Published: 26/09/2002, Volume II2, No. 5824 Page 18
Only if you have been on a long holiday can you be unaware of the publication of the draft Mental Health Bill.
It is by now a cliché to say that the unique achievement of this government has been to unite in protest a diverse group of organisations that have little in common aside from their interest in mental health.
Rather than repeat their objections, what concerns me now are two related issues: why did the bill stir such passionate and hostile emotions, and how could the debate have taken on such a negative tone?
Reading some of the publicity generated by campaign groups, I am struck by the negative implications inferred from every paragraph of the bill and the potential disasters foretold if it were to become law.
A telling example is the prediction that the new act will cause many thousands of people to be treated inappropriately, and that unsuspecting students will wake up in a mental hospital after a night in the pub.
Professional organisations support this view, even though it still requires two psychiatrists to apply a 'section'.
Even more striking are survey findings from one charity that have achieved impressive media coverage. They apparently indicate that more than 30 per cent of those with a mental health problem would not seek help if the bill became law.
Ignoring the selection of the sample group and their impressive grasp of the Matt Muijen is director of the Sainsbury Centre for Mental Health.
proposals, how did they acquire their negative attitude in the first place which could lead to stigma, avoidance of care and suffering? I suspect the same angry charity.
It is not as if the present Mental Health Act does not allow detention and treatment against service users'wishes.
Many of the responses to the draft bill have been characterised by lack of realism, sometimes bordering on irresponsibility.
What has caused so many sensible and balanced leaders of respected organisations to react so emotionally and angrily?
A major factor is surely the inherent policy contradiction the bill brings into the open. Ever since the publication in 1999 of the strategy paper Safe, Sound and Supportive Mental Health Services, the government has sought to balance patient rights with public safety. Since then many policy documents, including the national service framework for mental health and the NHS plan, have promised improved standards of care and increased resources.
Although the government has been consistent in its plans to deal with those with dangerous personality disorders, ministers always seemed to be open to debate, and it was hoped that they would eventually come around to a better way of thinking.How foolish we were.
Poor communication and consultation has contributed to the anger. Inviting an expert group to formulate a vision for the future which is, in the main, rejected and publishing a green paper inviting comments which in turn are largely ignored is adding insult to injury.
And it has not helped that the bill is poorly drafted.Definitions are vague, systems unrealistic and resource implications massive.
In particular, the lack of transparency seems to have raised many anxieties.Very broad entry definition implicitly covering personality disorders combined with access restricted by tight gate-keeping is confusing.
The role of treatability, reading more like an astonishing extension of the definition of medical treatment rather than its abolition, would benefit from explanation.And safeguards are lacking in detail.
The present position, with government spokespeople claiming that objections are due to misunderstandings and that public safety will be achieved, while mental health charities reinforce the anxieties of service users and play on public distrust of government, is ludicrous and dangerous.
And following Soham, both sides must more than ever take part in a constructive dialogue and be seen to agree on a way forward, reassuring service users and the public that we will achieve a balance between individual rights and safety.
This is not a good time for quick publicity wins or opportunistic passing of bad legislation.
We need each other if we are to achieve satisfactory lives for the people we all try to help.