Page last updated at 13:04 GMT, Tuesday, 12 July 2005 14:04 UK

Support so key to mental health

By Sharon Alcock
BBC News health correspondent

Government proposals to give doctors powers to compel mentally ill patients to undergo treatment in the community have provoked widespread concern.

This week ministers will respond to the criticisms.

The BBC went to Nottingham to find out what people involved in the mental health care system think.

Drug treatment will be compulsory
The mental health residential project in Nottingham is in a leafy residential street.

A large detatched house in a working class, ethnically diverse area of the city, its residents do nothing to draw attention to their home - because the consequences are something they don't want to think about.

This is a home for nine men who have mental health problems which have led to them committing crimes or being seriously at risk of hurting others.

They can come and go, but they are well aware it is a condition of their freedom that they take medication, see social workers and psychiatrists regularly, and are home by curfew.

Effectively, it is a half-way house between secure psychiatric hospital, or prison, and living 'a normal life'. 'Gabriel' is one resident.

Compulsory medication

"The treatment I now receive is compulsory medication - it is neccessary because of my past.

"It is restrictive, but it's not hampering your life. It's helpful to check in with people, see a friendly face and get support.

"The main thing I'd like in my future is to meet somebody, settle down and raise kids, away from the past."

The police have to protect the public, but with the right treatment, medication and support, I don't think there's a danger
Andrew, a mental health patient

The government's Draft Mental Health Bill plans are most controversial for their focus on treating people who are at risk of becoming like 'Gabriel', and 'Andrew', another former 'client' of the home.

"I was disgnosed with schizophrenia and an underlying personality disorder.

"I was in for ten months on different medication, none of which seemed to help.

"I was discharged, but had no support. I went back to my old self - constant solvent abuse, drug abuse, drink abuse. I'd stopped taking medication.

"Violent occurences started and eventually, because of not having any support, not having anyone saying you've got to take your medication, things accelerated out of control and I committed a violent offence."

Locked up

Andrew's crime was serious enough for him to be convicted and locked up in a secure hospital for many years.

It was only when doctors eventually found a drug which seemed to help his personality disorder - not always a condition which can be treated - that he was able to work towards being released and "getting back the parts of my life which were lost".

But he can't help thinking about what his life might have been like without having to live with what he did.

"If care plans had been in place and I was restricted in the community before the offence had happened, I think there's a good chance that the offence would not have happened.

"It would have made a great difference. Obviously, because of my crime, someone had to suffer, and that needn't have happened.

"In the past, I was a dangerous person. I had no friends. My family had rejected me because of the things I was doing at the time.

"But I don't think people should be scared of me now."

Revolving door

Andrew was a 'revolving door' mental health patient - in and out of hospital many times.

They already think we have too much power over them
Social worker

Each time he was sectioned, under the present laws, he was taken in to hospital and stabilised after several months or years.

Each time they let him go, the lack of support and quality life he had, coupled with his illness, he says, led him to stop taking medication and fall through the loop. He freely admits he was dangerous.

"The services available at the moment are essential as a safety net, should I or someone else become ill.

"Once someone gets out of control and violent its very unpredictable what a person's going to do.

"The police have to protect the public, but with the right treatment, medication and support, I don't think there's a danger."

But talking to people in Nottingham with enduring mental health illnesses which have not led them into crime, there's not as much confidence in the neccessity for a new law.

Abuse fear

Fiona Whelpton has a psycho-somatic disorder which causes paralysis when she is anxious.

Mental health - good or bad - is a part of life for everyone
Allan Foreman

She fears a new law will be abused by a system of which she had fallen foul.

"I have been in hospital and was sectioned under the Mental Health Act - I spent my teenage years in and out, in and out.

"I found myself being intimidated, treated aggressively by members of staff - I didn't feel like a normal human being.

"The side effects of the drugs people are being treated with make them react aggressively, but a lot of it is to do with fear."

It's fear also which some say is driving the government's plans.


Critics say the Bill is weak because it's designed to allay the fears amongst the general public about living alongside people with mental health problems.

Allan Foreman, another Nottingham resident, suffered rare permanent brain damage as a result of tranquillisers which were prescribed to him for manic depression.

He says the general public fail to understand they might easily become one of the patients they fear in the future.

"Mental health - good or bad - is a part of life for everyone, and if they benefit us all, then there isn't a NIMBE issue, there isn't a 'them and us' issue, there isn't an issue about exclusion, because we're talking about everybody."

Speaking to patients and those who work with them in homes alongside yours and mine, it's easy to see that people are fearful of being misunderstood.

What all of them said, without exception, was that if they had more people to talk to, more places to live where they were accepted, many of their outward manifestations of mental health problems might not be obvious.

But waiting lists for "talking therapies" are long and increasing numbers of patients don't qualify because the goal posts have to be moved to catch those most in need of help because of risks.

No new powers

One social worker, who spoke anonymously for fear of recrimination at work, said the government needed to listen to their more practical needs, rather than giving them powers to police patients.

"I spend more and more time at my desk filling in forms, and less time than I need to with seriously ill and potentially risky patients, building a relationship.

"Staff leave constantly, so a client might have three or four different workers in a year - it doesn't help overcome their frustrations with the service.

"They already think we have too much power over them - if they are to be told I can force treatment on more of them, in more circumstances, it won't help. They will be frightened and cut off contact."


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