Mental health charities have outlined concerns on proposed
temporary changes to the detention of patients under the Mental
Health Act in the event of a pandemic flu outbreak.
Rethink and Mind warned that patient safeguards could be
compromised after the Department of Health yesterday issued
consultative proposals to ensure Mental
Health Act functions could be maintained should a flu outbreak
trigger severe staff shortages.
The consultation, which is unusually short, closes on 7 October
and would lead to the introduction of emergency legislation in the
early autumn.
Proposed changes
The proposed amendments fall into three areas:-
- Reducing from two to one the number of doctors required to
comply with a number of actions under the act, including detention
for assessment or treatment if the approved mental health
professional making the application believes there would otherwise
be an undesirable delay.
- Extending or suspending time limits that apply to certain
provisions - for instance suspending the requirement for a second
opinion appointed doctor (SOAD) to approve giving a patient
medication without consent if they have been in hospital for three
months or more.
- Allowing certain additional people to be approved to undertake
some specific functions - for example some recently retired
approved social workers may be temporarily approved to undertake
the role of the approved mental health professional.
'Fair and reasonable'
The consultation asks whether the overall package of proposed
amendments to the act is "fair and reasonable" and whether it will
be "effective and helpful" during staff shortages.
The DH said its intention was for the contingency measures to be
used "only be used if local circumstances make it necessary to do
so", while it would also ask regulator the Care Quality Commission
to convene a group including service user representation to advice
on the need to retain the measures.
Inappropriate detention warning
However, Mind's chief executive, Paul Farmer, said: "Any
proposals that will reduce the number of professionals involved in
the sectioning process are concerning. Sectioning effectively
deprives people of their liberty, and the reason that a number of
professionals are involved is to ensure that the best decision is
made for the patient, and no one is detained inappropriately. We
have to be clear that these are serious changes, and should only be
used as a last resort."
Rethink chief executive Paul Jenkins said it was right to plan
for an outbreak, but added: "The act is very carefully balanced,
ensuring that there are significant protections and safeguards for
individuals faced with losing their liberty and being forced to
accept treatment for an illness.
“We will be looking closely at the proposals and measuring them
against the need for people to access services early even during a
pandemic crisis and be protected at the same time."
Those with schizophrenia 'need vaccine
access'
He added that the DH should be offering people with
schizophrenia early access to the swine flu vaccine because of
their high rates of respiratory illnesses.
The current planning assumptions are for a 10-12% rate of
absence from work in the general population in the peak weeks of
the pandemic, but this could reach up to 25% in some health and
social care organisations where there are a high number of staff
with childcare and other caring responsibilities.
National director of mental health services
Louis Appleby said it was important to find out if temporary
changes in the act would help professionals and protect
patients.
'Exceptional circumstances'
He added: "We will also consider in what kind of exceptional
circumstances we might need to use them. It would only be in
exceptional circumstances and strong safeguards would remain in
place.
"We are determined to make sure we have a sensible,
proportionate approach that ensures that vulnerable mental health
patients continue to get the treatment they need, when they need
it, even in the event of staff absences. It is only sensible to be
prepared for every eventuality."
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