Policy driven to restriction

Mental health services continue to have stigma attached to them,
and, despite government statements to the contrary, mental health
does not appear to be high on the priority list for funding.

In June last year, the draft mental health bill was unveiled, with
a focus on the detention of those individuals judged to be at risk
of committing a crime, and the proposals for compulsory community
treatment orders. I know from my own charity that these worry
people to the extent that they may not seek help for problems such
as depression, because of the fear of compulsion. The bill has
caused widespread anxiety and links mental illness with
dangerousness. As one in four people will be affected by a mental
health problem at some point during their life it seems absurd to
think that our society could be full of dangerous people.

With regard to special hospitals, I spent nine years as chief
executive and general manager of Broadmoor Hospital. During that
time we tried to move away from custodial care to developing
therapeutic programmes – public safety is more likely to be
enhanced if you prepare patients properly for discharge rather than
contain them. But since 1997, £52m has been spent on security
for special hospitals, with the result that clinicians are finding
it difficult to deliver care programmes because of restrictive
security practices. Why is this?

Looking at the security record of the special hospitals, the
justification for spending £52m is simply not there – it is
more about the government’s drive to contain.

A psychiatrist who left Broadmoor in 2002 recently told me that it
was not possible for care programmes for seriously ill patients to
be delivered in the way that clinicians wanted. The treatment that
is available is marred by unnecessary restrictions.

Although special hospitals are part of NHS trusts, there seems to
be considerable influence from the Home Office, which we also see
in the plans for mental health legislation. In my view, we are
taking retrograde steps in the treatment of mental illness, which
is not only sad and worrying for the health professionals
concerned, but damaging for the patients in need of help.

So will this government ever listen to those who constantly tell
them that poorly thought out policies and central control will
simply take us back 50 years?

Alan Franey is director of Buckinghamshire Association for
Mental Health and a reviewer for the Commission for Health
Improvement.