Kingston Council's Health Overview and Scrutiny Panel has discussed significant upcoming reforms to the Mental Health Act 2025, focusing on their impact on local services and residents.
The Mental Health Act 2025, which received Royal Assent in December 2025, aims to modernise mental health legislation, enhance patient autonomy, address racial inequalities in detention, and prevent the inappropriate detention of individuals with autism or neurodiversity. The reforms are being rolled out gradually over a ten-year period, with a new code of practice expected in 2027-2028. A major public consultation on the draft Code of Practice is anticipated in early 2027. This Code will instruct professionals on how to apply the new laws and will embed guiding principles of choice, autonomy, least restriction, therapeutic benefit, and individualised care, while also considering racial disparities and specific cohorts such as children and young people.
Key changes include stricter detention thresholds, requiring a serious risk
and therapeutic benefit
test for detention. Under the new Act, individuals will only be detained if they are at risk of causing serious harm and will receive therapeutic benefit from hospitalisation. The Act introduces the term 'psychiatric disorder', excluding autism and learning disability on their own, and states that the 'nature or degree' of the condition must relate to a treatable psychiatric condition. The criteria for detention will be amended so that individuals will only be detained if they are expected to receive therapeutic benefit and are at risk of causing 'serious harm' to themselves or others.
People with autism or learning disabilities will no longer be detained under Section 3 of the Act unless they have a co-occurring mental illness requiring hospital treatment. The Act states there will be a 'clear expectation of community-based alternatives.' The changes will only be commenced when there are 'strong community services' in place. Integrated Care Boards (ICBs) and local authorities have a duty to ensure that the needs of people with a learning disability and autistic people can be met without detaining them under Part 2 of the Act.
Alcohol and drug abuse on its own, without any mental disorder or mental illness, would not be grounds for detention under the Act. However, if there is comorbidity, meaning individuals have both mental illness and problems with drugs, they could be treated under the Act. Work is ongoing to support people with comorbid drug use and mental health needs in the community, including specialist mental health workers within drug and alcohol services and specialist drug and alcohol workers in the psychiatric liaison team.
The role of the Nearest Relative
will be replaced by a Nominated Person,
granting patients more control over who represents them. This nominated person will have strong legal rights to object to detention and be involved in care planning. The government has given a specific commitment to focus carefully on this area due to potential impacts, and a nominated persons task force is being developed. Approved Mental Health Professionals (AMHPs) will be heavily involved in shaping what this might look like, and capacity will need to be assessed at a given point to ensure the nominated person is chosen when the patient is in the right state of mind.
Patients will also be able to create Advanced Choice Documents
outlining their future treatment preferences when well. Independent Mental Health Advocates (IMHAs) will be automatically offered to patients unless declined.
Furthermore, police stations and prisons will no longer be used as places of safety for individuals in mental health crisis, with a requirement to take them to health-based settings. This is expected to increase demand on services such as A&E and crisis teams. The meeting noted that police stations have not been used as places of safety in Kingston since 2017. Kingston Hospital has a mental health assessment unit where people can be brought while awaiting their mental health act assessment. The Trust has two 'place of safety' suites at Springfield. There is ongoing work nationally to review the position of A&E departments and the potential increase in demand.
The reforms will also necessitate significant workforce training and potential expansion, particularly for Approved Mental Health Professionals (AMHPs).
During the meeting, Adriana Lazdins, Corporate Head of Service for Adult Social Care at Kingston Council, and Zoe Mears, Head of Social Work at South West London and St George's Mental Health NHS Trust (SWLSTG), along with Dr Felix Mendez, Consultant Psychiatrist at SWLSTG, provided detailed explanations. They highlighted that the full implementation of these reforms is dependent on the forthcoming Code of Practice and that resourcing plans will be developed as national requirements become clearer.
Councillor Roger Hayes inquired about Key Performance Indicators (KPIs) and milestones to measure the success of these changes. Specific KPIs are still being developed and will be clearer once the Code of Practice is published. The meeting was informed that the proposed Code of Practice will give a clearer idea of how things will happen. As an NHS provider, work has started on the care and treatment plan, which will have KPIs against it, including new deadlines for completion. The Trust has also looked at data around tribunals, as there will be additional tribunals at different periods of time.
Councillor Peter Higgins requested a summary of the differences between the new and old Acts, which officers agreed to provide. Councillor Jane D'Souza asked about the role of the police and places of safety. Public reports pack Thursday 09-Jul-2026 19.30 Health Overview and Scrutiny Panel and Agenda frontsheet Thursday 09-Jul-2026 19.30 Health Overview and Scrutiny Panel were referenced during the discussion.
