Pandering to prejudice

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.