17 January
2006
A meeting of the Mental Health APPG in association with the APPGs on Ageing &
Older People, Autism, Carers, Children, Disability, Drugs Misuse, Associate Parliamentary
Health Group, Learning Disability, Primary Care & Public Health and Prison Health, to
discuss:
THE MENTAL HEALTH BILL
Speakers included:
Lord Carlile of Berriew, Chair,
Joint Committee on the Draft Mental Health Bill
Professor Sheila Hollins,
President, Royal College of Psychiatrists
Liz Main, Service User
representative
Lord
Ashley (Chair of the All Party Parliamentary Disability Group) opened the meeting and
introduced the speakers.
Lord Carlile, Chair of the Joint Committee on the Draft
Mental Health Bill
Lord Carlile expressed his
disappointment that the Minister was unable to attend, as he was keen to find out whether
the Government intended to proceed with the Bill this session. He was pleased to see so
many people in the room and felt this reflected the importance of this legislation to the
public. He felt privileged to have chaired the Joint Committee and noted that many
Committee members were in attendance at the meeting. He thanked those who had given
evidence to the Committee and noted that the report had received unanimous support from
the members.
Lord Carlile’s Committee
report highlighted that the process of reforming the 1983 Act had already been through
many stages since Professor Richardson’s expert committee first reported on the Act and
that the Joint Committee had felt on balance that the Government should take the
opportunity to reform the Act though with many recommendations for change. The main
concern he had was that the Bill should be focused on mental health rather than social
control. Many people raised issues around learning disability during the Committee’s
work and they concluded that people should not be included in the scope of the Bill due to
learning disability alone.
Lord Carlile noted that the people
with mental health problems needed a clear expression of their rights in legislation and
therefore that principles should be on the face of the Bill as in the Scottish
legislation.
Lord Carlile said that he did not
expect the Bill to be published this session as time is running out but that when it comes
it is likely to be published in the Commons first as it is controversial. His Committee
would be very unhappy if the Government published a Bill ignoring the recommendations made
in his report.
Liz Main, service user
Professor Sheila Hollins, President of the Royal College of
Psychiatrists
Prof.
Hollins thanked Lord Carlile for his report which had overlapped with many of the
College’s own recommendations. The College has aimed to maintain a constructive
position throughout the process of reform but hasn’t been afraid to criticise
Government when necessary.
Prof.
Hollins expressed concern that the Bill would extend the use of compulsion and the
implications this would have on the workforce. She noted that the College is working with
the Department of Health to encourage more medical students into psychiatry but need 10%
of all medical students to choose the speciality to fulfil the requirements of the new
Bill, when the current level is 4%. The provisions of the new Bill may also discourage
people from becoming psychiatrists and others may leave the profession if the relationship
with patients is damaged through the focus on compulsion.
Prof.
Hollins said she was particularly interested in learning disability, which is her field of
work, but also her son has a learning disability. She agreed with Lord Carlile that people
with learning disability should not be covered by the Act unless they also have a mental
disorder. She also raised concerns about the treatability clause being removed from the
legislation.
Q&A
Lynne
Jones thanked the speakers and
began the Q&A by asking how much the Government moved in their response to the Joint
Committee’s report. Lord Carlile noted that the Government had not conceded very much
but hoped that they would look again at CTOs and tribunals. He also noted that the
Government needed to resolve the Bournewood Gap to ensure that people who are currently
under “quasi detention” in hospital are given the full rights and safeguards of
those who are formally detained.
Lord
Rix spoke about learning disability in the Bill and had been dismayed that the Government
rejected the Joint Committee’s recommendation that learning disability be excluded
from the Bill. He felt that this could lead to enormous difficulties for people with
learning disabilities who might be placed in inappropriate care.
Other
points raised included stressing the importance of the unity of the mental health field on
this campaign, particularly the professionals working with the charities. Also that
tribunals need to be better qualified to recognise when people are inappropriately
detained.
Baroness
Murphy highlighted the unintended consequences of increasing the use of compulsion,
particularly the likelihood that more people from BME backgrounds would be detained.
Angela
Browning stated that people with Autism Spectrum Disorder should not be included in the
Bill unless they have a mental disorder and was concerned that the Government had rejected
this. She also noted that evidence from the Royal College of Psychiatrists had shown that
up to 5,000 people would have to be detained to prevent one homicide and that this was
unacceptable.
Other
points raised included that professionals needed to take better care of the physical
health of people under compulsion, those who become physically ill or who suffer side
effects from the treatments need particular help. Adrian Whyatt said that psychiatrists
needed to be better trained to recognise learning disabilities. Another speaker noted that
the public needed to be better informed about what was happening to mental health
legislation and the impact it could have on their lives. Lord Carlile noted that it is
very hard to get the media and public interested in mental health, it is far easier to
raise awareness and raise funds for other medical issues.
Further
points were raised about the importance of a strong tribunal service and the significance
of treatability under the old Act which protected many disabled people from falling under
the Act purely because of their disability. Julian Seymour noted that the Government needs
to focus on a total care package to help recovery and aid “revolving door”
patients.
Philip
Dixon-Phillips noted that the Bill would be in place for a generation and so it was vital
that Parliament amended the Bill appropriately. Clive Evers raised the Bournewood Gap and
the thousands of people under “quasi detention” in care homes.
Paul
Farmer, chair of the Mental Health Alliance summed up the debate by highlighting how
passionately people feel about the reform of the Act even after seven years of the
process. The Alliance has brought many diverse groups
together including the BMA, NUS and Local Government Association. Compulsory treatment is
very damaging and upsetting to all involved, the service users, families and the
professionals and its use needs to be kept to a minimum. He stressed the importance of
working together when the Bill reaches Parliament so that members realise that the Bill
will affect every constituency in England and Wales and will also have human rights
implications.
Lynne
Jones then asked the speakers to
sum up. Liz Main said that it is important that people feel able to approach professionals
when they feel their mental health is suffering but that people will be afraid to engage
with services if the Bill is passed as it stands. She also noted the importance of
training for the police. She noted that it was important that people recognise that mental
illness is a disability.
Prof.
Hollins said that there are many good things happening in the mental health service but
that this was not linked to the Bill and this had a very negative impact on how people
view the legislation. She said that the physical health of people with mental health
problems was a priority for her as President. The training for psychiatrists now requires
the involvement of patients and carers. Recruiting enough psychiatrists to fulfil the new
Act will be difficult and the profession wouldn’t be happy if they were forced to do
tribunal work.
Angela
Browning MP summed up for Lord Carlile who had to leave early. She said that the Joint
Committee had really appreciated the quality of the evidence they had received and that
Lord Carlile had been an excellent chair. She hoped that the Government would adopt more
of their recommendations and noted that there would be a fight when it reached Parliament.
Lynne
Jones thanked the speakers and
noted that the Minister would be invited to a future meeting to respond.
Attendees:
Lynne Jones MP
Lord Ashley
Lord Carlile
Lord Rix
David Drew MP
Angela Browning MP
Sandra Gidley MP
Paul Burstow MP
Evan Harris MP
Lord Alderdice
Baroness Murphy
Lord Turnberg
Baroness McIntosh
Baroness Stern
Baroness Eccles
Liz Blackman MP
Maria Miller MP
Des Turner MP
Janet Dean MP
Tim Boswell MP
Baroness Howarth
John Hayes MP
Baroness Massey
Tim Loughton MP
Lord Northbourne
Baroness
Greengross
Madeleine Moon MP
Patrick Hall MP
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