The government today announced it had dropped many key proposals outlined in its draft mental health bill. However it still plans to press ahead with giving psychiatrists extra powers to detain people diagnosed with personality disorder.
Mental health minister Rosie Winterton said a new shorter “streamlined” bill will be a list of amendments to the present Mental Health Act (1983).
Almost all mental health organisations have fiercely criticised the “draconian” measures contained in the 2004 draft mental health bill. Last year a parliamentary scrutiny committee concluded that the draft bill plans would erode civil liberties by imposing compulsory treatment on people who had done no wrong and would not benefit.
Specifically, critics said compulsion would be extended by the draft bill’s inclusion of a wide definition of mental disorder and the ditching of the “treatability” test contained in the 1983 act. This specifies that, before detention, patients must be treatable.
However, although Ms Winterton told parliament today that the new bill will include a “simplified definition of mental disorder”, the “treatability” test will be removed. In its place will be a “test that appropriate treatment is available”.
Ms Winterton said: “Unlike the treatability test, the availability of appropriate treatment will be a requirement [for detention] for all groups of patients, regardless of their particular diagnosis.
“This is important to ensure that patients are not brought under compulsory powers unless appropriate treatment is available.”
These new plans could mean that people diagnosed with personality disorder can be detained if treatment is available.
Although some psychiatrists argue such patients are untreatable, a number of treatment services for these patients do operate in the UK.
Plans to extend compulsory powers of detention over people with drug and alcohol problems but no mental disorder have also been dropped by the government.
However, the extent to which plans to introduce “community treatment orders” (whereby people are treated under compulsion in their own homes) have been changed remain unclear. Ms Winterton only said today that there will be “supervised treatment in the community” for patients who had previously been detained in psychiatric hospital.
Ms Winterton also said the new bill would take into account obligations due under the European Convention on Human Rights, and that it would take account the new Mental Capacity Act 2005 which provides legal safeguards people judged to lack capacity.
Plans for some professional groups, such as clinical psychologists, to have increased powers in treating detained patients have been retained.
Paul Farmer of the Mental Health Alliance, composed of 77 mental health and law groups, welcomed the government’s ditching of controversial draft bill proposals.
However, he added that abolishing the treatability test “risks increasing compulsory powers unnecessarily for people who will have no therapeutic benefit from being deprived of their liberty.”
Dr Tony Zigmond, honorary vice-president of the Royal College of Psychiatrists, welcomed the government’s “change of heart”.
He said: “The 2004 draft bill alienated many of us in the mental health sector from the process of reform. An ethical, non-stigmatising and workable mental health bill is achievable and must continue to be our aim. I hope we can now all work together to improve legislation and services.”
Cliff Prior, chief executive of the charity Rethink, gave a “cautious welcome” to the new proposals.
However, he added: “We are extremely concerned that the new proposals to amend the 1983 act will merely serve to change the process for this bill and not fundamentally change the content…It seems that they have kept all of the bad elements of the original proposals and left out all the good.”
Sophie Corlett, policy director for the charity Mind said: “These proposals leave a lot still to be decided.”
The government said the new bill will be introduced “when parliamentary time allows”