Labour bows to popular prejudice
by Mike Fenwick
The Government's new Mental Health Bill has provoked a wide range of concerns about it's extension of compulsory powers and changes to the assessment and definition of a mental illness.
Numerous organisations have come together to seek to change these provisions. The Mental Health Alliance consists of professional bodies such as the Royal College of Psychiatrists and those groups that represent users and carers like MIND and SANE. This is a big step forward as such organisations are often in conflict over methods of treatment and approach to those suffering from mental illness.
The main cause of anger is the proposal that will allow compulsory treatment of individuals within the community. At present treatment orders only provide for those in hospital. The new powers would increase the number of people subject to the orders. Much treatment, almost without exception, means medication and that raises the question of whether personal choice counts. Yet it's rarely the case that patients cannot contribute to a discussion about treatment.
There are good reasons for people not to comply with medication, particularly as many of the older anti-psychotic drugs have debilitating side-effects. The bloke on the bus who you think is "mad" because his mouth is dribbling, his legs are restlessly bouncing up and down, and his jaw and tongue are trapped in relentless jerky movements is displaying side effects of such medicines rather than symptoms of illness. In fact compliance among people receiving treatment for mental illness is better than it is for those on long-term treatments for diabetes and heart disease.
The government through the National Institute for Clinical Excellence has recommended the use of newer drugs, which are a great improvement, but no money has been forthcoming to pay for them. The new bill says little about any guaranteed rights to a choice of treatment.
The opportunities to access psychological and social interventions are subject to the usual postcode lottery seen in all sectors of the NHS. For those 40% of people with psychosis who have medication resistant symptoms the medicine is fundamentally permanent sedation rather than effective help for their problems.
Driven by a fear of another headline grabbing mentally ill murderer hitting the front pages, the Bill over emphasises risk. Most people sectioned are at risk to themselves either as through self-directed violence (suicide) or self-neglect as a result of deteriorating mental state. Some individuals are a risk to others, but most studies show that the proportion of violent offences committed by people with mental health problems is lower than the general rate.
If, as is proposed, those with severe dangerous personality disorders are to be considered for indefinite detention it should be the job of the courts and due process rather than the decision of small groups of largely unaccountable psychiatrists. The current Mental Health Act has much stricter definitions of mental disorder and treatability than those now proposed. Indefinite detention could be counted as treatment, which it couldn't be now.
The public perception is shaped by the caricature psycho-killer perpetuated in most of the press. The tragic events in Soham and the widespread publicity about the use of a "section" have led the majority of organisations in the Mental Health Alliance to cancel a march due this month. It was felt that the fear and hatred whipped up would make it unsafe for people to march under a banner that may identify them as mentally ill or sympathetic to their rights. Instead they are going to organise a more discreet lobby of parliament in October.
The great irony of course is that it is exactly this form of popular prejudice that allows the Government to propose a restrictive act. Some of the minority organisations and individuals have decide to go ahead with the demonstration and take on the discrimination that blights the day to day lives of those with mental illness. They should be supported in their efforts, as rights have always had to be fought for against the dominant ideas of the day. In a country where one in five will suffer a mental illness in the course of their lives it is not a concern of a minority alone but an issue that could affect all of us and our families and friends in years to come.
No Force March
Saturday 14th September.
Meet Whitehall Place from noon, march at 1pm past Downing Street and Department of Health to rally at Geraldine Mary Harmsworth Park. The park is close to Lambeth North Tube station on the Bakerloo line and is the site of the original Bethlem (Bedlam) Asylum. For latest details see http://groups.yahoo.com/group/MHCampaigns.