New mental health powers must be used wisely, says Alliance

3 November 2008

New powers in the Mental Health Act allow for compulsory community treatment Orders, from today. The powers must be used proportionately and sensitively if they are to benefit people with mental health problems, the 75 members of the Mental Health Alliance said today. On the day most of the 2007 Mental Health Act comes in to force in England and Wales, Alliance chair Alison Cobb said: "Mental health professionals now have significant new powers over people who have been discharged from hospital care through the new system of supervised community treatment.

"These powers are designed to help the small number of people with mental health problems who are frequently detained in hospital to remain at home, rather than always returning to hospital care. However, there is a danger that in a risk-averse climate some clinicians will use the powers too readily and too widely, and risk sweeping people into compulsion and restrictions when it is neither helpful nor appropriate. Therefore the powers must be used wisely and sparingly.

"The Alliance calls on mental health professionals to respect people’s dignity and autonomy. While the compulsory powers of the Mental Health Act have now come into force, we now face a delay of at least six months before people can access the statutory advocacy services included in the Act to protect them. It is now up to the NHS and local authorities to ensure no one who is subject to the new powers misses out on essential safeguards through lack of access to advocacy during this time."

Ian Johnston, Chief Executive, British Association of Social Workers says: "The impact of treatment being compulsorily imposed at a time when someone is maybe feeling disorientated and powerless can have a catastrophic impact on their confidence and self esteem and access to independent advice at such times is absolutely essential." Simon Lawton-Smith, Head of Policy, Mental Health Foundation, says: "We need better local services, not more compulsion. The benefits of these new powers are not proven. Sadly, their introduction has been driven by concerns about the threat some people with mental health problems may pose to members of the public if they become unwell. However, the general risk to the public is grossly over exaggerated."

Sophie Corlett, Director of External Relations, Mind says: "This is a historic day for mental health in this country where we will see significant changes to the way that people with mental health problems are treated. For the first time compulsory treatment will be extended into the community. We have strong concerns about how these new powers will be used and how many people will be affected. After a long hard fight to secure independent advocacy services for people who will be subjected to compulsory treatment we are disappointed that the Government does not have the necessary safeguards in place today. The Government must urgently address this problem to ensure that service users are adequately protected."

Paul Corry, Director of Public Affairs for mental health charity RETHINK says: "We will be watching closely to make sure that the positive features of the new Act are used and that people do not fall foul of the more backward looking aspects. The Bill was delayed for nine years before becoming an Act for very good reasons - it falls well short of the positive rights-based legislation that is fit for the 21st century."

Dinesh Bhugra, President of the Royal College of Psychiatrists: "The amended Mental Health Act is now in force. The important thing is to make it work, for patients, carers and others. For it to do so we need to ensure the availability of high quality mental health services. That is the key to improving the mental health of the nation".

Angela Greatley, Chief Executive, Sainsbury Centre for Mental Health says: "I am particularly concerned that people are able to get advocacy support if they are detained under the Act and not least that there is support for those affected by the new provisions for supervised community treatment."

Marjorie Wallace, Chief Executive, SANE says: "With the new Mental Health Act now in place, it is urgent that the Government turns its attention to providing good quality mental health services so that crises are better prevented and coercion used only as a last resort. We do not yet know how often and in what ways supervised community treatment will be used, but we are aware of a number of people for whom it could provide a more acceptable means of providing sustained care and preventing self-neglect and suicide.

Liz Felton, Chief Executive, Together: Working for Wellbeing says: "We hope compulsion orders do not undermine the hard work of people on the ground delivering care services. People can only gain confidence in mental health services through the development of trusting relationships between themselves, and the professionals involved in their care. Feeling respected, being treated with dignity and feeling in control of your life is essential to recovery. Therefore we are disappointed that access to independent mental health advocates is not currently available. This would act as a safeguard for individuals whose wellbeing might be adversely affected by compulsion orders and we are keen to see this in place as soon as possible."

The 2007 Mental Health Act amended key parts of the 1983 Mental Health Act. Key provisions are implemented from today, including the introduction of supervised community treatment, new conditions for the use of compulsion and changed roles for health professionals in using compulsory powers. A statutory right to advocacy was also in the Act but will not be implemented in England until April 2009.