White Paper; Ingenious or Expected?
Updated: Mar 6
Although looking good on paper, are the adjustments to the mental health act fulfilling to what the patients need?
To reform the mental health act, the UK government has recently published 'White Paper', launched by the department of health and social care in January this year. The White Paper was designed to augment to advocacy of the Mental Health Act 0f 2018 by Sir Simon Wessely's independent review. This sought what needed to change in both law and practice in order to deliver a modern mental health service that respects the patient’s voice and empowers individuals to shape their own care and treatment. The objective of the White Paper 2021, according to the UK government website is, "We want your views on changes to the Mental Health Act to help put patients at the centre of decisions about their own care. The alterations to the act are influenced by 4 principles: choice and autonomy, least restriction, therapeutic benefit, the person as an individual.
The reactions to these alterations are mixed; although appreciated and welcomed, they would be mistaken to propose the changes were a groundbreaking moment on how we approach mental healthcare. It is suggested that there are more problematic and substantial issues that the government failed to recognise within the alterations if they are entirely dedicated to refine things for their population suffering from mental illness. The guardian writes, "Reform of the act will do little to change the experience of care in a consistently underfunded system. A system that, for all the talk of parity of esteem between physical and mental healthcare, still lacks the money, workforce planning and community resources to provide adequate support."
So what is it that needs to be done? Firstly, the wards themselves need improvement; currently, they are not the therapeutic environments that they need to be with on some wards, eight or 10 people share a toilet or bathroom and an overall dissatisfaction with their facilities. Mostly, this is due to lack of acknowledgment of mental health over physical health. For instance, during the 2019 general election a new hospital building programme was announced, however, almost all of this money will be spent on physical healthcare, such as new accident and emergency departments, maternity wards and cancer centres. This, of course, is an incredible push for technology and facilitation for physical healthcare in the UK, however the neglect of mental health suggests that the mental health estate requires substantial investment and a good place to start would be with meaningful investment in new wards fit for the 21st century.
Secondly and perhaps most importantly, those with chronic mental illness accordingly sustain poor physical health, with consequently, a reduced life expectancy. As well as adding to the stigma around mental illness, poor integration of physical and mental healthcare can result in delays to patients accessing the help that they need. This means that there absolutely needs to be proper integration of physical and mental health services.
Essentially, people feel that if the government wants to get serious and committed to addressing and focusing on mental health as a substantial area for improvement in the UK, then the focus needs to be on so much more than the White Paper and the Mental Health Act. After many years of talking a good game, it is high time that the money and effort were spent in order to turn the rhetoric into reality.