The final report of the Independent Review of the Mental Health Act 1983, published today (6 December), makes several very welcome proposals for strengthening the care and protection of children, including:
- That children’s capacity to consent to admission to a mental health unit, and to treatment for a mental disorder, be based on their understanding and communication, rather than strictly tied to age. The review recommends the Government undertake a consultation on whether parents should continue to be allowed to have children (aged under 16) admitted to mental health units against the child’s wishes. Currently domestic law gives children aged 16 and 17 the right to consent to medical treatment; below this age, consent is dependent upon the child’s understanding. (See a summary of the legal position on our rights4children website).
- That every child receiving in-patient care should have a care and treatment plan which clearly sets out their views and wishes.
- That the Government should consider introducing a duty on health providers to support families to stay in touch when a child is placed out of their home area; this could include financial support.
- That children’s right to independent mental health advocacy be extended to include care planning and making advance choices about care (this would include use of restraint). Very positively, the review recommends that advocacy be opt-out (taking the onus away from patients to seek support) and that children (and adults) in prison awaiting transfer to a mental health unit should have the right to an independent mental health advocate. Independent mental health advocates working with children and young people must be trained for this and providers should be required to produce quarterly reports, incorporating the views of those who have used their services, the review says.
- Greater attention should be given to meeting the health needs of African and Caribbean children at a much earlier stage, particularly those at risk of school exclusion.
- That children admitted to a mental health unit be legally defined as a child in need, thus entitling their parents to support from councils under Section 17 of the Children Act 1989.
- That the Care Quality Commission makes special efforts to obtain the views of children and young people when it inspects and reviews mental health services. It should be notified within 24 hours of every child placed out of their home area.
Read the full report here. Recommendations relating to children and young people, and parents, appear throughout the report and in a dedicated section on pages 167-177.