Pandering to prejudice
The net is closing in on people with mental health problems. The Mental Health Bill, whose inspiration in places owes more to the Criminal Lunatics Act of 1800 than to enlightened thinking, implies a warning from the government to all those unlucky enough to have a mental illness: do as we say or we'll lock you up. And, sometimes, we'll lock you up anyway.
In this respect, three measures in the bill go hand in hand. People deemed to have untreatable personality disorders may be detained indefinitely, compulsory treatment orders will be available to compel those who refuse treatment in the community and approved social workers will no longer be assured of a key role in deciding when compulsory powers of the kind contained in the Mental Health Act 1983 should be applied. As such the bill would set into reverse one of the finest achievements of the user movement, that hard-won and still fragile right to exercise choice and a degree of self-determination. Needless to say, it has run into strong opposition from users, ASWs and even psychiatrists, who hardly need their dominance of the mental health system to be enhanced in this way.
It is here, in the shift of power away from social care to the medical establishment, that there is most cause for concern. As the structural distinction between social care and health care blurs, the need to enshrine their distinction in practice is more acute. ASWs have their roots in advocacy, protection of clients' interests, and the social model of care. If this tradition is pushed aside, the psychiatric establishment's tendency to find a pathological basis for every departure from the behavioural norm will grow unchecked. The line between eccentricity and mental illness will be obscured precisely when it ought to have been made clearer because of the aggressively restrictive measures contained elsewhere in this proposed legislation. The numbers of people forcibly admitted to psychiatric hospital have soared in the last decade and the Mental Health Bill will do nothing to improve matters.
Nor will it do anything to weaken the link in the public mind between mental illness and homicide. Instead of pandering to this tired old prejudice, the government ought to have built on the good work it has done in setting up the national service framework and investing in community solutions to mental health problems. The new bill is an incongruous throwback to 19th-century ideas of social control.
Freedom to complain
The government has an opportunity to use the Adoption and Children Bill to ensure children in the care system are given appropriate opportunities and support to complain about their treatment, whether at the hands of residential staff, adoptive parents or foster carers. It must not be missed.
It is not enough to enshrine the principle of complaints in the Children Act 1989. It is not enough to draw up a complaints procedure within a local authority. It is not enough to install a phone in a children's home with the number of ChildLine attached. Many adults are put off from complaining about the treatment they have received and many fear there will be repercussions. For young people who rely upon adults for their day-to-day care, it is even more difficult to contemplate complaining about their care giver's behaviour. That few complaints made by children in care are ever investigated is another deterrent.
Young people in the care system need substantial support in making a complaint. To ensure this, we need a national independent advocacy service.
