Great Britain Changes Mental health Act - re detention.

The Economist Com. (I will give the url - but it may be "premium content" - which means that only subscribers can see it - FULL STORY )
reports changes to the Mental health Act in Great Britain - which, amongst other changes, increase the ability to detain people:

"Psycho politics

Sep 9th 2004
From The Economist print edition


The government responds to worries about mad people who kill

MENTAL health is the Cinderella of the National Health Service. It generally registers on politicians' radar screen only when the public gets worked up about the dangers posed by mad people. New government proposals to reform mental health law are a response to such concerns. The draft bill will make it easier to detain people with a mental disorder who pose a threat to others.

Popular worries about this danger are stoked whenever someone with a history of mental illness commits a murder. Such tragedies are often blamed upon the switch to treating people in the community, which has gathered momentum in the past two decades.

When mentally ill people are discharged from hospital, they can fail to follow the treatments they need. The bill deals with this by allowing mandatory treatment within the community. It also closes a loophole in the current legislation under which individuals with a personality disorder cannot be detained unless there is a good chance that treatment will improve the condition. The new legislation allows them to be detained if psychiatrists think treatment is clinically appropriate even if it may not work....."


The key words here are: "It also closes a loophole in the current legislation under which individuals with a personality disorder cannot be detained unless there is a good chance that treatment will improve the condition. The new legislation allows them to be detained if psychiatrists think treatment is clinically appropriate even if it may not work....."


Here are some definitions of personality disorder:

Britannica Com:
"Mental disorder that is marked by deeply ingrained and lasting patterns of inflexible, maladaptive, or antisocial behaviour to the degree that an individual's social or occupational functioning is impaired.

Rather than being illnesses, personality disorders are enduring and pervasive features of the personality that deviate markedly from the cultural norm. They include the dependent, histrionic, narcissistic, obsessive-compulsive, antisocial, avoidant, borderline (unstable), paranoid, and schizoid types. The causes appear to be both hereditary and environmental. The most effective treatment combines behavioral and psychotherapeutic therapies."

A brief definition of personality:
"Personality

An individual's more-or-less stable set of internally motivated predispositions to respond (i.e., affective, cognitive, perceptual, and motivational dispositions) and actual modes of responding (i.e., observable behaviors) in various life situations or contexts. These dispositions and behaviors usually have regularity and orderliness across time and space."

The bill's opponents say it will infringe the rights of mentally ill people - and (since the increased detention powers are seen to be the result of public fears about mentally ill people who harm others) that very few mentally ill people DO, in fact, harm others.

"....Aside from their ethical objections, the bill's opponents say that the case for more compulsory treatment is weak. The mentally ill are responsible for a relatively small number of murders and other killings (see chart). An historical analysis of homicides found that the proportion committed by the mentally ill fell between the late 1950s and the mid 1990s. ...."


"......Such arguments have not swayed the government. Ministers know that they are much more likely to be blamed for a murder committed by someone with a history of mental disorder than for a stabbing after a night of binge-drinking. If nothing else, the reforms will allow them to enter a plea of diminished political responsibility."





Press Release Draft mental health bill: Royal College of Psychiatrists anxious about civil liberties, ethics, practicality and effectiveness. Unfair, stigmatising and dangerous


"The Royal College of Psychiatrists remains very concerned about the Government's proposed mental health legislation. The newly published second Draft for the Mental Health Bill has not taken into account the College's grave anxieties in terms of civil liberties, ethics, practicality and effectiveness.
'This proposed legislation would further distance the practice of psychiatry from the rest of medicine and ensure that people with mental health problems have less rights than people with physical illnesses, " said Dr Mike Shooter, President of the College.

'We recognise that government has made some welcome, but limited changes, particularly by removing Community Treatment Orders (CTOs) in prisons, and on the use of CTOs on a person's first admission for compulsory treatment."

'We are worried, however, that the Bill will extend the use of compulsory powers to a wider group of patients than is medically necessary, thus putting greater pressure on psychiatric services and the existing workforce, and infringing people's human rights. This is particularly the case for people who have physical illnesses with mental health complications - for example epilepsy, or multiple sclerosis and for people with alcohol or other substance misuse problems............"

See link for full release.



The Draft Mental Health Bill 2002