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Tuesday, 2 January, 2001, 12:36 GMT
Should people be detained against their will?

The government has unveiled plans to detain people with serious personality disorders who are thought to pose a risk to others. It also proposes powers to force mentally ill people to take their medication.

Health Secretary Alan Milburn says the proposals are necessary to protect patients and mental health staff as well as the public.

However, critics say there can be no justification for detaining people against their will who have committed no crime.

Are these powers necessary to protect staff, patients and the public? Or are they a viloation of human rights?

This debate is now closed. Read a selection of your comments below.

Your reaction

Difficult one really, I think if this were to be implemented then a serious re-think would have to be made into the state of the hospitals that are available. The mental hospitals at present have a tendency to make people feel worse, not better. Forced incarceration would be full of its own psychological problems to a person faced with it. This could send someone "over the top" and then they remain incarcerated as a result. If there is serious threat to others or themselves a person should be looked after appropriately but there should be a middle house perhaps before hospitalisation.
Louise, UK

It won't spend any money to improve their treatment

Dan Griffith, US
Your government is much like ours, it doesn't mind segregating the mentally ill, but it won't spend any money to improve their treatment. Just getting the mentally ill out of the way so you don't have to think about them is what was done with them in previous centuries, remember Bedlam? Look out Britain you are becoming a police state, they are segregating your society into categories, and imposing punishments for being in those categories.
Dan Griffith, U.S.

As an ex-pat mental health nurse of some 19 years standing I have read with interest the comments on this page. It is clear that the majority of comments have missed the single most important point - there is a huge difference between a formal mental Illness such as schizophrenia and the various types of personality disorders. Someone with schizophrenia may (and I repeat may) represent a risk because of a clear and identifiable delusion - perhaps they may be convinced that another individual means them harm and so chooses attack as the best form of defence so to speak. While this is tragic it is much more predictable than problems caused by personality disorders. These individuals often have no comprehension of right and wrong as we know it. They will have no empathy for those they hurt nor will they have any genuine understanding of "our" point of view. Whilst the former is reasonably easy to identify the latter certainly is not.
Peter Truman, Australia

Having myself been detained under a "section", and having been labelled as having a borderline personality disorder, I think that it is totally wrong just to detain people who have committed no crime just because there is a possibility that they might harm someone. Also I think what the Government is proposing just heightens the fear that the general public already feel because they aren't correctly informed about mental illness. The majority of people with a mental illness are just trying to get on with their everyday lives the best way they can. However I do accept that a small number of people do need to be detained for their own safety, and for the safety of the public
Tina Boardman, United Kingdom

If we should detain people to protect the public, maybe we should start by locking up politicians!
Helen, UK

Why all the fuss? People are 'Sectioned' every single day in the UK. This is for the benefit of themselves and of others. There are already safeguards which presumably are working as I can't recall any complaints recently. This appears to be another excuse for Human Rights organisations to stir up non-existent issues.
Malcolm, England

I just can't believe some of the arguments against detaining dangerous people!

Kevin, UK
I just can't believe some of the arguments against detaining dangerous people! My mother had very severe delusional mental health problems. One of the consequences was that she felt compelled to jump in front of any passing red car. She used to sit at the window entranced by red vehicles. She was nearly killed on numerous occasions but luckily never caused a serious accident that harmed others. She spent the last six years of her life in a secure unit for the mentally ill, unfortunately managing to kill herself by other means. Should she have been allowed 'freedom' to cause accidents and possibly kill others? She did not have the capacity to realise the consequences of her actions. Many others are in the same situation and take actions that directly harm others.
Kevin, UK

Generally it is a good idea to protect the general public from mentally ill and potentially dangerous patients. Still, I fear that this law may well be misused in order to silence people of controversial political opinions or to carry out personal vendettas. Forcing people to take medication that they don't want to take, specially considering the side-effects of most such medication seems a little drastic.
Vivien Cooksley, Cyprus

Naturally this system could be open to abuse, but there is also a great deal of potential for good. If this system is ONLY to be used to detain those who are a serious risk to others then one can imagine the benefits. The question that is immediately raised, is, of course, how to decide who should be admitted for treatment. Perhaps admittance could be based on a nomination basis.
I Wright, England

What about the families, the neighbours, who have to live in such close proximity of mentally sick people?

Jeanne Lane, UK
My father was mentally ill, and for our entire childhood teenage years, made our lives and that of our mothers dreadful. Numerous meeting's were called discussing my fathers 'best interests' All I can say is that to enable one person to live a 'free' life, left several others in the depth of hell. He never took any medication given, the mental hospitals at that time were being emptied, he terrified all of us. What about the families, the neighbours, who have to live in such close proximity of mentally sick people?
Jeanne Lane, UK

The greatest threat to our remaining freedoms and liberties no longer comes from external enemies but from our own Government.
Chris Millbank, London, UK

What happened to the Universal Declaration of Human Rights that all UN countries subscribed to? I believe that all forms of human beings deserve protection even when some have disabilities. I condone the detention of these unfortunate people even if it is in the interest of public as its not their fault to be impaired. The people calling for their detention should wake-up and thank God they are more able physically and mentally. Even then question your conscience.
Steven Mun, Malaysia

Persons who are significantly dangerous to themselves or to others should be detained whether they like it or not. These are the only justifications for detaining people against their will.
James Castro, USA

Believe it or not patients do get injected against their will it's our duty of care to them

Pamela Jones (ex pat), Australia
Believe it or not patients do get injected against their will it's our duty of care to them. Psychiatric patients are intelligent people and don't forget it they remember their florid symptoms and are grateful for their recovery - medications have revolutionised their lives especially Clozaril and many psychiatric patients hold down very good jobs. We are giving them Human rights. Don't Ministers ever read the Mental Health Act 1983 I'm sure it must have passed through Parliament somewhere along the line.
Pamela Jones (ex pat), Australia

Liza, thank you so very much for your comment. It is so easy for society to label those with mental illness as a danger to the so-called sane. The majority of those with mental illness suffer from neurosis not psychosis. No one would ever dream of forcing a cancer patient to undergo chemo, or a diabetic to take their insulin. Diagnosing a mental illness is far from being an exact science. There have been many a person misdiagnosed as being a schizophrenic. Who is going to protect the mental ill from society? The greater population allows and participates in trivialising and stigmatising the mentally ill.
J Innis, Canada

My sister-in-law, aged 30, is currently in a mental hospital. She has been ill for at least ten years and it was only last month that she had her first contact with the services. Her family had tried to look after her, but basically failed and her condition has steadily deteriorated. Over the past few months she was eating hardly anything, had become paranoid (convinced she was being followed, bugged at all times). Would not sleep in case 'they' got her. Would not bathe in case 'they' saw her. She set fire to her papers which she didn't want 'them' to find (started a fire in a plastic bin). She had been living with her sister, who was stressed, exhausted, miserable, missing work, had no social life and who's house had become a fortress (of which she was frequently locked out). My sister in law was sectioned last month and is in hospital. I am glad she is there, and hope she stays there until she is happier and healthier and in a condition where she can take better care of herself, be more pleasant to be around, and plan a future. It is very rare, I believe that you are 'only' a threat or danger to yourself.
Nadia Tontus, UK

There does need to be some mechanism for protecting family, friends and bystanders

Katharine, Canada
Our family lives daily with the reality of an adult schizophrenic in and out of hospital because she will not take her medication, refusing to believe there is anything wrong with her. Most schizophrenics are no danger to others, or to themselves. Ours is both. It is only luck that so far none of the injuries she has inflicted on herself or others (she has a thing for wielding large bits of broken glass) has been fatal. So, despite being a strong supporter of civil liberties and privacy, I favour someone having the power to hospitalise or medicate her. While I sympathise with Ms. Johnston, who is undoubtedly one of the 98% who are not dangerous to anyone, there does need to be some mechanism for protecting family, friends and bystanders from the few who are. We all know that, sooner or later, my niece will kill herself or her parents. And, under Canada's laws, there is nothing we can do to help her or them. Is there no compromise possible? Does my brother have to die for someone else's freedom?
Katharine, Canada

People with serious mental disorders who pose a risk to others should be detained, because everyone of us has the right to live in a safe society. Whether the detention violates human rights depends on how the government or the people who are in charge of the action implement it. In tyrant countries, governments often detain political dissidents in psychiatric hospitals and force them to take psychiatric medicines. These governments certainly violate the human rights. But if the government detains someone with a serious mental disorder for the safety of others you can't say that it violates human rights. Actually it protects our majority's human rights.
John Yiu, Hong Kong

The important thing is to make sure that the process by which we decide who is mentally impaired is reliable and just

Peter Nelson, USA
The whole philosophical basis for the freedom to act on one's will is the assumption of rationality. All of the great philosophers who have developed our ideas of political and civic liberty and freedom did so on the assumption that individuals could make rational choices. Thus, someone who is mentally impaired and cannot rationally choose what is in their own best interest is not subject to those assumptions, and we should not talk as though their own freedom of assent is being violated, since they don't meet the basic requirements of having such freedom. The important thing is to make sure that the process by which we decide who is mentally impaired is reliable and just, so that we don't deny basic liberty to anyone who is not impaired, since the power to do so is, obviously, tempting to abuse.
Peter Nelson, USA

The purpose of incarceration is not principally to punish the offender but to stop him/her committing acts which are injurious to the public. The point is that jail and previously the death penalty and other less serious "punishments" were put in hand for the protection of society by locking the perpetrators of crime away so they could do no more harm and by letting it be known that any similar crime would be dealt with in a like manner. Thus, the purpose of the law is to protect the public. The implementation is another matter, however. It is possible, even in the best of societies, that errors will arise and that someone may be intentionally locked away in malice: for this we have the fact that this is said to be a democracy, and that the law and medical services are in the vast majority of cases able to keep such unfortunate aberrations to a minimum. The new system will be a lot better than the old, where being incurably insane was apparently a method of achieving one's freedom.
James Bruce Reid, Scotland

This is just an attempt to sweep a social problem under a legal carpet and should be resisted by all right minded people who value civil liberties

Huw Sayer, England
I think this is a very worrying and draconian development. It is a classic kneejerk reaction in the light of some limited but highly publicised cases. Laws made in haste are invariably bad laws and subject to abuse. This is a dictators' charter to lock up anyone the state deems unsound without trial: a legal convenience well used by Stalin and others to crush their opponents. Our common law has always presumed innocence. Predictive law has always been frowned upon because of lack of compelling evidence. Let us not confuse possibility with actuality. More to the point, who could we trust to make the call - doctors? I think not, they have been shown to be far from infallible. There are plenty of examples (see Nazi Germany) of the medical establishment and other so called "respectable institutions" becoming instruments of state terror. Remember the dictum "Power tends to corrupt, absolute power tends to corrupt absolutely". This is just an attempt to sweep a social problem under a legal carpet and should be resisted by all right minded people who value civil liberties.
Huw Sayer, England

People with serious mental disorders should be detained in a secure environment, for their own and the public's safety. A question I raise is this, are the people who are calling for these people to live within the community, prepared to give up their own time to look after them, or do they expect relatives or social services to do it. My wife works for social services, and I would not like to think that she would have to call on mentally ill people when their is a high risk of personal injury. Please think it through!
Phil Hart, England

This is one Big Brother step too far towards an authoritarian regime for me

E George, UK
So who defines what exactly is or isn't a "personality disorder"? Is it the political activist who doesn't agree with the prevailing ideology, the old lady who lives like a hermit in self chosen squalor, or what? Many a regime has used mental hospitals to constrain dissident opinions. This is one Big Brother step too far towards an authoritarian regime for me.
E George, UK

Is this an admission, at last, that care in the community has failed?
Chris, UK

There is a two-way process that means give and take on both sides. The mentally ill patients have a right to be cared so that they do not injure themselves, but more importantly so that they do not hinder the general public. You have to be realistic and get away from this "infringement of human rights" nonsense.
M Rouse, UK

As long as safeguards are in place I cannot see why people are so against this. I think it is only common sense that you don't allow people who are considered dangerous to roam around. To say that total freedom for a relatively small group of people is more important than innocent people's lives is not sensible.
Chris Singer, UK

Invariably all people suffer periods of their life which contain bouts of depression and irrational behaviour that could be construed as mental illness, there is a fine line between irrational and dangerous. It would appear to be on the increase in more recent times, so far from treating the symptom, shouldn't the powers that be try and find the reasons for this sudden upsurge in the proportion of the population that are unable or unwilling to cope with the stresses of everyday life?
Gareth, UK

As a psychiatric nurse, I obviously share the concerns of the community and politicians of safety

Anna Bye, England
As a psychiatric nurse, I obviously share the concerns of the community and politicians of safety. We do currently have the power to readmit patients, voluntarily or under a section of the Mental Health Act (1983) if their condition deteriorates in the community. However, mental illness and personality disorder are two separate entities. A mental illness can be treated. A personality trait cannot be medicated. If a psychopath has committed at crime, then they should be imprisoned. There is no point detaining them for detention's sake - they cannot be "cured".
Anna Bye, England

While it is important to protect the public from those who may harm them, it is equally important to safeguard the rights of the disadvantaged. Careful controls will be required to ensure that such measures are not taken to extremes and used to justify injustices against those with disorders over which they have no control.
Martin Espinoza, USA

Is it 1984 already?
Viktor, Kuwait

Care in the community was not introduced for medical reasons, rather to permit the large-scale sale of hospital sites. It is a policy that has failed sufferers as well as the public and shames us all. These are vulnerable members of society, and they deserve better than being thrown onto the streets where many are forced to live in the absence of proper care facilities.
Ted, UK

Care in the community is practically non-existent

Rather not say, UK
I am perhaps one of the people you refer to. I have a personality disorder but am harmful to myself rather than to others. At the worst times I wish someone would take me and put me in a safe place, although I would never admit that to anyone. I even denied this while in hospital following a suicide attempt. I think it is tragic that someone can be allowed into the community and then maybe kill someone and spend the rest of their life in a secure hospital or jail when maybe a short spell in hospital to get a working medication sorted out could have saved both lives. We don't want to return to mentally ill people being effectively imprisoned and forgotten about but care in the community is practically non-existent and I think we need somewhere between the two extremes.
Rather not say, UK

What is being suggested here is detention without trial for crimes that haven't been committed.
Ben Eaton, England

Who is perfect and who is normal? Better still who is to say so?
Peter, Australia

I'm all for it. In fact, I think we should detain most of the Cabinet right away.
Jon Livesey, USA

I anticipate the first legal challenge with interest

Nick, UK
The proposals are so draconian as to be described as fascistic. Locking people up who have committed no crime is false imprisonment. If the white paper is steam-rollered into law, then I anticipate the first legal challenge with interest.
Nick, UK

I have been an Approved Social Worker for the past 17 years and thus been responsible for many people admitted to hospital under a 'section' of the Mental Health Act. Let's move slowly and carefully on this one or we might do more injustice than we would wish.
Paul Bridle, UK

I have a friend who spent some time in a mental hospital suffering from schizophrenia. While she was suffering badly, she had very little control over her actions and was almost entirely unpredictable. In those circumstances, it was in her best interests to be held somewhere safe and made to take her medication until she returned to (almost) normality. She's very glad that she was helped, as she's a lot happier now.
Andrew Ducker, Scotland

We need to fundamentally reform the way in which we treat the mentally ill

Emma, UK
This is a complex issue. As a psychologist having worked in psychiatric wards, I am aware that there are occasions during lucid moments where psychiatrists mistakenly believe a patient has recovered, and where mentally ill people can seem very convincing when claiming that they have taken their medication. As many psychiatric drugs have unpleasant physical and/ or psychological side effects, avoidance of them is understandable, but often the lucidity passes. It is essential that we do all we can to protect staff and the public from potentially dangerous mentally ill people, although in order to do this, we need to fundamentally reform the way in which we treat the mentally ill.
Emma, UK

These powers are only acceptable if backed up by safeguards to prevent their abuse. Is it better to wrongly detain a healthy person or let an ill person go free?
Cam, UK

The first question to be answered in this debate is who defines that a person is mentally ill? History shows that the answer depends heavily on the political and economic systems you happen to live in. And as long as there is no definite line you can draw between "normal" and "ill" persons there should be no detention for people with mental health problems whatsoever.
Ingo Thoene, Germany

When we are talking about people with a serious personality disorder, I believe that they should be detained. Human rights is an important issue but whoever considers the rights of the victims of these people?
Steve Lockwood, UK

This kneejerk reaction legislation would not have been necessary had care in the community been introduced slowly and with an appropriate support structures in place

Liza Johnston, UK
I am incensed by the proposed introduction of these new laws, particularly the attempts to force people to take medication under duress in their own homes.

How on earth do the government think they are going to inforce this? In my experience (9+ years of severe mental illness with repeated addmissions to hospital) the only way to medicate forcabely is to detain a patient and we already have those powers in the existing Mental Health Act.

Medication for mental illness is not like taking an asprin and getting an imediate response. The only way to really get effective treatment with medication taken by anyone who has mental illness is to supervise them 24hrs a day in a secure hospital environment.

No-one likes this but untill there are more effective support groups and 1-2-1 care available for those who want and need it we will continue to see 1000+ people killing themselves a year and a few tragic deaths of innocent by-standers who become targets for pschotic individuals who have slipped through the care net.

Unfortunately this kneejerk reaction legislation would not have been necessary had care in the community been introduced slowly and with an appropriate support structures in place.

If the government were truly interested in preventing unnecessary deaths in this country in any substantial way they would be targeting killers in cars, drunk drivers and speeding offences in inner city areas where many more people are killed every year than by psychiatric patients.

This is yet another institutionalised way of marginalising the "other" in our society, the mentally ill who are already the but of prejudice, hate crimes,isolation, discrimination, made vulnerable,and disenfranchised by society as a whole.

We are the new trendy target for "humorous" advertising campaigns, fear of our illnesses is rife due to widespread ignorance of our illnesses, all the media seem to revel in the persicution of us, and for what?

We were all just like you once, before we developed these illnesses we are normal working, average people who know as little about our illnesses as you. It's only when we are given a diagnosis that we have to learn whatever we can.

I believe the real reason all the "yous" out there are scared of all the "uses" out here is that you all know in your hearts you are potentially the next patient to be admitted.

It's time for us to face up to this as a mature society and realise that like the eldery, the mentally ill need to be given the respect we deserve because it could be you next, to be forced to take powerful medication in your own home against your will. We are the under class of the 21st century, pray to God you don't become one, it's a who different world from this side of the medication.
Liza Johnston, UK

These proposals are a recipe for future injustice. No party that supports them will have my vote.

Justin Horton, England
The proposals to indefinitely detain some mental patients, and enforce the medication of others, constitute the final straw for me. I will no longer vote Labour.

The government's already poor record on civil liberties is to be compounded by the detention of people who have committed no offence, on the basis that someone else suspects them of suffering a mental disorder.

Psychiatric disagnosis is not exact. You cannot diagnose a disorder like you can a broken leg. Yet people are now to be locked up on the basis of what are no more than educated guesses.

Meanwhile, those patients who remain free are to be deprived of the common right to decide for themselves whether their medication - and medication can be harmful - is suitable or necessary.

By what right are people to be treated as incapable of making their own decisions?

It is no use talking of "safeguards". Anyone who, like me, has been through the psychiatric system, knows how difficult it is to get professional people, like doctors, to accept that their colleagues are capable of error.

Moreover, the stigmatising of mental patients implict in these proposals makes it that much more unlikely that the patient's views will be listened to.

These proposals are a recipe for future injustice. No party that supports them will have my vote.
Justin Horton, England

Well, Thatcher's Care in the Communty didn't work did it! It's only taken 15 years to make this astounding connection. If people are a threat then they should be removed from the public domain. Harsh I know, but effective.
Philip F, USA

It is a shame that people can be detained at all. "Mental health" has been a tool used lately by the Russians to detain whoever they want to. The Chinese are doing it too. It is a form of mental abuse rather than mental health. It ought to be outlawed but, knowing how we in the West seem to vote for the wrong people and do what is against our interests - that will probably happen to us too.
Dave Adams, USA

It's important to protect the public from unstable people. It's not a question of imprisoning or punishing mentally ill people, but rather keeping them in a place where they can be treated constantly at no risk to themselves or other people. Eventual release from a hospital would also be a great incentive to get better, a light at the end of the tunnel for detained patients.
Richard West, UK

They should detain people if they're a threat to the public. Not if they're only a threat to themselves - one's own body is one's own property.
Julian Morrison, England

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