The Mental Health Act 2025 will affect mental healthcare in England and Wales, centring on community-based services, service user rights and therapeutic benefit

The Mental Health Act 2025 is the most significant overhaul of mental health legislation in England and Wales for more than 40 years. Designed to modernise the delivery of mental health and learning disability care, it replaces the 1983 act.

‘Central to the new act is increased autonomy granted to service users, who will gain greater rights in how their care is managed’

Service users, families and professionals working in mental health and learning disability services were involved in shaping the new act. As a result, the legislation is expected to have a lasting impact on how care is provided for years to come. 

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Central to the new act is increased autonomy granted to service users, who will gain greater rights in how their care is managed. There is emphasis on community-based care and notable restrictions have been introduced about the use of the act to detain individuals with autism and/or learning disabilities.

Changes to Mental Health Act prioritise therapeutic benefit over detention

These changes are intended to prioritise therapeutic benefit over detention, with stricter criteria to ensure that detention is used only as a last resort. It also aims to tackle the disproportionate detention of black people in the mental health system.

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The act introduces the concept of a ‘nominated individual’, chosen by the service user to act in a supportive role, replacing the previous nearest relative provision. Families and carers will also have greater involvement in decisions about treatment, reinforcing the principles of partnership and  decision-making in care.

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It is expected to take between eight and ten years before the act is embedded consistently in England and Wales.

An accompanying code of practice is also under development and some organisations are starting to introduce elements such as Advance Choice Documents.

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The act will have a profound impact on how mental healthcare is provided with increased expectations for community-based services and a renewed focus on service user rights and therapeutic benefit.

Emma Wadey is consultant editor, Mental Health Practice