Key takeaways
Bill reshapes detention and treatment pathways
Providers must adapt to stricter admission criteria and oversight.
Community care will take on greater responsibility
Shift from inpatient settings demands robust local support systems.
Early planning ensures compliance and continuity of care
Training and policy updates critical for smooth implementation.
Mental Health Bill: provider focus
Inpatient and community mental health teams
The Mental Health Bill which will bring reform of the Mental Health Act 1983 (MHA) is progressing through Parliament. It has just passed Report stage and 3rd reading on 14 October 2025 and is now in Parliamentary ‘ping pong’ where the House of Commons and House of Lords resolve their differences relating to the Bill.
This article provides a ‘light touch’ exploration of the impact of key changes for the mental health provider sector, namely inpatient and community mental health services.
New detention criteria
Detention under section 2 and section 3 MHA 1983 will require evidence of a risk of serious harm to self or others, and consideration of the ‘likelihood’ of that serious harm arising when considering the need to detain a patient.
This will affect initial assessments for detention and renewals of detention.
Relevant to AMHPS, section 12 doctors, other clinicians involved in assessment for detention, liaison teams, inpatient teams and CMHTs
These changes will also apply to the grounds for making a community treatment order (‘CTO’), and Tribunals considering criteria for discharge from detention in hospital or CTOs.
Amendments to appropriate treatment criteria including this needing to be of therapeutic benefit.
LD and/or ASD and Section 3 detention
Autism and learning disability will no longer be grounds for detention under Section 3 MHA 1983 unless there is a co-occurring psychiatric disorder.
Relevant to inpatient teams (admission criteria), community teams (care planning and risk management)
Will need to consider available legal frameworks to provide lawful, safe and effective care and/or treatment in hospital or in the community.
Advance Choice Documents (ACDs)
Integrated Care Boards (ICBs) will have duties to ensure support for patients in making ACDs – this is likely to form a part of mental health provider commissioned services.
Relevant to community teams (early intervention/CMHTs), inpatient teams (discharge planning).
The Bill will place duties on health bodies to make information available about, and help people to create, ACDs. Clinicians must have regard to these documents, though aside from advance decisions to refuse treatment they will not be binding. More guidance will be provided in the Code of Practice.
Responsible Clinician (RC) consultation duty
RCs must consult with another professional before discharging a patient.
Relevant to inpatient teams (discharge process), community teams (post-discharge support).
Supervised discharge powers
A new option for supervised discharge will be available for some Part 3 patients.
Relevant to inpatient teams (discharge planning), community teams (monitoring and support).
Care and treatment plans – Statutory requirement
All detained patients must have a statutory care and treatment plan, co-produced with the patient and their nominated person.
Relevant to inpatient teams (care planning), community teams (continuity of care).
Nominated Person replacing nearest relative
Patients can choose a Nominated Person to be involved in decisions about their care and detention under the MHA 1983.
Relevant to both inpatient and community teams alongside AMHPs – affects admission, who can exercise rights in relation to discharge and decision-making processes.
Dynamic Support Registers (DSRs) and Care, (Education), Treatment Reviews (C(E)TRs)
Whilst ICBs will hold duties to establish and maintain DSRs (registers of people with LD and/or ASD at risk of detention) and to ensure C(E)TRs take place, both inpatient and community teams will play a significant role in ensuring these happen.
Relevant to community teams for identification and early intervention and care coordination, and discharge and care planning for inpatient teams.
Removal of prisons/police cells as places of safety
These settings will no longer be used for patients in crisis.
Relevant to mental health liaison teams, crisis response teams.
Significant changes to the Code of Practice
The amendments arising from the Bill will also see the Code of Practice being significantly updated, shifting the focus away from public protection to patient autonomy, choice and dignity considering their values, beliefs, and past experiences.
Four key principles set out below will appear on the face of the MHA 1983, which mental health providers will need to consider when making decisions:
choice and autonomy – ensuring service users’ views and choices are respected
least restriction – ensuring the MHA’s powers are used in the least restrictive way
therapeutic benefit – ensuring patients are supported to get better, so they can be discharged from detention under the MHA 1983
the person as an individual – ensuring patients are viewed and treated as individuals.
Much will be clarified in the Code of Practice and Regulations that will follow the Bill achieving Royal Assent. It is expected to come into force in stages, and some sections will take several years to come into force, with others coming in immediately.
