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Last Updated: Wednesday, 8 September, 2004, 10:14 GMT 11:14 UK
Viewpoints: Mental Health Bill
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.

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 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.

Mike Shooter, president of the Royal College of Psychiatrists

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.

We recognise that government has made some welcome, but limited changes, particularly by removing Community Treatment Orders (CTOs) in prisons, and on the use of CTOs on a person's first admission for compulsory treatment.

We are worried, however, that the Bill will extend the use of compulsory powers to a wider group of patients than is medically necessary, thus putting greater pressure on psychiatric services and the existing workforce, and infringing people's human rights.

This is particularly the case for people who have physical illnesses with mental health complications, for example epilepsy or multiple sclerosis, and for people with alcohol or other substance misuse problems.

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.

Marjorie Wallace, chief executive of 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.

Only if new laws are backed by improved services can they lead to compassionate care rather than increased fear and stigma.

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.

Jason Pegler, mental health service user

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.

What do you think? Please use the form below to tell us your views.

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Q&A: Mental health laws
25 Jun 02  |  Health

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