Sarah Markham: Independent review of the mental health act—including patients at the heart of the review

It is now almost a year since the prime minister Theresa May announced an independent review of mental health legislation and practice to tackle the issue of mental health detention. I have been part of a group of service users and carers who have been directly involved with the review process. The past 12 months have been exciting and at times very intense.

After the publication of the interim report of the review in May, specific topic groups were formed to consider the issues raised in the report. Throughout the past four months these groups have been hard at work formulating their own topic specific recommendations and reviewing recommendations emerging from their fellow groups. In September they will submit their recommendations to the review’s advisory panel, and the chair of the review, Simon Wessely.

The dominant and consistent theme throughout the review has been to achieve the best possible outcomes for patients and their families and carers. One of the most reassuring aspects of the review for me, is that at every meeting in which I have participated, everyone; judges, psychiatrists, lawyers, social workers, academics, regulators, other mental health professionals, and of course patients and carers, have acknowledged the terrible experiences that so many service users have endured under the Mental Health Act (MHA) and the imperative to change this for the better.

We know that the review hasn’t been taking place in a vacuum and that the ultimate outcomes will depend as much on the political climate as they will on the recommendations made by Simon Wessely in the final report. We have focused on producing recommendations that will be practicable and have the potential to lead to as much positive change for patients under the MHA as possible.

Simon Wessely committed to ensuring that patients are at the heart of the review from the very beginning and this promise has been kept. People with lived experience have informed and shaped every step of the review. Patients have responded to national online surveys. They have participated in focus and engagement events around the country. They have also submitted evidence to the review’s service user and carer group, which is comprised of individuals who are or have previously been detained under the MHA, or have experience caring for an individual who has been.

I have been impressed how none of the representatives from the various professional stakeholder groups have sought to dominate discussion or further their own interests; instead they have demonstrated consistent dedication to formulating possible recommendations which will have the desired effect of improving care and treatment for patients under the MHA.

I cannot overstate how wonderful it has been to have worked with so many very intelligent and dedicated people who have so clearly demonstrated both their concern for patients under the MHA and their determination to improve what can be for so many a very painful and traumatising experience. I would like to pay tribute to fellow patients and the carers who have had the courage to bear testimony to their personal experiences and those of their loved ones during the course of the review. As anyone who has been involved with people who have been caught up in mental health legislation will recognise; they are brilliant and often incredibly resilient individuals. No one is defined by their illness, but through dealing with the adversity that can come with it, many come to achieve remarkable things. Regardless of what happens in the wake of the final report, the MHA Review will leave a very positive mark on so many brave lives.

Sarah Markham is an academic mathematician and patient representative currently pursuing a second PhD in theoretical computer science. She is a member of the BMJ Patient Advisory Panel. Twitter: @DrSMarkham

Competing interests: None declared.