Mental Health Act 2025

Prospective

4 People with autism or learning disability U.K.

In the Mental Health Act 1983, after Part 8 insert—

“Part 8A U.K. People in England with autism or learning disability

125A Children and young people with autism or learning disability: reviews

(1) The responsible commissioner must make arrangements for ensuring that care, education and treatment review meetings take place in relation to a patient if—

(a) the patient is liable to be detained under this Act in a hospital or registered establishment in England otherwise than—

(i) by virtue of an emergency application where the second medical recommendation referred to in section 4(4)(a) has not been given and received, or

(ii) by virtue of section 5(2) or (4), 135 or 136 or directions for detention in a place of safety under section 35(4), 36(3), 37(4), 38(4) or 45A(5),

(b) the patient is considered by the responsible commissioner to have autism or a learning disability,

(c) the patient—

(i) is aged under 18, or

(ii) is aged 18 or over and is a person for whom a plan is maintained under section 37 of the Children and Families Act 2014 (education, health and care plans), and

(d) either—

(i) the patient 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

(ii) the patient lacks capacity or competence to give that consent but the responsible commissioner considers that it is nonetheless in the patient’s best interests for the meetings to take place, and information to be disclosed and used, as mentioned in sub-paragraph (i).

(2) In this section “care, education and treatment review meeting” means a meeting, convened by the responsible commissioner, for the purpose of reviewing a patient’s case in order to—

(a) identify any needs of the patient for—

(i) social care provision,

(ii) special educational provision, or

(iii) medical treatment, and

(b) make recommendations about—

(i) whether and how any such needs can be met,

(ii) how the patient’s safety can be ensured while they are liable to be detained,

(iii) the discharge of the patient from the hospital or registered establishment under section 23 (where that section applies in relation to the patient), and

(iv) how to reduce any risk of the patient being re-admitted to a hospital or registered establishment following discharge.

(3) The arrangements under subsection (1) must include—

(a) arrangements for the preparation of a report (whether by the responsible commissioner or another person) setting out the needs identified, and recommendations made, at each meeting,

(b) arrangements for 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)—

(i) the responsible commissioner,

(ii) the patient’s responsible clinician,

(iii) the integrated care board that will have the duty under section 117 to provide or arrange for the provision of after-care services for the patient, and

(iv) the local authority in whose area the patient is ordinarily resident.

(The arrangements may also include provision authorising or requiring a copy of the report to be given to other persons.)

(4) The arrangements under subsection (1) must include arrangements for ensuring that—

(a) the first meeting in relation to the patient takes place within the period of 14 days beginning with the applicable day, and

(b) a further meeting takes place at least once in each successive period of 12 months for which the patient remains liable to be detained under this Act, beginning with the day on which the first meeting takes place.

(5) In subsection (4) “the applicable day” means—

(a) in relation to a patient who is liable to be detained by virtue of an emergency application—

(i) if, when the second medical recommendation referred to in section 4(4)(a) is received, the patient is considered by the relevant commissioner to have autism or a learning disability, the day on which that recommendation is received;

(ii) otherwise, the day on which the responsible commissioner forms the view that the patient has autism or a learning disability;

(b) in relation to any other patient—

(i) if, when the patient becomes liable to be detained as mentioned in subsection (1)(a), the patient is considered by the relevant commissioner to have autism or a learning disability, the day on which the patient becomes so liable;

(ii) otherwise, the day on which the responsible commissioner forms the view that the patient has autism or a learning disability.

(6) A patient may withdraw consent to the taking place of meetings and to the disclosure of information in accordance with arrangements under subsection (1).

(7) The arrangements under subsection (1) must include provision about—

(a) how consent to the taking place of meetings or the disclosure of information may be withdrawn;

(b) what is to happen when consent is withdrawn (which may include provision about who is to be informed).

125B Other people with autism or learning disability: reviews

(1) The responsible commissioner must make arrangements for ensuring that care and treatment review meetings take place in relation to a patient if—

(a) the patient is liable to be detained under this Act in a hospital or registered establishment in England otherwise than—

(i) by virtue of an emergency application where the second medical recommendation referred to in section 4(4)(a) has not been given and received, or

(ii) by virtue of section 5(2) or (4), 135 or 136 or directions for detention in a place of safety under section 35(4), 36(3), 37(4), 38(4) or 45A(5),

(b) the patient is considered by the responsible commissioner to have autism or a learning disability,

(c) the patient is aged 18 or over and is not a person for whom a plan is maintained under section 37 of the Children and Families Act 2014 (education, health and care plans), and

(d) either—

(i) the patient 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

(ii) the patient lacks capacity to give that consent but the responsible commissioner considers that it is nonetheless in the patient’s best interests for the meetings to take place, and information to be disclosed and used, as mentioned in sub-paragraph (i).

(2) In this section “care and treatment review meeting” means a meeting, convened by the responsible commissioner, for the purpose of reviewing a patient’s case in order to—

(a) identify any needs of the patient for—

(i) social care provision, or

(ii) medical treatment, and

(b) make recommendations about—

(i) whether and how any such needs can be met,

(ii) how the patient’s safety can be ensured while they are liable to be detained,

(iii) the discharge of the patient from the hospital or registered establishment under section 23 (where that section applies in relation to the patient), and

(iv) how to reduce any risk of the patient being re-admitted to a hospital or registered establishment following discharge.

(3) The arrangements under subsection (1) must include arrangements for—

(a) the preparation of a report (whether by the responsible commissioner or another person) setting out the needs identified, and recommendations made, at each meeting, and

(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)—

(i) the responsible commissioner,

(ii) the patient’s responsible clinician,

(iii) the integrated care board that will have the duty under section 117 to provide or arrange for the provision of after-care services for the patient, and

(iv) the local authority in whose area the patient is ordinarily resident.

(The arrangements may also include provision authorising or requiring a copy of the report to be given to other persons.)

(4) The arrangements under subsection (1) must include arrangements for ensuring that—

(a) the first meeting in relation to the patient takes place within the period of 28 days beginning with the applicable day, and

(b) a further meeting takes place at least once in each successive period of 12 months for which the patient remains liable to be detained under this Act, beginning with the day on which the first meeting takes place.

(5) In subsection (4) “the applicable day” has the meaning given by section 125A(5).

(6) A patient may withdraw consent to the taking place of meetings and to the disclosure of information in accordance with arrangements under subsection (1).

(7) The arrangements under subsection (1) must include provision about—

(a) how consent to the taking place of meetings or the disclosure of information may be withdrawn;

(b) what is to happen when consent is withdrawn (which may include provision about who is to be informed).

125C Reviews: supplementary

In exercising functions in relation to a patient in respect of whom a review meeting has taken place under section 125A or 125B, the following must have regard to the recommendations set out in a report prepared in accordance with that section—

(a) the patient’s responsible clinician;

(b) the responsible commissioner;

(c) the integrated care board to which the report is provided;

(d) the local authority to which the report is provided.

125D Registers of people at risk of detention

(1) Each integrated care board must, in accordance with this section, establish and maintain a register and include a person in that register if—

(a) the person is someone for whom the board has responsibility for the purposes of this section,

(b) the person is someone the integrated care board considers—

(i) to have autism or a learning disability, and

(ii) to have specified risk factors for detention under Part 2 of this Act, and

(c) either—

(i) the person consents to their inclusion in the register and the use, in accordance with this section, of information about them, or

(ii) the person lacks capacity or competence to give that consent but the board considers that it is nonetheless in their best interests to be included in the register and for the use, in accordance with this section, of information about them.

(2) The register must specify the local authority in whose area each person included in it is ordinarily resident.

(3) The Secretary of State may by regulations make provision about—

(a) the establishment and maintenance of a register under subsection (1);

(b) the information about a person that is to be included in a register;

(c) the obtaining by an integrated care board of—

(i) information for the purpose of determining whether subsection (1)(b) or (c) applies in relation to a person, or

(ii) information for inclusion in the register;

(d) the disclosure by or to any person of information included in a register or obtained by virtue of paragraph (c);

(e) the withdrawal of consent by a person to their inclusion in the register.

(4) The Secretary of State must by regulations specify the description of people for which each integrated care board is “responsible” for the purpose of this section, who must be people in relation to which the board has commissioning functions.

(5) In this section “specified risk factors for detention under Part 2 of this Act” means factors which are specified in regulations made by the Secretary of State as factors that the Secretary of State considers increase the probability of a person being detained under Part 2 of this Act.

125E Registers: duties relating to commissioning of services etc

(1) An integrated care board must, in exercising its commissioning functions—

(a) have regard to the information included in its register under section 125D and any other information obtained by it by virtue of section 125D(3)(c), and

(b) seek to ensure that the needs of people with autism or a learning disability can be met without detaining them under Part 2 of this Act.

(2) A local authority must, in exercising its market function—

(a) have regard to any information disclosed to it by virtue of section 125D(3)(d), and

(b) seek to ensure that the needs of people with autism or a learning disability can be met without detaining them under Part 2 of this Act.

(3) In this section “market function”, in relation to a local authority, means its function under section 5(1) of the Care Act 2014 (promoting diversity and quality in provision of services).

125F Guidance

(1) The Secretary of State must publish guidance for the following about the exercise of their functions under this Part—

(a) responsible clinicians;

(b) responsible commissioners;

(c) integrated care boards;

(d) local authorities.

(2) The persons referred to in subsection (1)(a) to (d) must have regard to guidance published under this section.

125G Interpretation of Part 8A

(1) In this Part—

• “commissioning functions”, in relation to an NHS commissioning body, means functions of the body in arranging for the provision of services as part of the health service continued under section 1(1) of the National Health Service Act 2006;

• “local authority” means—

  (a)

  a county council in England,

  (b)

  a district council for an area in England for which there is no county council,

  (c)

  a London borough council,

  (d)

  the Common Council of the City of London, or

  (e)

  the Council of the Isles of Scilly;

• “NHS commissioning body” means NHS England or an integrated care board;

• “responsible clinician” has the same meaning as it has in Part 2 (see section 34(1));

• “responsible commissioner”, in relation to a patient liable to be detained in a hospital or registered establishment, means the NHS commissioning body in pursuance of whose commissioning functions arrangements are required to be made for the patient's admission to the hospital or registered establishment;

• “social care provision” has the same meaning as it has in Part 3 of the Children and Families Act 2014 (see section 21 of that Act);

• “special educational provision” has the same meaning as it has in Part 3 of the Children and Families Act 2014 (see section 21 of that Act).

(2) References in this Part to a patient who lacks capacity are to a patient who lacks capacity within the meaning of the Mental Capacity Act 2005.

(3) In determining the ordinary residence of a person who is aged under 18 for the purposes of section 125A(3)(b)(iv) or125D(2), section 105(6) of the Children Act 1989 applies as if there were inserted after paragraph (c)—

“(d) while the child is being provided with accommodation under section 117 of the Mental Health Act 1983; or

(e) while the child is being provided with accommodation under the National Health Service Act 2006.”

(4) A person aged under 18 who—

(a) does not have an ordinary residence, and

(b) is living in a place listed in section 105(6) of the Children Act 1989, as modified by subsection (3) of this section,

is to be treated for the purposes of section 125A(3)(b)(iv) or125D(2) as ordinarily resident in the area in which they were present immediately before living in such a place.

(5) In determining the ordinary residence of a person who is aged 18 or over for the purposes of section 125A(3)(b)(iv), 125B(3)(b)(iv) or125D(2), section 39(1) to (6) of, and paragraphs 1(1), 2(1) and (2) and 8 of Schedule 1 to, the Care Act 2014 apply.”

Commencement Information

I1 S. 4 not in force at Royal Assent, see s. 56(3)