Published: 27/06/2002, Volume II2, No. 5811 Page 4
The four-year struggle to reform the 1983 Mental Health Act finally resulted in a draft bill this week - and sparked anger from professionals and service-user groups over its failure to address their concerns.
The draft bill brings together proposals for compulsory treatment in the community with proposals for the preventative detainment of people with dangerous and severe personality disorder (DSPD).
Many user groups and psychiatrists remain unconvinced that personality should be classed as a mental health condition and are fearful that proposals on compulsion undermine human rights (news focus, 11 January 2001).
Announced by health minister Jacqui Smith on Tuesday, the draft mental health bill emerges little changed from the original white paper Reforming the Mental Health Act 1983, published in December 2000, which followed a green paper and earlier consultation.
At a press conference to launch the draft bill, Ms Smith focused on public safety and suggested that one of the main challenges for the government was to close the 'loophole' which keeps DSPD patients out of the mental health system.
She said the new proposals replaced the idea of patients being defined by their condition and offered instead a single definition of mental disorder.
The draft bill defines this as 'any disability or disorder of mind or brain which results in an impairment or disturbance of mental functioning' and removes the concept of treatability from the equation.Under current law, individuals can only be detained under mental health provisions if their condition is deemed treatable.
The Royal College of Psychiatrists is so furious at the lack of consultation it and other mental health organisations were given over the reforms that in February it pulled out of talks with the Department of Health.
Chair of the college's general and community faculty Dr Tony Zigmond, who was involved in the discussions after the white paper, told HSJ the DoH 'certainly didn't listen' to concerns about the proposals for community treatment orders and detaining people with severe personality disorders. 'We stopped the meetings as they were pointless, ' he said. 'At the last one, we were told that the proposals had moved forward from the white paper. We asked if we could see them but were told we could not.
'They brought with them to the meeting a book where they would read to us at the meeting selected bits.We were not allowed to see it.
We could not take it away with us.
We had no feedback.'
The Mental Health Alliance, which represents 50 organisations including the National Schizophrenia Fellowship, Mind and Sane, was also angry and said that despite a number of representations to the government, 'we do not feel we have been listened to'.