Mental Health Bill published

The long-awaited mental health bill was published today by health minister Rosie Winterton outlining a raft of reforms aiming to modernise services.

The bill, which comes in the wake of two draft mental health bills abandoned by the government, controversially introduces supervised community treatment for patients to ensure they take their medication.

Speaking at the bill’s launch, Louis Appleby, national director for mental health at the Department of Health, said that failing to take medication had been a factor in a number of cases where a member of the public had been killed by someone who was mentally ill.

He said the supervised treatment would help to deal with “revolving door” patients.

“At the moment as a clinician you are in the position of discharging a patient into the community but you know that that person will be back in hospital in a few months. [having relapsed after stopping taking their medication] so clinicians and families are in an unacceptable position.”

The bill also replaces the treatability test, which states that compulsory treatment should only be given if it will make someone better, with an appropriate treatment test which will state that patients should be given appropriate treatment if it is available.

Health minister Rosie Winterton, who was also at the launch, said that the treatability test meant that some people who needed treatment were not getting it.

Essential mental health information

Response to the Mental Health Bill

Lucy Smith, mental health policy officer for rehabilitation agency Nacro, said: “Nacro welcomes the Bill’s proposals for a broader definition of mental disorder.  This means that some offenders with a diagnosis of personality disorder, who have previously been excluded from services, will be more likely to receive appropriate care and treatment. 

“However, offenders should not be detained under the Mental Health Act unless treatment is proven to be of real therapeutic benefit to them.

“Any amendments to mental health laws must be fully resourced.  Legislation alone will not prevent tragedies such as the murders of Denis Finnegan and Lin and Megan Russell. 

Professor Sheila Hollins, President of the Royal College of Psychiatrists said: “We will work with Parliament on the Mental Health Bill to ensure a modernised framework to deliver a safe and effective service for people with mental health problems.  The College is particularly concerned that any compulsory treatment should have a clear clinical purpose, and be of benefit to the patient.”

The College has other significant concerns:

* compulsion should be used as a last resort

* patients and carers must receive a full assessment of their health and social needs when they request it, and these assessments must be adequately resourced

* detained patients should have a right to advocacy

* patients should be able to decide whether or not to accept medical help if they have the capacity to make the decision for themselves

Rethink director of public affairs Paul Corry said: “Rethink fundamentally opposes the Government’s plans – the amended Bill is unfair to people with mental illness and their carers, unfit for purpose and unnecessary. The law as it stands can protect the public – but it doesn’t give people with mental illness enough rights.”

Rethink are calling for people with mental illness who are detained for treatment in England and Wales to be given the same rights as people in Scotland including:

–          Legal representation
–          A right to a review of their treatment in a reasonable time
–          A right to services they need
–          A choice to say, when well, what they want when ill; including which family members they want to be involved in their care.

Corry continued, “The proposed mental health bill is akin to making a law saying that people must attend gyms when gyms are in short supply, some are dirty with faulty equipment and many have too few staff to attend adequately to people’s needs. What the Government should be doing is giving people a right to the services they need.”

Andy Bell, chair of the Mental Health Alliance, said: “People who use services, their families and the people who work in them have for eight years campaigned for a better Mental Health Act. They will be profoundly disappointed with the flawed Bill being presented to Parliament today.

“The Alliance recognises that the Government has listened to some of its members’ concerns. But the Bill does not address the shortcomings in mental health law that were identified as long ago as 1999 by the Government’s own expert committee. The legislation falls far short of what is needed and does not truly reflect the needs of those who have to live and work with it. It introduces new powers for services without the necessary safeguards for patients.”

“The Government argues that requiring a person to be ‘treatable’ before they are detained is a major loophole in the Act, but there is no evidence that this is the case. Health legislation should not be used to impose treatment that has no benefit on a patient under compulsion. What matters most is that people with mental health problems have access to decent services that work well.”

Paul Farmer, chief executive of Mind, said: “It’s quality health services that will protect people, not this legislation, opposed by mental health experts across the board.  We hope that the widespread concern in Parliament will lead to the essential changes that must be made to give any chance of providing an effective mental healthcare system.  It is vital that health legislation is focused on benefiting and treating health problems. Treatment that cannot improve or treat a person’s health, should not be forcibly given to them.”

Campaign group BMH UK (Black Mental Health UK) have stepped up their offensive to tackle the widespread discrimination within mental health services  in response to the Governments new Mental Health Bill.

“The 1983 Act was really about depriving people of their rights and very little about protecting them, amending it  was a chance to put this right not make things worse. I am not even aware that a proper Race Equality Impact Assessment has been  done because we weren’t informed about the Bill. You can’t have a proper consultation without knowing what the amendments to the Bill are going to be.  I think it’s all been a bit of a charade this REIA,” said consultant psychiatrist Professor Suman Fernando, member of the National Black and Minority Ethnic Network.

“Failing to address the widespread discrimination within mental health services proved to be the stumbling block  that felled the Government’s proposals over the 2004 Mental Health Bill.  With such large numbers of Black people detained under this law, the Department of Health would be well advised to take on board the concerns of Black groups this time around,” Matilda MacAttram director of BMH UK said.

Useful links

Mental health bill

Department of Health