The 2025 Mental Health Act reforms, which received Royal Assent in December 2025, represented a "watershed moment" for UK mental health care, according to Health Secretary Wes Streeting. The historic update to the 1983 legislation primarily aims to end the inappropriate detention of people solely because they have a learning disability or autism.
However, campaigners, including Mencap, and the families of vulnerable patients warn that significant numbers will remain "trapped in hospital" despite the new law. They argue that legal reform alone cannot solve deeply rooted systemic problems and that the failure to invest in community support will render the new protections ineffective.Current figures indicate that more than 2,000 people with a learning disability and/or autism remain detained in mental health hospitals in England. A substantial number of these individuals do not need to be there but cannot leave because a critical shortage of appropriate housing and social care support exists in the community. Analysis by disability charities shows that the lack of suitable community placements detains over 40% of patients with learning disabilities and autism. This lack of community infrastructure is the major bottleneck preventing discharge. Advocacy groups reported that 215 people were already ready for release in late 2025 but institutions still held them. A separate 2025 review found 2,045 people in inpatient settings, often for periods far longer than clinically necessary.
Charities highlight that repeated government targets to halve the number of people in inpatient settings have been missed, and numbers have even increased in recent years. Critics attribute this failure to chronic underinvestment in community infrastructure. Crucially, the new Mental Health Act's provisions banning detention based solely on learning disability or autism depend on the government ensuring "robust" community support exists before they take effect. While this safeguard aims to prevent patients from being discharged into unsuitable environments, campaigners fear this conditional approach, without clear timelines and funded plans for service expansion, risks delaying reform indefinitely. They warn that alternative legal frameworks, such as the Mental Capacity Act, may continue to detain patients.
Family testimonies underscore the profound human toll, with some people spending years or even decades in inpatient settings because supported accommodation or care packages are unavailable. These long stays cause trauma and institutionalisation, and observers widely see them as a failure of the care system.
To translate the promise of the Mental Health Act into reality, Mencap and other sector organisations assert that urgent, adequately funded community services, including supported housing, specialist outreach teams, and early intervention, are essential. The success of the 2025 reforms will depend on whether the government and NHS leaders can pair these legal safeguards with a real-world, financial transformation of care pathways to enable thousands of people to live independently in their communities.
