Mental illness and mental incapacity are perhaps the last great social taboos and that is why it is so important that people have time to discuss and understand the implications of the Government's draft Mental Health Bill.
Mental illness, like physical illness, takes many forms and varies in its severity. We are all familiar with the problem of depression suffered by hundreds of thousands of people. With medication, most people improve or get no worse but some sink further into severe depression and may need to be admitted to hospital. The majority of patients in psychiatric hospitals are there voluntarily because they recognise that they need treatment and that they probably would not pursue the treatment themselves outside hospital. Some are so ill that they would deliberately harm themselves or put themselves in potentially dangerous situations, even commit suicide.
To protect them from that danger, doctors detain (section) them under the Mental Health Act. Detention typically lasts from a few days to several months. About 66,000 patients are detained under the Mental Health Act every year. Only a small proportion present a risk to anyone other than themselves. Some are young girls with eating disorders such as anorexia nervosa, some are frail, elderly and confused, while others are simply the victims of the pace and pressure of modern life.
That is why the proposed new legislation, with its emphasis on exaggerated perceptions of risk to the community (in reality, posed by only a small number of people with severe mental disorders) is disproportionate and misconceived.
The proposed Mental Health Bill appears to have been drafted in response to public concern about the rare high-profile cases where individuals suffering from very severe mental disorders have committed serious crimes. Unfortunately, there are many dangerous people on the streets, only a small minority of whom suffer from mental illness. Many serious crimes are committed by people under the influence of alcohol, but no one suggests that everyone calling at their local pub for a drink is a potential criminal. Categorising people suffering from mental illness by way of potential risk is equally inappropriate.
The impression that the streets will be made safer by this legislation is a myth. The Richardson committee, which advised the Government on the scope of the new legislation, recommended the wider definition of mental illness and greater powers of detention, but only if there was a reciprocal right on the part of the patient to receive appropriate treatment. Psychiatric services have long been under-funded, many hospitals have been closed, and there are currently 400 consultant psychiatric posts vacant nationwide.
The Government has announced increased funding to implement the proposals in the Bill, but it is likely to be woefully inadequate to provide services for all the people detained under the new definition. That, presumably, is the reason why the element of reciprocity stressed by the Richardson committee is absent from the Bill; the Government does not want to create a statutory right to services that it cannot provide.
The Royal College of Psychiatrists, one of a number of organisations which are working with the Law Society to defeat this Bill, has reported such a level of concern among its members about the proposed legislation that it predicts the number of consultant vacancies will rise to 600 if the Bill is implemented. …