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Saturday 22nd October 2016

Mental Health Bill Axed

3rd April 2006

04042006_windowQ.jpgThe next step for the Mental Health Bill was announced on Thursday 23 March.  The Health Minister Rosie Winterton outlined proposals for a Bill to amend the existing Mental Health Act. The new amending Bill will be substantially shorter than the draft Mental Health Bill 2004.

What is the background?

An expert committee began to examine the possibility of a new mental health bill in 1998, after the conviction of Michael Stone for the murder of Lin and Megan Russell in 1998. Michael Stone had been left free to commit the crime because his severe personality disorder was considered untreatable and because of this loop-hole he could not be detained under the Mental Health Act.

A draft bill was first published in 2002. Despite opposition during the consultation by service users, carers and mental health charities to many of its proposals, the subsequent bill published in 2004 was largely similar. Last year a committee of MPs and peers concluded that the bill was "fundamentally flawed".

Why has it been abandoned?

Rosie Winterton said that the Government had taken into account concerns over the length and complexity of the earlier draft, as well as pressures on parliamentary time, and had therefore introduced the shorter Bill "which will be easier for clinicians to use and less costly to implement."

The "shorter, streamlined" legislation amending the existing Mental Health Act 1983 would replace the controversial draft bill.

What are the new proposals?

The government retained proposals to extend the forcible treatment of people with personality disorders. It will introduce a simplified definition of mental disorder throughout the Act and remove the “treatability� test. 'Both changes will ensure that people who require treatment to prevent harm to themselves or others are able to receive it.' said the Health Minister.

The new proposals do not abandon the test entirely but broaden its definition to include non-medical treatments such as detention in a prison or psychiatric hospital. They also remove the requirement that the patient must be able to benefit from treatment, instead permitting detention on the basis that appropriate treatment is available.

The new amending Bill will also introduce supervised treatment in the community to ensure that patients who have been discharged from compulsory treatment in hospital continue to comply with treatment. 'This will benefit patients and improve public safety' said Health Minister Rosie Winterton. She said: “Introducing supervised community treatment is a vital part of getting help to people who need it, supporting carers and protecting the wider public."

The shorter bill retains the right of patients to choose their own representative, who currently must be their nearest relative. This representative will be able to apply for a patient to be discharged from hospital or to trigger an assessment of their case.

However, Mental Health groups are concerned that other details of the new bill are sketchy;

The Department of Health says the bill will also close a legal loophole that means thousands of people with learning disabilities or dementia may be kept indefinitely in hospitals and nursing homes because they are unable to communicate their wishes. But how exactly this will be changed is unclear.

The right to independent advocacy promised to patients in the draft bill has gone. Ministers claim more advocacy will be made available, but the Mental Health Alliance, a group of 70 organisations that campaigned against the draft bill, believe this will lack clout without legislation.

The future role of mental health tribunals, which review the use of compulsory treatment, is also uncertain. Plans to give young people aged 16 or 17 the right to refuse treatment have also been dropped. The government says this right will instead be covered by the Children Act 1989, but it is unclear whether that legislation will be amended.

What was the reaction to the Government announcement?

Many gave a guarded welcome to the dropping of the Mental Health Bill in its present state.  However there is concern both over the content of the suggested amendments to the Mental Health Act, and the process of further consultation that may take place. 
The mental health charity Mind hails the dropping of the 'draconian Mental Health Bill' after eight years of campaigning from mental health stakeholders, but says that key issues still need to be addressed.

The Mental Health Alliance welcome the scrapping of the draft bill but are concerned the shorter version will be just as draconian. "Some of the proposed amendments to the current Mental Health Act are cause for concern," said Mental Health Alliance chair Paul Farmer. In particular concern was expressed by the Mental Health Alliance over the decision to abolish the treatability test, and the absence of independent advocacy in the Government’s plans.

However the Mental Health Alliance welcomed the decision to limit the use of compulsory powers outside hospital and to abandon plans to reduce the power of families over how people are treated.

Andrew McCulloch, Chief Executive of the Mental Health Foundation emphasised the over-representation of black people in the mental health care system and Lord Adebowale, Turning Point Chief Executive, agreed there must be a full Racial Equality Impact Assessment and "effective measures taken to tackle this inexcusable discrimination."

Liberal Democrat Shadow Health Secretary, Steve Webb MP expressed his concerns more strongly; he said that "scrapping the entire bill means we have also lost the opportunity to do something positive to tackle the mental health crisis in Britain" continuing "We urgently need an audit of the state of mental health services and a clear plan to tackle the worsening situation."

What will happen now?

The new proposals look "little less controversial than the main sticking points in the ill-fated Bill" said Mark Easton, BBC Home Affairs Editor.

"We are now in uncharted waters" agreed Paul Farmer, Mental Health Alliance Chair, noting that the amendments will need careful consideration and full consultation to provide an Act that is 'fit for the 21st Century'.

As Angela Greatley, Chief Executive of the Sainsbury Centre for Mental Health concluded, the revision of the governments plans provide an opportunity to move forward with a more workable alternative, but "the devil will be in the detail."

The shorter bill is expected to be published in October or November.

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