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NEW MENTAL HEALTH ACT?
 

Reform of The Mental Health Act 1983
Plans for a new Mental Health Act are now well advanced and although no date has yet been set for its introduction it will certainly be within the lifetime of the next parliament. The Act is one part of the wider reform of mental health services described in the National Framework for Mental Health.


One of the key aims for reform of the Mental Health Act is to break "the automatic link between compulsory care and treatment and detention in hospital". The Act is very likely to include some form of Compulsory Treatment Order (CTO) which will, in theory at least, allow (require?) Community Mental Health Teams to force treatment on somebody subject to one without first admitting to them to hospital. The implications of this radical change in practice are likely to be profound for service users and providers alike. It is particulary hard to see how CTOs can be reconciled with rights accorded by The Human Rights Act.


Another key change in emphasis may allow those applying for compulsorily powers, to make an application purely on the basis of a person's past psychiatric history and assumptions made from it. This is a significant step beyond the existing powers which allow those making an Assessment under the Mental Health Act to do so only on the basis of the "snapshot" of a persons mental health that they observe at the time of assessment.


If the new law allows assumptions to be made on the basis of probability it could mean, a person becoming liable to detention and/or compulsory treatment for the sole reason that he/she has decided to stop taking medication - the rationale being that by doing so they are placing themselves at risk of a mental illness that could endanger themselves or others.


Summary of likely changes :

The Act will introduce a single point of entry to compulsory treatment.with an initial 7 day assessment period. During this time the Care Team can apply for a provisional order of a further 21 days.

If, at the end of 28 days, the Care Team believe that someone either lacks the "capacity" to make informed decisions about their health or with capacity, presents a risk to themselves or others they can apply to the tribunal for a six month treatment period. This treatment can be delivered either in the hospital or in the community.

All applications for compulsory admission and/or treatment will be made to a new 3 person Tribunal (one of whom will be a lawyer).

It is recommended that "thought be given" to extending the "applicant" role to other mental health professionals. In practice this could mean nurses (traditionally excluded because of their supposed susceptibility to the influence of doctors) receiving the powers to make applications under the Act alongside their social work colleagues.

The role of "Nearest Relative" will be replaced by "a Nominated Person" identified by the patient if possible. This person will be accorded certain rights and responsibilities as yet undefined.

People with a diagnosis of "severe personality disorder" previously left outside the scope of mental health legislation on the basis of their untreatability will be liable to compulsory treatment under the new Act.


For full details of what is being proposed in the new Mental Health Act go to:

www.doh.gov.uk/menhlth.htm

 www.doh.gov.uk/mhar/report.htm

 www.official-documents.co.uk/document/cm44/4480/4480.htm