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The Pharmaceutical Journal
Vol 269 No 7207 p90
20 July 2002

Caution required with atypical antipsychotic drugs

Mental Health Bill

The draft Mental Health Bill is intended to require mentally disordered people to submit to treatment without unnecessary detention. A new mental health tribunal may authorise compulsory treatment for non-offenders beyond 28 days with community-based orders.

The requirements for compulsory treatment will be that people must have mental disorders that require specialist treatment for their own health or the protection of others and that appropriate treatment is available.

The Bill is intended to remove an anomaly in the Mental Health Act 1983 which means that the mentally impaired or psychopathic can only be detained for compulsory treatment if it is effective.

Atypical antipsychotic drugs are only a modest improvement over older antipsychotic drugs and will not be suitable for all patients, according to Professor Robin Murray, professor of psychiatry, Institute of Psychiatry, London.

Professor Murray was speaking at a meeting to discuss issues surrounding mental health, organised by pH7, a parliamentary health magazine, in London earlier this week. He said that National Institute for Clinical Excellence guidelines on the use of atypicals (PJ, 8 June, p793) were exactly what most user groups wanted. "However, we have to be cautious with these new drugs. They are a modest improvement ... we must not push everyone on to atypicals."

Stephen Bazire, pharmacy services director, Norfolk Mental Health Care NHS Trust, said it was important for patients to be properly educated about the therapies on offer so they could make an informed choice about their treatment. "Atypicals should be included as an option in the first choice for an antipsychotic. But they will not necessarily be the first choice."

Recent Government proposals were also discussed at the meeting. Professor Murray said that the draft Mental Health Bill (see Panel) was authoritarian and stigmatising and that it should be abandoned. "It will lead to patients trying to avoid treatment," he said. Dr Mike Shooter, president of the Royal College of Psychiatrists, said that if the Bill was brought into effect, mental health teams would be overwhelmed and would not be able to supervise patients in their care. Coupled with patients not coming forward for treatment for fear of stigmatisation, the effects of the proposals would be to increase rather than decrease the risk of violence from people with mental health problems, he said.