Tuesday, June 28, 2022

Draft mental health bill announced

The government has announced a draft mental health bill together with better support for people in crisis. I just wanted to pick up on how the draft bill is presented as modernising legislation from almost 40 years ago. Both the 1959 and 1983 Mental Health Acts were progressive Acts, associated with opening of the doors of the traditional asylum and dehospitalisation (see eg. my eletter). What's quietly forgotten is that a root and branch reform of the 1983 Act was initiated from 1999, followed by a several year process of expert review, green and white papers, draft Bill with parliamentary scrutiny and an actual bill. Because of opposition, particularly to the introduction of community treatment orders (CTOs), the 1983 Act was merely amended in 2007, rather than there being, as originally planned, a new Mental Health Act (MHA). CTOs were still introduced in these amendments despite the controversy.

There was some progressive change in the 2007 amendments, such as the introduction of Independent Mental Health Advocates (IMHAs), However, in my view, this development was never properly funded and the draft Bill announced yesterday could have done more to develop advocacy further (see previous post). Although there are amendments being made to CTOs, there was no consultation on this issue in the White paper leading to the draft bill yesterday. In fact several organisations, such as Mind and the National Survivor User Network (NSUN), in their responses to the White paper, suggested CTOs should be repealed and I agree, or at least, no further CTOs should be enacted. There is little evidence of the effectiveness of CTOs.

It could, therefore, be seen as misleading to view the current reforms as merely modernising mental health law from 40 years ago. They need to be understood in the context of the last attempt to reform the 1983 Act, which led to the 2007 amendments. There has been a over-preoccupation with risk in mental health services over recent years, which has been counter-productive (see eg. previous post). True, the current reforms have been more motivated by reducing detention and inequalities in services than managing risk. But they do not go far enough in taking forward the 1959 and 1983 Acts to improve the rights of people with mental health problems (see eg. last post). The draft Mental Health bill also needs to be associated more specifically with the reduction of the use of force in mental health services, as in Seni’s law (see another previous post).

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