Government presses ahead with bid to force psychiatric patients to take medication in community

December 1, 2006
by Angela Hussain

(Please note that this news item was revised on December 4, 2006, for clarification purposes)

The government is pressing ahead with plans to force some psychiatric patients to take their medication while living in the community.

Community treatment orders (CTOs) could be ordered on patients who have been previously detained in psychiatric hospital.

The government says CTOs will ensure that potentially violent patients living in the community will receive the treatment they need to both protect themselves and the public.

The plans for England and Wales are contained in a mental health bill published earlier this month.

The bill states conditions that must be met for patients to be treated under compulsion. The planned new law is a series of amendments to the 1983 Mental Health Act.

The bill follows the abandonment in March this year of a draft mental health bill. The government says the new bill fulfills obligations under new European human rights law

As well as CTOs, other planned amendments to the 1983 act include a “simplified” single definition of mental disorder and a criterion for compulsion that “appropriate treatment” must be available.

But the Mental Health Alliance, a coalition of more than 70 mental health, law and carer organisations which vociferously opposed the previous draft bill, still fears treatment will be imposed on patients without it necessarily being beneficial.

Andy Bell, chair of the alliance, said: “The [planned] 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 [present] 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 Royal College of Psychiatrists has emphasised that it wants CTOs to only be used on ‘revolving door’ patients.

House of Lords peers last week criticised the bill as “deeply flawed” and needing “substantial amendment”.

The Bishop of Manchester described the appropriate treatment criteria as “unacceptable vague”.

He suggested introducing a number of conditions to raise the threshold of eligibility for compulsory treatment in the community.

And Labour peer Baroness Morgan of Drefelin suggested the lack of a statutory right to independent advocacy was “a missed opportunity that could easily be put right”.

Amendments can be tabled during the next stage of the bill’s progress, which will be a committee of the whole House of Lords, expected in the next few weeks.

Meanwhile, the mental health “tsar” Professor Louis Appleby accused critics of bill of “scaremongering” over the CTO proposals. He said opponents of CTOs were scaring patients into thinking they would come under compulsory powers.

"When people criticise our proposals [and say] that more people will come under compulsion that’s scaremongering.
It’s frightening to patients and it shouldn’t happen," he said.

Read for yourself:
The government's mental health bill (amendments to the 1983 Mental Health Act (pdf))
The Royal College of Psychiatrists' statement on the mental health bill.
The second reading of the mental health bill in the House of Lords

See also:
Feature
Nov 9, 2006: Are homicides by people with mental health problems preventable? Tony Maden believes recommendations he submitted to the government could result in a cut in homicide rate by psychiatric patients of 10 per cent in five years. Is he realistic?
March 23, 2006: Government drops key proposals of draft mental health bill - new "streamlined” bill will be an amendment to the present mental health act, says mental health minister Rosie Winterton

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