Fears patients with learning disabilities ‘will remain trapped in hospitals’ despite Mental Health Act changes

Wes Streeing says passing of the new Mental Health Act is ‘a personal milestone’ – but campaigners warn more work needs to be done

Thousands of patients with learning disabilities will remain trapped in hospitals despite “milestone” changes to the Mental Health Act, campaigners have warned.

The government’s new Mental Health Act, which includes changes to how the act is used to detain those with learning disabilities, received royal assent to become law on Thursday.

Writing exclusively in The Independent, health secretary Wes Streeting hailed it as “a watershed moment for mental health care in Britain” that will mean giving patients more rights over their care.

Campaigners and health leaders have welcomed the new law but warn that more than 2,000 people with learning disabilities and autism will remain stuck in hospital without a plan to bolster community support services.

In 2023, an investigation by The Independent revealed that 27-year-old Nicholas Thornton had been trapped in inappropriate settings, including psychiatric hospitals, for a decade, because NHS and social care services were unable to fund a place that could meet his needs in the community. Mr Thornton was finally granted a full community care package in 2024 and his own home, following the exposé.

Nicholas Thornton spent 10 years in hospital wards, but is now free after telling his story to The Independent and Channel 4 News (The Independent)

In 2018, the Conservative government launched a review of the Mental Health Act to look at how it needed to be updated in order to improve care. Its implementation was repeatedly delayed under the previous government, which was accused of stalling on the reforms. However, Labour pledged to bring it into force.

Mr Streeting said: “For too long, our mental health laws have been a relic of another era. The 1983 Mental Health Act is older than many of the clinicians now working under it.

“For four decades, it has too readily stripped vulnerable people of their dignity, their voice, and their agency. Its application has been unequal, leading to demonstrable racial inequalities.

“It’s seen autistic people and those with learning disabilities are detained inappropriately. And it has left families often shut out of the care of their loved ones.

“But today, this changes as we embark on a watershed moment for mental health care in Britain – the Mental Health Act receiving royal assent to become law. This is a personal milestone as the first piece of legislation passed by my department under this government. But much more importantly, it’s a promise kept to the thousands of vulnerable people who have been failed for decades by a system stuck in the past.”

Nicholas Thornton in his room at Rochford hospital in Essex (Emma Thornton)

The latest figures for November show 2,045 people with learning disabilities and autism are stuck in hospitals. Of those, 215 people are ready to be discharged but cannot be due to a multitude of reasons, including a lack of social care, with 43 per cent of those unable to leave because of a lack of housing.

Among the changes within the new act, patients can no longer be detained in a hospital under the Mental Health Act if they have no mental health condition. However, this clause will only come into place once the government ensures there is “robust” community support to allow them to be cared for outside of hospitals.

The government has committed to setting out a plan to address this; however, it has yet to commit to a timeline for funding.

Speaking with The Independent, Labour MP Jen Craft, who has lobbied for more mental health funding, said: “We need direction, something that kind of articulates that the government is serious about ending this, because it is a scandal. It’s outrageous. When you highlight some of the cases where people have found themselves basically locked in a room, with just a bare mattress on the floor, and not seeing anyone, only being able to speak to family members through a hole in the door.

“Without a clear direction as to ‘this is what good community support looks like’, on how we’re going to get there… realistically, the situation is just going to continue.”

The number of detentions under the Mental Health Act has increased 47 per cent in the last decade (iStock)

She said the plan for community support would need to be delivered within this parliament, with funding secured.

Jon Sparkes, chief executive of learning disability charity Mencap, said the act becoming law was a “landmark moment and a vital step towards ending the inappropriate detention of people with a learning disability and autistic people in mental health hospitals”.

He said: “This new legislation, after years of campaigning for changes to outdated and harmful sections of the Mental Health Act, is a milestone to celebrate. But the most transformative change will happen only when the government assesses that robust community support is in place.”

The government faced criticism earlier this year for dropping a commitment called the Mental Health Investment Standard. Brought in under the Tory government, it committed to increasing spending on mental health services to a greater degree than the growth of investment in physical healthcare services to address decades of underinvestment in the sector.

Responding to the confirmation of royal assent for a new Mental Health Act, chief executive of NHS Providers Daniel Elkeles said: “It’s time to give mental health the priority it deserves and this is an important and long overdue step forward. But reform of the Mental Health Act alone will not be enough.

“It will be vital to address the underlying issues driving pressures on services, and to ensure sustainable funding, with investment in the mental health workforce and services in the community, to deliver care in the right place at the right time.”