MENTAL HEALTH 'Paper trials' being considered in draft practice code

Published: 15/12/2005 Volume 115 No. 5986 Page 9

Proposals which could see mental health patients detained against their will for over 100 days have been condemned by mental health campaigners.

A draft code of practice seen by HSJ also suggests that tribunals determining whether or not patients should be detained could be run by a single person, who might not be a psychiatrist.

And the government's mental health czar has told HSJ that he is considering introducing a triage system of tribunals under which some patients would have their cases assessed on paper.

The government's draft mental health bill suggested that patients subject to compulsory treatment should be assessed within 28 days.

But a draft code of practice set to be attached to the bill suggests extending the initial assessment period to 42 days. An order for a further assessment to take place within another 60 days could then be made. Again the current draft bill set the time limit at 28 days.

The draft code also says tribunals could be run by a single person, and that tribunal staff could include nurses, psychologists and occupational therapists as well as psychiatrists.

In March, the Commons joint scrutiny committee on the draft bill warned of serious concerns that expanding the role of tribunals under the new bill would 'require such a significant increase in resources and staff training that the proposals may not be workable'.

Speaking to HSJ last week, national director for mental health Professor Louis Appleby said the government was now considering extending the assessment period, and looking at whether patients could be triaged.

He said: 'Ideas are being worked on as to how to make tribunals more workable. Ideas include lengthening the period of time a person can be detained [before seeing a tribunal] or a triage system.' Under this system, patients not wanting to go before a tribunal, or whose existing detention was being extended, could have their cases assessed on paper. This was not included in the draft code of practice seen by HSJ, dated 31 October.

Tim Spence-Lane, policy officer for the Mental Health Alliance, a coalition of 60 organisations with concerns about the bill, said the alliance hoped the concept of paper trials had been discarded. And he said details from the leaked document were totally unexpected: 'It is concerning. You could have a patient in for 100 days of assessment. Having tribunals within 28 days is unworkable, ' he said.

Leading mental health lawyer Lucy Scott-Moncrieff, managing partner at law firm Scott-Moncrieff, Harbour and Sinclair, said it would contravene human rights laws if patients were not assessed by psychiatrists. She said: 'Article five of the European Convention of Human Rights states that anyone detained for unsoundness of mind has to be objectively examined by someone with medical expertise. That means a psychiatrist.'

Equality commission to monitor race progress The Commission for Race Equality is to scrutinise trusts' progress in implementing the government's action plan on equality in mental health.

The CRE is to work with the Healthcare Commission and the Mental Health Act Commission in assessing the performance of mental health services since the government's response to the inquiry into the death of psychiatric patient David 'Rocky' Bennett.

The announcement follows a survey of mental health services by the Healthcare Commission, which showed Black African and Caribbean people are three times more likely than white people to be admitted to hospital, and 44 per cent more likely to be admitted under the Mental Health Act.