Wednesday, September 08, 2004

UK Mental Health Laws Allow Enforced Treatment

UK Mental Health Laws Allow Enforced Treatment
BBC | September 8 2004

A fresh version of government plans to allow enforced treatment of potentially dangerous mental health patients is to be unveiled on Wednesday.

The new draft of the Mental Health Bill is expected to include concessions in the wake of the heavy criticism made of the first draft published in 2002.

The Tories said those plans infringed basic human rights.

Mental health campaigners have been expressing concern about the latest draft even before publication.

'Inhumane and unethical'

The 2002 draft of the Mental Health Bill proposed measures to detain mentally ill patients for their own protection and the protection of others, even if their condition was not treatable.

There were also proposals to allow compulsory treatment in the community under Community Treatment Orders. If a patient did not stick to the treatment orders they could be detained in hospital.

The proposals were condemned as inhumane and unethical by the Mental Health Alliance and other charities, and prompted some 2,000 objections.

Critics were concerned doctors would turn into policing bodies rather than carers, and the net would be cast too wide meaning people posing no risk to others would be detained.

The re-worked draft legislation, for England and Wales, is expected to resolve some of the points of contention.

The changes

It is expected to tighten the criteria of which patients can be forced to be detained and treated in hospital to those at highest "risk" - those who are suicidal, a risk to others or are at severe risk of neglect.

It would be up to three health professionals treating the patient to define this risk.

It could include people with personality disorders if the doctors could justify that the planned treatment was clinically sound to a tribunal.

If treatment could not be justified but the person was deemed a danger to others, they should be referred to another appropriate agency such as the police, it is expected to say.

The criteria for Community Treatment Orders are also tipped to be tightened to apply to patients who relapse and are continually in and out of psychiatric hospital.

It is expected to rule against prisoners being treated under these Orders. Instead, any in need of psychiatric care should be transferred to a hospital.

Patient empowerment

Also, patients who have the capacity to make decisions about their care would be able to refuse treatments such as ECT or shock therapy, even if they were detained in hospital.

However, doctors would be able to over-ride these refusals if they and a tribunal believed the treatment would be in the patient's best interest.

Patients would be able to nominate a person as their designated carer who would no longer need to be their nearest relative.

These carers would have to be consulted when there were changes to the patient's care, such as admissions to and discharges from hospital.

Andy Bell from the Mental Health Alliance said: "The government has had lots of time to listen to everybody in the mental health community.

"Everyone, from psychiatrists to services users, carers to nurses and social workers, has said very clearly that the [original] proposals were unwise because they are not practical and in many ways not ethical.

"We are obviously hopeful that they will have headed those very strong warnings."

A committee of MPs will now review the new draft.