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Psychiatric services need better support, not more legal scrutiny | Letters

Tom Burns challenges the Law Society’s claim that the state has the power to detain under the Mental Health Act; Sally Cheseldine writes about Scotland’s appeals process against detention; plus a letter from Brendan Kelly

Christina Blacklaws of the Law Society is wrong to say that patients detained under the Mental Health Act have to wait six months to challenge their treatment (Lawyers seek end to forced treatment of psychiatric inpatients, 24 January). There is an automatic review at six months, but they can lodge a challenge via the mental health tribunal or the hospital managers (or both) from day one. It is misleading to talk of the act giving “the state” the power to detain. The act empowers clinicians to do this, and two professionals have to agree. One must be a trained psychiatrist, the other an “approved mental health professional” (usually a social worker) charged with exploring alternatives and safeguarding the patient’s rights. The law already requires compulsion to be used only as a last resort and only when there is obvious risk. The section papers require an explanation of why effective treatment cannot be achieved without it.

Community treatment orders are not linked to payment. Whether the current 5,000 per year are justified is highly questionable, given that all three published randomised controlled trials find them ineffective. There is, however, no doubt that we do not have enough beds. No mental health act is perfect. My experience of those in countries with front-loaded legal scrutiny is of rubber-stamping. Currently a third of UK adult admissions are on section and a further third are placed on section while in hospital. These are very distressed individuals, struggling with terrible illnesses. What they need and deserve are vastly improved services. They do not need a cosmetic revision of an act that was thoroughly rewritten only a decade ago.
Tom Burns
Professor emeritus of social psychiatry, University of Oxford. Psychiatric adviser to the 2007 parliamentary review of the MHA

Continue reading... January 25, 2018 at 11:30PM

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