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MPA and NHS to examine policing and related mental health issues

The Metropolitan Police Authority and representatives from the National Health Service in London have launched a joint review into mental health and related policing issues.

Richard Sumray, chair of the MPA’s planning, performance and review committee, will co-chair the review with David Taylor, chair of Camden and Islington Mental Health Trust.

mpa.gov.uk 30 Sept

Mr Sumray said:

“This is an area of growing importance. There are very significant issues to be addressed in the relationships between police and mentally ill people and health services.

“This review is the first of its kind conducted by the MPA and aims to look at these issues in depth and propose recommendations which will lead to significant changes. It will have a stronger impact as it will be jointly run by police and the NHS.”

Mr Taylor said:

“This is a controversial area and we want to take an objective look at how we can improve services to people with mental health problems, and balance these with the needs of the wider community.”

The first review meeting is tomorrow and a report and recommendations are expected to be published mid-2005.

The review will explore a number of issues, including the exchange of information between agencies, the way in which police deal with mentally ill people, and how police can provide support to the health services when necessary.

The review panel drawn from members of the MPA and health services will hold a number of sessions in which people will be asked to give their views and experiences and conduct its own research. It will also draw on the advice of a significant number of experts in the field.

YOUNGSTERS DEPRIVED OF MENTAL HEALTH HELP

Depressed North Staffordshire teenagers are being denied help to cope with mental health problems because they live outside Stoke-on-Trent. The postcode lottery of care has developed because council officials have failed to come up with more than £20,000 of vital funding for a lifeline counselling charity.

thisisstaffordshire.co.uk 27 Sept

Hanley-based North Staffs Mind asked Staffordshire County Council for the cash so it could offer support to desperate youngsters from areas like Newcastle, the Moorlands and Stone.

Young people from the Potteries are being supported because officials in the city have given more than £72,000. But children from outside Stoke-on-Trent are being refused help because the county cash has not been handed over.

As Sentinel Sunday revealed yesterday, 16 youngsters are on a waiting list and 34 are being helped, but only because Mind bosses have dipped into their cash reserves.

Charity director Chris Bennett said: "We've put a stop on further clients from outside the city and have told the kids on the waiting list they may or may not get a service.

"We don't want to tell them they will get a service and then not be able to offer them one. "They've been told there is a funding problem and it's likely the service will be withdrawn in the future."

Mr Bennett added: "We have been running the service on our reserves for the last six months and we can't afford it.

"How many kids are not getting the service they need? What happens to them? They end up overdosing on drugs or self-harming. Either that or they are the people who will turn up in need of our adult services in 10 years' time."

Mind is the only specialist provider of counselling and support for young people besides a team of NHS experts in child and adolescent mental health.

Since June last year more than 500 clients, aged five to 21, have turned to the charity with a variety of emotional and psychological difficulties, including depression, anxiety, bullying and abuse.

National research has also recently highlighted a sharp decline in the mental well-being of Britain's teenagers over the last 25 years.

Mind's caseload comes from families who refer their own children but many clients are also sent by GPs, teachers, social workers and other professionals.

A county council spokesman said the authority provided £10,000 to the charity to help children from outside Stoke-on-Trent last year on the understanding it was "a one off".

"They have now approached us for another grant of more than double that amount. That's not available from any existing budgets but we are looking at ways we can help," he added.

"It is a worthwhile project but it could be a question of robbing Peter to pay Paul."

A spokesman for Newcastle PCT said: "It is unlikely at this present time that we would be able to commit funds to this project. However, we will keep the situation under review."

Nobody from Staffordshire Moorlands PCT was available for comment.

Medical profession dismisses police call to loosen patient confidentiality

Calls by a senior policeman for a review of the law on patient confidentiality to allow doctors to share information more easily on people with mental illnesses who may be dangerous have been dismissed as “nonsense” by the Royal College of Psychiatrists.

Vice president of the RCP Tony Zigmond said the General Medical Council’s rules already permitted doctors to breach confidentiality where they were concerned a patient may be a risk to others and they did not need to be reviewed.

“The difficult thing is identifying which people are a risk to others. To know that would be magical. But you can’t foretell the future, much as you would like to. There will always be tragedies because you just cannot stop them.”

He added that patients may decide to avoid treatment or not disclose everything if they felt their confidence might be broken.

Zigmond’s comments follow a call last week by Commander Andy Baker, Scotland Yard’s head of murder, that the law on patient confidentiality should be reviewed so doctors can share information more easily.

Baker is working on a number of research projects looking at ways in which murders can be prevented including looking at how agencies can identify which people with mental health problems may kill.

Charity SANE, which has been working alongside Baker, has backed the call. Chief executive Marjorie Wallace said: “Over emphasis on patient confidentiality to protect patients’ rights can conflict tragically with the rights of families and the community.”

Wallace added that work by the Metropolitan Police on an “urgent change in practice and attitudes …could prevent at least one third of the 48 homicides involving mental illness each year”.

But a spokesperson for the Sainsbury Centre for Mental Health said: “More important than a change in this law is that services users are really listened to. Our concern is that it has the potential to erode trust between doctors and service users.”

communitycare.co.uk 29 Sept

Mental Health Tribunal Headquarters confirmed

24/09/2004

Health Minister Malcolm Chisholm today announced that Bothwell House, Hamilton in South Lanarkshire will be the location for the headquarters of the new Mental Health Tribunal for Scotland.

The Headquarters will provide the office of the President, Chief Executive and, initially, 30-35 administrative and operational staff.

The new body, established under the Mental Health (Care and Treatment) (Scotland) Act 2003, will take and review decisions on long term compulsory care and treatment of people with a mental disorder.

Tribunals will be convened throughout Scotland in both hospital and community settings.

Panels with expertise in mental health law, care and treatment and will comprise of three members - one legal (the convenor) , one medical and one general member - and will make determinations on around 4000 cases each year.

The building chosen for the Headquarters will also provide a training base for tribunal members and will have a tribunal suite for hearings to take place.

Health Minister Malcolm Chisholm said:

"Today I am able to confirm that the location of the headquarters will be in Bothwell House, Hamilton in South Lanarkshire. We have been able to secure a building which meets the needs of this new body which will be a vital part of Scotland's new approach to mental health legislation and care.

"The Tribunal system will allow for patients and their carers to be more involved in care and treatment provided. I am delighted that we have been able to take a further step forward in delivering the provisions of this ground-breaking Act."

Locating the new body in Hamilton, South Lanarkshire is in line with the Scottish Executive policy of dispersing jobs throughout Scotland.

The Tribunal system is scheduled to begin hearings in April 2005. More information on the Tribunal can be found at: www.mhtscot.org

The Mental Health (Care and Treatment) (Scotland) Act 2003 can be accessed on the HMSO website.

Further information on the implementation of the Mental Health Act and its provisions can also be accessed on the Executive website.

The appointment of the President of the Mental Health Tribunal for Scotland is currently in progress.

Admission of Patients to Mental Health Facilities, 2003-04 (Wales)

Key points:

In 2003-04 there were 15,516 admissions to mental health facilities in Wales, down from 15,670 in 2002-03.

92 per cent of the admissions in 2003-04 were to NHS facilities in Wales, with the remainder admitted to independent hospitals.

1,387 were admitted under the Mental Health Act 1983 (excluding place of safety detentions) and other legislation compared to 1,362 in 2002-03.

Overall, more females were admitted than males, although of the formal admissions 57 per cent were males.

Part II admissions accounted for 93 per cent of formal admissions (excluding place of safety detentions) with over half of these (58 per cent) being admitted for assessment, with or without treatment (Section 2 of the Mental Health Act 1983).

External Link

Full Document

Discussion Paper on the Use of Guardianship and Intervention Orders

'Authorising significant interventions for adults who lack capacity'

The provisions of the Adults with Incapacity Act have brought many benefits to people who lack capacity and those who care for them.

The Act’s principles are widely regarded as setting a demanding and appropriate foundation for work with people who lack capacity. The Act has also established a wide range of statutory measures which can protect and promote their welfare. Guardianship is more flexible than it was under the Mental Health (Scotland) Act 1984 and guardians can be granted the powers to take those actions designed to meet an individual’s needs.

Unfortunately, however, the Act does not make clear when Welfare Guardianship or Intervention Orders should be sought.This uncertainty has led to widely different recommended practices.

Download full document

Doctors 'could spot murder risk'

The head of Scotland Yard's murder squad has urged a review of the law to make it easier for doctors to identify mentally ill patients who could kill.
Doctors can currently face disciplinary action for breaking a patient's confidentiality, even where they consider the person a serious danger.

Commander Andy Baker believes mental health professionals could hold the key to identifying potential killers.

But some senior psychiatrists disagree, saying such predictions are impossible.

Cdr Baker is attending a forensic science conference with leading psychiatrists and academics.

Speaking on BBC Radio 4's Today programme, he said his call was based on murder cases which he believed could have been prevented if health professionals had told police of the threat.

The threat was predominantly towards carers, parents and other loved ones, Cdr Baker said.

"There are cases where there has been a history of mental health support where someone hasn't had the confidence to raise it," he said.

"Rather than the doctor having to take the risk of sitting on it and one life being taken and one life going to prison for life, I think that doctor should be able, in confidence, to raise the issue so that it can be looked at and risk assessed."

Under the Police and Criminal Evidence Act, section 115, such threats can be raised in the interests of protecting the public.

Cdr Baker said some doctors "felt some tension between confidentiality towards their client - which I fully understand - and the issue of possibly saving a life.

"On proportionality terms, the saving of a life must come over and above that confidentiality."

However, he did emphasise that people who suffer from mental health problems were more likely to be victims of crime rather than perpetrators.

His views have received the support of mental health charity SANE.

Marjorie Wallace, the charity's chief executive, said: "Over-emphasis on confidentiality to protect patients' rights can conflict tragically with the rights of families and the community.

"Psychiatrists and mental health teams should work more closely with the police and families.

"SANE is working with the Metropolitan Police and others for an urgent change in practice and attitudes which we believe could prevent at least one-third of the 48 homicides involving mental illness each year."

Cdr Baker's call is also backed by Jayne Zito, whose husband Jonathan was stabbed to death by a mentally ill man in 1992.

Independent inquiries later found that vital information about Christopher Clunis, who was out of hospital under the care in the community programme, had not been shared.

The government is already planning enforced treatment of potentially dangerous mental health patients.

bbc.co.uk 24 Sept

STAFF PROBLEMS AT MENTAL HEALTH UNIT, SAYS REPORT

An independent commission has delivered its verdict on the state of mental health services in Devon. The report, by the Healthcare Commission, reveals that the Devon Partnership NHS Trust faces recruitment problems, together with issues of employees feeling bullied and harassed.

The health watchdog's Clinical Governance Review also states that the trust should continue to learn lessons from the tragedy involving the Cedars Unit, Wonford, Exeter, when three of its patients took their own lives by falling from cliffs at Sidmouth.

thisisdevon.co.uk

Several measures have already been put in place after a series of failures were highlighted at the Cedars Unit during an inquiry carried out by Dorset Healthcare Trust and South London and Maudsley NHS Trust.

Claims of staff shortages at the unit were also made following the deaths of Shaun Sheppard, 17, of Upton Pyne, Jamie Hague, 19, of Cullompton, and Anne Harris, 29, of Tiverton.

The chairman of the Devon Partnership Trust, Keith Portlock, said: "Every time an incident has happened, we have learnt and we can hope that it does not happen again."

The trust emphasised that several of the recommendations made by the Healthcare Commission had already been acted on.

Mr Portlock stressed that the report had highlighted the fact that the trust had been making progress.

He said: "The report was drawn up after three public meetings and a week-long visit to some of our services in March 2004. It sets out areas where we need to improve, and we are already working on an action plan to respond to those challenges."

The report states: "Since its inception in 2001, the trust has faced major challenges regarding its workforce, including mergers and what the trust reports as poor HR structures.

"Some staff reported that they had experienced or were currently experiencing bullying and harassment within the workplace."

Draft Mental Health Bill does not help the mentally ill

Government proposals to reform mental health laws do not help people with mental health problems, the Law Society has said.

Commenting on the publication of the Revised Draft Mental Health Bill, Law Society Chief Executive Janet Paraskeva said:

“The overall emphasis of this Bill is wrong because it does not help people suffering from mental illness. It should be shelved.

“New mental health laws are needed to protect the rights of a particularly vulnerable section of society. The Bill instead concentrates on the perceived risk and danger posed by people suffering from mental health problems – even though evidence shows that people with mental health problems are more likely to self harm and be victims of violence.‿

The Society is concerned about the broad definitions in the Bill and believes the scope for enforcing compulsory treatment is too wide. The core definition of mental disorder is so broad that it could include those who suffer from epilepsy or who are just simply drunk. This broad definition will lead to a denial of people's human rights. It will also increase the pressure on mental health services.

Janet Paraskeva continued:
“This Bill should be about improving the lives of those with mental illness. It should focus
on providing for proper care of people, provide for a legal duty to assess their needs and
then provide expertise and services to meet those needs.

Instead it will further stigmatise
people who suffer from mental illness
“The Government seems to have ignored the pleas of mental health experts, service users
and carers to concentrate on the very real problems experienced by people with mental
illness rather than trying to solve other problems in society by increasing its powers to
detain people who do not really suffer from a mental illness.‿

The Law Society is part of the Mental Health Alliance which has long called for this Bill to be
shelved in favour of a new approach to meet the needs of people well into the 21st century
based on rights to quality care and treatment and where compulsion is only used as the
last resort.

lawsociety.org.uk

Mental detention for 'armed' PO robber

A MENTALLY ill man who robbed a rural post office armed with a fake gun has been detained indefinitely at a psychiatric hospital.

Jason Kaveney, of Rickfield, Gossops Green, burst into Balcombe Post Office in March 2003 and demanded cash at gunpoint from a cashier.

Stephen Shay, prosecuting, told Lewes Crown Court there was more cash in the till than usual as it was pension day.

He said: "Just after noon the defendant walked in wearing a cap and sunglasses.

"He pointed what looked like a revolver at her, gave her a plastic bag and told her to hurry up. He took £3 shy of £3,000. As he left she pushed the panic button."

The court heard an eagle-eyed witness saw the robber flee in a hire van. Police later tracked it down and arrested Kaveney.

A search of his property revealed a black imitation firearm, two receipts for Euros, £145 in new notes and a box for an imitation gun.

Kaveney admitted robbery and possession of an imitation firearm.

Sarah Lindop, defending, told the court her client needed psychiatric supervision and treatment for his mental disorder.

She said: "Clearly, this case is a very serious one. In my submission, given the content of the reports, the appropriate disposal would be a hospital order."

Judge Anthony Niblett heard Kaveney suffered from a personality disorder and a paranoid psychotic illness.

As he sentenced Kaveney under the Mental Health Act, he said: "You pleaded guilty to two very serious offences for which only a very substantial prison sentence would have been appropriate.

"In my judgement in the absence of mental illness, even for a man of previous good character with a guilty plea, the sentence would have been one of five years' imprisonment."

icsurreyonline.co.uk 22 Sept

More cash for mental health plan

Specialist mental health care services for young people in Wales are to receive an extra £500,000.
Health Minister Jane Hutt said the money had been allocated for emergency beds and specialist services.

It is three years since the assembly government launched its Strategy for Child and Adolescent Mental Health.

Children's Commissioner for Wales Peter Clarke had earlier expressed his frustration that the strategy was not receiving enough funding.

In his last annual report, Mr Clarke had made child and adolescent mental health services the number one priority.

He said it was a "service in crisis, with poor and patchy provision".

In response, Ms Hutt gave an extra £700,000 for the service in March this year, which Mr Clarke welcomed but said was not enough on its own.

He repeated his concerns at a conference in Llandrindod Wells this week.

The additional £500,000, announced on the BBC's Politics Show on Sunday, will be used at "the sharp end of treatment", Ms Hutt said.

According to two recent reports, mental health problems among young people, including depression, anxiety, and stress as well as self-harming, are on the rise.

Research over 25 years by the Nuffield Foundation uncovered a 70% increase in emotional problems in adolescents.

The main causes are exam stress, bullying, worries about the future and family problems.

Children's charity Childline took 4,300 calls in 2003 related to self-harming, an almost 30% increase on the previous year.

Recently, Cardiff-based group the Amber Project, which supports young people who self-harm, had its assembly government funding withdrawn.

One of the group's members, Adam (not his real name), began self-harming at the age of 12.

He told The Politics Show: "There were a lot of problems in school with bullying and I was getting no help.

"I didn't think I was alive because no one was listening to me. So I wanted to see if I was still alive so I decided to cut myself."

He thinks there needs to be more support for young people with problems.

"More training for people in schools, in hospital, A lot more training around, so people understand," he said.

Announcing the strategy, Ms Hutt said: ""We're very concerned about the mental health of our young people and that's why we launched Everybody's Business, our 10-year plan for children's and adolescents' mental health services in 2001.

"We will be building on this strategy when we launch our children's National Service Framework (NSF) for consultation next month.

"A key element of the NSF is how to help prevent children suffering mental health problems and how to support them if they do.

"It must focus on providing the right help and support when they need it and highlights the need for children to have access to high-quality health, education and social services."

bbc.co.uk 19 Sept

Silent March over mental health plans

PROTESTERS have arranged a silent march in opposition to plans to remove all mental health inpatient beds from Banbury.

They hope hundreds of people will take to the streets of Banbury to make their feelings heard on the Cherwell Vale Primary Care Trust (CVPCT) and Oxfordshire Mental

Healthcare Trust's (OMHT) proposals to relocate all inpatient beds to Oxford.
Campaigners believe lives will be lost if the plans to close Orchard Lodge mental health unit, in Warwick Road, Banbury, and increase community care in the town goes ahead.

March organiser Rachel Gittus, 23, of Hightown Road, Banbury, who has previously been treated as an inpatient at Orchard Lodge, Warwick Road, Banbury, said: "If you care about your community then please support the most vulnerable people in that community, by taking part in this march.

She added it would be a disaster to remove all inpatient beds from Banbury.

Miss Gittus added: "In my opinion there are a lot of people who will kill themselves if this happens because of the reduced level of care, and I'm worried about some of my friends. The plans are dangerous."

She added CVPCT and OMHT have put five options on the table for the future of mental health provision in the county.

The preferred plan would see all inpatient beds situated at Littlemore and Warneford hospitals, in Oxford, with none based in Banbury. Community services would then be extended in Banbury.

Fellow campaigner Diane Wallace, 40, of Bretch Hill, Banbury, has a partner who is treated at Orchard Lodge.

She said: "I spend three hours a day with him at the moment, but if things are moved to Oxford the amount of time I will spend with him will be reduced by half."

The protesters have decided to stage a silent protest because they think it will make a stronger statement to CVPCT and OHMT.

Miss Gittus's grandmother Stevie Ball, 67, of Springfield Avenue, Banbury, said: "It seems appropriate to do a silent march as it appears the views of Banbury people are not being listened to."

Emma Tidy, associate director of commissioning, Cherwell Vale Primary Care Trust, said the aim of the consultation was to provide an opportunity for users, carers and the public to express their views.

Those views would be taken into account before the final decision was made.

The date for the protest is October 2, If police confirmation is received, it will start at 11am at the Elms, on the Horton Hospital site before going to Orchard Lodge and ending up at Banbury Town Hall.

banburytoday.co.uk 19 Sept

Scottish legislation, based on "care and treatment," has lessons to offer

Reform of mental health legislation in England and Wales has caused widespread concern.

Initial recommendations, from an expert committee for progressive and ethical reform, mutated into an initial draft bill uniting all interested organisations in opposition. Despite suggestions that the bill would be shelved, a revised draft bill, apparently addressing the concerns expressed, has been published.

Meanwhile Scotland has new legislation—the Mental Health (Care and Treatment) (Scotland) Act 2003. Several organisations have pointed towards Scottish reform as an example of how things should be approached south of the border.

BMJ.com 18 Sept Editorial

The Mental Health (Scotland) Act 1984 is similar to the Mental Health Act 1983, both tracing origins to the Percy Report of 1957.

In Scotland, in parallel with review in England and Wales, well received recommendations from an expert committee led to a positive response from government. The new act received royal assent in April 2003 and starts in April 2005. Major differences in Scotland are that the act adheres to recommendations from the expert committee and the process has not been hijacked by a government department more concerned with locking up dangerous offenders than with the care of people with mental health problems.

Another committee considered offenders who pose a high risk to others; its proposals were appropriately placed within the criminal justice system, resulting in specific criminal legislation.

The ethical basis for mental health legislation has developed from paternalism, emphasising dangerousness and humane care, towards autonomy, emphasising individual rights and capacity. Autonomy features prominently in the new act (box on bmj.com). It starts with guiding principles with no reference to risk, dangerousness, or public safety among these. The categories of mental disorder are modernised and exclusions are retained. To compel treatment, patients must be treatable, some risk to self or others must exist, and their ability to make decisions about treatment should be clinically significantly impaired because of their mental disorder. The last point introduces incapacity into compulsion criteria, although the term is absent because of its central place in specific incapacity legislation.

Emergency and short term detentions in hospital remain, but longer term compulsory treatment orders will be available in hospital or in the community. Community orders will allow compulsory medication, with non-compliance leading to potential hospital detention. The introduction of the Mental Health Tribunal for Scotland marks a major change in the legal review process. Extra safeguards and supports should be provided by advocacy services, the recognition of advance statements, an extended role for the Mental Welfare Commission for Scotland, and the introduction of named people.

A broad range of orders will remain available for offenders with mental disorders, but the incapacity criterion will not apply—an understandable, but perhaps ill thought through, discriminatory measure. Procedures for the most worrying offender patients are included but contained within sections relating to restriction orders and not pervading the act. Public safety will continue to trump all other issues in decisions on discharging restricted patients and comprehensive assessment in hospital will be necessary before such disposals are made.

In a previous editorial Birmingham summarised the main proposals in the initial draft bill for England and Wales. Superficially this draft bill and the Scottish act look similar, but important differences make most concerns about that bill inapplicable: to whom the act applies is strictly defined, with exclusion criteria; no over-emphasis on risk to others; inclusion of capacity; inclusion of ethically sound principles; no loss of discretion for services in applying procedures; comprehensive legislation on incapacity already in place; no compulsory treatment in prison; and genuinely responsive consultation by government. Clinicians and other stakeholders have been closely involved in the review and implementation processes in Scotland. The new draft bill for England and Wales only really addresses the concern about prison treatment; the other concerns remain valid, marking clear and persisting differences between legislative proposals in the two jurisdictions.

In Scotland concern remains about resources, bureaucracy, implementation, and training. Currently patients rarely contest detention, but new tribunal hearings will occur frequently, requiring personnel and infrastructure, and potentially disrupting clinical care. Tribunals will also consider appeals against being held in excessive security. This measure must start in May 2006 despite the likelihood that beds will be insufficient to cater for patients who no longer require care in a high security hospital.

The long term impact of complex legislation that allows much room for discretion is difficult to predict. The act on paper may not match the act in practice, so day to day reality may be different from the intention behind the policy. Funding for research on the operation of the new act is promised. Scotland will have ethically sound modern legislation, with principles supported by most stakeholders. In the United States, cycles of reform show that impact is less dramatic than predicted by optimists or pessimists.

New legislation reflects, rather than changes, social, clinical, or political aspirations. In Scotland, unlike England and Wales, considerable harmony has existed between these. However, new legislation does not in itself provide improvements in clinical care or resources.

Balancing between public safety and the rights of offenders with mental health problems, UK

UK Organisations which work with offenders who have mental health problems are struggling to find a balance between protecting the public and respecting their clients' rights to confidentiality, according to a director at Nacro's Mental Health Unit.

Dave Spurgeon, policy director at the crime reduction charity, voiced his concerns at Nacro's mental health and crime conference and stressed that sharing information was vital in not only protecting the public from high-risk patients, but also helping the individuals themselves.

Mr Spurgen said that often agencies were not being "deliberately obstructive" but instead were unclear about what constitutes a breach of patient confidentiality.

He added: "The dilemma for practitioners is knowing when, how and what information they can share."

The policy director suggested that agencies should employ liaison officers to deal with requests for information.

However, critics argue that it is important to ensure that confidentiality standards are maintained otherwise it could undermine public confidence in the privacy of all NHS records.

medicalnewstoday.com 16 Sept

Mental health fears as teenage cases rise

THE number of teenagers being treated for mental health problems Edinburgh has soared by nearly a quarter in just three years.

Figures obtained by the Evening News reveal a massive rise in the number of young people receiving psychiatric help for conditions such as depression, anxiety and eating disorders.

Experts today blamed growing stress related to exam results and divorce for contributing to the huge rise.

Health chiefs said the number of people aged 14 to 19 being treated as outpatients at the Royal Edinburgh Hospital jumped from around 340 between January and May 2001 to 420 for the same period this year.

Consultant clinical psychologist Matthias Schwannauer, who works at the Royal Edinburgh, said a number of theories have been put forward to explain such a big increase.

"There is no single factor that we can pick out," he said. "People hazard different guesses and I think the main one is that the social environment of children is becoming more unsafe. There is higher competition, more stress, exams and social competition.

"Social and environmental stress has a bearing on the emotional welfare of young people. Parental discord and educational pressures, if they accumulate at the same time, would have a strong effect. Other factors are the increase in divorce rates and single-parent families."

Dr Schwannauer claimed that a growing awareness of mental health issues could also partly explain the growth.

"People are more sensitive to emotional distress, rather than labelling it as adolescence. They recognise they are in significant distress that requires treatment," he said.

Teenagers come to the clinic with a variety of problems, including anorexia, self-harm and depression. The number of children aged up to 14 who are seen at the hospital’s children and families clinic has also risen ten per cent in the last two years.

This service mainly deals with children who have behavioural difficulties such as attention deficit disorder. A 12-bed in-patient unit for young people at the Royal Edinburgh takes referrals from across south-east Scotland and is usually full.

Many young people are also admitted to adult wards because of a lack of capacity tailored specifically for teenagers.

Pat Little, Scottish development manager for young people’s services at mental health support group Penumbra, suggested that more prevention and early intervention schemes were urgently required.

He added: "There has been an explosion in the number of young people being referred to psychiatric agencies and, by and large, a reduction of services for them.

"Often by the time someone has been referred to a psychiatrist they’ve developed other issues like drug or alcohol abuse."

Officials with the Scottish Association for Mental Health acknowledged it was difficult to pinpoint the reasons behind the "steep increase".

A spokesman added: "One reason may be more access to mental-health services. But it could also be due to societal changes and the increasing pressure on young people."

Tom Ponton, the Lib Dem health spokesman on Edinburgh City Council, called for additional funding to tackle mental health problems.

He said: "The council has a very small budget for mental health services through the social work department and has ignored pleas for years to increase the amount of resources.

"This is an issue both the council and Scottish Executive need to look more closely at."

A report this week revealed that the mental health of British teenagers has declined dramatically during the last 25 years.

The study found that the chances of 15-year-olds having behavioural problems had more than doubled.

edinburghnews.com

NSF urges better mental health services for children

Better mental health services for children from birth until their 18th birthday is among the standards set out in the National Service Framework unveiled by the government this week.

The document, which has been delayed nine months, says local services must make arrangements for 24-hour cover, and mental health assessments must be undertaken within a day when the child’s needs are urgent.

Specialist support for children’s mental health in early years must also be provided and children and young people should be cared for in appropriate and safe settings, says the report.

The NSF, which sets out a 10-year plan for improvements in children’s health and social care services, sets out 11 standards.

The Royal Colleges of Nursing and Paediatrics and Child Health have welcomed the NSF, but have warned that if its implementation is left to local discretion some areas may have more difficulty implementing the standards.

President of the RCPCH Alan Craft said: “Finally the NHS has been given the green light to improve services for children and their families. We urge all families, and people working with children to take the opportunity to use standards to push for better services for children.”

Unlike other NSFs, such as the one for mental health, this one does not attach deadlines for implementation to each standard.

communitycare.co.uk 15 Sept

Mental health care facing beds crisis

London is facing a crisis in mental health care, new figures show.

The Evening Standard has discovered a big decline in the number of NHS beds available for the mentally ill.

The revelations come amid concern about the Government's mental health policy draft law, which would give psychiatrists the power to detain patients deemed a danger to themselves or others.

thisislondon.co.uk

The revelations come amid concern about the Government's mental health policy draft law, which would give psychiatrists the power to detain patients deemed a danger to themselves or others.

Some care-in-the-community patients would be forced to attend clinics for treatment. Those who dropped out would be taken back into secure hospitals. But there is still a need for beds in hospital, mostly for short-term admissions.

The number of available beds in London have fallen by 12 per cent since Labour came to power, the figures show. From 7,186 in 1997, there were 6,321 in 2002-3, a drop of 865.

Opposition MPs and mental health groups are critical. Liberal Democrat MP Simon Hughes said: "However good care in the community may be, there's still a great need for more beds and more places for short-term admissions, respite care and out-of-hours support." Concern about London's mental health system has escalated following a series of attacks, some fatal, allegedly by released mental patients. Nationally, from 2001 to last year, the community mental health team caseload grew by nearly 60,000 to 310,000.

A spokesman for mental health charity Mind said: "The most appropriate setting for crisis care is hospital." But a Department of Health spokesman said the fall in beds had been offset by alternative forms of support. "The NHS is at the forefront of new mental health services, providing the right treatment tailored to the patient's best interests."

Reforms pledged on mental health of children

The government last night pledged fundamental reform of children's mental health services after the Guardian published evidence of a sharp increase in emotional and behavioural problems among teenagers.

The health secretary, John Reid, will tomorrow announce plans to provide 24-hour access to psychiatric services for the seriously disturbed and more help for troubled children through schools and local authorities.

guardian.co.uk 14 Sept

The Children and Adolescent Mental Health Service (CAMHS) will be instructed to include 16 and 17-year-olds, who have previously been treated as adults, and hospitals will be told that it is no longer acceptable to admit young people to adult wards.

The initiative comes in response to mounting concern about the deterioration of teenagers' mental health over the past 25 years.

A study due to be published in the Journal of Child Psychology and Psychiatry in November - reported in the Guardian yesterday - said the proportion of 15-year-olds with behavioural problems had doubled in Britain over the past 25 years. The proportion with emotional problems such as anxiety and depression has increased by 70% over the same period.

The scientific study appeared to confirm the experience of charities working with troubled children. Last week the Mental Health Foundation reported that more than 24,000 teenagers a year are admitted to hospital in the UK after deliberately harming themselves. The charity ChildLine said the number of children disclosing self-harm to its counsellors had increased by 65% in the last two years.

Louis Appleby, the government's mental health tsar, said the children's mental health budget would increase by £300m over the three years to 2005-06, mostly through extra local authority services. Although the government was cautious about the figures in the latest research, it accepted there was a consensus among academics that adolescents' mental health was deteriorating.

Mr Appleby said about 2% of 11-15-year-olds were depressed and 5% had emotional problems such as anxiety and phobias. About 3% of girls and 8% of boys in this age group have conduct problems, such as aggressive behaviour.

The Association of Directors of Social Services said it was concerned that the CAMHS service was not available until children had severe symptoms needing intensive psychiatric care.

The document expected to be published tomorrow will establish new guidelines for the NHS, local authorities, schools and training providers to work closely together to refer children to where they can get the most appropriate help. The emphasis will be on training everyone involved with children to recognise mental health problems but refer only a minority to specialist mental health services.

Education experts yesterday pointed to a link with the pressure heaped on youngsters as a result of tests and exams.

A spokesman for the Department for Education and Skills said: "All examinations are designed to be appropriately challenging for candidates. Exams can be stressful for some students, but teachers will use their professional judgment to counsel and advise their students."

An assault on the rights of the mentally ill

From a speech by Peter Beresford, Brunel University's Professor of Social Policy to the Mental After Care Association conference

The Independent 15 Sept.

Mental health service users face some of the most difficult discrimination, the most ready hostility, the least understanding, the greatest loneliness and isolation, the most routine poverty and exclusion, the greatest rejection and pain, of any group in a society.

We know that the Government's Mental Health Bill has been revised. But we can't be reassured these changes are anything like good enough. Indeed, it seems as if the principles which have worried people still essentially underpin it and remain the same - restricting people's rights. We will have to fighting a battle we shouldn't have to be fighting, which diverts our energies from what we want to be doing.

But the situation is not all doom and gloom. All the pioneering work over the last 15 to 20 years, has been paying off. Instead of writing off service users as "sick people" who don't get "better", new models are highlighting a social understanding of mental health service users, which takes account of, and seeks to do something about, the stigma and discrimination they face. Instead of talking just about "treatment" and "cure" in isolation, it talks about support and people's need for the right kind of support, whatever that might be, to live their lives to the fullest extent possible.

Even as Government has been seeking to reduce mental health service users' rights even further, there has been a greater emphasis among us on safeguarding service users' rights.

Such a rights based approach to mental health issues helps us to stop thinking of people as individual "sufferers", and puts their situation and difficulties in the proper context of the barriers they face to be able to live their lives with some equality, as well as coping with their mental and emotional distress.

Mental health tsar attacks draft Bill's 'hysterical' critics

Senior official hits back at those who have labelled the Government's controversial reforms as 'unfit for the 21st century'

Professor Louis Appleby, the mental health "tsar", last night hit back at critics of the Government's controversial mental health reforms, labelling them "hysterical and absurd".

independent.co.uk 12 Sept

His attack follows the publication last week of a new version of the draft mental health Bill, the second in two years, which now includes new safeguards to prevent patients being unnecessarily detained against their will.

Under the new Bill, an individual with a serious mental illness can be detained only if they are at risk of suicide or of harming themselves or other people.

The proposals come in response to widespread criticism - led by The Independent on Sunday - of the Government's first attempt at reform, with complaints that the planned measures would have increased the stigma attached to mental illness, and would drive patients underground instead of seeking treatment.

However, the Mental Health Alliance, whose members include the Royal College of Psychiatrists as well as patient groups, said that the new Bill remains "unfit for the 21st century" and could still deter thousands from seeking the help they need.

In an interview with this paper, Professor Appleby, the National Director for Mental Health, said he sympathised with psychiatrists who had expressed concerns that the first draft of the Bill would force to act as "jailers".

But he also said many professionals supported the reforms, and he singled out the Royal College of Psychiatrists for criticism, saying that their views were not reflective of the majority of clinicians.

"Psychiatrists were concerned that they would be taking on a criminal justice role and I certainly empathised with their concerns," said Professor Appleby, who was responsible for drawing up the reforms.

"The Act must be of benefit to people and not just about locking them up. People are saying we are taking the clock back but we are not. If someone is not a risk they will not be detained.

"The Royal College of Psychiatrists believes that people should be allowed to commit suicide if they had the legal capacity. How many psychiatrists would agree to that?" he asked.

The IoS has been campaigning for more than two years for better rights for the mentally ill and has pressed for ministers to rethink their original proposals, which were published in June 2002.

Clinicians have always had powers to detain people who are a risk to themselves or to the public. But in the past, psychiatrists have often refused to detain people with severe and dangerous personality disorders because they consider them untreatable.

The original draft Bill sought to close this loophole in existing legislation by removing the "treatability test" to reassure the public in the wake of the murders of Lin and Megan Russell by Michael Stone. Stone had been discharged from a mental hospital shortly before the killings.

However, this attracted fierce opposition from campaigners, who said that too many people would be detained.

In response, ministers have added special safeguards to the Bill, which mean that psychiatrists can only detain people in cases that are "clinically appropriate".

Dr Tony Zigmund, vice-president of the Royal College of Psychiatrists, said the revised draft Bill was better than previous proposals, and that some concerns had been acknowledged but they were still not "satisfactory".

"Not only do I think our views are in line with the vast majority of psychiatrists, they are in line with our user group," he said.

"I'm not a traitor to democracy, but I do think such an Act would be damaging to the psychiatric profession and to patients."

NEW MENTAL HEALTH PROMOTION PILOTS TO HELP REDUCE THE RISK OF SUICIDE IN YOUNG MEN

Suicide is a leading cause of death worldwide, particularly in younger people. Over 1,300 young men in England take their own life each year. As suicide is now the commonest cause of death in men under 35 the National Institute for Mental Health in England (NIMHE) is developing mental health promotion pilots in Camden, Manchester and Bedfordshire to try to encourage young men to seek help earlier and access services or support to help reduce the risk of suicide. These pilot programmes are key elements of the suicide prevention strategy for England.

Professor Louis Appleby, National Director for Mental Health, said:

"Suicide is a major cause of preventable death in England and elsewhere. At a personal level, suicide is a terrible and needless tragedy. Each suicide represents both an individual tragedy and a loss to society.

"We know that there is no single approach to suicide prevention. In developing strategies, we need to involve and collaborate with a wide range of organisations and individuals. That is why today is so important. This initiative promotes increased awareness about the problems of suicide and more important it helps us share initiatives at a local, national and international level.

"I am pleased to announce, on World Suicide Prevention Day, that the pilot work will begin in Manchester, Camden and Bedfordshire at the beginning of October. Young men are a key group to target in our efforts to reduce the risk of suicide. It is vital that we understand more about the variations in risk amongst young men. These are important initiatives in our work to engage with young men and encourage them to seek help or support when in distress. The pilots will be evaluated and if successful will be disseminated widely as part of NIMHE's national mental health promotion work. "

Suicide rates whilst fluctuating year on year, show a downward trend since the early 1980's and current indications suggest that this downward trend is continuing. The suicide prevention strategy for England have identified those with a mental illness as being of particular high risk of suicide.

About 1 in 4 of suicides.are amongst people in contact with specialist mental health services in the year before their death. Of these,16% were in-patients at the time. There has been a sharp fall in in-patient suicides in recent years due to measures we have put in place."

Implementation of standards one to six of the Mental Health National Service Framework will all contribute to reducing suicides. In addition it is vital that services develop local systems for suicide audit to learn lessons and take necessary action. NIMHE has published an audit toolkit which will help services to assess what progress they are making in implementing the recommendations Safety First, and will signpost them to additional resources and advice.It is being disseminated through NIMHE Development Centres.

Professor Appleby said, "The fall in in-patient suicides is positive news. In-patient safety has been a particular policy focus for the NHS, including specific measures such as better risk management, appropriate care and treatment for people who self harm and removal of ligature points from which hangings could occur."

Mental health unit to close next year

Banbury's only mental health in-patient unit will close early next year, a public meeting heard on Monday.

The unit, at Orchard Lodge, will shut on or before March 31, 2005, after which mental health patients who need to stay in hospital will have to travel to the Warneford or Littlemore hospitals in Oxford.

thisisoxfordshire.co.uk 9 Sept

The meeting at Banbury town hall was told that the lease on Orchard Lodge was coming to an end, and that alternative in-patient facilities were not being provided.

The possibility of buying the lodge for mental health use was dismissed as too costly. The meeting was part of a consultation exercise to determine the future of mental healthcare in Oxfordshire.

A panel of representatives from the Oxfordshire Mental Healthcare Trust and Cherwell Vale Primary Care Trust told the meeting they had not decided what would happen after the closure of the lodge.

But none of the 100 people at the town hall, including Banbury MP Tony Baldry, were left in any doubt that Orchard Lodge would close and not be replaced.

Mr Baldry told the panel it would be naive for people to believe anything different. Banbury's mental health saga began three years ago when the in-patient and day clinic at The Elms, in Oxford Road, closed. A short-term lease was taken on Orchard Lodge, which is owned by Oxfordshire County Council, and plans were revealed for the building of a new mental health unit at the Horton Hospital site.

The new-build plans have been abandoned, and five new options are now being discussed. The preferred option of the trusts is to have in-patient beds at Warneford and Littlemore with extended community services in Banbury.

The trusts say the option would address the immediate and medium term mental health needs of local residents. The extension of community services would include a seven-day crisis resolution team, longer acute day hospital hours, and an early intervention service.

The Rev Janet Jackson, vicar of St Mary's, told the panel: "We keep hearing about 'care in the community' and we feel angry and hurt about how you are treating the most vulnerable members of society."

MOVE TO CLOSE MENTAL HEALTH UNIT OPPOSED

The trust behind a proposal to close a mental health facility in North Devon has sparked much controversy from members of the public. Rebecca Short reports

A controversial proposal to shut down a mental health unit in North Devon has sparked anger among local people.

thisisdevon.co.uk 7 Sept

The Devon Partnership Trust, which runs mental health services in North Devon as well as the rest of the county, wants to close Hyde House, a rehabilitation, assessment and treatment unit in Barnstaple.

The trust is making the proposal in an attempt to move away from an institutionalised bed-based service and to provide more community-based mental health care.

But supporters of Hyde House, including many carers and users, have said the services due to replace the unit in the area will be inadequate and will not solve any problems.

Their claim comes during a nine-week consultation exercise, which the trust set up to find out the public's responses to the proposal.

North Devon district councillor, Carol McCormack said: "People are intimidated by the bureaucracy, because this is their illness, they hold things close to their chest.

"They believe people are going to hurt them, care in the community is not the answer. These people need proper attention.

"They have been talked about but not actually spoken to - they need to be asked what they want," she said.

In July, ten people who have suffered mental ill health sat together holding hands outside Hyde House, in a silent protest.

Hyde House has ten beds and is staffed 24 hours a day. It provides a drop-in centre and round-the-clock helpline for ex-residents.

Now, mentally ill patients fear that their support will be eroded, and in some cases will push them to breaking point.

Former resident Carol Griffiths believes there are not enough crisis intervention staff locally to help. She said the atmosphere and depth of feeling is escalating and the fear of impending abandonment is sending both psychiatric patients and carers into panic. She said: "Hyde House is unique but unfortunately housed in a building that managers have allowed to fall into disrepair."

She also described it as a "centre of excellence" staffed by highly trained people who had "saved lots of lives".

Another ex-resident, Jenny Baxani said: "I think its absolutely ridiculous. Hyde House did so much for me when I was a resident there. It gave me my life back.

"When people have children its really difficult, and sometimes people need to get away from their own home. I just don't think carers coming to people's houses will work with mental health.

"Sometimes it is the family who are causing the problems, therefore it is another reason to get away.

"There is always the reassurance at Hyde House that you can go back if you experience a relapse.

"Believe me if this resource is removed the suicide and drugs rate will rise dramatically."

A spokesperson for the trust said they had agreed to hold another public meeting.

She said: "Following the public meetings we met with members of mental health charity, Rethink, and the mental health service users and carers' group.

"A meeting will be held before the end of the consultation to look in detail at the range of services currently provided at Hyde House and explore how these services can be safely provided from a community setting.

"Once the consultation period finishes on September 10, the two organisations will collate the feedback received and prepare proposals for discussion at another public meeting before any final decision is taken."

Mental hospital patients 'in fear'

Over half the patients in psychiatric hospitals were threatened during their stay and 20% were physically assaulted, the mental health charity Mind reports today after a survey of conditions on the wards.
It found that 51% of recent or current inpatients said they had been verbally or physically threatened, 18% were sexually harassed and 5% were sexually assaulted.

The charity said it was particularly concerned that 23% of patients were accommodated on mixed sex wards, which the government had promised to abolish by 2002.

Patients with access to single-sex bathrooms and daytime facilities consistently felt safer and were more likely to feel that the hospital environment helped their recovery than those without.

The charity said: "We found a climate of fear on many wards, with patients exposed to harassment, abuse and un-therapeutic conditions, exacerbated by overworked staff, often from agencies, who can sometimes treat patients with a lack of dignity and respect."

The charity's report comes as the government prepares to publish a draft mental health bill tomorrow. Its main purpose is to introduce powers for the compulsory treatment in the community of patients who might pose a risk to others, but are not ill enough to be sectioned.

More than half said the hospital surroundings did not help their recovery. A third thought they had made their health worse. Only one in five thought they were treated with respect by hospital staff.

Richard Brook, the charity's chief executive, said: "Ward Watch paints a picture of two extremes in the NHS: examples of excellent practice experienced by some, contrasted sharply with the pitiful conditions that others endured."

The Department of Health said that it appreciated the concerns, but could not accept the validity of findings based on a sample of 4% of patients.

www.guardian.co.uk 7 Sept

Official Solicitor and Public Trustee Office annual report [19 August 2004]

The Official Solicitor provides representation for minors or adults under legal disability, and sometimes others, in county court or High Court proceedings in England and Wales, and in the Court of Protection. The Public Trustee and the Official Solicitor can both act as personal representative of the estate of a deceased person and act as trustee of a trust.

Full Report

Draft Code of Practice for Mental Capacity Bill

Draft Code of Practice for Mental Capacity Bill [September 2004]

Click Here

BASW Press Release: THE MENTAL HEALTH BILL - BETTER BUT NOT NEARLY GOOD ENOUGH

The new version of the Mental Health Bill is an improvement on the 2002 draft, but despite the government’s claim that it has listened to and learnt from the avalanche of criticism which greeted that draft, there is no evidence that it has been prepared to shift its ground significantly on the major issues of principle, and it remains a profoundly unsatisfactory measure which is still out of step with the rest of government policy on mental health.

In particular, BASW is concerned that:

although the conditions for compulsion have been tightened, the examiners still lack the discretion not to detain when the conditions are met, and this is bound to result in the detention of a great many people who would not be detained under the present Act. In particular, it would force them to detain people who were neglecting their own health, for instance as a result of chronic alcohol or drug use, but who retained the capacity to make their own judgement about the risks of this; and there are of course tens of thousands of such people. At present, the Approved Social Worker (ASW) can take capacity into account as part of “all the circumstances of the case” but although this phrase has now been included in the Bill, it applies only to “the availability of appropriate medical treatment.”

although there is a promise that tighter entry criteria for non-resident assessment will be set out in Regulations, these are unlikely to be enough to satisfy BASW’s concerns that this provision will be abused in places where there are not enough assessment beds for those who need them. BASW’s view remains that compulsory non-resident assessment is both unnecessary and impracticable and that it ought to be deleted entirely from the Bill.

although the government claims to have noted the concern of BASW that powers in respect of Tribunal applications and the operation of non-resident orders are entirely in the hands of clinical supervisors, and that other members of the multi-disciplinary team may therefore find themselves in a position where they are expected to implement decisions about which they have not been consulted or to which they are opposed, they have effectively brushed these concerns aside. BASW’s position is that social workers should never allow themselves to be put in a situation where they are effectively forced to follow the directions of a member of another profession against their own professional judgement, and it will advise its members accordingly.

In respect of the Approved Mental Health Professional (AMHP),which is intended to replace the ASW, BASW is pleased that the local authorities will continue to be responsible for training and approval. However, there is no provision, once approval has been awarded, for the AMHPs to be legally accountable to the local authorities for their statutory work or for the authorities to have operational management control over them as they do over ASWs at present, nor is there any requirement in the Bill for them to ensure that a sufficient number of AMHPs is made available to carry out the duties laid down. Without these provisions, and given that most AMHPs will be NHS employees and that at least a high minority may well be from health professions, it is difficult to see how the local authorities will be able to influence practice after approval and to ensure that standards and quality of service will be maintained, let alone for them to guarantee the independent standing which is the most crucial element of the role.

BASW is also concerned that the government appears to have taken no heed of the repeated warnings that the present ASW role is becoming unviable, leading to a steady loss of practitioners which may soon result in the service breaking down in some areas, and that this problem will not be solved simply by opening-up the role to other professionals, who are unlikely to be any more keen than social workers to take it on in its present form. Nor has it addressed the difficulty of finding second doctors, which has been a chronic problem since 1959, is one of the factors which makes the ASW’s job unnecessarily difficult, and is now about to get much worse due to the withdrawal of GP s from out-of-hours cover. Three years ago, BASW put forward proposals which would have gone a long way to resolving all these problems, but once again they have been ignored in favour of perpetuating the present unworkable system.

The government has at least recognised that its handling of the AMHP proposal in 2002 had a disastrous effect on ASW morale which has contributed to the loss of experienced staff, and it is now at pains to emphasise that it wants to retain both the ASWs themselves and their accumulated expertise. However, even if it can persuade them that they are still valued and wanted, it is unrealistic to expect that experienced ASWs, who have a wide variety of other employment opportunities and many of whom are within sight of retirement, will want to stay on to implement an Act with which they are not in sympathy and which they regard as flawed and impracticable, nor for the same reasons will newly-qualified social workers see it as a good career option. In view of the absence of discretion, it is still questionable whether the role of AMHP-examiner is compatible with social work’s codes of ethics, and in this and many other respects, the government has a great deal more to do if it wishes to convince social workers that this is a role which is consistent with their professional values and aspirations.

Mental Health

Collected comments from various people

epolitix.com

Click Here

Mental Health Bill to 'protect patients and public'

From number-10.gov.uk

The government has unveiled the biggest reform of mental health legislation since the 1950's.

The new draft Mental Health Bill, published today, provides better safeguards and treatment for patients who may harm themselves and others.

Significant changes have been made to the 2002 draft following consultation with stakeholders and the public. They include changing the definition of mental disorder, and increasing the maximum sentence for people convicted of ill treatment or neglect of patients.

The Bill will be subject to pre-legislative scrutiny by a parliamentary committee, which has been asked to present its report by the end of March 2005.

Health Minister Rosie Winterton said the revised Bill puts a new focus on the individual, allowing compulsory powers to be used in ways that fit with patients' changing needs.

She said people would only be subject to treatment under the Bill if they pose a risk to themselves or others.

"Patients in the community who are ill and vulnerable or at risk will now be able to get the treatment they need.

"To make sure we get the legislation right we have asked a Joint Parliamentary Committee to scrutinise the draft Bill, and we look forward to receiving their report."

Home Office Minister Paul Goggins said public safety would not be compromised.

"If we are to protect the public we must ensure that those with a mental disorder who are a risk to others receive the high quality mental health treatment they need. The Bill will help to achieve this."

Liberty at risk under new mental health plan

Shadow Health Minister Tim Loughton has warned that the Government's new draft mental health legislation will prove widely unacceptable, and remain a threat to individual liberty.

Despite minor changes made to earlier legislation, he said new proposals just published still focus too much on the dangers to the public rather than the medical needs of the patients, he said.

Although ministers have accepted call for stricter criteria for detaining patients suffering from mental illness, Mr Loughton declared: "Everyone's liberty is still at risk by the way the legislation is framed. The Government have still failed to grasp that mental illness is a medical condition requiring treatment like any other physical problem rather than a criminal offence demanding incarceration. Compulsion should be a means of last resort, and we fear that many people with mental health problems will still be deterred from seeking treatment for fear of being subjected to compulsory treatment or detention."

The Conservatives have promised to produce alternative proposals, which take the beneficial parts of the draft Bill but remove the unacceptable coercion measures.

"This will form part of our election manifesto with a commitment to legislate early in the next Conservative Government. We have waited too long already to update our mental health laws, which mainly hark back to the 1950's and it is a disgrace that the Government have fudged this once in a generation opportunity to update this vital legislation," Mr Loughton told conservatives.com.

conservatives.com 8 Aug

New Mental Health Bill "will alienate patients"

Redrafted government plans on compulsory treatment for potentially dangerous mental health patients will alienate them from healthcare staff, according to the mental health charity Mind.

The original 2002 version of the legislation prompted consternation in the field by proposing new powers to impose compulsory treatment on severely affected patients.

Mental health charities and practitioners also condemned plans to detain those suffering from severe personality disorders even if they have not committed a crime.

Thousands of objections prompted a reworking of the bill, but the chief executive of Mind Richard Brook has expressed disappointment that the government "has not adequately addressed the profound misgivings of both service users and medical practitioners."

While more palatable than the original, the bill is still "fundamentally flawed" according to Mind. The retention of proposals on compulsory treatment in the community risks introducing fear and mistrust into the doctor-patient relationship and may discourage patients from seeking help, the charity warns.

Mr Brook adds: "Compulsion must be a means of last resort - the government must understand that what a person in crisis needs above all else, is care and compassion."

The Royal College of Psychiatrists is also anxious about the revised proposals, describing the bill as "unfair, stigmatising and dangerous".

While acknowledging some welcome changes have been made to the bill, the RCP's president Dr Mike Shooter warns that extending the use of compulsory powers to a larger group of patients will infringe human rights and exert greater pressure on psychiatric services.

"This proposed legislation would further distance the practice of psychiatry from the rest of medicine and ensure that people with mental health problems have less rights than people with physical illnesses."

The government has defended the proposals. Health Minister Rosie Winterton told the BBC: "We believe that we now have a Bill that puts a new focus on the individual, allowing compulsory powers to be used in ways that fit with patients' changing needs."

plitics.co.uk 8 Aug

Mental health Bill 'is good compromise'

Ministers have promised that a revised draft of the Mental Health Bill will improve public safety while giving patients proper treatment.

The review of the Bill comes two years after its first version was criticised by campaigners who claimed it could infringe the human rights of mental health patients.

However, ministers said they believed that the new draft provides a compromise between protecting the public and ensuring patients get the right treatment.

"We will not compromise public safety," said Paul Goggins, the Home Office minister.

telegraph.co.uk 8 Aug

"If we are to protect the public we must ensure that those with a mental disorder who are a risk to others receive the high quality mental health treatment they need."

Under current laws, psychiatrists can order the compulsory treatment or detention of people with personality disorders if they believe they can provide treatment to relieve their symptoms - referred to as the treatability test.

But the draft proposals allow doctors to use compulsion if they can prove that the patient would benefit from a clinically appropriate care plan and if their view is supported by a tribunal.

Where treatment cannot be justified in this way, but the patient is deemed a danger to others, the case would be referred to another agency such as the police.

Other changes in the Bill include altering the definition of mental disorder to make sure the emphasis is on the psychological condition and not the underlying disorder.

It also gives clear criteria on detaining patients against their will, setting out guidelines for doctors to judge whether there is a serious risk that a person could commit suicide or seriously hurt themselves or other people.

However, plans to use so-called community treatment orders in prisons have been dropped, patients will be allowed to choose their own representative at hearings, and compulsory treatment lasting longer than 28 days will need to be authorised by the new Mental Health Tribunal.

Critics have raised concerns that the Bill will provide a loophole to release dangerous patients with personality disorders because their conditions are viewed as untreatable.

But Rosie Winterton, the health minister, said the draft Bill would allow "compulsory powers to be used in ways that fit with patients' changing needs".

"People will only be subject to treatment under the Bill if they are at risk of harm to themselves or others," she said.

"The Bill means that the small minority of people with mental health problems who need to be treated against their wishes, normally for their own protection but occasionally to protect the public, will get the right treatment at the right time."

Revised mental health bill must not waste opportunity, UK

Revised mental health bill must not waste opportunity to improve services for people with mental health problems, says King's Fund.

Responding to the publication of the Government’s revised draft Mental Health Bill, the King’s Fund today warned Ministers not to squander an historic opportunity to come up with workable legislation that truly supports people with mental health problems while taking account of legitimate public safety issues.

King’s Fund chief executive Niall Dickson said: “We have all waited too long for this legislation. Let us hope that this is not another wasted opportunity - this time politicians really must listen to those who use these services as well as the nurses, doctors, psychologists and all the other professionals who provide them.”

But the King’s Fund did welcome the Government’s decision to put the draft Bill to a cross-party pre-legislative scrutiny committee before introducing a Bill to Parliament.

Simon Lawton-Smith, the King's Fund’s senior policy adviser in mental health, said: “This is a welcome opportunity to debate the key issues and we will be looking carefully at the revised draft to see whether the concerns of many organisations in this field have been taken on board.”

The King's Fund is part of the Mental Health Alliance, a coalition of over 60 service user and carer groups, charities and professional bodies.

MENTAL HEALTH BILL MUST PROTECT PATIENTS, NOT DEMONISE THEM - BURSTOW

Commenting on the re-draft of the Mental Health Bill, Liberal Democrat Shadow Health Secretary Paul Burstow MP, said:

"For the Mental Health Bill to work, the Government must have made changes to their earlier extreme and draconian Draft Bill.

"A new Mental Health Act is desperately needed, but it must be a law to protect and improve services for patients, not a means to demonise those with mental health problems."

libdems.org.uk

Anger over government's mental health plans

Mental health campaigners today condemned government proposals to detain people with untreatable mental disorders for care which would not alleviate their symptoms.
A revised draft mental health bill, published today, would enable psychiatrists to force people with severe personality disorders to undergo "clinically appropriate" care which would not need to improve their mental condition.

society.guardian.co.uk 8 Aug

Tony Zigmond, vice-president of the Royal College of Psychiatrists, warned that the plan risked "fundamentally undermining standards of mental healthcare".

He said that while detaining such patients might control their behaviour it would "probably do them no good, and would probably damage them".

Dr Zigmond said: "If you're talking about controlling their behaviour it probably does that. Does it do them any good? No."

The government's mental health tsar, Professor Louis Appleby, claimed that the proposal was far less draconian than the original draft bill, published two years ago, which would have allowed people with severe mental disorders to be detained without a care plan.

Under current laws, psychiatrists can only order the compulsory treatment or detention of people with personality disorders if they believe they can provide treatment to relieve their symptoms - referred to as the "treatability test".

Prof Appleby said the revisions to the draft bill would ensure that where doctors did not accept that appropriate clinical care could be provided they would be under no obligation to detain patients.

The bill would also mean patients could be subject to compulsory treatment in the community, focusing on so-called "revolving door" patients who leave hospital only to return when they fail to take their medication. Ministers claim this measure has been revised so that patients would first need to be assessed in hospital.

But Dr Zigmond said the wording of the proposed legislation suggested that someone could be forcibly treated in the community on the basis of an assessment carried out in hospital 20 years ago.

The bill also sets clear criteria on when someone could be detained against their will. This would only apply when doctors decided patients were at serious risk of committing suicide or risking their own safety through neglect, or other people would be at risk of harm.

The mental health minister, Rosie Winterton, said the draft bill put a new focus on the individual, "allowing compulsory powers to be used in ways that fit with patients' changing needs".

She said: "People will only be subject to treatment under the bill if they are at risk of harm to themselves or others.

"The bill means that the small minority of people with mental health problems who need to be treated against their wishes, normally for their own protection but occasionally to protect the public, will get the right treatment at the right time."

The first draft of the bill prompted widespread criticism from campaigners that the human rights of those with mental illness would be damaged by the broad criteria used to decide who should be detained.

But mental health campaigners expressed disappointment that the definition still includes people with drug and alcohol problems as well as "sexual deviants", whom they believe would be better dealt with outside of the mental health system.

Campaigning organisation the Mental Health Alliance said the bill risked bringing mental health services to their knees as hundreds more people were brought under compulsory powers.

Its chairman, Paul Farmer, said the alliance members were "deeply disappointed" that the government had still not listened to the concerns of professionals, carers and people using services.

He said: "The most worrying of all is that the government's way of defining who qualifies for treatment against their will is far too broad. This will force professionals to bring too many people in for compulsory treatment, damage the trust that is so vital between doctors and patients and lead to a bureaucratic overload on an already overstretched system."

Mr Farmer added that the bill was "rooted in an out-dated, false stereotype that people with mental health problems are a danger to society".

"The revised bill remains objectionable in principle and unworkable in practice," he said.

Retreat over powers to lock up mental patients

Ministers were today accused of staging a U-turn over plans to lock up dangerous mental health patients.

The Government pulled back from closing a loophole which prevents people with severe personality disorders from being detained if their condition is untreatable.

thisislondon.co.uk

A watered-down draft Mental Health Bill included a new "treatability" test under which some dangerous individuals would continue to slip through the net.

Ministers will, however, go ahead with controversial plans to force care-in-the-community patients to undergo treatment or be returned to hospital.

Labour claimed its reforms amounted to the biggest shakeup in mental health laws since the Fifties. But critics focused on the decision on dangerous and untreatable patients.

In 1998, the then home secretary Jack Straw promised action amid public anger over the case of Michael Stone, who had been diagnosed with an untreatable personality disorder and is now appealing against his conviction for the murders of Lyn and Megan Russell.

Draft laws published in 2002 would have closed the loophole. But ministers came under pressure from psychiatrists who were reluctant to take responsibility for ordering the detention of people they judged untreatable.

Under today's plans, people with severe personality disorders could only be treated if a psychiatrist could devise a plan of "clinically appropriate treatment" which would help their condition, although not necessarily-cure it. Louis Appleby, the Government's national director for mental health, said: "There are obviously other people who are dangerous but they are not the people for whom this Mental Health Act is designed.

"It will be for clinical and social care staff to decide whether it is clinically appropriate to treat someone under the Act."

When Mr Straw promised to take action his officials estimated that 2,500 individuals were judged dangerous and untreatable.

Despite today's U-turn, mental health charities maintained their opposition to the proposals.

Q&A: Mental health laws

The government has re-drafted plans to change mental health laws after criticisms about earlier proposals for the enforced treatment of potentially dangerous mental health patients.

BBC News Online looks at what is in the new Bill.

What are the main changes being proposed by the government?

Doctors treating patients in the community who they believe should be forced to undergo treatment will be able to obtain a Mental Health Act Order.

The Act removes the need for patients to be sectioned - confined to hospital - in order to make them take their medication.

A new broader definition of mental disorder includes people with severe personality disorders. This will make it easier to force them to undergo treatment or to detain them, whether or not they have committed a crime, if there's a substantial risk that they will be a danger to themselves or to others.

But doctors would have to be able to justify that the planned treatment was clinically sound to a tribunal.

If treatment cannot be justified, but the person is deemed a danger to others, they should be referred to another appropriate agency, such as the police.

Why are they being proposed?

Ministers believe the current legislation doesn't go far enough to protect the public, or to provide safeguards for individual patients.

Existing legislation is out of date they argue, when the vast majority of people with mental illness are treated in the community rather than in hospital.

How do ministers believe these changes will improve on the current system?

Ministers say the proposals for new mental health tribunals and a new healthcare audit and inspectorate body will ensure that there are better safeguards in place than at present to ensure patients' rights are protected.

The argue the new powers will provide better protection to the public from those who are deemed a risk to others, by ensuring they receive the treatment they need.

It will also stop the so called 'revolving door' problem where patients in the community go in and out of psychiatric units because that's the only way to compel them to take their medication, according to ministers.

What concerns do mental health groups have about the proposals?

The Mental Health Alliance which represents around 50 of the largest mental health groups in the UK is gravely concerned about the proposals to extend compulsory treatment.

It says many people will be too frightened to seek help from mental health professionals because of the risk they'll be forced to take medication which would mean more people wandering the streets without help.

It also risks placing many hundreds of people under compulsory powers which could overwhelm mental health services, according to the Alliance.

It says new mental health legislation should have enshrined a right to treatment rather than broadening the sweep of compulsory treatment.

It pledged to use the Pre-Legislative Scrutiny process to present its own proposals for examination by the committee of MPs and Peers.

What happens now before they become law?

A committee of MPs will review the new draft.

'No-one listens to the patients'

Proposals to allow the enforced treatment or detention of mental health patients have been watered down in the face of pressure from campaigners.
Two people who have experienced mental illness tell BBC News Online why it is so important to listen to those who have been through the system.

Jason Pegler, a 29-year-old publisher from London, realised his life would never be the same again after he was hospitalised for six months, aged 17, for manic depression.

He said: "Being in hospital you feel like you are no longer a human being and it's like being in prison when you haven't done anything wrong."

bbc.co.uk

The 2002 draft Mental Health Bill proposed measures to detain people for their own protection and the protection of others - even if their condition was not treatable and they had committed no offence.

The criteria under which people can be detained have been tightened under Wednesday's new draft bill but the proposals still have many critics.

Mr Pegler, who has spent time in five different hospitals and remains on medication voluntarily, said any move to force people into treatment would be counter-productive.

"What will happen is people won't seek help from the health service and they will be more isolated," he said.

"I think compulsory treatment is a human rights violation.

"What I would want as a patient is to be treated as a human being, not as someone who has done something wrong - and that's what hospitals are like.

"They are not somewhere you want to put your worst enemy, let alone yourself or a close friend or member of your family."

He argues health professionals and society need to take a more humanitarian approach to mental illness by realising it could affect everyone.

Mr Pegler, who published his autobiography A Can of Madness in 2002, said it was only by removing the taboo around mental illness that attitudes would change.

The vast majority of people were not given the information they needed while in hospital or receiving treatment, he said, which made them more vulnerable.

"I felt mental health services had let me down and society let me down and I felt I would have mental health problems for the rest of my life," he said.

"It took me more than eight years to emotionally get over it.

"Mental health is meant to be a government priority and yet they are not listening to the patients who actually go through the service."

Anne Beales, who works with mental health charity Maca, said it was vital people were involved in their own treatment rather than having it imposed on them.

The 47-year-old, from Littlehampton in West Sussex, has experienced several bouts of depressive illness - but has found her way through each one in different ways.

She said: "When you experience distress the things you look for are safety and to be looked after.

"If the legislation is not careful, it will feel like we are being punished because our rights are being taken away and that's not helpful at all.

"The process of having your rights taken away can be as traumatic as the feeling of terrible distress because it makes you feel more powerless and leaves you with no choice."

Ms Beales said the government ought to view compulsory treatment in terms of patients' rights to housing, employment and no discrimination from society.

"Their idea of treatment and our idea of treatment are very different," she said.

"What government legislation has to do is support us in our recovery - and that means allowing us choices, allowing us privacy and affording us respect."

Mental health plans are 'diluted'

The government has watered down its plans to allow the enforced treatment of potentially dangerous mental health patients.
The long-awaited re-draft of the Mental Health Bill, released on Wednesday, sets stricter criteria on which patients can be detained.

When the original draft was unveiled in 2002, psychiatrists and charities condemned it as unethical and inhumane.

They criticised the new draft for failing to resolve all of the issues.

'Inhumane and unethical'

Current laws make it impossible to detain people with personality disorders who have committed no offence.

The 2002 draft of the Mental Health Bill proposed measures to detain mentally ill patients for their own protection and the protection of others, even if their condition was not treatable.

THE MAIN CHANGES TO THE DRAFT
Those at "risk" can be detained
Doctors must justify planned treatment as clinically sound
Automatic review if detained past 28 days
A previous psychiatric admission required for Community Treatment Orders
Prisoners should not be treated under Community Treatment Orders
Patients who have capacity to make decisions about their care can refuse treatments
Doctors can over-ride refusals if treatment is in the patient's best interest
Designated carers no longer need to be the nearest relative
Carers consulted when there are changes to the patient's care

There were also proposals to allow compulsory treatment in the community under Community Treatment Orders.

If a patient did not stick to the treatment orders they could be detained in hospital.

The proposals prompted some 2,000 objections.

Critics were concerned doctors would turn into policing bodies rather than carers, and the net would be cast too wide meaning people posing no risk to others would be detained.

The re-worked draft aims to resolve these points of contention.

The changes

The criteria under which patients could be forced to be detained and treated in hospital have been tightened to those at highest "risk" - those who are suicidal, a risk to others or are at severe risk of neglect.

Like the original draft, this would continue to include people under the broad definition of "psychological dysfunction arising from any disorder of the mind or brain", such as depression or schizophrenia.

It would be up to three health professionals, which would no longer have to include a social worker, treating the patient to define this risk.

People with personality disorders could be detained for treatment if the doctors were able to justify that the planned treatment was clinically sound to a tribunal.

bbc.co.uk

If treatment could not be justified but the person was deemed a danger to others, they should be referred to another appropriate agencies such as the police, says the draft.

Any patient detained for more than 28 days would automatically be reviewed by an independent tribunal to check whether the detention was still valid.

Currently, patients can request an independent review but will not get one automatically.

The criteria for Community Treatment Orders have also been tightened to apply to patients who relapse and are continually in and out of psychiatric hospital.

Prisoners should not be treated under these Orders. Instead, any in need of psychiatric care should be transferred to a hospital.

Empowerment

Patients who have the capacity to make decisions about their care would be able to refuse treatments such as ECT or shock therapy, even if they were detained in hospital.

However, doctors would be able to over-ride these refusals if they and a tribunal believed the treatment would be in the patient's best interest.

Patients would be able to nominate a person as their designated carer who would no longer need to be their nearest relative.

These carers would have to be consulted when there were changes to the patient's care, such as admissions to and discharges from hospital.

If treatment could not be justified but the person was deemed a danger to others, they should be referred to another appropriate agencies such as the police, says the draft.

Any patient detained for more than 28 days would automatically be reviewed by an independent tribunal to check whether the detention was still valid.

Currently, patients can request an independent review but will not get one automatically.

The criteria for Community Treatment Orders have also been tightened to apply to patients who relapse and are continually in and out of psychiatric hospital.

Prisoners should not be treated under these Orders. Instead, any in need of psychiatric care should be transferred to a hospital.

Empowerment

Patients who have the capacity to make decisions about their care would be able to refuse treatments such as ECT or shock therapy, even if they were detained in hospital.

However, doctors would be able to over-ride these refusals if they and a tribunal believed the treatment would be in the patient's best interest.

Patients would be able to nominate a person as their designated carer who would no longer need to be their nearest relative.

These carers would have to be consulted when there were changes to the patient's care, such as admissions to and discharges from hospital.

Revised Mental Health Bill is unfit for the 21st century

Mental Health Alliance

Today’s long-awaited draft Mental Health Bill will fail to match the needs of the
21st century, the Mental Health Alliance predicted today.

The Alliance, a coalition of over 60 service user and carer groups, charities
and professional bodies, warned today that the revised Bill could bring mental
health services to their knees. It risks placing many hundreds of people under
compulsory powers, and driving thousands more away from services, for the
sake of a tiny number of people who pose a risk to others.

Alliance chair Paul Farmer said:

“We are deeply disappointed that the Government has still not listened to professionals, carers or people using services. Despite receiving 2,000 responses opposing its original plans, the Government has pressed ahead with many of its most disturbing proposals.

“The most worrying of all is that the Government’s way of defining who
qualifies for treatment against their will is far too broad. This will force
professionals to bring too many people in for compulsory treatment, damage
the trust that is so vital between doctors and patients and lead to a
bureaucratic overload on an already overstretched system.

“We are living in the 21st century and need legislation that reflects society’s
deeper understanding of mental ill health and the vastly improved
opportunities for inclusion and recovery. We need a law that respects
patients’ human rights and avoids stigmatising them.

“Instead, we have a Bill that is rooted in an out-dated, false stereotype that
people with mental health problems are a danger to society and are unable to
make their own decisions about care and treatment. The revised Bill remains
objectionable in principle and unworkable in practice.”

Jason Pegler, campaigner and mental health service user said:
"Those of us who, like myself, have had to use mental health services know just how important this legislation is. Service users need to feel that they will be
understood, respected and treated with compassion.
Making them feel that they are more likely to be punished for being ill will mean fewer people coming forward to receive the care they need, when they need it.

This Bill could seriously violate innocent people's fundamental human rights."

The Alliance pledges to use the Pre-Legislative Scrutiny process to present its
own proposals for examination by the committee of MPs and Peers.

Rowena Daw, policy lead for the Alliance said: “We look forward to the
opportunity to put to the Committee our proposals that have the support of our
large membership, of the previous Expert Committee, and which have been
accepted in Scotland. Maybe then we may end up with legislation that is truly
fit for purpose.

“The next Mental Health Act will need to last for decades. This new draft Bill
will need careful scrutiny by those people who have to live and work with it. It
is imperative we get it right.”

Members of the Mental Health Alliance today spoke out about the new
draft Bill:

Niall Dickson, chief executive, King’s Fund: "We have all waited too long
for this legislation. Let us hope that this is not another wasted opportunity -
this time politicians really must listen to those who use these services as well
as the nurses, doctors, psychologists and all the other professionals who
provide them."

Gil Hitchon, chief executive, Maca: "A glance at the Government's own
figures of the additional workforce requirements cause you to wonder
immediately whether there will be enough staff to implement the proposed
new Mental Health Act. For example, the Department of Health calculates that
only 140 advocates are needed, but unless their role is much diminished then
it is going to prove very difficult for them to undertake their expected key role."
Andrew McCulloch, chief executive, Mental Health Foundation: “Mental
Health is everybody's business, yet here we have a draft Bill that stigmatises
and marginalises people with mental health problems. The Government has a
once-in-a-generation opportunity to use legislation to drive mental health up
the political and social agenda and make mental health services more
accessible and acceptable to those who need them. This draft Bill if it were to
be become law, would represent a shameful step backwards since the 1983
Mental Health Act.”

Richard Brook, chief executive, Mind: "We need a new Mental Health Act,
that is a fact that cannot be denied. We need legislation that will provide an
effective and compassionate 21st century mental health service. This Bill
does not deliver that. It risks introducing fear and coercion into what should be
a purely therapeutic relationship. It risks driving those who most need care
and treatment away from seeking help as and when they need it most."
Cliff Prior, chief executive, Rethink: "This draft Bill lets down a huge
constituency of service users and carers who want a new Mental Health Act
that reflects the new realities of the 21st century, not the last century's
prejudice, ignorance and fear."

Beverly Malone, general secretary, Royal College of Nursing: "The RCN
believes that collaboration with patients, rather than compulsion,
is at the heart of good nursing practice. Although we recognise that the
Bill has moved some way to address concerns about enforced treatment, it is
imperative that relationships with clients are strengthened, not damaged.
We know that negative perceptions about mental health services can drive
people away from therapeutic care and it is in the interests of clients,
carers and families that this outcome is avoided. We will examine the
details of the Bill in order to assess what are the likely consequences of
its proposals - and in particular, what safeguards will be in place to
protect clients from inappropriate compulsion."

Tony Zigmond, deputy president, The Royal College of Psychiatrists:
"People who are capable of making choices about their healthcare should be
entitled to do so. Those who are not capable should have the right to
treatment that is in their best interests. These principles should not
depend on the patient's diagnosis. The equivalent laws in Scotland respect
these principles. The proposals in this Bill do not and are an affront to
justice."

Angela Greatley, acting chief executive, Sainsbury Centre for Mental
Health: “The Government has once again proposed a law that will place
psychiatrists and social workers under pressure to detain thousands of people
and compel them to take treatments that do not benefit them. The draft Bill is
now badly out of step with the rest of the Government’s agenda. It is
incompatible with the Government’s efforts to tackle social exclusion; to
promote patient choice; and to improve race equality.”

Marjorie Wallace, chief executive, SANE: “We have campaigned for reform
to achieve a better balance of rights between individuals, families and carers,
and the community. But changing the law alone will not work unless we
ensure proper care and treatment, which are still so often lacking. If we don’t
make good the desperate shortage of doctors, nurses, skilled front-line staff
and supervised accommodation, whether in hospital or the community, the
new Mental Health Bill will not provide the ‘safe, sound and supportive’ mental
health services promised when the government came to power. A major
concern is that in the most critical situations, families and carers may still be
left without rights to essential information that could prevent unnecessary
suffering or tragedy.”

Notes to Editors
For all media enquiries to the Mental Health Alliance today, 8 September,
please contact the Mind press office on 020 8522 1743 or 07850 788514.
The members of the Mental Health Alliance are:
Core members: Afiya Trust, AWAAZ (Manchester), BASW, British
Psychological Society, Mental Health Nurses Association, College of
Occupational Therapists, Critical Psychiatry Network, Manchester Race and
Health Forum, GLAD, King's Fund, Maca, Manic Depression Fellowship,
Mental Health Foundation, Mind, National Autistic Society, POPAN, Rethink
severe mental illness, Revolving Doors, Richmond Fellowship, Royal College
of Nursing, Royal College of Psychiatrists, SANE, The Sainsbury Centre for
Mental Health, SIRI, Turning Point, UK Federation of Smaller Mental Health
Agencies, UKAN, UNISON, United Response, US Net, Voices Forum,
YoungMinds.
Associate Members: African Caribbean Initiatives, Age Concern England,
Alcohol Concern, AWETU, The British Deaf Association, Carers UK, Church
of England Board for Social Responsibility, Confederation of Indian
Organisations, Democratic Health Network, Depression Alliance, Footprints
UK, Greater London Mental Health Advocacy Network, Having a Voice Ltd,
Homeless Link, JAMI, Justice, Kente, Law Society, Mencap, NHS
Confederation, Race on the Agenda, RADAR, UK Council for Psychotherapy

Law Society condemns mental health bill

The Law Society today condemned government proposals for a new mental health bill. Chief executive Janet Paraskeva said that the bill does not help people suffering from mental health problems, instead concentrating on the perceived danger posed by those people. The society also says that the bill’s definition of mental health is too broad, and that it could lead to a denial of human rights. As it stands, there is potential for epilepsy or even being drunk to be counted as mental disorders.
As part of the Mental Health Alliance, the Law Society believes care and treatment are the best ways to deal with mental illness.

thelawyer.com

Viewpoints: Mental Health Bill

From BBC.co.uk

A fresh version of government plans to allow enforced treatment of potentially dangerous mental health patients has been unveiled.
The new draft of the Mental Health Bill was drawn up after the original, released in 2002, was condemned as unethical and inhumane by psychiatrists and charities.

We asked experts for their views on the new version and whether the changes resolve the concerns raised. Please use the form at the bottom of the page to tell us what you think:

Professor Louis Appleby, National Director for Mental Health

Paul Farmer, chairman of the Mental Health Alliance

Mike Shooter, president of the Royal College of Psychiatrists

Beverly Malone, Royal College of Nursing

Marjorie Wallace, chief executive of SANE

Jason Pegler, mental health service user

Mental Health Tsar Professor Louis Appleby
I genuinely think we have made changes that respond to the criticisms that were made.

The Bill specifies quite precisely under what clinical circumstances compulsion powers can be used.

The criticism was that the conditions of compulsion were drawn too broadly and that they could, in theory, have allowed a lot of people to be detained who should not have been.

The answer was to look at how sensible clinical practice happens - look at the system when it is working well.

We always have detained people if we think the risk is high enough. That's the whole point, to prevent something from happening.

We are determined to develop an effective Act that best serves the interests of people with mental health problems.

It will be for clinical and social care staff to decide whether, in their professional judgement, it is clinically appropriate to treat someone under the act.

If they decide that they are not then compulsory powers cannot be used.

Paul Farmer, chairman of the Mental Health Alliance
We are deeply disappointed that the government has still not listened to professionals, carers or people using services.

Despite receiving 2,000 responses opposing its original plans, the government has pressed ahead with many of its most disturbing proposals.