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Tuesday, November 9, 1999 Published at 01:12 GMT


Alliance to fight mental health plans

Health officials believe community care needs more safeguards

Proposals to extend compulsory treatment of mentally ill people could increase violence and damage race relations, a group of charities is warning.

Fifteen leading mental health, carers, nursing, legal and disability groups have formed an alliance to counter moves to introduce compulsory treatment orders (CTOs).

Mental Health
The government is expected to issue a green paper on changes to mental health legislation later this month, based on a review by a panel of experts.

The review recommended the imposition of CTOs for people who are deemed at high risk of endangering themselves or the public.

This would mean if they failed to take their medication while in the community, they could be returned to hospital.

The review follows concerns about a number of killings by community care patients, some of which were due to the patients failing to take their medication.

Some mental health groups, such as Schizophrenia: A National Emergency (Sane), believe the public needs more protection, although they also have concerns about CTOs.


The alliance is launching a leaflet, highlighting 10 main concerns about the CTOs, at the annual conference of mental health charity Mind on Tuesday.

The groups, including Mind, the Carers National Association and the Mental Health Foundation, say they have "serious reservations about whether compulsory treatment in the community, and the way in which it will be implemented, will deliver the benefits alleged".

The leaflet will be distributed to the organisation's members.

The 10 questions are:

  • Will the CTOs reduce violence?
  • Will they help engage people in treatment and support?
  • Will they increase compulsion?
  • Will they focus only on medication?
  • Will they be enforceable?
  • Will they be applied disproportionately to black people?
  • Will they change the role of health professionals?
  • Will the interests of users be protected?
  • Will they be compatible with the European Convention on Human Rights?
  • Are there any alternatives?

Mind says its research shows the importance of non-compliance with medication in killings by community care patients has been overstated and other factors, such as lack of support for patients, are more important.

Last resort

The alliance believes few community care patients are a risk to the public.

It is concerned CTOs might deter people from accessing services which could lead to a deterioration in their condition, increasing the risk of violence.

It believes legislation should reduce the emphasis on compulsion in mental health treatment, ensuring it is used as a last resort, and ensure patients have more rights rather than less.

Groups are also concerned about the focus on medication, rather than support, and about how the CTOs will be enforced.

In addition, they want assurances they will not be used in a racist way, given research showing black people are more likely to be detained in hospital and less likely to receive alternatives to medication than whites.

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