Mental health law changes could put autistic people at risk
By: Communications
Proposed reforms to the Mental Health Act (MHA) in England and Wales could inadvertently strip vital protections from autistic people and those with learning disabilities – according to UEA experts.
They say the move could lead to greater risk of criminalisation, homelessness, and reduced access to care.
Dr Peter Beazley is a clinical associate professor and clinical psychologist, with experience working in inpatient mental health settings. He is also involved in research, teaching and training in the clinical applications of Mental Health Law.
He has submitted evidence to the Commons Mental Health Bill Committee.
The changes, which aim to restrict the use of compulsory hospital detention for people with autism and learning disabilities, have been criticised for potentially forcing professionals to rely on weaker legal frameworks, such as the Deprivation of Liberty Safeguards (DoLS).
These alternative mechanisms lack key protections, including robust rights to appeal, automatic tribunal review, and funded aftercare support under Section 117 of the current Act.
Study at Norwich Medical School
Why the proposed changes won't work
In a detailed report to the Committee, Dr Beazley, argues that while the intention behind the reforms is to reduce unnecessary institutionalisation, they could have the opposite effect – with an increase in the number of autistic people entering the criminal justice system.
He said: “There are many positive intentions behind these reforms, but the current proposals risk creating more problems than they solve. Compulsory care for people with autism and learning disability must improve, but this is not the way to do it.
“The group who these changes are intended to protect may in fact be directly and significantly disadvantaged.
“Most autistic people or people with a learning disability present no risk to others. But in some cases, risk-related behaviours - such as fire-setting or stalking - require effective and responsive care. Hospital detention is currently a key mechanism to prevent harm and support recovery.
“The proposed changes mean that autistic people or with a learning disability, would be more likely to go to prison because they can no longer be detained under the Mental Health Act.
More autistic people could be sent to prison
“Without access to hospital detention, individuals experiencing crises may face unmanaged escalation of risk in the community, leading to arrest and imprisonment.
“For those with the most profound impairments who commit significant acts of violence, there is also a separate concern that they may in practice be left with literally nowhere to go because routes to compulsory care through both the hospital and criminal justice systems will be effectively closed.”
Drawing on international comparisons, Dr Beazley points to New Zealand’s experience with similar legislative reforms. After changes to its mental health laws, several people with learning disabilities committed serious offences following unsupervised community release. New Zealand has subsequently rolled back these reforms.
Dr Beazley is also critical of the proposed legal definition of autism in the proposed legislation, describing it as overly broad and poorly suited to the purpose of exclusion from the Act.
“The changes may cause unintended consequences for people without autism or learning disability by unintentionally excluding those people from the scope of the Mental Health Act and therefore rendering them less able to access the support they need - in particular, people who have conditions which may overlap with aspects of autism or learning disability, such as schizophrenia or personality disorder.
“In practice, this may mean that mental health tribunals, which make independent decisions about when to release people who are detained, end up releasing people simply because they have a condition with similarities to autism - even if they continue to present a risk to themselves or other people, and even if they don’t actually have autism.”
These concerns are more fully outlined in an article due imminently for publication in the British Journal of Psychiatry, which reflects the collaborative views of 21 academics and four carer authors who have significant collective expertise in this area.
Among their recommendations, Dr Beazley and colleagues are urging the government to:
- Remove Clause 3 from the legislation.
- Develop clearer, research-based definitions of autism and other clinical conditions which can be applied effectively in law.
- Retain or expand legal routes to care for individuals as an alternative to arrest.
- Learn from the unintended consequences of international policy changes, particularly those seen in New Zealand.
- They also call for urgent consultation and further research before any changes are implemented.
“We are at risk of replacing hospital-based detention with prison-based deprivation of liberty that is even less transparent, less safeguarded, and more harmful,” he said.
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