reduced to zero within 5 years, and for the Secretary of State to produce a report on how this will be achieved.</p>

NC18

To move the following Clause—<br> <b>“Report on the impact of this Act on patients with eating disorders</b><br> (1) Within a period of 12 months following the day on which this Act is passed, the Secretary of State must publish a report on the impact of relevant provisions in this Act on patients with eating disorders.<br> (2) In subsection (1), “relevant provisions” include—<br> (a) section 5 (Grounds for detention),<br> (b) section 11 (Making treatment decisions),<br> (c) section 17 (Urgent treatment to alleviate serious suffering),<br> (d) section 21 (Care and treatment plans), and<br> (e) section 47 (After-care services).”

<p>This new clause would require the Secretary of State to report on the impact of this Bill on patients with eating disorders within 12 months of the passage of this Bill.</p>

NC19

To move the following Clause—<br> <b>“Report and Guidance: Improving Outcomes for LGBT Patients</b><br> (1) The Secretary of State must, within 12 months of the day on which this Act is passed, prepare and lay before Parliament a report on the mental health outcomes of patients who are treated under the Mental Health Act 1983 and who identify as lesbian, gay, bisexual, or transgender (LGBT).<br> (2) The report under subsection (1) must include an assessment of—<br> (a) any differences between non-LGBT patients and LGBT patients in—<br> (i) the extent of the use of detention measures under the Mental Health Act 1983; and<br> (ii) treatment outcomes following detention, and<br> (b) the availability and accessibility of "culturally competent" mental health treatment under the 1983 Act for LGBT patients.<br> (3) Following publication of the report under subsection (1), the Secretary of State must publish guidance for responsible bodies and individuals working with patients under the Mental Health Act 1983, including but not limited to those working in—<br> (a) mental health hospitals;<br> (b) places of safety;<br> (c) crisis accommodation; and<br> (d) relevant community mental health services.<br> (4) The guidance under subsection (3) must include—<br> (a) provisions about updated training standards for staff regarding the specific mental health needs and experiences of LGBT individuals, including training on non-discriminatory practice and inclusive communication approaches;<br> (b) steps to improve safety for LGBT patients in relevant mental health settings, with particular regard to addressing discrimination and harassment; and<br> (c) a definition of “cultural competent mental health treatment” for the purposes of subsection (2).<br> (5) Responsible bodies and individuals working with patients under the Mental Health Act 1983 must have regard to guidance published under subsection (3).<br> (6) In preparing the report under subsection (1) and the guidance under subsection (3), the Secretary of State must consult—<br> (a) patients with a mental disorder who identify as LGBT;<br> (b) the families or carers of patients with a mental disorder who identify as LGBT;<br> (c) relevant professional bodies;<br> (d) integrated care boards;<br> (e) local authorities;<br> (f) providers of mental health treatment; and<br> (g) such other persons as the Secretary of State considers appropriate.<br> (7) The Secretary of State must update the guidance under subsection (3) at regular intervals, and no less frequently than every three years.”

<p>This new clause would require the Secretary of State to report on mental health outcomes and disparities for LGBT patients in treatment under the Mental Health Act 1983 and publish guidance covering training and safety for this specific group.</p>

NC20

To move the following Clause—<br> <b>“Report and Guidance: Transition to Adult Mental Health Treatment</b><br> (1) The Secretary of State must, within 18 months of passing of this Act, prepare and lay before Parliament a report on improving provision for patients transitioning from treatment in a hospital environment for children and young people to one for adults when they attain the age of 18.<br> (2) The report under subsection (1) must include an assessment of—<br> (a) the current pathways and outcomes for young people transitioning between hospital environments for children and for adults;<br> (b) any gaps in care or support experienced by patients during this transition;<br> (c) best practices for ensuring safe and effective transitions.<br> (3) Following the report under subsection (1), the Secretary of State must publish guidance for integrated care boards, local authorities, and providers of mental health treatment on improving outcomes and ensuring continuity of care for patients transitioning to a hospital environment for adults.<br> (4) The guidance under subsection (3) must include—<br> (a) specific steps to guarantee continuity of care for patients transitioning between treatment in a hospital environment for children and young people and one for adults;<br> (b) measures to identify young people requiring transition support at an appropriate stage;<br> (c) provisions for joint working and information sharing between providers of treatment for children and young people and for adults;<br> (d) requirements for the review and updating of care and treatment plans to reflect the needs of patients transitioning to a hospital environment for adults.<br> (5) Integrated care boards, local authorities, and providers of mental health treatment must have regard to guidance published under subsection (3).<br> (6) In preparing the report under subsection (1) and the guidance under subsection (3), the Secretary of State must consult—<br> (a) young people with experience of transitioning between children and young people’s and adult mental health services, and their carers and guardians;<br> (b) relevant professional bodies;<br> (c) integrated care boards;<br> (d) local authorities;<br> (e) providers of mental health treatment;<br> (f) such other persons as the Secretary of State considers appropriate.<br> (7) The Secretary of State must update the guidance under subsection (3) at regular intervals, and no less frequently than every three years.”

<p>This new clause would require the Secretary of State to review and report on the transition of patients from children's to adult mental health settings for treatment at age 18 and publish guidance for relevant bodies on improving provision and ensuring continuity of care during this transition.</p>

NC21

To move the following Clause—<br> <b>“Duty to provide advice and support to families and carers</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) After section 117B, insert—<br> <b>“117C</b> <b>After-care: provision of support and advice to families and carers</b><br> (1) The responsible integrated care board must ensure that, as part of the provision of after-care services under section 117 of this Act, advice and support is offered to the family or carers of the person discharged.<br> (2) This support must include—<br> (a) information about the person’s condition and recovery;<br> (b) guidance on how to support their recovery at home and avoid relapse;<br> (c) access to financial, housing, and social care advice services relevant to the situation of the person’s family; and<br> (d) procedures for family members or nominated persons to notify the integrated care board of concerns that the person is at future risk of detention under Part 2 of this Act.<br> (3) Where a concern is raised under subsection (2)(d), the integrated care board must—<br> (a) consider whether the individual meets criteria to be included on the register of persons at risk under section 125D of this Act; and<br> (b) take reasonable steps to involve the family or nominated person in planning of subsequent support, subject to—<br> (i) the person’s consent; or<br> (ii) if they lack capacity, the person’s best interests.<br> (4) The Secretary of State must publish guidance under section 125B of this Act on the format and provision of support under subsection (3)(b).””

<p>This new clause would require the integrated care board, as part of the aftercare services offered under the Mental Health Act 1982, to offer support and advice to the family or carers of the person being discharged from treatment.</p>

NC22

To move the following Clause—<br> <b>“National strategy on mental health units</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In Part VIII (Miscellaneous Functions of Local Authorities and the Secretary of State), after section 118, insert—<br> <b>“118A</b> <b>National strategy on mental health units</b><br> (1) The Secretary of State must, within 12 months of the passing of the Mental Health Act 2025, publish a national strategy to set out how the Government will ensure that all relevant mental health units meet or exceed “good” safety standards as assessed by the Care Quality Commission (CQC).<br> (2) A strategy issued under this section must address the following matters—<br> (a) recruitment, retention and training of mental health staff,<br> (b) patient-to-staff ratios, and<br> (c) safe staffing levels during crises and night shifts.<br> (3) Following publication of the strategy, a report on implementation progress must be laid before Parliament annually.<br> (4) For the purposes of this section, a “relevant mental health unit” is a facility used for treatment under this Act.””

<p>This new clause would require the Secretary of State to publish a strategy, followed by an annual progress report, on how the Government will ensure that all mental health units used for treatment under the Mental Health Act 1983 are rated “good” or above by the CQC.</p>

NC23

To move the following Clause—<br> <b>“Impact assessment: children and young people in temporary foster care</b><br> (1) The Secretary of State must, within 18 months of the passing of this Act, publish and lay before Parliament an impact assessment on the impact of this Act on children and young people who are in temporary foster care.<br> (2) The impact assessment under this section must consider—<br> (a) whether the ordinary residence provisions result in delays or inequities in accessing treatment or after-care under this Act;<br> (b) the effect of transitions between placements on continuity of treatment under this Act; and<br> (c) any unintended consequences for children and young people in temporary foster care arising from the application of subsections (3) to (5) of section 125G of the Mental Health Act 1983.”

<p>This new clause would require the Government to publish an impact assessment on the impact of this Act on children and young people in temporary foster care.</p>

NC24

To move the following Clause—<br> <b>“Application in respect of patient already on hospital grounds</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In section 5(1) (Application in respect of a patient already in hospital), after “or,” insert “that the patient has attended a hospital or been brought to a hospital to seek help or admission as a patient or,””

<p>This new clause would allow people who have attended or been brought to a hospital to seek help or admission as a patient to pursue an application for admission under the Mental Health Act.</p>

56

Clause 3, page 3, line 19, at end insert—<br> “(4) The Secretary of State may by regulations update the definitions in subsection (2) in response to scientific advancements.<br> (5) A statutory instrument containing regulations under this section may not be made unless a draft of the instrument has been laid before and approved by a resolution of each House of Parliament.”

<p>This amendment would allow the definitions for mental disorder, autism, learning disability and psychiatric disorder to be updated by secondary legislation as science evolves.</p>

51

Clause 4, page 4, line 41, at end insert—<br> “(iv) accommodation and relocation, and”

<p>This amendment ensures that the impact of accommodation and relocation is considered in care and treatment reviews for patients with autism or learning disabilities.</p>

47

Clause 4, page 9, line 20, at end insert—<br> “(6) The risk factors specified in regulations under subsection (5) must include—<br> (a) homelessness;<br> (b) addiction;<br> (c) domestic abuse;<br> (d) miscarriage and traumatic birth;<br> (e) experience of armed conflict; and<br> (f) bereavement.”

<p>This amendment would specify risk factors for detention for people on the register of people at risk of detention under Clause 4.</p>

52

Clause 5, page 11, leave out lines 20 to 22 and insert—<br> “(b) in the case of a patient who lacks capacity or competence to consent to admission for assessment (or for assessment followed by medical treatment), serious harm may be caused to the health or safety of the patient or of another person unless the patient is so detained by a constable or other authorised person, or in the case of a patient who does not lack capacity or competence to consent to admission for assessment (or for assessment followed by medical treatment) serious harm may be caused to the health or safety of another person unless the patient is so detained by a constable or other authorised person; and”

53

Clause 5, page 11, leave out lines 27 to 29 and insert—<br> “(b) in the case of a patient who lacks capacity or competence to consent to admission for medical treatment, serious harm may be caused to the health or safety of the patient or of another person unless the patient receives medical treatment, or in the case of a patient who does not lack capacity or competence to consent to admission for medical treatment, serious harm may be caused to the health or safety of another person unless the patient receives medical treatment,”

<p>This amendment, along with Amendment 52, would add to the grounds for admission to hospital for assessment or treatment that the patient must lack the capacity to consent to that admission, if they would not be detained due to being a risk to others.</p>

44

Clause 8, page 15, line 17, at end insert—<br> “(iii) seeks to minimise the patient’s distress and promote psychological wellbeing and recovery from any childhood trauma;”

45

Clause 8, page 15, line 22, after “manifestations” insert “and seeks to minimise the patient’s distress and promote their psychological wellbeing and recovery from any childhood trauma.”

<p>This amendment, along with Amendment 44, seeks to promote a therapeutic environment and culture which recognises a patient’s trauma.</p>

48

Clause 21, page 30, line 28, at end insert—<br> “ <span class="sub-para subsection"><span class="sub-para-num">(ab)</span><span class="sub-para-text">containing steps to alleviate social and financial stressors contributing to the patient’s risk of requiring detention in future; and”</span></span>

<p>This amendment would require social and financial stressors be addressed in care and treatment plans.</p>

50

Clause 21, page 30, line 41, at end insert—<br> “(4A) For the purposes of preparing a plan under this section, a discharge planning meeting must be held.<br> (4B) A meeting under subsection (4A) must include—<br> (a) the patient;<br> (b) the patient’s nominated person;<br> (c) any independent mental health advocate acting for the patient;<br> (d) a representative of the integrated care board;<br> (e) a local housing officer;<br> (f) a local authority social worker;<br> (g) a representative from the Department for Work and Pensions; and<br> (h) any other person or agency involved in the patient’s care or likely to support recovery in the community.<br> (4C) A care and treatment plan under this section must include—<br> (a) actions agreed by relevant agencies to support the patient’s recovery;<br> (b) provisions to address clinical, financial, housing, and social needs;<br> (c) steps to reduce the likelihood of readmission or further detention under this Act; and<br> (d) a record of any points of disagreement and how they are to be resolved.<br> (4D) Where an agency listed under subsection (4B) fails to attend a discharge planning meeting, the responsible clinician must take reasonable steps to obtain their input in writing and record it in the plan.<br> (4E) For the purposes of subsection (4A) to (4D), the Secretary of State must issue guidance on best practice for discharge planning meetings and multi-agency collaboration.””

<p>This amendment would require the clinician preparing a care and treatment plan to hold a multi-agency planning meeting to inform it, and specifies what must be included within the plan.</p>

32

Clause 45, page 57, line 11, at end insert “, and<br> (c) bringing the availability of that information and help to the attention of such people as it considers appropriate.”

<p>This provides that NHS England and integrated care boards must make arrangements for bringing information and help available under new section 130M to the attention of such people as they consider appropriate.</p>

40

Schedule 2, page 81, line 25, leave out from beginning to end of line 3 on page 82 and insert—<br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(3)</span><span class="sub-para-text">If no local authority has parental responsibility for the relevant patient but there are one or more other persons who have parental responsibility and who are willing to act as the nominated person, the approved mental health professional must appoint one of them.”</span></span>

<p>This requires a person with parental responsibility to be appointed as nominated person even if a child arrangements order or special guardianship order is in place.</p>

33

Clause 45, page 57, line 11, at end insert—<br> “(1A) The arrangements that must be made under subsection (1) include such arrangements as NHS England or the integrated care board considers appropriate for people to be given information or help by having a conversation with someone who is suitably qualified, whether in-person or remotely.<br> (1B) In deciding how to discharge the duty under subsection (1), NHS England or an integrated care board must have regard to the particular benefits to a person of making an advance choice document within 12 months of their discharge from a hospital or a registered establishment where they were receiving medical treatment for, or assessment in relation to, mental disorder.”

<p>This imposes further requirements on NHS England and integrated care boards in relation to their duty to make arrangements to make available information about advance choice documents and to help people to make advance choice documents.</p>

41

Schedule 2, page 82, line 4, leave out “[sub-paragraph removed]” and insert “sub-paragraph (3)”

<p>This is consequential on amendment 40.</p>

34

Clause 45, page 58, line 10, at end insert “, and<br> (c) bringing the availability of that information and help to the attention of such people as it considers appropriate.”

<p>This provides that Local Health Boards must make arrangements for bringing information and help available under new section 130N to the attention of such people as they consider appropriate.</p>

35

Clause 45, page 58, line 10, at end insert—<br> “(1A) The arrangements that must be made under subsection (1) include such arrangements as the Local Health Board considers appropriate for people to be given information or help by having a conversation with someone who is suitably qualified, whether in-person or remotely.<br> (1B) In deciding how to discharge the duty under subsection (1), a Local Health Board must have regard to the particular benefits to a person of making an advance choice document within 12 months of their discharge from a hospital or a registered establishment where they were receiving medical treatment for, or assessment in relation to, mental disorder.”

<p>This imposes further requirements on Local Health Boards in relation to their duty to make arrangements to make available information about advance choice documents and to help people to make advance choice documents.</p>

31

Page 48, line 9, leave out Clause 35

<p>This leaves out clause 35, which requires discharged patients to be offered a consultation with an independent mental health advocate to review their experiences of hospital treatment.</p>

36

Page 60, line 32, leave out Clause 50

<p>See explanatory statement for amendment 26.</p>

NC10

To move the following Clause—<br> <b>“Human Rights Act 1998: extension to certain private care providers</b><br> In the Mental Health Act 1983, after section 142B insert—<br> <b>“142C</b> <b>Human Rights Act 1998: extension to certain private care providers</b><br> (1) A registered care provider is to be regarded for the purposes of section 6(3)(b) of the Human Rights Act 1998 as exercising a function of a public nature in providing any of the services mentioned in subsection (2) (to the extent that it would not otherwise be so regarded).<br> (2) The services are—<br> (a) after-care services provided in pursuance of arrangements made under section 117;<br> (b) services provided in pursuance of arrangements made by a local authority in Scotland discharging its duty under section 25 of the Mental Health (Care and Treatment) (Scotland) Act 2003;<br> (c) the provision of medical treatment for mental disorder or assessment in relation to mental disorder, for an in-patient at a hospital, but only where that treatment or assessment is arranged or paid for by an NHS body.<br> (3) In this section—<br> “hospital” means any institution for the reception and treatment of people—<br> (a) suffering from mental disorder or other illness,<br> (b) convalescing, or<br> (c) requiring medical rehabilitation;<br> “illness” includes any injury or disability requiring medical treatment or nursing;<br> “NHS body” —<br> (a) in relation to England, has the meaning given by section 275(1) of the National Health Service Act 2006;<br> (b) in relation to Wales, has the meaning given by section 206(1) of the National Health Service (Wales) Act 2006;<br> (c) in relation to Scotland, a health board constituted by order made under section 2 of the National Health Service (Scotland) Act 1978;<br> (d) in relation to Northern Ireland means—<br> (i) the Department of Health, or<br> (ii) a Health and Social Care Trust;<br> “registered care provider” means--<br> (a) a person registered under Chapter 2 of Part 1 of the Health and Social Care Act 2008,<br> (b) a person registered under Part 2 of the Care Standards Act 2000 or Part 1 of the Regulation and Inspection of Social Care (Wales) Act 2016,<br> (c) a person providing—<br> (i) a care service which is registered under section 59 of the Public Services Reform (Scotland) Act 2010, or<br> (ii) an independent health care service registered under section 10P of the National Health Service (Scotland) Act 1978, or<br> (d) a person registered under Part 3 of the Health and Personal Social Services (Quality, Improvement and Regulation) (Northern Ireland) Order 2003.””

<p>This extends the remit of the Human Rights Act 1998 to cover private care providers when providing certain services arranged or paid for by public authorities.</p>

42

Schedule 3, page 92, leave out lines 22 and 23 and insert—<br> “(c) the patient is not liable to be detained under this Act or any other legislation or by virtue of a court order.”

<p>This changes the definition of “English qualifying informal patient” to exclude those detained under any legislation or by virtue of a court order (rather than just those detained under the Mental Health Act 1983).</p>

43

Schedule 3, page 94, line 36, at end insert—<br> “8 In section 130J (Welsh qualifying informal patients), in subsection (2), for paragraph (c) substitute—<br> “(c) the patient is not liable to be detained under this Act or any other legislation or by virtue of a court order”.”

<p>This changes the definition of “Welsh qualifying informal patient” to exclude those detained under any legislation or by virtue of a court order (rather than just those detained under the Mental Health Act 1983).</p>

37

Clause 57, page 68, line 3, at end insert “subject to subsection (2).”

<p>This is consequential on amendment 38.</p>

38

Clause 57, page 68, line 4, leave out “This section, section 55” and insert “Section (<i>Human Rights Act 1998: extension to certain private care providers</i>), section 55, this section”

<p>This ensures that NC10 extends to England and Wales, Scotland and Northern Ireland.</p>

39

Clause 59, page 68, line 25, leave out subsection (2)

<p>This removes the privilege amendment inserted in the Lords.</p>

26

Clause 5, page 11, line 22, leave out “by a constable or other authorised person”

<p>One of the tests for detaining a person under the mental health legislation is that harm may be caused, or that treatment is not possible, without detention. This amendment and amendments 27, 28 and 29 remove wording stipulating that the detention that is necessary must be detention by a constable or other authorised person (as defined).</p>

27

Clause 5, page 11, line 33, leave out “by a constable or other authorised person”

<p>See explanatory statement for amendment 26.</p>

28

Clause 5, page 12, line 6, leave out “by a constable or other authorised person”

<p>See explanatory statement for amendment 26.</p>

29

Clause 5, page 12, line 23, leave out subsection (7)

<p>See explanatory statement for amendment 26.</p>

30

Clause 6, page 13, line 7, leave out subsection (3)

<p>This amendment removes provisions relating to the duration and review of community treatment orders.</p>

NC9

To move the following Clause—<br> <b>“Veterans’ Mental Health Oversight Officer</b><br> After section 142B of the Mental Health Act 1983, insert—<br> <i class="text-centre">“Veterans’ Mental Health Oversight Officer</i><br> <b>142C</b> <b>Veterans’ Mental Health Oversight Officer: establishment</b><br> (1) The Secretary of State shall appoint a Veterans’ Mental Health Oversight Officer ("the Officer") to oversee the treatment and care of veterans under this Act.<br> (2) The Officer shall—<br> (a) oversee the cases of veterans who are:<br> (i) at risk of detention under this Act;<br> (ii) currently detained under this Act; or<br> (iii) following detention under this Act, subject to community or outpatient treatment or other post-discharge mental health provisions;<br> (b) advocate for mental health assessments and care tailored to veterans' service-related experiences;<br> (c) collaborate with mental health professionals, veterans' services, legal representatives, and third-sector organisations to safeguard veterans' rights and well-being within relevant treatment settings;<br> (d) promote diversion from detention where clinically appropriate, including the use of veteran-specific support services; and<br> (e) submit an annual report to Parliament detailing:<br> (i) detention rates of veterans under this Act;<br> (ii) outcomes and recidivism rates for veterans detained under this Act;<br> (iii) recommendations for service improvement.<br> (3) In this section:<br> (a) “veteran” refers to a person who has served or currently serves in the armed forces of the United Kingdom or a Commonwealth nation.<br> (b) “relevant health authority” includes NHS England, regional NHS boards, or their successors.””

<p>This new clause introduces a dedicated oversight role for veterans within the framework of the Mental Health Bill, recognising that service personnel have unique needs and experiences that need to be considered in mental health care and detention decisions.</p>

21

Clause 58, page 68, line 15, at end insert—<br> “(5A) The Secretary of State must by regulations make provision for sections 3, 4 and 21 to come into force in full no later than two years after the day on which this Act is passed.”

<p>This amendment would establish an accelerated implementation timeline for provisions related to autism and learning disabilities, requiring them to be fully implemented within 2 years.</p>

20

Clause 4, page 9, line 38, at end insert—<br> <b>“125ZF</b> <b>Registers: duty to maintain crisis accommodation</b><br> (1) In exercising its functions under section 125E, an integrated care board must seek to ensure that there is appropriate crisis accommodation for people with autism or a learning disability within its area.<br> (2) For the purposes of this section, "appropriate crisis accommodation" means accommodation which—<br> (a) is designed to meet the specific needs of people with autism or learning disability during periods of acute mental health crisis;<br> (b) is staffed by persons with specialist training in supporting people with autism or a learning disability;<br> (c) maintains appropriate staffing ratios determined by guidance issued by the Secretary of State; and<br> (d) provides a safe alternative to detention under section 136 of this Act.<br> (3) The Secretary of State must issue guidance about the exercise of functions under this section, and integrated care boards must have regard to this guidance.”

<p>This amendment would require integrated care boards to establish and maintain appropriate crisis accommodation specifically designed for people with autism or learning disability as one of its duties in relation to registers of people at risk of detention.</p>

22

Clause 4, page 10, line 5, at end insert—<br> <b>“125FA</b> <b>Assessment: provision of services for people with autism or learning disability</b><br> (1) Each financial year, an integrated care board must—<br> (a) conduct an assessment of the availability and adequacy of services within its area for people with autism or a learning disability who have specified risk factors for detention under Part 2 of this Act;<br> (b) publish the results of the assessment; and<br> (c) publish an action plan to address any gaps in provision identified.<br> (2) The assessment under subsection (1) must include consideration of—<br> (a) the availability of appropriate crisis accommodation;<br> (b) the availability of appropriate community support services;<br> (c) the adequacy of training for responsible bodies and individuals to carry out support, diagnostic and treatment plans; and<br> (d) the experiences of people with autism or a learning disability who have specified risk factors for detention under Part 2 of this Act and their families or carers.<br> (3) The integrated care board must consult the following in conducting the assessment—<br> (a) persons with autism or a learning disability who have specified risk factors for detention under Part 2 of this Act and their families or carers;<br> (b) the relevant local authority or authorities;<br> (c) providers of relevant services; and<br> (d) such other persons as the integrated care board considers appropriate.<br> (4) The Secretary of State must issue guidance about the conduct of assessments under this section, and integrated care boards must have regard to this guidance.”

<p>This amendment would require integrated care boards to conduct and publish annual assessments of the provision available for people with autism or learning disability at risk of detention and to prepare action plans to address any identified gaps.</p>

24

Clause 4, page 10, line 5, at end insert—<br> <b>“125FA</b> <b>Report: services for people with autism or learning disability</b><br> (1) The Secretary of State must, within 12 months of this section coming into force and annually thereafter, prepare and lay before Parliament a report on—<br> (a) the availability of appropriate accommodation for people with autism or learning disability detained under this Act;<br> (b) the number of instances where appropriate accommodation could not be found within statutory timeframes;<br> (c) the progress towards implementation of sections 3 and 4 of the Mental Health Act 2025 and the impact of any delays to implementation on people with autism or a learning disability; and<br> (d) progress made towards meeting the needs of people with autism or a learning disability without detaining them under Part 2 of this Act.<br> (2) In preparing the report, the Secretary of State must consult—<br> (a) people with autism or a learning disability who have specified risk factors for detention under Part 2 of this Act and their families or carers;<br> (b) integrated care boards;<br> (c) local authorities; and<br> (d) such other persons as the Secretary of State considers appropriate.”

<p>This amendment would require the Secretary of State to report annually to Parliament on the availability of appropriate placements for people with autism or learning disabilities and on progress implementing the relevant provisions of the Act.</p>

25

Clause 4, page 10, line 5, at end insert—<br> <b>“125FA</b> <b>Training standards</b><br> (1) The Secretary of State must by regulations make provision about training standards for responsible bodies and individuals working with people with autism or a learning disability in—<br> (a) mental health hospitals;<br> (b) places of safety designated under sections 135 or 136 of this Act;<br> (c) crisis accommodation; and<br> (d) such other settings as the Secretary of State considers appropriate.<br> (2) Regulations under subsection (1) must—<br> (a) specify minimum training requirements;<br> (b) require training to be co-produced with people with autism or learning disability and their families or carers;<br> (c) require regular refresher training; and<br> (d) include training on de-escalation techniques and alternatives to restraint.<br> (3) The Secretary of State must publish guidance about the standards set out in regulations under subsection (1).<br> (4) A statutory instrument containing regulations under this section is subject to annulment in pursuance of a resolution of either House of Parliament.”

<p>This amendment would require the Secretary of State to produce guidance on minimum training standards for staff working with people with autism or learning disabilities in mental health settings and require that training be co-produced with people with lived experience and their families.</p>

23

Clause 21, page 30, line 41, at end insert—<br> “(4A) Where a patient has autism or a learning disability, the care and treatment plan must—<br> (a) identify specific crisis prevention strategies appropriate to the patient's individual needs;<br> (b) identify suitable crisis accommodation options in the event that the patient's current placement becomes unable to meet their needs;<br> (c) specify how the patient's sensory needs will be met;<br> (d) specify communication approaches appropriate to the patient's needs; and<br> (e) record the views of the patient's family members or carers, where appropriate and with the patient's consent.”

<p>This amendment would ensure that care and treatment plans for patients with autism or learning disabilities include specific components addressing their particular needs, including crisis prevention strategies and identification of suitable crisis accommodation options.</p>

18

Clause 45, page 57, line 33, at end insert—<br> “(3A) An “advance choice document” under subsection (3) should include consideration of the person’s financial circumstances.”

<p>This amendment ensures that the advance choice document includes matters relating to the patient’s financial circumstances.</p>

19

Schedule 3, page 91, line 13, after “patient” insert “or English qualifying informal patient under 18”

<p>This amendment extends the provision of opt-out advocacy services in England to informal inpatients under 18.</p>

NC1

To move the following Clause—<br> <b>“Reporting: racial disparities relating to community treatment orders</b><br> (1) Within a period of 12 months following the day on which this Act is passed, the Secretary of State must undertake a review of racial disparities which relate to the use and administering of community treatment orders.<br> (2) The review under subsection (1) must include, but is not limited to—<br> (a) an assessment of whether certain racial or ethnic groups are disproportionately represented among individuals subject to community treatment orders compared to their representation in the general population;<br> (b) a review of the outcomes and effectiveness of community treatment orders across different racial groups, including health outcomes, and patient experiences.<br> (3) The Secretary of State must lay a report of the findings of the review before Parliament within 18 months of the day on which this Act is passed.”

<p>This new clause seeks to gauge the Government’s view on prevalent racial disparities as they relate to the use of community treatment orders under the Act.</p>

NC2

To move the following Clause—<br> <b>“Mental Health Crisis Breathing Space</b><br> (1) Any person detained under sections 3, 37, 41 or 47 of the Mental Health Act 1983 must be offered support from the mental health crisis breathing space debt respite scheme.”

<p>This new clause ensures that MHCBS, a debt respite scheme, is offered and available to patients detained under sections 3, 37, 41 and 47 of the Mental Health Act 1983.</p>

NC3

To move the following Clause—<br> <b>“Addressing and reporting on racial disparities and other inequalities in the use of the Mental Health Act 1983</b><br> After section 120D of the Mental Health Act 1983, insert—<br> <b>“120E</b> <b>Mental health units and services to have a responsible person</b><br> (1) A relevant health organisation that operates a mental health unit or community mental health service for qualifying patients must appoint a responsible person for that unit or service for the purposes of addressing racial disparities and other disparities based on protected characteristics related to functions discharged under the Mental Health Act 1983.<br> (2) The responsible person must—<br> (a) be employed by the relevant health organisation, and<br> (b) be of an appropriate level of seniority.<br> (3) Where a relevant health organisation operates more than one mental health unit or service, that organisation must appoint a single responsible person in relation to all of the mental health units or services operated by that organisation.<br> (4) A patient is a qualifying patient if they are—<br> (a) liable to be detained under this Act, otherwise than by virtue of section 4 or 5(2) or (4) or section 135 or 136;<br> (b) subject to guardianship under this Act;<br> (c) a community patient.<br> <b>120F</b> <b>Policy on racial disparities and other disparities based on protected characteristics</b><br> (1) The responsible person must publish a policy on how the unit plans to reduce racial disparities and other disparities based on protected characteristics in that unit or service.<br> (2) The policy published under subsection (1) must cover the following topics—<br> (a) the application of the guiding principles to all aspects of operation of this Act;<br> (b) staff knowledge and competence in connection with promoting equality and anti-discriminatory practice in relation to this Act;<br> (c) workforce demographics, recruitment, retention and progression;<br> (d) implementation of the patient and carer race equality framework (England only) and any other requirements of relevant national policies;<br> (e) care planning and decision-making in the use of this Act including section 56A (making treatment decisions);<br> (f) the availability of alternatives to detention and involuntary treatment;<br> (g) take-up of independent mental health advocacy;<br> (h) the cultural appropriateness of independent mental health advocacy;<br> (i) access to and use of advance choice documents;<br> (j) what steps will be taken to reduce racial disparities and other disparities based on protected characteristics in that unit or service.<br> (3) Where a responsible person is appointed in relation to all of the mental health units operated by a relevant health organisation, the responsible person must publish a single policy under subsection (1) in relation to those units or services.<br> (4) Before publishing a policy under subsection (1), the responsible person must—<br> (a) consult any persons that the responsible person considers appropriate;<br> (b) have regard to the following matters—<br> (i) the views, wishes and feelings of people from ethnic minority communities who have been detained;<br> (ii) the views, wishes and feelings of people with other protected characteristics who have been detained.<br> (5) The responsible person must keep under review any policy published under this section.<br> (6) The responsible person may from time to time revise any policy published under this section and, if this is done, must publish the policy as revised.<br> (7) If the responsible person considers that any revisions would amount to a substantial change in the policy, the responsible person must consult any persons that the responsible person considers appropriate before publishing the revised policy.<br> <b>120G</b> <b>Training in racial disparities and other disparities based on protected characteristics</b><br> (1) The responsible person for each mental health unit or service must provide training for staff that relates to addressing racial disparities and other disparities based on protected characteristics in that unit or service.<br> (2) The training provided under subsection (1) must include training on the topics covered in section 120F(2).<br> (3) Subject to subsection (4), training must be provided—<br> (a) in the case of a person who is a member of staff when this section comes into force, as soon as reasonably practicable after this section comes into force, or<br> (b) in the case of a person who becomes a member of staff after this section comes into force, as soon as reasonably practicable after they become a member of staff.<br> (4) Subsection (3) does not apply if the responsible person considers that any training provided to the person before this section came into force or before the person became a member of staff—<br> (a) was given sufficiently recently, and<br> (b) is of an equivalent standard to the training provided under this section.<br> (5) Refresher training must be provided at regular intervals whilst a person is a member of staff.<br> (6) In subsection (5) “refresher training” means training that updates or supplements the training provided under subsection (1).<br> <b>120H</b> <b>Annual report by the Secretary of State</b><br> (1) As soon as reasonably practicable after the end of each calendar year, the Secretary of State must conduct a review in consultation with relevant bodies with commissioning functions on the use of treatment and detention measures contained in the Mental Health Act 1983 broken down by race and other demographic information.<br> (2) Having conducted a review under subsection (1), the Secretary of State must publish a report on the progress made in reducing inequalities in treatment outcomes and the use of detention measures in the use of this Act on people who have protected characteristics under the Equality Act 2010.””

<p>This new clause requires mental health units and services to appoint a responsible person tasked with addressing racial disparities related to functions discharged under the Mental Health Act 1983.</p>

NC4

To move the following Clause—<br> <b>“General duty to secure sufficient resources for services in the community</b><br> (1) It is the general duty of integrated care boards to ensure, insofar as is reasonably practical, that services in the community responsible for delivering care, treatment, or detention provisions under the Mental Health Act 1983 and this Act have the necessary resources, including financial support, to meet service demands.<br> (2) Additional forms of resource may be determined by integrated care boards in consultation with relevant local authorities or health care service providers and may include—<br> (a) sufficient numbers of trained medical professionals;<br> (b) purpose-built facilities for patient care;<br> (c) community services responsible for out-patient care.<br> (3) Each Integrated Care Board must conduct an assessment of its resources every two years to evaluate its ability to deliver services in the community effectively.<br> (4) Each Integrated Care Board must publish a report outlining its findings upon completing the assessment in subsection (3). The first reports must be published within one year of the passage of this Act.”

<p>This new clause places a general duty on integrated care boards to ensure that services in the community have the necessary level of resource to meet demand on services to ensure that the provisions of the Bill function as intended and to assess and report on this every 2 years.</p>

NC5

To move the following Clause—<br> <b>“Report: statutory competency test for under-16s</b><br> Within 12 months of day on which this Act is passed, the Secretary of State must undertake a review of whether a statutory competency test for under-16s in determining their ability to make a relevant decision would be expedient for the purposes of this Act or the Mental Health Act 1983.”

<p>This new clause requires the Secretary of State to undertake a review of whether a statutory competency test for under-16s would be expedient for the purposes of this Bill and the Mental Health Act 1983.</p>

NC6

To move the following Clause—<br> <b>“Duty to promote mental health wellbeing</b><br> After section 142B of the Mental Health Act 1983, insert—<br> <b>“Duty to promote mental health wellbeing</b><br> (1) It is a general duty of local authorities and anybody in carrying out functions under this Act or the Mental Health Act 2025 to promote mental health wellbeing.<br> (2) In carrying out the duty under subsection (1), local authorities and commissioning bodies must have regard to—<br> (a) the prevention of mental illness,<br> (b) the promotion of positive mental health,<br> (c) the reduction of stigma and discrimination associated with mental health conditions, and<br> (d) the provision of accessible and appropriate support services to individuals experiencing mental health challenges.<br> (3) Local authorities and commissioning bodies must publish an annual report outlining the steps taken to discharge their duty under subsection (1), including an assessment of—<br> (a) progress in improving mental health wellbeing in their area for persons affected by the provisions of this Act, and<br> (b) any barriers to promoting mental health wellbeing for such persons and proposed actions to address them.<br> (4) The Secretary of State may issue guidance on the discharge of the duty under subsection (1), and local authorities and commissioning bodies must have regard to such guidance.””

<p>This new clause would require local authorities and commissioning bodies to promote and report annually on mental health wellbeing, with regard to any guidance published by the Secretary of State.</p>

NC7

To move the following Clause—<br> <b>“Funding and reporting</b><br> (1) For each financial year until all sections of this Act have come into force, of the total health service expenditure by the bodies (taken together) in subsection (2), the proportion which relates to mental health spending—<br> (a) under the Mental Health Act 1983, and<br> (b) under this Act or which, in future, would be made under provision inserted into the Mental Health Act 1983 by this Act, (taken together) must not decrease.<br> (2) The bodies are the Department of Health and Social Care, NHS England and integrated care boards.”

<p>This new clause would require that mental health spending as a proportion of health service expenditure must not decrease in the implementation period of the Act.</p>

NC8

To move the following Clause—<br> <b>“Mental Health Commissioner</b><br> After section 142B of the Mental Health Act 1983, insert—<br> <i class="text-centre">“Mental Health Commissioner</i><br> <b>142C</b> <b>Independent Mental Health Commissioner: establishment</b><br> (1) There is to be an office known as the Office of the Mental Health Commissioner.<br> (2) The Office in subsection (1) must be established by the Secretary of State three months after the day on which the Mental Health Act 2025 is passed.<br> (3) The Office of the Mental Health Commissioner will be led by an individual appointed by the Secretary of State titled the “Independent Mental Health Commissioner”.<br> (4) The role in subsection (3) is referred to as the “Mental Health Commissioner”.<br> (5) The Mental Health Commissioner may appoint staff to the Office of the Mental Health Commissioner they consider necessary for assisting in the exercise of their functions in section 142D.<br> <b>142D</b> <b>Functions of the Commissioner</b><br> (1) The Mental Health Commissioner is responsible for overseeing the implementation and operability of functions discharged by relevant bodies and persons under the provisions of this Act, the Mental Health Act 1983, and the Mental Capacity Act 2025 particularly regarding the provision of treatment, care, and detention of people with a mental disorder.<br> (2) The Mental Health Commissioner must publish an annual report on the use of functions discharged under this Act, which must assess—<br> (a) the quality of mental health care treatment provided by relevant services;<br> (b) the accessibility of mental health care treatment services;<br> (c) the relationship between mental health and the criminal justice system;<br> (d) inequalities of mental health care provision regarding protected characteristics under the Equality Act 2010;<br> (e) the use and effectiveness of detention measures under this Act, including but not limited to Community Treatment Orders, for the purposes of therapeutic benefit outlined in section 1(2B);<br> (f) challenges surrounding stigma of mental health conditions;<br> (g) the accessibility of advice and support to mental health service users, their families and carers on their legal rights;<br> (h) other issues deemed appropriate by the Mental Health Commissioner.<br> (3) In fulfilling their duties under subsection (1), the Mental Health Commissioner may review, and monitor the operation of, arrangements falling within subsection (1), (2) and (3) for the purpose of ascertaining whether, and to what extent, the arrangements are effective in promoting the principles in section 118(2B) of this Act.<br> (4) Subject to any directions from the Secretary of State, the Commissioner may take action necessary or expedient in connection for the purposes of their functions.<br> (5) This may include—<br> (a) collaborating with health services, public authorities, charitable organisations, and other relevant entities, including NHS bodies, the Care Quality Commission, and the Parliamentary and Health Service Ombudsman;<br> (b) ensuring enforcement authorities and public bodies under the Mental Health Act 1983 have the necessary capacity and resources to adequately discharge duties under the Mental Health Act 1983 and this Act.<br> <b>142E</b> <b>Appointment, Tenure, and Remuneration of the Mental Health Commissioner</b><br> (1) The Secretary of State may by regulation make provision for the appointment, tenure, removal, and general terms of appointment of the Mental Health Commissioner.<br> (2) The Secretary of State may also by regulation determine the Commissioner’s remuneration, allowances, and pension entitlements.<br> <b>142F</b> <b>Examination of cases</b><br> (1) The Secretary of State may, by regulations, make provision for the examination by the Mental Health Commissioner of the cases of those who are detained under this Act receiving treatment by authorised mental health care providers.<br> (2) The Secretary of State may, by regulations, provide for the Office of the Mental Health Commissioner to access and examine relevant data on mental health treatment provision held by NHS England and any other authorities the Secretary of State considers appropriate.<br> <b>142G</b> <b>Regulations</b><br> A statutory instrument containing regulations under sections 142E and 142F may not be made unless a draft of the instrument has been laid before and approved by a resolution of each House of Parliament.””

<p>This new clause establishes the office of the Mental Health Commissioner and makes provisions for relevant duties and responsibilities.</p>

1

Clause 4, page 4, line 41, at end insert—<br> “(iv) housing.”

<p>This amendment ensures that housing needs are considered as part of care, education and treatment review meetings.</p>

2

Clause 4, page 5, line 23, at end insert—<br> “(v) the patient,<br> (vi) the patient’s nominated person, and<br> (vii) the patient’s independent mental health advocate.”

<p>This amendment would ensure that nominated persons and independent mental health advocates receive copy of a care, education, and treatment review meeting report for children and young people with autism or a learning disability.</p>

3

Clause 4, page 5, line 31, for “12” substitute “six”

<p>This amendment would shorten the length between care and treatment reviews from 12 months to six months.</p>

4

Clause 4, page 7, line 6, at end insert—<br> “(iii) housing, and”

<p>This amendment ensures that housing needs are considered as part of care and treatment review meetings.</p>

5

Clause 4, page 7, line 32, at end insert—<br> “(v) the patient,<br> (vi) the patient’s nominated person, and<br> (vii) the patient’s independent mental health advocate.”

<p>This amendment ensures that nominated persons and independent mental health advocates receive a copy of a care and treatment review meeting report.</p>

6

Clause 4, page 7, line 40, for “12” substitute “six”

<p>This amendment would shorten the length between care and treatment reviews from 12 months to six months.</p>

7

Clause 4, page 8, line 12, leave out “must have regard to” and insert “have a duty to carry out”

<p>This amendment ensures that integrated care boards and local authorities responsible for a patient's treatment and care have a duty to implement recommendations arising from a care and treatment review.</p>

8

Clause 4, page 8, line 27, at end insert—<br> “(ba) the person is under 18 years old and satisfies the conditions in (b)(ii).”

<p>This amendment inserts a new subsection that extends the duty on integrated care boards to establish and maintain a register for those at risk of detention to all children and young people under the age of 18.</p>

9

Clause 4, page 9, line 29, at end insert—<br> “(c) seek to ensure that the needs of children and young people can be met without detaining them under Part 2 of this Act.”

<p>This amendment extends the duty on integrated care boards and local authorities to exercise their marketing functions in a way that seeks to ensure that children and young people’s needs can be met without detaining them.</p>

10

Clause 4, page 10, line 5, at end insert—<br> “<b>125FA Report: sufficient commissioning services for people with autism or learning disability</b><br> (1) Within four months of the day on which the Mental Health Act 2025 is passed, the Secretary of State must lay before Parliament a plan to allocate sufficient resources for commissioning services regarding the treatment and detention of autistic people and people with learning disabilities to ensure operability of provisions in this Act.<br> (2) The plan must include—<br> (a) revised assumptions of the number of autistic people and people with learning disabilities who may require detention under this Act;<br> (b) the actions that the Secretary of State will take to ensure community services are available to meet demand after the 28-day detention period;<br> (c) plans for data collection to support commissioning sufficient services;<br> (d) plans to allocate appropriate resource to ensure operability of services, including, but not limited to, financial resource;<br> (e) plans to ensure that responsible bodies and individuals receive the necessary training to carry out support, diagnostic, and treatment plans.”

<p>This amendment requires the Secretary of State to present a plan within four months to ensure sufficient services, resources, data, and training are in place to support autistic people and those with learning disabilities under the Act.</p>

11

Clause 6, page 13, line 6, at end insert—<br> “(c) after subsection (6) insert—<br> “(6A) Any person subject to a community treatment order must be informed orally and in writing at the time of the making of the order of their right to an independent mental health advocate under section 130A of this Act.””

<p>The amendment would ensure that people who are to be subject to a community treatment order would receive information about their right to advocacy.</p>

12

Clause 8, page 15, line 11, after “treatment” insert “including the setting in which treatment takes place,”

<p>This amendment ensures that the definition of appropriate medical treatment includes the setting in which treatment takes place.</p>

13

Clause 18, page 27, line 22, at end insert—<br> “(1A) Regulations under subsection (1) may only be made to provide for circumstances where—<br> (a) the treatment is immediately necessary to save the patient’s life,<br> (b) obtaining a second opinion would cause a delay that places the patient at a significant and imminent risk of death or serious physical harm, and<br> (c) the treatment is reversible.”

<p>The amendment limits the power to dispense with a second medical opinion for urgent electro-convulsive therapy to exceptional, life-threatening cases, introduces periodic reviews of its use, and ensures transparency by prohibiting retrospective application.</p>

14

Clause 21, page 30, line 39, at end insert—<br> “(iii) the discussion of the person’s finances and financial situation.”

<p>This amendment ensures that the care and treatment plan includes matters relating to the patient’s financial circumstances.</p>

15

Clause 21, page 30, line 41, at end insert—<br> “(4A) The information authorised or required to be included in, or attached to, a care and treatment plan by virtue of regulations under subsection (3) must include provision to protect the patient's housing and accommodation during and immediately after they are subject to a care and treatment plan.”

<p>This amendment ensures that protection of housing and accommodation are considered as part of care and treatment plans.</p>

16

Clause 21, page 31, line 26, at end insert—<br> “(g) following the patient turning 18 years of age during the course of a care and treatment plan.”

<p>This amendment ensures that individuals turning 18 during a care and treatment plan have their plans reviewed to maintain continuity of care while transitioning from child to adult services.</p>

17

Clause 21, page 31, line 29, leave out from “so” and insert—<br> “(a) consult the persons mentioned in subsection (5)(f),<br> (b) ask whether there are children in the family and take actions to respond if the children need help or protection from harm.”

<p>This amendment seeks to deliver earlier identification of children who might be in need of information, support, or protection from potential harm.</p>

Clause 30, page 41, line 24, at end insert—<br> “(c) in paragraph (e), for “six months” substitute “three months”.”

<p>This amendment is consequential on clause 29(2) of the Bill and changes the period within which an application to the tribunal may be made where a patient is transferred from guardianship to a hospital to align that period with the initial detention period in relation to the patient.</p>

63A

After Clause 51, insert the following new Clause—<br> <b>“Duty to implement preventative policies for mental disorders</b><br> (1) The bodies listed in subsection (3) must implement policies which take a preventative approach to the management of mental disorders which are likely to lead to detainment under the Mental Health Act 1983.<br> (2) The policies must be adapted to the needs of the local community that those bodies serve.<br> (3) The bodies in subsection (1) are integrated care boards, local health boards and local authorities.”

<p>This amendment seeks to ensure that ICBs, LHBs and local authorities take a preventative approach to the management of mental disorders which lead to detainment and adapt their approaches to the needs of their local area.</p>

62

After Clause 51, insert the following new Clause—<br> <b>“Report on the racial disparities in secure mental health units and among patients subject to Community Treatment Orders</b><br> (1) The Secretary of State must publish a report to assess the factors underlying racial disparities—<br> (a) in secure mental health units, and<br> (b) among patients subject to community treatment orders.<br> (2) The report under subsection (1) must be published within two years of the day on which this Act is passed.<br> (3) The report under subsection (1) must be laid before Parliament.”

63

After Clause 51 insert the following new Clause—<br> <b>“Powers of tribunals to determine challenges against treatment decisions</b><br> After section 77 of the Mental Health Act 1983 (general provisions concerning tribunal applications) insert—<br> <b>“77A</b> <b>Powers of tribunals to determine challenges against treatment decisions</b><br> (1) The Secretary of State may by regulations make provision about the powers of the appropriate tribunal to—<br> (a) consider and determine questions relating to care and treatment during the course of an application or reference made under sections 66 to 71 (applications and references relating to discharge);<br> (b) consider and determine questions relating to care and treatment other than during the course of an application or reference made under sections 66 to 71 (applications and references relating to discharge).<br> (2) Regulations may make provision about pilot schemes relating to either paragraph (1)(a) or (1)(b).””

<p>This amendment would allow the Minister to set up pilots under which the Mental Health Tribunal could determine challenges against treatment decisions.</p>

7

Clause 5, page 11, line 22, after “detained” insert “by a constable or other authorised person”

<p>This amendment and others in the name of Lord Kamall seek to introduce a new category of “authorised person” who can carry out detentions under the 1983 Act to offer better inter-agency response. The proposed amendments would remove the need for the presence of police at mental health incidents in the absence of any risk.</p>

8

Clause 5, page 11, line 33, after “detained” insert “by a constable or other authorised person”

<p>This amendment and others in the name of Lord Kamall seek to introduce a new category of “authorised person” who can carry out detentions under the 1983 Act to offer better inter-agency response. The proposed amendments would remove the need for the presence of police at mental health incidents in the absence of any risk.</p>

9

Clause 5, page 12, line 6, at end insert “by a constable or other authorised person”

<p>This amendment and others in the name of Lord Kamall seek to introduce a new category of “authorised person” who can carry out detentions under the 1983 Act to offer better inter-agency response. The proposed amendments would remove the need for the presence of police at mental health incidents in the absence of any risk.</p>

10

Clause 5, page 12, line 21, at end insert—<br> “(7) In section 145(1) (interpretation), at the appropriate place insert—<br> ““authorised person” means a medical practitioner, approved mental health professional, mental health nurse or doctor, or a person of description specified in regulations made by the Secretary of State, who has been trained and equipped to carry out detentions under this Act and who would not be put at unnecessary risk by carrying out those functions;””

<p>This amendment and others in the name of Lord Kamall seek to introduce a new category of “authorised person” who can carry out detentions under the 1983 Act to offer better inter-agency response. The proposed amendments would remove the need for the presence of police at mental health incidents in the absence of any risk.</p>

23

After Clause 22, insert the following new Clause—<br> <b>“Duty to review community treatment orders</b><br> (1) Within two years of the day on which this Act is passed, the Secretary of State must arrange for a review of the continuing use of community treatment orders.<br> (2) Thereafter the Secretary of State must arrange for a review of the continuing use of community treatment orders every five years.<br> (3) The reviews in subsections (1) and (2) must include—<br> (a) the impact of community treatment orders on people from different ethnic minority backgrounds,<br> (b) the effectiveness of the continued use of community treatment orders in preventing readmission to hospital and detention under the Mental Health Act 1983,<br> (c) an assessment of whether community treatment orders provide net therapeutic benefits to patients, and<br> (d) a recommendation on whether the use of community treatment orders should continue.<br> (4) The review in subsections (1) and (2) must be published in a report.<br> (5) The Secretary of State must lay any report published under subsection (4) before both Houses of Parliament.”

<p>This amendment requires the Secretary of State to initiate a review of the continued use of community treatment orders and their impacts, and to repeat such review every 5 years.</p>

38

Clause 36, page 49, line 25, at end insert—<br> “(d) a specified accountable person or body is appointed, who will be responsible for ensuring that the provisions within this subsection are completed within the specified time limit.”

<p>This amendment seeks to ensure that there is an accountable person, who will ensure that transfer to hospital takes place within 28 days.</p>

40

After Clause 37, insert the following new Clause—<br> <b>“Appropriate ongoing treatment for released prisoners</b><br> After section 53 of the Mental Health Act 1983, insert—<br> <b>“53A</b> <b>Appropriate ongoing treatment for released prisoners</b><br> (1) When a prisoner who has been treated for a mental disorder under this Act is released, the relevant detention authority must ensure that appropriate arrangements are put in place for their continued treatment in the community.<br> (2) A relevant detention authority in subsection (1) includes all those listed in section 48B (supplementary) and any other relevant centres associated with criminal justice detention.””

<p>This amendment seeks to ensure that prisoners who are treated for a mental disorder under the Mental Health Act 1983 and are then released have access to continued treatment in the community.</p>

41

Clause 43, page 54, line 36, leave out from beginning to end of line 2 on page 55 and insert—<br> “(1) All eligible patients shall have a right to create an advance choice document.<br> (1A) For the purposes of this section, an “eligible patient” is a patient who—<br> (a) has previously been detained under Part 2 or Part 3 of this Act,<br> (b) has been diagnosed with a mental disorder which may lead to the possibility they will be detained under this Act in the future, or<br> (c) is an English qualifying informal patient (see section 130CA).<br> (1B) NHS England and each integrated care board must make such arrangements as it considers appropriate for—<br> (a) ensuring that all eligible patients for whom it is responsible for the purposes of this section are informed of their right to create an advance choice document, and<br> (b) helping an eligible patient to create an advance choice document.”

<p>This amendment gives all eligible patients the statutory right to create an advance choice document if they so wish.</p>

42

Clause 43, page 55, line 27, at end insert “and has relevant wishes or feelings they wish to express”

<p>This amendment seeks to align Mental Health Act 1983 with the existing best practice on providing advance choice documents.</p>

43

Clause 43, page 56, line 2, at end insert—<br> <b>“130O</b> <b>Advance choice documents: duty</b><br> Any person or body discharging relevant functions under this Act must consider, so far as relevant and reasonably ascertainable, any wishes, feelings, beliefs and values contained in an advance choice document.”

<p>This amendment seeks to ensure that clinicians and relevant bodies consider the information contained in the advance choice document and use it to inform care and treatment given under the Mental Health Act 1983.</p>

44

After Clause 47, insert the following new Clause—<br> <b>“Removal of patients by authorised persons</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In section 135 (warrant to search for and remove patients)—<br> (a) in subsection (1), after “constable”, insert “or authorised person”;<br> (b) in subsection (1A), after “constable”, insert “or authorised person”;<br> (c) in closing words of subsection (2), after “constable”, insert “or authorised person”;<br> (d) in subsection (3ZA)(a)(ii), after “constable”, insert “or authorised person”;<br> (e) in subsection (7)(b), after “constable”, insert “or authorised person”.<br> (3) In section 136 (removal etc of mentally disordered persons without a warrant)—<br> (a) in subsection (1), after each instance of “constable”, insert “or authorised person”;<br> (b) in subsection (1A), after “constable”, insert “or authorised person”;<br> (c) in subsection (1B), after “constable”, insert “or authorised person”;<br> (d) in subsection (2A)(a)(ii), after “constable”, insert “or authorised person”.”

<p>This amendment and others in the name of Lord Kamall seek to introduce a new category of “authorised person” who can carry out detentions under the 1983 Act to offer better inter-agency response. The proposed amendments would remove the need for the presence of police at mental health incidents in the absence of any risk.</p>

24

Schedule 2, page 72, line 24, leave out “county court” and insert “Mental Health Act tribunal”

28

Schedule 2, page 75, line 28, leave out “county court” and insert “Mental Health Act tribunal”

35

Schedule 2, page 79, line 16, leave out “county court” and insert “Mental Health Act tribunal”

34

Leave out sub-paragraph (3) and insert—<br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(3)</span><span class="sub-para-text">Where sub-paragraph (2) does not apply, the approved mental health professional must appoint as a nominated person—</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(a)</span><span class="sub-para-text">a guardian who has been appointed for the relevant patient,</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(b)</span><span class="sub-para-text">a person who is named in a child arrangements order, as defined by section 8 of the Children Act 1989, as a person with whom the relevant patient is to live, or</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(c)</span><span class="sub-para-text">a person who has parental responsibility for the relevant patient.</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(3A)</span><span class="sub-para-text">In this paragraph “guardian” includes a special guardian within the meaning of the Children Act 1989 but does not include a guardian under section 7 of that Act.</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(3B)</span><span class="sub-para-text">Where there is more than one person identified as a potential nominated person in sub-paragraph (3)(a), (b) or (c) then the approved mental health professional must in deciding who to appoint—</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(a)</span><span class="sub-para-text">take into account the relevant patient’s past and present wishes and feelings so far as reasonably ascertainable, or</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(b)</span><span class="sub-para-text">where it has not been possible to ascertain the relevant patient’s past and present wishes, preference must be given to the eldest person.”</span></span>

59

After Clause 51, insert the following new Clause—<br> <b>“Funding and reporting</b><br> (1) For each financial year until all sections of this Act have come into force, of the total health service expenditure by the bodies (taken together) in subsection (2), the proportion which relates to mental health spending—<br> (a) under the Mental Health Act 1983, and<br> (b) under this Act or which, in future, would be made under provision inserted into the Mental Health Act 1983 by this Act,<br> <span class="wrapped">(taken together) must not decrease.</span><br> (2) The bodies are the Department of Health and Social Care, NHS England and integrated care boards.”

<p>This amendment seeks to ensure that, within whatever overall health service funding is set by Government, the share spent on mental health in England does not fall while the Act is being implemented.</p>

60

After Clause 51, insert the following new Clause—<br> <b>“Duty to review the functions of the regulatory authority</b><br> (1) Within the period of one year from the passage of this Act, the Secretary of State must carry out a review of the regulatory authority’s role under the Mental Health Act 1983.<br> (2) The review under subsection (1) must include an assessment of the effectiveness of the regulatory authority’s role—<br> (a) in carrying out its duties under the Mental Health Act 1983, and<br> (b) in regulating the provision of mental health services under the Mental Health Act 1983.<br> (3) The review under subsection (1) must also include an assessment of whether the regulatory authority will be able to effectively carry out its duties under this Act.<br> (4) The Secretary of State must publish the results of the review in a report and must lay that report before both Houses of Parliament.”

61

After Clause 51, insert the following new Clause—<br> <b>“Review: causes and consequences of rates of diagnosis of mental disorders</b><br> (1) Within three months of the day on which this Act is passed, the Secretary of State must commission a review to investigate the effect of—<br> (a) any increase in young people being diagnosed with mental disorders, and<br> (b) unregulated practitioners and online tools which diagnose mental disorders,<br> <span class="wrapped">on the availability of services to treat people with a mental disorder under the Mental Health Act 1983.</span><br> (2) The Secretary of State must publish the review and lay it before both House of Parliament.”

<p>This amendment seeks to ensure that the Secretary of State undertakes a review of the effect of rates of diagnosis of mental disorder on the availability of services which treat people with mental disorder under the Mental Health Act 1983.</p>

4

Clause 4, page 10, line 5, at end insert—<br> <b>“125FA</b> <b>Community Services Sufficiency Plan: commissioning of services for autistic people and people with a learning disability</b><br> (1) The Secretary of State must prepare and lay before Parliament a document setting out a plan for resourcing and commissioning sufficient community services for autistic people and people with a learning disability to ensure the operability of provisions in the Mental Health Act 2025.<br> (2) The document shall be referred to as the “Community Services Sufficiency Plan”.<br> (3) The Community Services Sufficiency Plan must be published within one year of the day on which the Mental Health Act 2025 is passed.<br> (4) The Community Services Sufficiency Plan must include—<br> (a) a definition of “sufficient community services” in relation to autistic people and people with a learning disability, including how sufficient community services will be assessed regarding the operability of provisions in the Mental Health Act 2025;<br> (b) the actions that the Secretary of State will take to ensure community services are available to meet demand for autistic people and people with a learning disability after the end of the 28-day detention period under section 2(4) of this Act (admission for assessment);<br> (c) the actions that the Secretary of State will take to ensure that sufficient community services for autistic people and people with a learning disability are available to prevent detention under section 3 of this Act (admission for treatment);<br> (d) plans to allocate appropriate resource to ensure operability of services, including, but not limited to, financial resource;<br> (e) plans to ensure that responsible bodies and individuals receive the necessary training in autism and learning disability to carry out support, diagnosis, and treatment;<br> (f) plans for data collection to support the commissioning of sufficient services for autistic people and people with a learning disability;<br> (g) targets and milestones relevant to—<br> (i) the number of autistic people and people with a learning disability who are detained under this Act, and<br> (ii) the development of sufficient community services for autistic people and people with a learning disability,<br> (h) any other information the Secretary of State deems relevant.<br> (5) For a period of 10 years beginning on the day on which the Community Services Sufficiency Plan is first published, the Secretary of State—<br> (a) must keep the plan under review, and<br> (b) may revise it.<br> (6) If the Secretary of State revises the Community Services Sufficiency Plan, the Secretary of State must publish it as revised.”

5

Clause 4, page 10, line 5, at end insert—<br> <b>“125FA</b> <b>Monitoring the progress of the Community Services Sufficiency Plan</b><br> (1) The Secretary of State must publish a report monitoring the progress made towards implementing the Community Services Sufficiency Plan.<br> (2) The report must first be published exactly one year after the day on which the Community Services Sufficiency Plan is first published, and every year thereafter, until either—<br> (a) the Secretary of State considers that the aims of the Community Services Sufficiency Plan have been met, or<br> (b) a period of 10 years has passed, beginning on the day on which the Community Services Sufficiency Plan is first published.<br> (3) The report must include information and data which monitors—<br> (a) the progress made towards achieving the milestones and targets included in the Community Services Sufficiency Plan,<br> (b) how allocated resource has been delivered and utilised to ensure the availability of sufficient community services for autistic people and people with a learning disability in order to operate the provisions of the Mental Health Act 2025, and<br> (c) any other provisions included in the Community Services Sufficiency Plan that the Secretary of State deems relevant.”

14

Clause 11, page 17, leave out line 39 and insert “statements set out in an advance choice document).”

<p>This amendment seeks to align the Mental Health Act with the existing best practice on providing advance choice documents.</p>

58

After Clause 51, insert the following new Clause—<br> <b>“Age appropriate treatment for children</b><br> (1) Section 131A of the Mental Health Act 1983 is amended as follows.<br> (2) After subsection (1), insert—<br> “(1A) A patient to whom this section applies must not be detained in, or admitted to, an adult ward unless the managers of the hospital consider that—<br> (a) there are exceptional circumstances which justify the patient’s detention in, or admission to, an adult ward, and<br> (b) the decision is in accordance with the best interests of the child.”<br> (3) After subsection (3) insert—<br> “(3A) Where a patient has been detained in, or admitted to, an adult ward, the managers of the hospital must record in writing the reasons for the admission, including—<br> (a) the reason, or reasons, why other options for accommodation were not available or suitable for the patient,<br> (b) details of the measures to be taken by the hospital to ensure that while the patient is detained or otherwise accommodated in the adult ward, the patient is provided with care in a safe environment, and<br> (c) unless it has been determined that an adult ward is the most appropriate environment for the patient in accordance with subsection (1A), the steps being taken by the hospital to transfer the patient to more appropriate accommodation.<br> (3B) Where a patient is detained in, or admitted to, an adult ward or placed out of area and the detention or admission is of more than 24 consecutive hours’ duration, the managers of the hospital must notify the regulatory authority without delay setting out why they consider that the requirements under subsection (1A) above are met and providing the information set out in subsection (3A).<br> (3C) Subsection (3E) applies when the managers of a hospital accommodate a patient for a consecutive period of at least 28 days.<br> (3D) Subsection (3E) applies where the managers of a hospital—<br> (a) detain a patient in, or admit a patient to, an adult ward, or<br> (b) detain or admit a patient who—<br> (i) was ordinarily resident immediately before being detained or admitted in the area of a local authority other than the local authority within whose area the hospital is situated, or<br> (ii) was not ordinarily resident within the area of any local authority.<br> (3E) Where this subsection applies the managers of the hospital must inform the appropriate officer of the responsible local authority without delay—<br> (a) of the patient's detention or admission, and<br> (b) when the patient's detention or admission ceases.”<br> (4) Leave out subsection (4) and insert—<br> “(4) In this section—<br> “adult ward” means a ward in a hospital to which persons aged 18 or over are detained in or admitted to;<br> “the appropriate officer” means—<br> (a) in relation to a local authority in England, their director of children's services, and<br> (b) in relation to a local authority in Wales, their director of social services;<br> “hospital” includes a registered establishment;<br> “the responsible authority” means—<br> (a) the local authority appearing to the managers of the hospital to be the authority within whose area the child was ordinarily resident immediately before being detained or admitted, or<br> (b) where it appears to the managers of the hospital that the patient was not ordinarily resident within the area of any local authority, the local authority within whose area the hospital is situated.””

<p>Inserted subsection (1A) seeks to ensure that children are only placed on adult wards where there are exceptional circumstances, and it is in their best interests. (3A)-3(E), and (4A) seek to ensure the presence of procedural safeguards, when determining the reasons behind, and suitability of, admitting a child to a hospital environment in which adults are simultaneously accommodated or in an out of area placement.</p>

12

Clause 8, page 14, line 19, at end insert—<br> “(iii) seeks to minimise the patient’s distress and promote psychological wellbeing and recovery from any childhood trauma;”

13

Clause 8, page 14, line 24, after “manifestations” insert “and seeks to minimise the patient’s distress and promote their psychological wellbeing and recovery from any childhood trauma.”

<p>This amendment seeks to promote a therapeutic environment and culture which recognises patient’s trauma and minimise the use of medical treatment as a form of coercive control.</p>

15

Clause 15, page 22, line 40, at end insert—<br> “(a) omit the “and” at the end of subsection (1)(a);<br> (b) after subsection (1)(a), insert—<br> “(aa) provision, by artificial means, of nutrition to the patient, and””

<p>This amendment would introduce new safeguards for providing artificial nutrition such as naso-gastric tube feeding for patients detained under the 1983 Act.</p>

52

After Clause 51, insert the following new Clause—<br> <b>“Segregation: code of practice</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) In section 118, at end insert—<br> “(8) The Code of Practice issued under this section must be revised to include updated guidance regarding the procedures for the use of long-term segregation (LTS) for patients with learning disabilities or autism or someone awaiting an autism assessment.<br> (9) The revised Code of Practice must specifically address—<br> (a) the definition of LTS;<br> (b) minimum standards and safeguards for patients subject to long-term segregation.””

<p>This amendment mandates a timely revision of the MHA Code of Practice (Section 118) to provide clear, updated guidance on the use of long-term segregation (LTS) for patients with learning disabilities or autism. It seeks to ensure that safeguards and procedures governing LTS are consistent and subject to appropriate oversight.</p>

53

After Clause 51, insert the following new Clause—<br> <b>“Accountability for non-compliance with the code of practice</b><br> (1) The Mental Health 1983 Act is amended as follows.<br> (2) After section 118 insert—<br> <b>“118A</b> <b>Accountability for non-compliance with the code of practice</b><br> (1) Where failure to comply with the Code of Practice under section 118 results in a breach of a detained patient’s rights or safeguards, the Secretary of State or a designated body must investigate and ensure corrective action is taken.<br> (2) The procedures for compliance enforcement, remedial actions, and regulatory oversight must be specified in the Code of Practice under section 118 this Act.””

<p>This amendment introduces explicit accountability for hospitals and relevant NHS bodies in situations where non-compliance with the Mental Health Act’s Code of Practice results in harm or breaches of the legal rights of detained patients.</p>

55

After Clause 51, insert the following new Clause—<br> <b>“Notification of long-term segregation</b><br> After section 142C of the Mental Health Act 1983, insert—<br> <b>“142D</b> <b>Notification requirements for long-term segregation for patients with learning disabilities or autism</b><br> (1) Where a patient with a learning disability or autism or someone awaiting an autism assessment is subject to long-term segregation under this Act, the responsible clinician must notify the Secretary of State or a body designated by the Secretary of State within 72 hours.<br> (2) The contents of the notification under subsection (1) must be specified in the Code of Practice under section 118 of the Mental Health Act 1983.””

<p>This amendment seeks to increase oversight, transparency, and accountability in the use of long-term segregation for patients with learning disabilities or autism under the Mental Health Act.</p>

56

After Clause 51, insert the following new Clause—<br> <b>“Long-term segregation: independent medical review</b><br> After section 142C of the Mental Health Act 1983, insert—<br> <b>“142D</b> <b>Independent medical review of long-term segregation of patients with learning disabilities or autism</b><br> (1) Where a patient with a learning disability, autism, or awaiting autism assessment is placed in long-term segregation under section 142D (Notification requirements for long-term segregation for patients with learning disabilities or autism), the Secretary of State or a designated body must arrange for an independent review within 28 days.<br> (2) The responsibilities, procedures, and reporting requirements for such reviews must be specified in the Code of Practice under section 118 of the Mental Health Act 1983.””

<p>This amendment seeks to introduce an independent review process for patients with learning disabilities or autism placed in long-term segregation under the Mental Health Act 1983.</p>

57

After Clause 51, insert the following new Clause—<br> <b>“Segregation: oversight</b><br> (1) The Mental Health Act 1983 is amended as follows.<br> (2) After section 118 insert—<br> <b>“118A</b> <b>Hospital managers' oversight of long-term segregation of patients with learning disabilities or autism</b><br> (1) The hospital managers must appoint a Responsible Officer to oversee the care of any patient with a learning disability or autism or someone awaiting an autism assessment who is subject to long-term segregation within the hospital.<br> (2) The role, responsibilities, and review procedures of the Responsible Officer must be specified in the Code of Practice under section 118 of the Mental Health Act 1983.””

<p>This amendment seeks to introduce mandatory hospital-level oversight of long-term segregation for patients with learning disabilities or autism and patients awaiting an autism diagnosis and ensure independent scrutiny and proactive efforts to reduce restrictive practices.</p>

64

Clause 52, page 64, line 23, at end insert—<br> “(3A) A statutory instrument containing (alone or with other provision) regulations under this section that amend or repeal provision made by primary legislation may not be made unless a draft of the instrument has been laid before, and approved by a resolution of, each House of Parliament.<br> (3B) Any other statutory instrument containing regulations under this section is subject to annulment in pursuance of a resolution of either House of Parliament.”

<p>This amendment and my other amendments to clauses 52 and 53 would ensure that regulations made under the consequential amendment powers in the Bill that amend or repeal primary legislation are subject to the affirmative resolution procedure.</p>

65

Clause 52, page 64, line 24, leave out subsection (4)

<p>See the explanatory statement for amendment 64.</p>

66

Clause 53, page 65, line 1, at end insert—<br> “(4A) A statutory instrument containing (alone or with other provision) regulations under this section that amend or repeal provision made by primary legislation may not be made unless a draft of the instrument has been laid before, and approved by a resolution of, Senedd Cymru.<br> (4B) Any other statutory instrument containing regulations under this section is subject to annulment in pursuance of a resolution of Senedd Cymru.”

<p>See the explanatory statement for amendment 64.</p>

67

Clause 53, page 65, line 2, leave out subsection (5)

<p>See the explanatory statement for amendment 64.</p>

6

After Clause 4, insert the following new Clause—<br> <b>“Costed plan to ensure community provision for individuals with learning disabilities and autism who are at risk of detention</b><br> (1) Within 18 months of the day on which this Act is passed, the Secretary of State must publish a fully costed plan which will show how Integrated Care Boards and Local Authorities will ensure provision of adequate community services for individuals with learning disabilities and autistic people who are at risk of detention under Part 2 of the Mental Health Act 1983.<br> (2) As part of the development of that plan, a formal consultation process must take place to determine how the decision to enact the relevant parts of this Act will be made.<br> (3) The consultation must include input from—<br> (a) relevant stakeholders, including individuals with learning disabilities and autistic people;<br> (b) carers for people with learning disabilities and autistic people;<br> (c) healthcare professionals;<br> (d) advocacy groups.”

<p>This amendment requires a costed plan to ensure that ICBs and LAs are able to provide adequate community services for individuals with learning disabilities and autistic people at risk of detention under Part 2 of the 1983 Act, informed by a consultation with a range of stakeholders.</p>

16

Clause 18, page 24, line 31, leave out from beginning to end of line 2 on page 25 and insert—<br> “(2) The treatment may be given to a patient who has capacity to consent to the treatment only if—<br> (a) the patient has consented to it, or<br> (b) the patient has not consented but a certificate has been given by a second opinion appointed doctor under subsection (4).<br> (3) The treatment may be given to a patient who lacks capacity to consent to the treatment only if—<br> (a) the giving of the treatment would not conflict with any of the following—<br> (i) a valid and applicable advance decision, or<br> (ii) a decision of a donee or deputy or the Court of Protection, or<br> (b) the giving of the treatment would conflict with such a decision but a certificate has been given by a second opinion appointed doctor under subsection (5).”

<p>This amendment clarifies that the requirement for a certificate by a second opinion appointed doctor does not apply to urgent electro-convulsive therapy if: (1) the patient consents, or (2) the patient lacks capacity but the treatment does not conflict with an advance decision etc.</p>

17

Clause 18, page 26, line 4, at end insert—<br> <b>“62ZAA</b> <b>Life-saving section 62ZA treatment: modified procedure in exceptional circumstances</b><br> (1) Where—<br> (a) a request is made to the regulatory authority under section 56B for the appointment of a second opinion doctor to perform the function of giving a certificate under section 62ZA in relation to any treatment, and<br> (b) the regulatory authority determines that there are exceptional circumstances which mean that there will be a delay in appointing a second opinion doctor,<br> <span class="wrapped">a function of a second opinion appointed doctor under section 62ZA in relation to the giving of a certificate containing a statement under subsection (4)(c)(i) or (5)(c)(i) of that section may be performed, instead, by the approved clinician in charge of that treatment.</span><br> (2) But no treatment may be given in reliance on a certificate given by the approved clinician by virtue of subsection (1) once the second opinion doctor has been appointed under section 56B.<br> (3) Each time a patient is given treatment in reliance on a certificate given by the approved clinician by virtue of subsection (1), the managers of the hospital or registered establishment in which the treatment is given must notify the regulatory authority of that treatment as soon as reasonably practicable.<br> (4) The regulatory authority’s annual report under section 120D must include—<br> (a) a statement of how many times the regulatory authority has made a determination under subsection <br> (1)(b)<br> in the period to which the report relates and a summary of the reasons why any determinations have been made, and<br> (b) a statement of how many times during that period treatment has been given in reliance on a certificate issued by virtue of subsection (1).”

<p>Where exceptional circumstances mean that a second opinion appointed doctor is not available to authorise life-saving electro-convulsive therapy, this amendment would allow the approved clinician to do so. The amendment replaces the regulation-making power currently in new section 62ZB(1).</p>

18

Clause 18, page 26, line 6, leave out from beginning to end of line 10

<p>This is consequential on my amendment to clause 18, page 26, line 4.</p>

19

Clause 18, page 26, line 17, leave out “or by virtue of regulations under subsection (1)”

<p>This is consequential on my amendment to clause 18, page 26, line 4.</p>

20

Clause 18, page 26, line 32, leave out subsection (7)

<p>This amendment leaves out text that is replaced by my new clause inserted after clause 18.</p>

21

Clause 18, page 27, line 15, leave out subsection (8)

<p>This is consequential on my amendment to clause 18, page 26, line 4.</p>

22

After Clause 18, insert the following new Clause—<br> <b>“Remote assessment for treatment</b><br> (1) Section 119 (practitioners approved for Part 4 and section 118) is amended as follows.<br> (2) In subsection (2)(a), for the first “and” substitute “or”.<br> (3) After subsection (2) insert—<br> “(2A) A person authorised by subsection (2) to carry out an interview or examination may, to the extent that they consider appropriate, carry it out—<br> (a) by live audio link, or<br> (b) by live video link.”<br> (4) In subsection (3), before the definition of “regulated establishment” insert—<br> ““live audio link” , in relation to the carrying out of an interview or examination, means a live telephone link or other arrangement which enables the patient and the person carrying out the interview or examination to hear one another;<br> “live video link” , in relation to the carrying out of an interview or examination, means a live television link or other arrangement which enables the patient and the person carrying out the interview or examination to see and hear one another;”.”

<p>This new clause would enable remote assessments to be carried out by certain people for the purpose of non-urgent electro-convulsive therapy and certain other treatments. It also replaces clause 18(7) which makes equivalent provision for urgent treatment.</p>

36

Clause 30, page 42, line 1, leave out “50” and insert “36”

<p>This is consequential on my amendment to leave out clause 50.</p>

37

After Clause 33, insert the following new Clause—<br> <b>“Ascertaining and learning from patients’ experiences of hospital treatment</b><br> After section 23 of the Mental Health Act 1983 (discharge of patients) insert—<br> <b>“23A</b> <b>Ascertaining and learning from patients’ experiences of hospital treatment</b><br> (1) A patient who has been detained under this Part of this Act must, within 30 days of their discharge, be offered a consultation with an independent mental health advocate to review their experiences of hospital treatment.<br> (2) A report from any consultation undertaken pursuant to subsection (1) shall be produced by the independent mental health advocate in partnership with the patient.<br> (3) The report referred to in subsection (2) shall be provided to the managers of the hospital within 14 days of its completion.<br> (4) The managers of the hospital shall publish each year a report setting out what they have learned from patients’ experiences at the hospital, and the actions they have taken.””

<p>This amendment would mandate the de-briefing of mental health patients after they have left hospital.</p>

39

Clause 36, page 52, line 4, leave out subsection (5) and insert—<br> “(5) In section 143 (general provisions as to regulations, orders and rules)—<br> (a) for subsection (2) substitute—<br> “(2) The following are subject to annulment in pursuance of a resolution of either House of Parliament—<br> (a) any Order in Council under this Act;<br> (b) any order made by the Secretary of State under section 54A or 68A(7);<br> (c) any statutory instrument containing regulations made by the Secretary of State under this Act, other than regulations made under section <br> 48B(3)<br> ;<br> (d) any statutory instrument containing rules made under this Act.”;<br> (b) after subsection (3) insert—<br> “(3ZA) A statutory instrument containing regulations under section <br> 48B(3)<br> (whether alone or with other provision) may not be made unless a draft of the instrument has been laid before and approved by a resolution of each House of Parliament.””

<p>This is consequential on my amendment to clause 18, page 26, line 6.</p>

45

Leave out Clause 50

<p>The material in this clause is, so far as it needs to be retained, inserted into clause 36 (see my amendment to that clause).</p>

46

After Clause 51, insert the following new Clause—<br> <b>“Review of duty to notify incidents</b><br> (1) The Secretary of State must carry out a review into—<br> (a) whether regulation 18 of the Care Quality Commission (Registration) Regulations 2009 (S.I.2009/3112) (duty to notify incidents) ought to be extended to require a notification to be given in any other cases in which a person under the age of 18 is admitted to a hospital or registered establishment for medical treatment for, or assessment in relation to, mental disorder, and<br> (b) whether the time period mentioned in regulation 18(2)(h) of those Regulations remains appropriate.<br> (2) The Secretary of State must prepare and publish a report setting out the conclusions of the review.<br> (3) The Secretary of State must lay a copy of the report before Parliament.<br> (4) The report must be laid and published before the end of the period of 2 years beginning with the day on which this Act is passed.<br> (5) In this section the following expressions have the meaning given by section 145 of the Mental Health Act 1983—<br> “hospital” ;<br> “medical treatment” ;<br> “mental disorder” ;<br> “registered establishment” .”

<p>This requires the Secretary of State to carry out a review into the circumstances in which incidents involving mental health patients under the age of 18 ought to be notified to the Care Quality Commission.</p>

26

Schedule 2, page 74, line 27, leave out from “writing” to end of line 19 on page 75 and insert “signed by the patient in the presence of a health or care professional or independent mental health advocate (“the witness”),<br> (c) the nominated person has signed a statement that they—<br> (i) meet the age requirement (see paragraph 2(2)), and<br> (ii) agree to act as the nominated person, and<br> (d) the witness has signed a statement that—<br> (i) the instrument appointing the nominated person was signed by the patient in the presence of the witness,<br> (ii) the witness has no reason to think that the patient lacks capacity or competence to make the appointment,<br> (iii) the witness has no reason to think that the nominated person lacks capacity or competence to act as a nominated person,<br> (iv) the witness has no reason to think that any fraud or undue pressure has been used to induce the patient to make the appointment, and<br> (v) the witness has no reason to think that the nominated person is unsuitable to act as a nominated person.”

<p>This changes the process for appointing a nominated person. It removes the requirement for the nominated person’s signature to be witnessed and the various statements and signatures no longer have to be contained in the same instrument.</p>

29

Schedule 2, page 77, line 27, leave out “16” and insert “18”

<p>This and my amendments to paragraph 10 of new Schedule 1A ensure that where a nominated person is appointed for a patient who is aged 16 or 17 and for whom a local authority has parental responsibility, the local authority is appointed as the nominated person.</p>

30

Schedule 2, page 78, line 5, leave out “under 16” and insert “16 or 17”

<p>See the explanatory statement for my amendment to Schedule 2, page 77, line 27.</p>

31

Schedule 2, page 78, line 6, leave out sub-paragraph (2) and insert—<br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(2)</span><span class="sub-para-text">If a local authority has parental responsibility for the relevant patient, the approved mental health professional must appoint that local authority.</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(2A)</span><span class="sub-para-text">If no local authority has parental responsibility for the relevant patient but the relevant patient has a competent deputy who is willing to act as the nominated person, the approved mental health professional must appoint the deputy.”</span></span>

<p>See the explanatory statement for my amendment to Schedule 2, page 77, line 27.</p>

32

Schedule 2, page 78, line 14, leave out “other case,” and insert “case in which sub-paragraphs (2) and (3) do not identify who is to be appointed”

<p>See the explanatory statement for my amendment to Schedule 2, page 77, line 27.</p>

33

Schedule 2, page 78, line 23, at end insert—<br> ““10A <span class="sub-para subparagraph"><span class="sub-para-num">(1)</span><span class="sub-para-text">This paragraph applies where an approved mental health professional is deciding who to appoint as a nominated person for a relevant patient who is aged under 16.</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(2)</span><span class="sub-para-text">If a local authority has parental responsibility for the relevant patient, the approved mental health professional must appoint that local authority.</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(3)</span><span class="sub-para-text">If no local authority has parental responsibility for the relevant patient but there are one or more other persons who have parental responsibility and who are willing to act as the nominated person, the approved mental health professional must appoint one of them.</span></span><br> <span class="sub-para subparagraph sub-para-indented"><span class="sub-para-num">(4)</span><span class="sub-para-text">In any case in which sub-paragraphs (2) and (3) do not identify who is to be appointed, the approved mental health professional must, in deciding who to appoint, take into account the relevant patient’s past and present wishes and feelings so far as reasonably ascertainable.”</span></span>

<p>This largely replicates the effect of existing paragraph 10 of new Schedule 1A but ensures that where a nominated person is appointed for a patient who is aged under 16 and for whom a local authority has parental responsibility, the local authority is appointed as the nominated person.</p>

68

Clause 55, page 65, line 9, at end insert—<br> “(A1) Section 3 comes into force no later than two years after the day on which this Act is passed.”

3

Clause 4, page 10, line 5, at end insert—<br> <b>“125FA</b> <b>Safeguarding and oversight for patients with learning disabilities or autism in long term segregation</b><br> (1) Where long-term segregation (LTS) is applied to a patient with a learning disability or autism or someone awaiting an autism assessment under this Act, the Secretary of State or a body designated by the Secretary of State must initiate an investigation in any of the following circumstances—<br> (a) the conditions of long-term segregation fail to comply with the minimum standards set out in the Code of Practice issued under section 118 of this Act,<br> (b) the patient is subject to continuous long-term segregation exceeding 15 consecutive days,<br> (c) the patient is subject to multiple episodes of long-term segregation which, in total, exceed 15 days within any 30-day period, or<br> (d) long-term segregation is applied to a patient who is under the age of 18.<br> (2) Where an investigation under subsection (1) identifies breaches of human rights or failures to implement care that is the least harmful and restrictive, the designated body must promptly notify the Secretary of State.<br> (3) Upon receiving notification under subsection (2), the Secretary of State must initiate a safeguarding review into the use of restrictive practices concerning the patient.”

<p>This amendment further enhances transparency and external oversight in the use of long-term segregation (LTS) for patients of with learning disabilities or autism under the Mental Health Act.</p>

None

Clause 4, page 10, line 5, at end insert- "125FA Community Services Sufficiency Plan: commissioning of services for autistic people and people with a learning disability (1) The Secretary of State must prepare and lay before Parliament a document setting out a plan for resourcing and commissioning sufficient community services for autistic people and people with a learning disability to ensure the operability of provisions in the Mental Health Act 2025. (2) The document shall be referred to as the “Community Services Sufficiency Plan". (3) The Community Services Sufficiency Plan must be published within one year of the day on which the Mental Health Act 2025 is passed. (4) The Community Services Sufficiency Plan must include - (a) a definition of “sufficient community services” in relation to autistic people and people with a learning disability, including how sufficient community services will be assessed regarding the operability of provisions in the Mental Health Act 2025; (b) the actions that the Secretary of State will take to ensure community services are available to meet demand for autistic people and people with a learning disability after the end of the 28-day detention period under section 2(4) of this Act (admission for assessment); (c) the actions that the Secretary of State will take to ensure that sufficient community services for autistic people and people with a learning disability are available to prevent detention under section 3 of this Act (admission for treatment); (d) plans to allocate appropriate resource to ensure operability of services, including, but not limited to, financial resource; (e) plans to ensure that responsible bodies and individuals receive the necessary training in autism and learning disability to carry out support, diagnosis, and treatment; (f) plans for data collection to support the commissioning of sufficient services for autistic people and people with a learning disability; (g) targets and milestones relevant to – (i) the number of autistic people and people with a learning disability who are detained under this Act, and (ii) the development of sufficient community services for autistic people and people with a learning disability, (h) any other information the Secretary of State deems relevant. (5) For a period of 10 years beginning on the day on which the Community Services Sufficiency Plan is first published, the Secretary of State - (a) must keep the plan under review, and (b) may revise it. (6) If the Secretary of State revises the Community Services Sufficiency Plan, the Secretary of State must publish it as revised."

None

Clause 4, page 10, line 5, at end insert- "125FA Monitoring the progress of the Community Services Sufficiency Plan (1) The Secretary of State must publish a report monitoring the progress made towards implementing the Community Services Sufficiency Plan. (2) The report must first be published exactly one year after the day on which the Community Services Sufficiency Plan is first published, and every year thereafter, until either (a) the Secretary of State considers that the aims of the Community Services Sufficiency Plan have been met, or (b) a period of 10 years has passed, beginning on the day on which the Community Services Sufficiency Plan is first published. (3) The report must include information and data which monitors – (a) the progress made towards achieving the milestones and targets included in the Community Services Sufficiency Plan, (b) how allocated resource has been delivered and utilised to ensure the availability of sufficient community services for autistic people and people with a learning disability in order to operate the provisions of the Mental Health Act 2025, and (c) any other provisions included in the Community Services Sufficiency Plan that the Secretary of State deems relevant.”

None

After Clause 51, insert the following new Clause – "Mental Health Commissioner After section 142C of the Mental Health Act 1983, insert - "Mental Health Commissioner 142D Independent Mental Health Commissioner: establishment (1) There is to be an office known as the Office of the Mental Health Commissioner. (2) The Office in subsection (1) must be established by the Secretary of State three months after the day on which the Mental Health Act 2025 is passed. (3) The Office of the Mental Health Commissioner will be led by an individual appointed by the Secretary of State titled the “Independent Mental Health Commissioner". (4) The role in subsection (3) is referred to as the “Mental Health Commissioner". (5) The Mental Health Commissioner may appoint staff to the Office of the Mental Health Commissioner they consider necessary for assisting in the exercise of their functions in section 142E. 142E Functions of the Commissioner (1) The Mental Health Commissioner is responsible for overseeing the implementation and operability of functions discharged by relevant bodies and persons under the provisions of this Act, the Mental Health Act 1983, and the Mental Capacity Act 2025 particularly regarding the provision of treatment, care, and detention of people with a mental disorder. (2) The Mental Health Commissioner must publish an annual report on the use of functions discharged under this Act, which must assess. (a) the quality of mental health care treatment provided by relevant services; (b) the accessibility of mental health care treatment services; (c) the relationship between mental health and the criminal justice system; (d) inequalities of mental health care provision regarding protected characteristics under the Equality Act 2010; (e) the use and effectiveness of detention measures under this Act, including but not limited to Community Treatment Orders, for the purposes of therapeutic benefit outlined in section 1(2B); (f) challenges surrounding stigma of mental health conditions; (g) the accessibility of advice and support to mental health service users, their families and carers on their legal rights; (h) other issues deemed appropriate by the Mental Health Commissioner. (3) In fulfilling their duties under subsection (1), the Mental Health Commissioner may review, and monitor the operation of, arrangements falling within subsection (1), (2) and (3) for the purpose of ascertaining whether, and to what extent, the arrangements are effective in promoting the principles in section 118(2B) of this Act. (4) Subject to any directions from the Secretary of State, the Commissioner may take action necessary or expedient in connection for the purposes of their functions. (5) This may include- (a) collaborating with health services, public authorities, charitable organisations, and other relevant entities, including NHS bodies, the Care Quality Commission, and the Parliamentary and Health Service Ombudsman; (b) ensuring enforcement authorities and public bodies under the Mental Health Act 1983 have the necessary capacity and resources to adequately discharge duties under the Mental Health Act 1983 and this Act. 142F Appointment, Tenure, and Remuneration of the Mental Health Commissioner (1) The Secretary of State may by regulation make provision for the appointment, tenure, removal, and general terms of appointment of the Mental Health Commissioner. (2) The Secretary of State may also by regulation determine the Commissioner's remuneration, allowances, and pension entitlements. 142G Examination of cases (1) The Secretary of State may, by regulations, make provision for the examination by the Mental Health Commissioner of the cases of those who are detained under this Act receiving treatment by authorised mental health care providers. (2) The Secretary of State may, by regulations, provide for the Office of the Mental Health Commissioner to access and examine relevant data on mental health treatment provision held by NHS England and any other authorities the Secretary of State considers appropriate. 142H Regulations (1) Regulations under sections 142F and 142G are to be made by statutory instrument."""

None

After Clause 51, insert the following new Clause – "Addressing and reporting on racial disparities and other inequalities After section 120D of the Mental Health Act 1983, insert - "120E Mental health units and services to have a responsible person (1) A relevant health organisation that operates a mental health unit or community mental health service for qualifying patients must appoint a responsible person for that unit or service for the purposes of addressing racial disparities related to functions discharged under this Act and the Mental Health Act 2025. (2) The responsible person must – (a) be employed by the relevant health organisation, and (b) be of an appropriate level of seniority. (3) Where a relevant health organisation operates more than one mental health unit or service, that organisation must appoint a single responsible person in relation to all of the mental health units or services operated by that organisation. 120F Policy on racial disparities (1) The responsible person must publish a policy on how the unit plans to reduce racial disparities in that unit or service. (2) The policy published under subsection (1) must cover but is not limited to the following topics- (a) steps being taken to reduce racial disparities and other disparities in that unit or service; (b) staff knowledge and competence in connection with anti-discriminatory practice in relation to this Act; (c) disparities in workforce demographics, recruitment, retention and progression; (d) implementation of the patient and carer race equality framework (England only) and any other requirements of relevant national policies; (e) care planning and decision-making in the use of this Act including section 56A (making treatment decisions); (f) the availability of alternatives to detention and involuntary treatment; (g) take-up of independent mental health advocacy; (h) the cultural appropriateness of independent mental health advocacy; (i) access to and use of advance choice documents; (j) what steps will be taken to reduce racial disparities and other disparities in that unit or service. (3) Where a responsible person is appointed in relation to all of the mental health units operated by a relevant health organisation, the responsible person must publish a single policy under subsection (1) in relation to those units or services. (4) Before publishing a policy under subsection (1), the responsible person must- (a) consult any persons that the responsible person considers appropriate; (b) have regard to the following matters — (i) the views, wishes and feelings of people from racialised communities who have been detained; (ii) the views, wishes and feelings of people with other protected characteristics who have been detained. (5) The responsible person must keep under review any policy published under this section and may revise it periodically, publishing the revised version if changes are made. 120G Training on racial disparity policy The responsible person for each mental health unit or service must provide training for staff that relates to addressing racial disparities in that unit or service and the topics covered in section 120F(2). 120H Recording of discharge of functions under this Act broken down by race and other demographic information (1) The responsible person for each mental health unit or service must keep a record of the use of functions discharged under this Act, broken down by race and other demographic information. (2) The responsible person must keep the record for three years from the date on which it was made.'"""

None

After Clause 51, insert the following new Clause- “Determination of ability to decide for persons under 16 (1) For the purposes of this Act and the Mental Health Act 1983, a person aged under 16 (referred to in this section as a child) is able to make the relevant decision if they can - (a) understand the information relevant to the decision; (b) retain the information; (c) use or weigh that information as part of the process of making the decision; (d) communicate their decisions (whether by talking, using sign language or any other means). (2) Where a child is able to decide in accordance with subsection (1) above, that child will be competent for the purpose of this Act. (3) A child is not to be regarded as unable to understand the information relevant to a decision if he is able to understand an explanation of it given to him in a way that is appropriate to his circumstances (using simple language, visual aids or any other means). (4) A person determining a child's ability to decide under this section must- (a) have due regard to Article 12 of the United Nations Convention on the Rights of the Child adopted and opened for signature, ratification and accession by General Assembly resolution 44/25 of 20 November 1989 ("the Convention”), and (b) must be able to show reasonable grounds for their belief that the child is or is not able to make the relevant decision. (5) When considered by any appropriate court or tribunal, any question whether a child is able to make the relevant decision within the meaning of this Act must be decided on the balance of probabilities."

None

After Clause 51, insert the following new Clause – “Segregation: code of practice (1) The Mental Health Act 1983 is amended as follows. (2) In section 118, at end insert- "(8) The Code of Practice issued under this section must be revised to include updated guidance regarding the procedures for the use of long-term segregation (LTS) for patients with learning disabilities or autism or someone awaiting an autism assessment. (9) The revised Code of Practice must specifically address – (a) the definition of LTS; (b) minimum standards and safeguards for patients subject to long-term segregation.”"

None

After Clause 51, insert the following new Clause – "Accountability for non-compliance with the code of practice (1) The Mental Health 1983 Act is amended as follows. (2) After section 118 insert- "118A Accountability for non-compliance with the code of practice (1) Where failure to comply with the Code of Practice under section 118 results in a breach of a detained patient's rights or safeguards, the Secretary of State or a designated body must investigate and ensure corrective action is taken. (2) The procedures for compliance enforcement, remedial actions, and regulatory oversight must be specified in the Code of Practice under section 118 this Act.'"""

None

After Clause 51, insert the following new Clause- "Notification of long-term segregation After section 142C of the Mental Health Act 1983, insert - "142D Notification requirements for long-term segregation for patients with learning disabilities or autism (1) Where a patient with a learning disability or autism or someone awaiting an autism assessment is subject to long-term segregation under this Act, the responsible clinician must notify the Secretary of State or a body designated by the Secretary of State within 72 hours. (2) The contents of the notification under subsection (1) must be specified in the Code of Practice under section 118 of the Mental Health Act 1983.""""

None

After Clause 51, insert the following new Clause – “Long-term segregation: independent medical review After section 142C of the Mental Health Act 1983, insert - "142D Independent medical review of long-term segregation of patients with learning disabilities or autism (1) Where a patient with a learning disability, autism, or awaiting autism assessment is placed in long-term segregation under section 142D (Notification requirements for long-term segregation for patients with learning disabilities or autism), the Secretary of State or a body designated by the Secretary of State must arrange for an independent review within 28 days. (2) The responsibilities, procedures, and reporting requirements for such reviews must be specified in the Code of Practice under section 118 of the Mental Health Act 1983.""

None

After Clause 51, insert the following new Clause – "Segregation: oversight (1) The Mental Health Act 1983 is amended as follows. (2) After section 118 insert- "118A Hospital managers' oversight of long-term segregation of patients with learning disabilities or autism (1) The hospital managers must appoint a Responsible Officer to oversee the care of any patient with a learning disability or autism or someone awaiting an autism assessment who is subject to long-term segregation within the hospital. (2) The role, responsibilities, and review procedures of the Responsible Officer must be specified in the Code of Practice under section 118 of the Mental Health Act 1983.""

54

After Clause 51, insert the following new Clause—<br> <b>“Human Rights Act 1998: provision of treatment for a mental disorder as a public function</b><br> (1) This section applies where—<br> (a) a patient is receiving aftercare under section 117 of the Mental Health Act 1983,<br> (b) a patient is accommodated in a hospital for the purpose of being given medical treatment for mental disorder, or<br> (c) a person's health or social care arrangements in connection with their mental disorder give rise to a deprivation of their liberty, within the meaning of that term as under Article 5(1) of the European Convention on Human Rights.<br> (2) The provider of treatment or care under subsection (1) is to be taken for the purposes of section 6(3)(b) of the Human Rights Act 1998 (acts of public authorities) to be exercising a function of a public nature, if the treatment or care is arranged by or paid for (directly or indirectly, and in whole or in part) by a local authority in England, Wales or Scotland, or by a NHS Health Board, an NHS Integrated Care Board, or by a Health and Social Care Trust.”

<p>This amendment ensures the Human Rights Act 1998 applies when people receive outsourced mental health treatment or after-care, or are deprived of their liberty in connection with a mental disorder. It addresses a gap in human rights protection exposed by Sammut & Ors v Next Steps Mental Healthcare Ltd & Anor [2024] EWHC 2265 (KB).</p>

None

After Clause 4, insert the following new Clause- “Notification of long-term segregation After section 125F of the Mental Health Act 1983, insert- "125FA Notification requirements for long-term segregation for patients with learning disabilities or autism (1) Where a patient with a learning disability or autism or someone awaiting an autism assessment is subject to long-term segregation under this Act, the responsible clinician must ensure notification of the placement in long-term segregation is sent within 72 hours to (a) the Secretary of State or a body designated by the Secretary of State, (b) the hospital managers (or equivalent governing body), and (c) the relevant NHS commissioner. (2) Notification under subsection (1) must include –

None

After Clause 4, insert the following new Clause- “Long-term segregation: safeguarding and oversight After section 125F of the Mental Health Act 1983, insert - “125FA Safeguarding and oversight for patients with learning disabilities or autism in long term segregation (1) Where long-term segregation is applied to a patient with a learning disability or autism or someone awaiting an autism assessment under this Act, the Secretary of State or a body designated by the Secretary of State must initiate an investigation where- (a) the conditions of long-term segregation fail to comply with the minimum standards set out in the Code of Practice issued under section 118 of this Act, (b) the patient is subject to continuous long-term segregation exceeding 15 consecutive days, (c) the patient is subject to multiple episodes of long-term segregation which, in total, exceed 15 days within any 30-day period, or (d) long-term segregation is applied to a patient who is under the age of 18. (2) Where an investigation under subsection (1) identifies breaches of human rights or failures to implement care that is the least harmful and restrictive, the designated body must promptly notify the Secretary of State. (3) Upon receiving notification under subsection (2), the Secretary of State must initiate a safeguarding review into the use of restrictive practices concerning the patient.

None

After Clause 4, insert the following new Clause- "Long-term segregation: independent medical review After section 125F of the Mental Health Act 1983, insert- "125FA Independent medical review of long-term segregation of patients with learning disabilities or autism (1) Upon receipt of notification that a patient with a learning disability or autism or someone awaiting an autism assessment has been placed in long-term segregation under section (Safeguarding and oversight), the Secretary of State, or a body designated by the Secretary of State, must arrange for an independent medical practitioner or other specialist practitioner to be appointed to undertake a review within 28 days. (2) Where the conditions of long-term segregation fail to meet the minimum standards specified in the Code of practice issued under section 118 (Code of practice), the Secretary of State or designated body must ensure that the review under subsection (1) is expedited and undertaken as soon as practicable. (3) The responsibilities, procedures, and reporting requirements for independent medical practitioners appointed under this section must be detailed within the Code of practice issued under section 118.”

None

After Clause 4, insert the following new Clause- "Segregation: oversight After section 125F of the Mental Health Act 1983, insert- "125FA Hospital managers' oversight of long-term segregation of patients with learning disabilities or autism (1) The hospital managers must appoint a Responsible Officer to oversee the care of any patient with a learning disability or autism or someone awaiting an autism assessment who is subject to long-term segregation within the hospital. (2) The Responsible Officer appointed under subsection (1) must- (a) review each case of long-term segregation at intervals no greater than 28 days,

None

After Clause 51, insert the following new Clause – "Segregation: code of practice After section 118 of the Mental Health Act 1983, insert- "118A Code of practice revision relating to long-term segregation for patients with learning disabilities or autism (1) The Code of practice issued under section 118 of this Act must be revised within four months from the date on which the Mental Health Act 2025 comes into force, to include updated guidance regarding the procedures for the use of long-term segregation for patients with learning disabilities or autism or someone awaiting an autism assessment. (2) The revised Code of Practice must specifically address (a) the definition of long-term segregation, (b) criteria for initiating, continuing, and ending long-term segregation, (c) minimum standards and safeguards for patients subject to long-term segregation, (d) requirements for regular review, oversight, and independent scrutiny of cases involving long-term segregation, and (e) the roles and responsibilities of healthcare professionals and oversight bodies in relation to long-term segregation for patients with learning disabilities or autism.”

None

After Clause 51, insert the following new Clause – “Accountability for non-compliance with the code of practice After section 118 of the Mental Health Act 1983 insert- "118A Accountability for non-compliance with the code of practice (1) Where a failure to comply with the code of practice issued under section 118 results in a breach of a detained patient's rights or safeguards under this Act, the Secretary of State, or a body designated by the Secretary of State, must investigate and ensure appropriate corrective action is taken. (2) Following an investigation under subsection (1), the Secretary of State or designated body will issue a compliance notice to the relevant hospital managers, responsible clinician, or NHS body.

2

Clause 4, page 7, line 32, at end insert—<br> “(v) a person or persons with parental responsibility who have not received a court order restricting the exercise of their parental responsibility.”

11

Clause 6, page 12, line 40, at end insert—<br> “(2A) In section 17B (conditions) after subsection (7) insert—<br> “(8) The responsible clinician must ensure that community treatment orders align with the code of practice as set out in section 118(2B).<br> (9) A community treatment order shall have a maximum duration of 12 months, subject to the following provisions—<br> (a) the responsible clinician may extend the duration of a community treatment order beyond 12 months only after—<br> (i) consulting the patient, the patient’s nominated persons, and any relevant mental health care professional involved in the patient’s treatment or care planning;<br> (ii) undertaking a review process to evaluate the ongoing necessity and therapeutic benefit of the community treatment order;<br> (iii) consulting a General Medical Council registered psychiatrist regarding the conditions of the community treatment order and obtaining their written agreement that an extension is necessary and in accordance with the principles set out in section 118(2B);<br> (b) community treatment orders with a duration of less than 12 months are not subject to the review process set out in subsection (9)(a)(ii);<br> (c) a tribunal may recommend that the responsible clinician consider whether to extend, vary, or terminate the duration and conditions of a community treatment order.<br> (10) Where a community treatment order is extended beyond a period of 12 months, the order shall be subject to review at intervals not exceeding six months, in accordance with the procedure set out in subsection 9(a).<br> (11) At the conclusion of the default period or any extended period, the responsible clinician must undertake a review to assess the effectiveness of the community treatment order in aligning with the code of practice stipulated in section 118(2B).””

<p>This amendment ensures that community treatment orders align with the code of practice, limits their default duration to 12 months, requires a structured review process for extensions, mandates six-monthly reviews for extended orders, and reinforces patient consultation and oversight by mental health professionals.</p>

25

Schedule 2, page 72, line 31, at end insert—<br> “(d) a person or persons with parental responsibility who have not received a court order restricting the exercise of their parental responsibility.”

27

Schedule 2, page 75, line 19, at end insert—<br> “(vi) the witness has, where applicable, consulted a person or persons with parental responsibility who have not received a court order restricting the exercise of their parental responsibility”

51

After Clause 51, insert the following new Clause—<br> <b>“Determination of ability to decide for persons under 16</b><br> (1) For the purposes of this Act and the Mental Health Act 1983, a person aged under 16 (referred to in this section as a child) is able to make the relevant decision if they can—<br> (a) understand the information relevant to the decision;<br> (b) retain the information;<br> (c) use or weigh that information as part of the process of making the decision;<br> (d) communicate their decisions (whether by talking, using sign language or any other means).<br> (2) Where a child is able to decide in accordance with subsection (1) above, that child will be competent for the purpose of this Act.<br> (3) A child is not to be regarded as unable to understand the information relevant to a decision if he is able to understand an explanation of it given to him in a way that is appropriate to his circumstances (using simple language, visual aids or any other means).<br> (4) A person determining a child’s ability to decide under this section must—<br> (a) have due regard to Article 12 of the United Nations Convention on the Rights of the Child adopted and opened for signature, ratification and accession by General Assembly resolution 44/25 of 20 November 1989 (“the Convention”), and<br> (b) must be able to show reasonable grounds for their belief that the child is or is not able to make the relevant decision.<br> (5) When considered by any appropriate court or tribunal, any question whether a child is able to make the relevant decision within the meaning of this Act must be decided on the balance of probabilities.”

<p>This amendment inserts a test for determining a child’s ability to make decisions (competence) under the Mental Health Act.</p>

50

After Clause 51, insert the following new Clause—<br> <b>“Workforce sufficiency assessment by Integrated Care Boards</b><br> After section 142C of the Mental Health Act 1983 (inserted by section 51 of this Act), insert—<br> <b>“142D</b> <b>Workforce sufficiency assessment by Integrated Care Boards</b><br> (1) Each Integrated Care Board must conduct a workforce sufficiency assessment every two years to evaluate whether it has sufficient workforce resources to deliver services under this Act effectively.<br> (2) The assessment may include—<br> (a) an analysis of current workforce levels across all relevant service areas;<br> (b) identification of workforce shortfalls;<br> (c) an evaluation of the impact of staff shortages on patient care and service delivery;<br> (d) proposals to address workforce challenges.<br> (3) Integrated Care Boards may consult any relevant personnel or organisations they deem appropriate when conducting the assessment.<br> (4) Each Integrated Care Board must publish a report outlining its findings upon completing the assessment.<br> (5) The first reports must be published 12 months after the day on which the Mental Health Act 2025 is passed.””

<p>The amendment requires Integrated Care Boards to produce a biennial report assessing workforce sufficiency, identifying shortages, and proposing measures to address workforce challenges in delivering services.</p>

48

After Clause 51, insert the following new Clause—<br> <b>“Review and reporting on inequalities in Mental Health Act Measures</b><br> (1) As soon as reasonably practicable after the end of each calendar year, the Secretary of State or appropriate national authority must conduct a review, in consultation with relevant bodies with commissioning functions, on the use of treatment and detention provisions contained in the Mental Health Act 1983, broken down by race and other demographic information.<br> (2) Having conducted a review under subsection (1), the Secretary of State or appropriate national authority must publish a report on the progress made in reducing inequalities in treatment outcomes and the use of detention under the Mental Health Act 1983 on people who have protected characteristics under the Equality Act 2010.<br> (3) In this section “the appropriate national authority” means—<br> (a) in relation to services or unit whose area is in England, the Secretary of State;<br> (b) in relation to units or services whose area is in Wales, the Welsh Ministers.”

<p>This amendment requires the Secretary of State or Welsh Ministers to review and report annually on the use of treatment and detention measures under the Mental Health Act 1983, analysing data by race and other demographics to assess progress in reducing inequalities for those with protected characteristics under the Equality Act 2010.</p>

49

After Clause 51, insert the following new Clause—<br> <b>“Addressing and reporting on racial disparities and other inequalities</b><br> After section 120D of the Mental Health Act 1983, insert—<br> <b>“120E</b> <b>Mental health units and services to have a responsible person</b><br> (1) A relevant health organisation that operates a mental health unit or community mental health service for qualifying patients must appoint a responsible person for that unit or service for the purposes of addressing racial disparities related to functions discharged under this Act and the Mental Health Act 2025.<br> (2) The responsible person must—<br> (a) be employed by the relevant health organisation, and<br> (b) be of an appropriate level of seniority.<br> (3) Where a relevant health organisation operates more than one mental health unit or service, that organisation must appoint a single responsible person in relation to all of the mental health units or services operated by that organisation.<br> <b>120F</b> <b>Policy on racial disparities</b><br> (1) The responsible person must publish a policy on how the unit plans to reduce racial disparities in that unit or service.<br> (2) The policy published under subsection (1) must cover but is not limited to the following topics—<br> (a) steps being taken to reduce racial disparities and other disparities in that unit or service;<br> (b) staff knowledge and competence in connection with anti-discriminatory practice in relation to this Act;<br> (c) disparities in workforce demographics, recruitment, retention and progression;<br> (d) implementation of the patient and carer race equality framework (England only) and any other requirements of relevant national policies;<br> (e) care planning and decision-making in the use of this Act including section 56A (making treatment decisions);<br> (f) the availability of alternatives to detention and involuntary treatment;<br> (g) take-up of independent mental health advocacy;<br> (h) the cultural appropriateness of independent mental health advocacy;<br> (i) access to and use of advance choice documents;<br> (j) what steps will be taken to reduce racial disparities and other disparities in that unit or service.<br> (3) Where a responsible person is appointed in relation to all of the mental health units operated by a relevant health organisation, the responsible person must publish a single policy under subsection (1) in relation to those units or services.<br> (4) Before publishing a policy under subsection (1), the responsible person must—<br> (a) consult any persons that the responsible person considers appropriate;<br> (b) have regard to the following matters—<br> (i) the views, wishes and feelings of people from racialised communities who have been detained;<br> (ii) the views, wishes and feelings of people with other protected characteristics who have been detained.<br> (5) The responsible person must keep under review any policy published under this section and may revise it periodically, publishing the revised version if changes are made.<br> <b>120G</b> <b>Training on racial disparity policy</b><br> The responsible person for each mental health unit or service must provide training for staff that relates to addressing racial disparities in that unit or service and the topics covered in section 120F(2).<br> <b>120H</b> <b>Recording of discharge of functions under this Act broken down by race and other demographic information</b><br> (1) The responsible person for each mental health unit or service must keep a record of the use of functions discharged under this Act, broken down by race and other demographic information.<br> (2) The responsible person must keep the record for three years from the date on which it was made.””

<p>This amendment requires mental health units and community services to appoint a senior responsible person to address racial disparities in the use of the Mental Health Act 1983, publish a policy on reducing inequalities, and provide staff training on anti-discriminatory practices.</p>

47

After Clause 51, insert the following new Clause—<br> <b>“Mental Health Commissioner</b><br> After section 142C of the Mental Health Act 1983, insert—<br> <i class="text-centre">“Mental Health Commissioner</i><br> <b>142D</b> <b>Independent Mental Health Commissioner: establishment</b><br> (1) There is to be an office known as the Office of the Mental Health Commissioner.<br> (2) The Office in subsection (1) must be established by the Secretary of State three months after the day on which the Mental Health Act 2025 is passed.<br> (3) The Office of the Mental Health Commissioner will be led by an individual appointed by the Secretary of State titled the “Independent Mental Health Commissioner”.<br> (4) The role in subsection (3) is referred to as the “Mental Health Commissioner”.<br> (5) The Mental Health Commissioner may appoint staff to the Office of the Mental Health Commissioner they consider necessary for assisting in the exercise of their functions in section 142E.<br> <b>142E</b> <b>Functions of the Commissioner</b><br> (1) The Mental Health Commissioner is responsible for overseeing the implementation and operability of functions discharged by relevant bodies and persons under the provisions of this Act, the Mental Health Act 1983, and the Mental Capacity Act 2025 particularly regarding the provision of treatment, care, and detention of people with a mental disorder.<br> (2) The Mental Health Commissioner must publish an annual report on the use of functions discharged under this Act, which must assess—<br> (a) the quality of mental health care treatment provided by relevant services;<br> (b) the accessibility of mental health care treatment services;<br> (c) the relationship between mental health and the criminal justice system;<br> (d) inequalities of mental health care provision regarding protected characteristics under the Equality Act 2010;<br> (e) the use and effectiveness of detention measures under this Act, including but not limited to Community Treatment Orders, for the purposes of therapeutic benefit outlined in section 1(2B);<br> (f) challenges surrounding stigma of mental health conditions;<br> (g) the accessibility of advice and support to mental health service users, their families and carers on their legal rights;<br> (h) other issues deemed appropriate by the Mental Health Commissioner.<br> (3) In fulfilling their duties under subsection (1), the Mental Health Commissioner may review, and monitor the operation of, arrangements falling within subsection (1), (2) and (3) for the purpose of ascertaining whether, and to what extent, the arrangements are effective in promoting the principles in section 118(2B) of this Act.<br> (4) Subject to any directions from the Secretary of State, the Commissioner may take action necessary or expedient in connection for the purposes of their functions.<br> (5) This may include—<br> (a) collaborating with health services, public authorities, charitable organisations, and other relevant entities, including NHS bodies, the Care Quality Commission, and the Parliamentary and Health Service Ombudsman;<br> (b) ensuring enforcement authorities and public bodies under the Mental Health Act 1983 have the necessary capacity and resources to adequately discharge duties under the Mental Health Act 1983 and this Act.<br> <b>142F</b> <b>Appointment, Tenure, and Remuneration of the Mental Health Commissioner</b><br> (1) The Secretary of State may by regulation make provision for the appointment, tenure, removal, and general terms of appointment of the Mental Health Commissioner.<br> (2) The Secretary of State may also by regulation determine the Commissioner’s remuneration, allowances, and pension entitlements.<br> <b>142G</b> <b>Examination of cases</b><br> (1) The Secretary of State may, by regulations, make provision for the examination by the Mental Health Commissioner of the cases of those who are detained under this Act receiving treatment by authorised mental health care providers.<br> (2) The Secretary of State may, by regulations, provide for the Office of the Mental Health Commissioner to access and examine relevant data on mental health treatment provision held by NHS England and any other authorities the Secretary of State considers appropriate.<br> <b>142H</b> <b>Regulations</b><br> (1) Regulations under sections 142F and 142G are to be made by statutory instrument.””

<p>This amendment establishes the office of the Mental Health Commissioner and makes provisions for relevant duties and responsibilities.</p>

1

After Clause 3, insert the following new Clause—<br> <b>“Application of the Mental Capacity Act 2005: autism and learning disability</b><br> (1) In Schedule 1A to the Mental Capacity Act 2005, paragraph 2, after the last line of the table, insert—<br> “<table class="top-and-bottom tableleft width-100" cols="3"><tbody class="left"><tr><td><p>Case F</p></td><td><p>P has autism or a learning disability and is not subject to any of the mental health regimes</p></td><td><p>See paragraph 5A</p></td></tr></tbody></table>”<br> (2) In Schedule 1A to the Mental Capacity Act 2005, paragraph 5, at end insert—<br> ““5A <span class="sub-para subsection"><span class="sub-para-num">(1)</span><span class="sub-para-text">This paragraph applies in Case F in the table in paragraph 2.</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(2)</span><span class="sub-para-text">P is ineligible if the following conditions are met.</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(3)</span><span class="sub-para-text">The first condition is that P objects to being—</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(a)</span><span class="sub-para-text">admitted for treatment as a mental health patient, or</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(b)</span><span class="sub-para-text">given some or all of the mental health treatment.</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(4)</span><span class="sub-para-text">The second condition is that a donee or deputy has not made a valid decision to consent to each matter to which P objects.</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(5)</span><span class="sub-para-text">In determining whether or not P objects to something, regard must be had to all the circumstances (so far as they are reasonably ascertainable), including the following—</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(a)</span><span class="sub-para-text">P’s behaviour,</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(b)</span><span class="sub-para-text">P’s wishes and feelings, and</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(c)</span><span class="sub-para-text">P’s views, beliefs and values.</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(6)</span><span class="sub-para-text">But regard is to be had to circumstances from the past only so far as it is still appropriate to have regard to them.</span></span><br> <span class="sub-para subsection sub-para-indented"><span class="sub-para-num">(7)</span><span class="sub-para-text">For the avoidance of doubt, Case F and this paragraph do not apply to determine P’s ineligibility in respect of admission for assessment of mental disorder.””</span></span>

<p>This amendment to the Mental Capacity Act 2005 would prevent the Deprivation of Liberty Safeguards scheme being used to replace detention under section 3 of the Mental Health Act for people with learning difficulties or autism who do not have a mental health condition.</p>