Mental Health Bill concessions fail to meet serious concerns, says Alliance

13 July 2005

The Government made major concessions on patients’ rights in its call for a new mental health act today, but failed to address widespread concerns that its plans will lead to an increased use of compulsion in the community, the Mental Health Alliance warned.

The Alliance pledged to continue pressing the Government to recognise the need to reduce compulsion in the mental health system, in line with recommendations from the Scrutiny Committee of MPs and Peers that the Government itself set up.

Speaking on the day the Government published its response, Alliance Chairman Paul Farmer said:

"After seven years and thousands of hours of consultation on this crucial legislation, some of the basic changes required are now being recognised, but we're a long way from acceptable legislation.

"Mental health workers, service users and carers will today be pleased that the Government has said it will consider improving patients’ rights, for example through advance statements which will give people more say in how they are treated, as well as extra powers for advocates. But they will be disappointed and angry that the Government intends to press ahead with plans to broaden out powers of compulsion and deny professionals the flexibility they need to offer people the right care and support. By rejecting a test of ‘therapeutic benefit’ for people to be compelled, the Government risks clogging up services with people who cannot be treated and should not be there. We know that the system cannot cope with this.

"The Alliance welcomes the Government’s pledge to look again at the use of compulsion outside hospital. This controversial plan needs much clearer safeguards.

"Our members today call on the Government to continue to work with us to produce a workable Mental Health Bill that has the confidence of those who will have to use it and that will stand the test of time. The Mental Health Alliance will be studying the Government’s response in great detail over the coming days to get more clarity where it is lacking, and we will continue our fight in the coming months for legislation that will work. The next mental health act will outlive the Government and the Mental Health Alliance."

The Alliance welcomes the Government’s responses to the committee’s recommendations that:

However the Mental Health Alliance is concerned that the Government has rejected the committee’s recommendations on:

Members of the Mental Heath Alliance today commented on the Government response to the scrutiny committee report:

Lord Adebowale, Chief Executive of Turning Point, said:

"Virtually everything in this bill disproportionately affects black people with mental health problems. Yet there is little in the government response to do anything about the issues and fears they face."

Richard Brook, Chief Executive of Mind said:

"We hoped that the Government would grasp the opportunity to deliver the necessary legislation for a mental health system delivering effective and compassionate mental healthcare. Yet sadly they have not listened fully to the Scrutiny Committee's report on top of advice from all other stakeholders to deliver the badly needed solutions. However, there are some benefits that we welcome - and we must now continue to work with and challenge the Government to prevent a stigmatising Bill."

Tony Zigmond, Honorary Vice President at the Royal College of Psychiatrists, said:

"The Joint Scrutiny Committee of Parliament, established by the Government, received 450 written submissions and took oral evidence from 124 witnesses. Their report made proposals for a Mental Health Act, which would enhance patient care and community, safety and command wide support from patients, their carers and professionals. The Royal College of Psychiatrists is saddened by the Government's failure to adopt many of the central recommendations of the committee."

Dr Andrew McCulloch, Chief Executive of the Mental Health Foundation, said:

"Concessions such as Advance Statements, which will give people with mental health problems some say over their care and treatment, are to be welcomed. But it is clear that the Government hasn’t listened to our very serious concerns over the grounds on which people can be treated under compulsion, and other crucial issues. The mental health sector must remain united, and put its shoulder to the campaign for further improvements to the Government’s plans in the coming months."

Cliff Prior, Chief Executive of Rethink, said:

"Rethink is deeply worried that the Bill still fails to help people with mental illness get help quickly - and fails their families even more - despite some welcome changes to improve rights and safeguards."

Angela Greatley, Chief Executive of the Sainsbury Centre for Mental Health, said:

"The Government has evidently listened to many of the detailed recommendations of the scrutiny committee. But there remains a long way to go before we have a Bill that all those who work in or use mental health services can support and implement."

Marjorie Wallace, Chief Executive of SANE, said:

"Whilst the Government has met some of the anxieties expressed by organisations in the mental health field, SANE remains concerned that the new proposals will not improve the lives of the majority of mentally ill people and their families. While there are 400 vacancies and rising for consultant psychiatrists, a chronic shortage of mental health nurses and a lack of beds, such measures as compulsory treatment in the community could become a temptingly cheap alternative to in-patient or other skilled 24-hour care. Without imposing a duty to provide the resources for both in-patient care and community teams, any intended reforms could become increased coercion without compassion."

Gil Hitchon, Chief Executive of Maca, said:

"While the government's response is a significant improvement on the original Draft Bill, it rejects many of the most important recommendations made by the Joint Committee, which would have given us a much better Bill. In particular, the government still wants to allow people to be detained and forced to have treatment which will not improve their condition, still wants to give compulsory treatment to people who are capable of making their own decisions, and still wants to charge patients for the cost of the care they need following compulsory treatment."

Ian Hulatt, Mental Health Advisor at the Royal College of Nursing, said:

"The RCN welcomes the government response to the PLS report, but we remain concerned over a number of issues. As the largest occupational group nurses are crucial to the delivery of the proposed Bill. There is a pressing need to recruit more nurses to deliver the Bill and the service changes proposed within it. We still have serious reservations about the controversial issue of non-residential treatment orders - whereby patients are not admitted to hospital but are legally required to attend places for treatment or take medication. The government have chosen to reject the suggested criteria for the application of this order. We shall be working hard with our Alliance colleagues to ensure that the workforce and service delivery issues are rigorously considered in our discussions with the government."

Su Sayer, Chief Executive of United Response, said:

"United Response works with GPs to support people at an early stage and help prevent their problems from escalating. More investment in early intervention services is crucial and makes economic sense. It would also help to reduce the stigma that millions of people with a mental health need face."


Notes to Editors