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MENTAL HEALTH ACT 2007

MENTAL HEALTH ACT 2007. Is Reform Needed?. In its 5th Biennial Report 1993 the Mental Health Act Commission argued that “ a full review of the 1983 Act is now needed”. Repeated in 7th BR 1997 “… the Act should be subject to a full review.

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MENTAL HEALTH ACT 2007

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  1. MENTAL HEALTH ACT2007

  2. Is Reform Needed? In its 5th Biennial Report 1993 the Mental Health Act Commission argued that “ a full review of the 1983 Act is now needed”. Repeated in 7th BR 1997 “… the Act should be subject to a full review. In its monitoring of the Act, the Commission has come across increasing difficulties in the interpretation and application of some parts of it, as well as instances which illustrate possible serious deficiencies in its provisions..” Need for transformation of mental health services from being primarily hospital based to community focused to be reflected in legislative framework.

  3. Reasons for Change • Current Act out of date • Perceived failures of community care • Treatability issue • Human Rights concerns

  4. Root and Branch Review announced Sept 1998 “We are going to bring the law on mental health up-to-date; in particular to ensure that patients who might otherwise be a danger to themselves and others are no longer allowed to refuse to comply with the treatment they need. We will also be changing the law to permit the detention of a small group of people who have not committed a crime but whose untreatable psychiatric disorder makes them dangerous. The law will be changed to deliver this protection for the public while at the same time respecting the civil rights of patients.” Frank Dobson

  5. Pace of Change Paul Boateng addresses the first meeting of the Richardson Committee in Oct 1998 “We do not have time to spend in years of contemplation.”

  6. Legislative Reform Timeline • Oct 1998 Expert committee established • Nov 1999 Expert Committee Report • Green Paper • Dec 2000 White Paper • June 2002 Draft Mental Health Bill • Sept 2004 New draft of Mental Health Bill • Mar 2005 Parliament Scrutiny Committee Report • Mar 2006 Govt abandon Bill and announce proposals to amend the 1983 Act • Nov 2006 Mental Health Bill to amend 1983 Act • July 2007 Mental Health Act 2007 royal assent • Nov 2008 Implementation of main provisions

  7. Report of Expert Committee Published July 99 Two Fundamental Underlying Principles Non Discrimination Principles governing mental health care should be the same as those which govern physical health. Patient Autonomy Mental Health Act should authorise treatment in the absence of consent only for those who lack capacity. (Exception if danger to public and possibly self).

  8. Green Paper Published Nov. 1999 Risk Model “It is the degree of risk that patients with mental disorder pose, to themselves or other, that is crucial …. Questions of capacity - while still relevant to the plan of care and treatment - may be largely irrelevant to the question of whether or not a compulsory order should be made.”

  9. The White Paper White Paper December 20th 2000 “These changes amount to the biggest shake up in mental health legislation in four decades. They will strengthen the current laws. They will introduce new safeguards for patients. They will improve protection for the public.” Alan Milburn and Jack Straw

  10. Mental Health Alliance Areas of concern • Definition of mental disorder over-inclusive • Breaking of link with treatability • Compulsory treatment in the community

  11. Joint Parliamentary Committee In strictly formal terms, the Government seems to have accepted much of that institutional structure [i.e. that which was recommended by the Richardson Committee]. In the new Bill, you have got a single gateway to compulsory power, you have got a broad diagnostic definition and you have got early intervention of an independent decision maker in the shape of the Tribunal, and an agreed care plan.” Professor Genevra Richardson, Joint Committee vol. II. evidence 2

  12. What was wrong with the Bill • the nature of the guiding principles and whether they should appear on the face of the Bill; • the absence of exclusions to avoid certain groups being inappropriately being caught in the mental health net; • the width of the conditions which would set the threshold for the use of compulsion; • the way in which the power of compulsory treatment in the community would be exercised; when, for whom and for how long; • the interface between the Bill and the Capacity Act; • miscellaneous matters to do with resources, implementation and monitoring, including the abandonment of the successor body to the MHAC as a separate entity.

  13. Mental Health Act 2007 • a single definition of mental disorder and a new appropriate treatment test • the broadening of the group of practitioners who can take on the functions currently performed by the ASW and the RMO • the right for Nearest Relatives to apply to displace their Nearest Relative • supervised community treatment • a statutory right to advocacy • age appropriate services for under 18 year olds • new safeguards for ECT • miscellaneous provisions (i.e. MHRT referrals, Guardianship power to convey, victim’s right to information, abolition of finite restriction orders)

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