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3 July 2007
The Government has missed an historic opportunity to achieve a modern and humane new Mental Health Act, but has made important concessions to protect patients and their families from abuse and neglect, the Mental Health Alliance said today.
As the Mental Health Bill nears completion, Andy Bell, chair of the 77-member Alliance, said: "The tireless commitment of people who use mental health services and their supporters has achieved real improvements to this controversial Bill.
"We now have a Bill that for the first time gives people a right to an advocate when they are detained and that protects children from being put on adult wards inappropriately. We also have new safeguards over the use of electro-convulsive therapy, for people detained under the Mental Capacity Act, and for the renewal of detention. These are hard-won improvements that are a credit to the persistence of activists from across the country.
"But our members will be disappointed today that the Government has rejected changes to many other aspects of the Bill. It has failed to heed the evidence about the risks of significant over-use of community treatment orders and the excessive powers the Bill gives to clinicians. And it treats people with mental health problems as second class citizens by allowing treatment to be imposed on those who are able to make rational decisions for themselves.
"We are now at a crossroads. We call on the Government to start listening to the people who are affected by the Act when it writes the new regulations and to ensure that sufficient resources are made available to mental health services to implement the changes fairly.
"We also call on ministers to take seriously the warnings made by the Commission for Racial Equality about the impact of the Bill on Black communities and to take action before it is too late to put this right."
Members of the Alliance and its supporters today gave their views of the Bill:
Marion Janner, a user of mental health services, said: "It is a real relief that the most punitive, counter-productive aspects of the Bill have been removed. But it is equally frustrating that the chance to create a law which protects and constructively treats mentally ill people has been squandered."
Fiona Woolf, Law Society President, said: "This Bill falls way short of what is needed for modern mental health legislation. We are deeply disappointed that the Government has failed to achieve ethical mental health law that has the full support of patients, carers and professionals. In particular the Bill fails to provide for exclusions from the wide definition of mental disorder and fails to restrict the imposition of community treatment orders to a small and tightly defined group of patients - and is likely to be challenged under the Human Rights Act. The Law Society will continue to campaign for a new Mental Health Act that is both humane and effective."
Dr Andrew McCulloch, Chief Executive, Mental Health Foundation, said: "Taken as a whole, the Bill is disappointing and represents a missed opportunity to provide truly progressive mental health legislation. However, we welcome the concessions made by government, in particular the decision to provide advocacy to service users. This is a fundamental change that should protect the rights of many people. In the months to come, it is vital that energy is directed to developing a Code of Practice that details how the various measures contained in the bill and community treatment orders in particular, should be applied in the best interests of service users and their carers."
Diane Hackney, a user of mental health services and project manager at Mental Health Media, said: "The Government has repeatedly said that its aim is to reduce the numbers of people who are at risk of self-harm and suicide. It is difficult to see how Community Treatment Orders will achieve this. It is highly likely that people like myself will start to avoid services altogether if we are not getting the care and treatment we need."
Paul Farmer, Chief Executive of Mind, said: "The new right to advocacy should help people who lose their liberty under the Mental Health Act to get their voice heard. However, a historic opportunity has been missed to tackle other fundamental problems - to fight race inequalities, give people with mental health problems the same rights to make choices as people with physical health problems, and to ensure that people can get help when they ask for it. It will be vitally important that the legislation is properly implemented so that the fears of many people with mental health problems are not realised."
Marcel Vige, chair of the National Black and Minority Ethnic Mental Health Network, said: "The law already disproportionately impacts people from black and minority ethnic communities. We are disappointed that the Government has chosen to press ahead with the Bill in its current form despite evidence that it is likely to make the situation far worse. The Commission for Racial Equality has stated unequivocally its belief that the Government has failed in its duty to properly assess the degree to which the legislation will have differential impacts on different ethnic groups. A proper assessment may well have prompted adjustments to measures such as Supervised Community Treatment. In its current form, the Bill will undermine government efforts to improve services through the Delivering Race Equality strategy."
Paul Jenkins, Rethink's Chief Executive said: "Rethink pays tribute to the Mental Health Alliance for campaigning for so long to get a better Bill than was first proposed back in 2002. It welcomes the Government's amendments, including the proposed changes on advocacy, but still believes more is needed to create a Mental Health Act that is fair and workable and which will not add further barriers for vulnerable people seeking help. We urge MPs to help make the Mental Health Act more workable by ensuring the Bill's code of practice will not allow someone to be detained because of their behaviour."
Dr Tony Zigmond, Vice-President, The Royal College of Psychiatrists, said: "Advocacy, treatability and the additional protections for children are all important and welcome gains for people with mental health problems. We hope sufficient resources will be provided for mental health services to ensure the legislative changes can be made to work properly."
Sainsbury Centre for Mental Health chief executive Angela Greatley said: "Community treatment orders will have a dramatic effect on mental health services. The number of people subject to CTOs must be kept to a minimum. If CTOs get used as a first, not last, resort, they will silt up community services and set back the modernisation of mental health care."
Marjorie Wallace, Chief Executive, SANE, said: "We are pleased that some of the concerns have been taken on board by the Government, but any new legislation will be counterproductive unless services are improved to provide high standards of care and treatment so that crises are better prevented and coercion is used as a last resort."
Andrew Voyce, a user of mental health services, said: "I accept that at times I have been severely psychotic and not realised that I was, and I have needed compulsory treatment. But what has worked under those circumstances has been that I have been given hope for the ultimate outcome, some aspirations, along with the compulsory restriction."
Barbara Herts, Chief Executive, YoungMinds, said: "A thousand vulnerable children a year will benefit from the changes to mental health legislation. To make this work the Government must ensure this is a key priority for the NHS over the next three years. The intention is excellent - now we need to see the delivery. Although the Government's commitment to providing advocacy for children who held under the Mental Health Act or who require ECT (Electroconvulsive Therapy) is welcomed, it is regrettable that this service will not be a right for those 2,700 children who are admitted voluntarily or under parental consent."
The Mental Health Bill was debated in the House of Lords yesterday evening. The House voted to keep the changes made in the House of Commons but added three new amendments:
The Bill is expected to return to the House of Commons for the final time next week.