The Northern Ireland executive has been hailed for announcing plans for a “world-first” single piece of legislation covering people with mental health problems and those who lack capacity.
Mental health leaders said the proposal to have unified, rights-based mental capacity and mental health legislation – departing from the approach taken in England and Wales, and Scotland – would combat stigma against people with mental health problems.
Professor Dinesh Bhugra, president of the Royal College of Psychiatrists, said: “Scotland, England and Wales each have two pieces of legislation, which is often seen as one for ‘good’ people with incapacity who primarily require protection and another for ‘bad’ people who primarily need detention and treatment against their will.
Separate legislation ‘endorses stigma’
“This effectively endorses the stigma that people with mental illness face every day, and which inhibits recovery and is a barrier to people living fully inclusive lives.”
The overall principle of the bill will be autonomy, meaning individuals with mental capacity will be able to make decisions for themselves, even if they have mental health problems. Though Scotland has separate pieces of legislation this chimes with the approach taken there.
Alison Cobb, chair of the Mental Health Alliance, which fought a long campaign in defence of users’ rights during the passage of England and Wales’s Mental Health Act 2007, said this principle would help tackle discrimination.
Discrimination ‘serious problem’
Cobb, policy officer at Mind, said: “Discrimination is a serious problem with the Mental Health Act, as unlike treatment for physical health conditions, under the Act people with mental health problems can be treated against their will regardless of whether they are able to make their own decisions or not.
She said the Northern Irish proposals were “potentially more ethical, and more humane” and said she hoped it would inform legislation covering England and Wales in the future.
However, the Department of Health said it had “no plans” to revisit the Mental Health Act 2007.
The Northern Ireland bill will be ready for introduction to the province’s assembly during 2011 at the earliest.
The plan echoes proposals in the final report of the five-year Bamford Review into reforming mental health and learning disability policy, which called for unified, rights-based legislation.
In January, the province’s Department of Health, Social Services and Public Safety issued consultative proposals for two separate pieces of legislation, supported by an overarching set of human rights principles.
However, responses to the consultation indicated opposition to separate bills, particularly from professional groups and charities, on the grounds of potential stigma to people with mental health problems.
Northern Ireland health minister Michael McGimpsey said: “I remain committed to ensuring that those with a mental disorder or learning disability are treated on the same basis as any other person and that their dignity and human rights are fully protected. And, to demonstrate this commitment, my department will pursue this opportunity for a transformational legislative approach.”
Northern Ireland response
Ursula O’Hare, of the Mental Health and Learning Disability Alliance in Northern Ireland, said: “We are delighted with the minister’s innovative approach to reforming the law in this area. A single mental capacity and mental health bill will bring much needed clarity to this complex area of law for all who use it. Crucially, it will mean that all those who lack capacity will be treated on an equal basis under the same piece of legislation.”
Dr Philip McGarry, chair of the Royal College of Psychiatrists’ Northern Ireland division, said: “Drafting a world-first piece of legislation will be challenging, but there will be considerable goodwill in the mental health and legal community in Northern Ireland and the Royal College of Psychiatrists has pledged to work closely with the [department] to ensure that legislation will work in practice.”
Bamford Review put service user rights first in N Ireland