Bill proposes compulsory treatment orders and indefinite detention

The government confirmed plans for the
compulsory treatment in the community of people with mental health
problems this week.

Compulsory treatment orders would
cover an estimated 26,000 people a year under proposals in the
draft Mental Health Bill.

A
small number of patients with dangerous personality disorders could
be detained in secure accommodation indefinitely even if they are
considered untreatable.

The
role of approved social workers in referring clients for assessment
will be replaced by a new role of approved mental health
professionals, which will also include mental health nurses,
psychologists and occupational therapists.

Home
Office minister Hilary Benn said: “Our aim is to improve protection
for both patients and public. We want to ensure that everyone who
needs treatment either for their own safety or the protection of
others will receive it.”

Under
the bill, compulsory treatment must be provided in the least
restrictive setting that is appropriate to the patient’s needs. But
it must be consistent with the safety of the patient, carers and
the wider public.

A
mental health order act will set out the conditions with which a
patient must comply. These will include allowing access by mental
health staff, attending a day centre or taking medication. The
order will also set out the care team’s powers if the patient fails
to comply.

Patients will not be forcibly
medicated in their homes, but if they refused treatment they would
be transferred to a clinical setting.

All
compulsory treatment orders longer than 28 days in length will have
to be authorised by a new mental health tribunal. An independent
advocacy service will be created to assist patients.

Additional assertive outreach
teams and crisis intervention teams will be created to ensure that
people in the community comply with the compulsory treatment
orders.

Patients could be compelled to
receive treatment even if it cannot be proved that this would
alleviate their condition. However, the patient’s views and wishes
will need to be considered when a treatment programme is
decided.

The
bill introduces a single definition of mental disorder, which
states that the mental disorder is of a nature that requires
specialist mental health treatment for the safety of the patient or
protection of others and that the appropriate treatment for the
disorder is available.

Health
minister Jacqui Smith said: “This means that people with
personality disorders will no longer be excluded from compulsory
treatment on the grounds that they are untreatable, provided they
meet the criteria for compulsion.”