What is the Mental Health Act Reform?

In December 2025 a new Mental Health Act became law in England and Wales. This new law updates the old Mental Health Act, which has been widely known as outdated for many years.

The reform is designed to make treatment fairer and to give people more control over their care.

What is the Mental Health Act used for?

The current Mental Health Act explains when someone can be taken into hospital for mental health treatment even if they do not agree to it. This can happen if professionals believe the person is at serious risk of harming themselves or others. The Act also sets out certain rights for people who are detained in hospital.

The old law has often been criticised for not involving people in decisions about their own treatment. Many people felt it did not protect dignity or respect personal wishes well. Campaigners also argued that the law was unfair in some cases, as some groups were more likely to be detained than others.

What the New Law Changes

The reform is based on four main ideas:

• People’s choices matter

• Care should be as least restrictive as possible

• Treatment should support recovery

• Every person is an individual

Along with these principles, the new law includes several specific changes.

1. Clearer rules for detention

Professionals must now clearly explain why someone needs to be detained. They must show:

• the person has a disorder that meets the legal definition

• detention will support recovery through treatment

• there is a real risk of serious harm without detention

These reasons must be written down and shared with the person.

2. Care and treatment plans

Everyone who is detained will have a written care and treatment plan. This plan must:

• be created with the person whenever possible

• explain the purpose of treatment

• show how the care will lead to recovery and discharge

If the person’s wishes are not followed, professionals must explain why.

3. Advance choice documents

People will be allowed to set out their treatment preferences in advance. This helps if they are unable to communicate their wishes during a crisis. These documents must be considered when decisions are made.

4. Better access to advocacy

More people will be able to get support from independent advocates. Advocates help people understand their rights and speak up about their needs. This support will be offered more widely.

5. Changes to community treatment orders

Community treatment orders will only be used when there is a clear benefit to the person. More professionals will need to agree before one is put in place. The rules for recalling someone to hospital will also be tightened so that it is only done when truly needed.

6. Changes for autistic people and people with learning disabilities

People will no longer be detained only because they have a learning disability or are autistic. They must also have a separate mental health condition that needs hospital treatment. This aims to reduce inappropriate and unfair detention.

7. Choosing a representative

People will be able to choose who represents their interests, instead of this role automatically going to the nearest relative. This allows people to have a voice and ability to pick someone they trust, such as a friend or carer.

8. Focus on treatment that benefits recovery

Detention must now be linked to treatment that will help the person get better. If there is no clear benefit, detention should not happen.

9. Better access to reviews and tribunals

People will have more opportunities to challenge decisions about their detention or treatment. Tribunals will be able to look more closely at whether the rules have been followed.

10. Stronger protection for children and vulnerable groups

The government and campaigners are still watching closely how the law will protect children, people with learning disabilities, and autistic people. Some final details will be decided during the next stages of planning.

When the Changes Will Start

Even though the new law has been approved, the changes will not begin straight away. Many parts of the system need time to prepare. Detailed guidance must be written so professionals know exactly how to put the new rules into practice. Because of this, it may take many months or even several years before all changes are fully in place.

The first major step will be creating a new Code of Practice, which will guide nurses, doctors, social workers and other professionals when they apply the law.

How the Changes Might Affect People

If the reform works as planned, people with mental health needs should feel more involved in their care. Detention should become clearer, more consistent and fairer. People should also have more support from advocates and more control over their treatment decisions. Campaigners hope these changes will create a system that is safer, more respectful and more focused on recovery.