Government’s latest concessions on draft bill fail to mollify campaigners

July 20, 2005 in Mental Health, Workforce

The government’s first draft Mental Health Bill, published in
2002, attracted so much criticism that it went back to the drawing
board. But its second attempt, published late last year, is proving
to be no more popular with campaigners.

While the government made a few concessions in response last week
to a damning report from a parliamentary scrutiny committee, it has
failed to satisfy the alliance of mental health organisations that
are pressing for a radical redrafting of the bill.

Fears remain that the government is overreacting to rare cases of
violence by people with mental health problems by introducing
legislation that will drive people away from seeking help.

The main complaint still centres on worries that the laws will lead
to a big increase in the number of people who will be forced to
receive treatment, both in hospital and in the community.
Campaigners liken the latter to a form of house arrest, and are not
convinced by the government’s promise last week to look at setting
a clear definition of people who would be eligible for assessment
and treatment in the community.

Jane Harris, campaigns officer at charity Rethink, believes this
will not be enough and says the committee was “probably right” to
ask that this definition should be included on the face of the
bill.

She says evidence shows treatment in the community only works if
there are good community services but the bill does nothing to
ensure they are in place. Indeed, the government has said that the
bill is about the “legal process for bringing people under
compulsion” – not service provision.

But Harris believes the bill’s focus on compulsion “doesn’t make
sense when the rest of the work in mental health is about getting
people to recognise their problems”.

The government has also angered campaigners by rejecting the
recommendation that the bill include a test for “therapeutic
benefit” of treatment. It says treatment may need to be given in
some cases where it is “unlikely either to improve a patient’s
condition or prevent it worsening”.

But the Mental Health Alliance, a coalition of more than 70
organisations, says this risks “clogging up services with people
who cannot be treated and should not be there”.

Charity Sane is also concerned that the compulsory treatment of
people in the community will become a “temptingly cheap
alternative” to in-patient care while there continues to be major
shortages in the number of consultant psychiatrists and mental
health nurses.

The government also rejected the suggestion that it should
introduce separate legislation for people who pose a danger to the
public but can’t be treated, saying it would be wrong to detain
them “otherwise than under criminal law”.

And there are also concerns over its rejection of the committee’s
call for the bill to include a capacity test for compulsory
treatment.

However, there was some welcome news for campaigners, particularly
the government’s major concession – that people will not be subject
to compulsory treatment if their sole mental disorder is a
dependency on drugs or alcohol – and its recognition of the
importance of advance statements, which give patients the chance to
record in advance their refusal to receive certain treatments. But
these statements will not be binding on clinicians.

Although the government’s response made some promises of further
consultation, Harris says campaigners will now start to take their
fight for changes to MPs, in preparation for the government
presenting a bill to parliament once it revisits some aspects of
the draft.