Mental Health Bill still not fit for the twenty-first century, says Alliance

17 November 2006

The Government today has missed an historic opportunity to bring forward modern mental health legislation, the 78-strong Mental Health Alliance said today.

Responding to the publication of the amended Mental Health Bill, Andy Bell, chair of the Mental Health Alliance, said:

"People who use services, their families and the people who work in them have for eight years campaigned for a better Mental Health Act. They will be profoundly disappointed with the flawed Bill being presented to Parliament today.

"The Alliance recognises that the Government has listened to some of its members’ concerns. But the Bill Act does not address the shortcomings in mental health law that were identified as long ago as 1999 by the Government’s own expert committee. The legislation falls far short of what is needed and does not truly reflect the needs of those who have to live and work with it. It introduces new powers for services without the necessary safeguards for patients."

"The Government argues that requiring a person to be ‘treatable’ before they are detained is a major loophole in the Act, but there is no evidence that this is the case. Health legislation should not be used to impose treatment that has no benefit on a patient under compulsion. What matters most is that people with mental health problems have access to decent services that work well."

The Alliance today announced it would continue in its campaign for a modern Mental Health Act that:

Members of the Mental Health Alliance today expressed their concerns about the Bill:

Fiona Woolf, President of the Law Society, said: "This Bill merely tinkers with the law when what is needed is radical revision of the Mental Health Act 1983. It is disappointing that after so many years and extensive discussion and consultation, and particularly following the report of the Joint Parliamentary Scrutiny Committee, the Government has decided to ignore widely held views and concerns about key issues. Our main concerns are that the legislation fails to uphold the human rights of patients, and provide access for care for people with mental illness, with compulsory treatment used only as a last resort."

Jo Williams CBE, Chief Executive of Mencap, said: "The recent horrifying cases of abuse of people in learning disability services in Cornwall shows what can go on behind closed doors if crucial safeguards are missing. The proposals in the new Mental Health Bill for people who lack capacity and are deprived of liberty would leave thousands of disabled people, living in care homes and hospitals, with even less protection than patients detained under the Mental Health Act."

Andrew McCulloch, Chief Executive of the Mental Health Foundation, said: "I am concerned that vulnerable people who lack capacity do not have access to advocacy under this proposed legislation. The bill must provide people with mental health problems the statutory right to access advocacy services. It is hard to understand why government has dropped this basis principle."

Paul Farmer, Chief Executive of Mind, said: "It's quality health services that will protect people, not this legislation, opposed by mental health experts across the board. We hope that the widespread concern in Parliament will lead to the essential changes that must be made to give any chance of providing an effective mental healthcare system. It is vital that health legislation is focused on benefiting and treating health problems. Treatment that cannot improve or treat a person's health, should not be forcibly given to them."

Vernon Beauchamp, Chief Executive of the National Autistic Society, said: "The National Autistic Society believes the mental health system should work for people with autism, not against them. We are concerned that the new definition of 'mental disorder' in the Bill is too broad and will mean that more people with autism will be wrongly detained. The NAS also fears that the proposed safeguards for people who lack the capacity to consent to treatment will be insufficient to protect their rights."

Paul Corry, Director of Public Affairs at Rethink, said: "Rethink deeply opposes the Government’s plans which are unfair, unnecessary and unfit for purpose. We have been working to counter plans for the mental health bill, in coalition with the Mental Health Alliance for 8 years and have called for a workable and ethical solution to providing the proper care and treatment that people with severe mental illness deserve in the 21st Century. High profile inquiries that have looked into cases such as John Barrett and Michael Stone haven’t recommended a change in legislation; but rather have highlighted the lack of resources, beds and appropriate treatment."

Alison Kitson, Executive Director of the Royal College of Nursing, said: "The Royal College of Nursing welcomes many of the proposals in the Bill. However, we remain concerned about patients being required to have compulsory treatment after discharge from hospital. This could have a serious impact on levels of trust between mental health nurses and their patients. There is a real potential that the most vulnerable patients will be discouraged from staying in the system and not get the full benefit of treatment that they need and deserve. We do recognise, however, a small number of people may require supervised community treatment. This group needs to be clearly defined in any legislation."

Professor Sheila Hollins, President of the Royal College of Psychiatrists, said: "We will work with Parliament on the Mental Health Bill to ensure a modernised framework to deliver a safe and effective service for people with mental health problems. The College is particularly concerned that any compulsory treatment should have a clear clinical purpose, and be of benefit to the patient."

Angela Greatley, Chief Executive of the Sainsbury Centre for Mental Health, said: "The Mental Health Bill is out of step with the Government's modernisation of the NHS. People subjected to compulsory treatment should all have access to advocacy and a chance to say in advance how they wish to be treated. Without these steps the Bill will do little to reduce the exclusion of those with mental health problems."

Marjorie Wallace, Chief Executive of SANE, said: "Our concern, like that of many others, is that the new proposals have been driven by public safety without giving positive rights to care and treatment both for people with mental illness and their families. While a few people may be protected by supervised community treatment in the right circumstances, the majority of those needing help will still be failed when beds, units, day centres, community and therapy services are being closed or reduced. We need care and compassion, not coercion."

Liz Felton, Chief Executive of Together, said: "Despite the advice of many mental health groups the Government's proposed amending of existing legislation does not provide us with a twenty-first century Mental Health Bill that supports well-being and helps people to achieve their potential. If the Bill becomes law then those with personal experience of mental distress and the many carers and professionals supporting them will have to live with the negative consequences of the Government's narrow viewpoint for decades to come."

Lord Victor Adebowale, Chief Executive of Turning Point, said: ‘We know that inpatients from black minority groups are far more likely to be detained under the Mental Health Act than their white counterparts. The new proposals do nothing to address this problem, and the new provisions for compulsory treatment in the community will also disproportionately affect such people. This is unacceptable. The proposals must address existing inequality, for example by making respect for diversity a key principle in the Bill."

Su Sayer OBE, Chief Executive of United Response, said: "As an organisation that constantly strives to give people with mental health needs or learning disabilities a voice they might not otherwise have, we believe the legislation should provide a right to independent advocacy for everyone sectioned under the Act, from the point at which they are detained. Also, mental health provision must be given greater priority by the Government and by service commissioners so that services are properly resourced, person-centred and offer a genuine choice to people experiencing mental distress."

Barbara Herts, Chief Executive of YoungMinds, said: "The Government are missing a vital opportunity to provide age appropriate assessment, treatment and supervision for those children treated under the Mental Health Act each year. Being treated under compulsion has lifetime consequences for vulnerable children and young people. Many become homeless, self-medicate with alcohol and illegal drugs, find it hard to get work and can become chronic revolving door patients because they fear engagement with statutory services. Young people are not ‘mini-adults’, they have differing levels of development and dependency and they process and react to problems in a different way. It is absolutely essential that the very specific needs of those children admitted under the Mental Health Act are met in an appropriate way."