New draft Mental Health Bill published last week
Draft Mental Health Bill
· Sets a new definition of mental disorder to emphasise that it
is the effect rather than the underlying cause that matters
· Defines the conditions for compulsion differently, to raise the
threshold for the health and safety of patients and to make clear
that appropriate treatment must be available for the individual
patient
· Proposes hospital assessment as a prerequisite to compulsory
treatment in the community
· Allows people to refuse electroconvulsive therapy if they retain
mental capacity
· Increases the maximum penalty for people convicted of ill treatment
or neglect of patients |
Mental health legislation has risen to the top of the Parliamentary agenda again with last week’s publication of a revised Mental Health Bill. The draft has been substantially revised following vigorous
opposition to a first draft published two years ago (PJ, 7 December,
2002, p809).
The revised Bill, which proposes the biggest reform of mental health
legislation since the 1950s, is so complicated and, in its original form,
so controversial that it will be scrutinised by a joint
parliamentary committee before being put before Parliament. The pre-legislative scrutiny
committee will take evidence from interested parties and recommend further
changes to be made to the draft Bill. Specialist pharmacists, for example,
are concerned that there is barely any mention of medicines and their
use in the latest version.
Health Minister Rosie Winterton said: “We have held extensive discussions
with stakeholders since we published a draft Bill for consultation in
2002 and we believe that we now have a Bill that puts a new focus on
the individual, allowing compulsory powers to be used in ways that fit
with patients’ changing needs. ... People will only be subject
to treatment under the Bill if they are at risk of harm to themselves
or others. The Bill means that the small minority of people with mental
health problems who need to be treated against their wishes, normally
for their protection but occasionally to protect the public, will get
the right treatment at the right time.”
David Branford, chief pharmacist at Derbyshire Mental Health Services
Trust, said: “This is an important piece of legislation for those
specialist pharmacists who practise in mental health care. There are
many concerns about the way in which psychotropic drugs are used in mental
health care and the UK Psychiatric Pharmacy Group has participated in
each of the many stages of the consultation process for the replacement
of the Mental Health Act 1983. This involved providing evidence to an
expert panel, commenting on the expert panel’s report, responding
to the Department of Health consultation documents on the reform of the
Mental Health Act and then, finally, the 2002 draft Bill.”
The original UKPPG submission made a range of recommendations about the
use of medicines in mental health and the need for safeguards. It also
made suggestions about how mental health pharmacists could help. Many
of the recommendations about the use of medicines in mental health appeared
in some form or other in the 2002 draft.
Dr Branford said: “This 2004 draft appears to have put the whole
process in reverse. Not only is there no reference to specialist mental
health pharmacists there is almost no mention of medicines either. The
big question now is whether a code of practice that will be published
by the Department of Health before the Bill is debated by Parliament
will provide any further guidance about the use of medicines.” |
The
Pharmaceutical Journal
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