Mental Health Care: Bridging the Gap Between Policy & Practice

Our Senior Human Rights Officer, Annie, reflects on World Mental Health Day 2025 and BIHR's work to connect mental health practice with policy influencing.

This year’s World Mental Health Day is a good reminder to reflect on the importance of mental wellbeing and the urgent need for accessible services. This year’s theme focuses on access to mental health services in emergencies. Here in the UK, we can rely on the Human Rights Act (which must be followed every day, including during emergencies) to guide the delivery of rights-respecting mental health care. As a former mental health social worker, I wish I’d known more then about how the Human Rights Act can support staff to challenge and change decisions that affect the rights of people drawing on mental health services, as well as how it can be used by people experiencing mental distress to advocate for better care.

The wider data tells us a few things about the prevalence of mental ill health, as well as the systemic stresses on services that are there to help…

• 1 in 4 people in England will experience a mental health problem of some kind each year (Mind).
• Between 2023-2024, people were detained 52,458 times under the Mental Health Act in England (NHS Digital) and 7,109 detentions took place in Scotland (Mental Welfare Commission for Scotland).
• In their annual report, the Healthcare Inspectorate Wales which monitors the use of the Mental Health Act 1983, identified areas of concern requiring immediate action, including delayed reviews of patient observations, workforce challenges relating to recruitment and retention of staff, and incomplete risk assessments and care planning documentation.

At BIHR, our focus on the implementation of the Human Rights Act means we spend a lot of time focused on securing mental health support with individuals, communities, public services, and policy professionals. This is because the Human Rights Act is all about putting checks and balances on public power, and this law matters here because the assessment and treatment of people experiencing mental distress is largely controlled by the state.

Through BIHR’s work, we know that the law can be used as an advocacy tool by people accessing support as well as people working in the organisations providing it. Often both have the common goal of ensuring that mental health treatment is person-centred, non-discriminatory, and delivered in least restrictive way possible, with full consideration given to people’s legally protected human rights.

At BIHR, we work with public bodies and services to increase their ability to apply their duties to uphold this right and others in practice and to speak up when they are worried about rights being risked. But we know that in order for change to come about, it’s also about empowering individuals with the knowledge and confidence to recognise a human rights issue and work with services to reach better decision. That’s why when we are planning a programme of capacity-building support for public officials, we also push for workshops with people getting support from that service to tell them about their rights, listening to their experiences and using this to inform staff workshops.

However, in the current climate we see fewer and fewer public bodies investing in large-scale programmes to embed a human rights-based approach in mental health services. We know that resources are stretched, but the appetite is still there. To meet this need, BIHR has this year started delivering open online human rights workshops, prioritising staff who work in inpatient mental health services. In our spring programme, we were joined by five different organisations across England including NHS Trusts and independent care providers, and our upcoming autumn programme is set to further expand the range of services taking part. 

This programme has also exemplified BIHR’s efforts to ground our policy influencing work in practice. Since November 2024, BIHR has been focusing on shaping key elements of the Mental Health Bill to ensure it better supports people’s human rights. Our work on the Bill has been strengthened by this programme in two key ways:

• First, we sought to include a different perspective for participants attending the programme by ensuring one of the workshops was co-delivered with a Lived Experience Expert. Within the space of a few weeks, the Expert involved in this programme was also enabled by BIHR to give evidence directly to the Joint Committee on Human Rights as they scrutinised the Bill.
• Second, the programme allowed BIHR to reach new audiences, including independent providers of mental health services. This linked in with our work to secure an amendment to the Bill which would clarify that the Human Rights Act legal duties would apply to independent organisations providing mental health aftercare services. One of our new clients on this programme strengthened this work, stating that this would not be a burden and would in fact ensure consistency and promote the dignity of people they serve. 

On World Mental Health Day, we hope to see more situations where people’s insights and experiences are amplified to create a world in which respect for human rights is a reality, and not something that may be overlooked by those in positions of power.