Mental health committee 'misses the point'

The Department of Health has issued a stinging response to criticism of the draft Mental Health Bill from a joint committee of MPs and peers.

Publishing its reply to parliament on Wednesday, the ministry accused the committee of "missing the point" and receiving imbalanced evidence.

The government wants to redraw mental health legislation to make it easier to force dangerous sufferers into care against their wishes, and provide new rights for patients.

The controversial Bill has been subject to much delay and redrafting as it treads on complicated legal ground.

However the committee, chaired by senior peer Lord Carlile, concluded in March that the draft legislation was still weighted far too heavily against patients, and would contribute to negative stereotypes.

Compulsory treatments should be limited to exceptional circumstances where there is a "significant risk" to the public, or where a patient's decision-making ability is impaired, it said.

And more resources should be put into mental health services, such as staffing and tribunals.

Lord Carlile said the legislation was "fundamentally flawed and warned that "far too many people could be forced into treatment unnecessarily".

Language

But in language far stronger than usual for equivalent documents, the Department of Health attacked the authors for misunderstanding both the intentions and consequences of the Bill.

"First of all, the report says that the legislation should be about improving services," the reply stated.

"The Bill is not about service provision. It is about the legal processes for bringing people under compulsion. Steps are being taken separately to improve services through a number of means.

"Secondly, we must state very firmly that we disagree with the committee's criticism that the Bill places too much emphasis on public safety and not enough on patient rights.

"We consider that the committee's concerns about the balance of public safety and patient autonomy miss the point that our concern is about the balance between patient and public safety and patient autonomy."

The ministry argued: "The great majority of people with a serious mental disorder are more likely to harm themselves than others, and it is wrong to paint a picture of a government or society obsessed with public safety."

"The government's and society's concern is to protect very vulnerable people from harming themselves or, much more occasionally, others," it added.

"And the concern to ensure that people can get the treatment they need to protect them from harming themselves or others is balanced by a concern to respect patients' rights to make decisions for themselves."

Safety

Accusing the committee of failing to "recognise the significance" of patient safety, the government said the parliamentary investigation of the Bill had received imbalanced evidence and underestimated the risk that is posed by some mental illness sufferers.

"The great majority of evidence came from stakeholders who represent health and social care professionals and service users, and relatively little from those with responsibility for protecting the public or from the general public themselves – the majority of whom do not share the committee's belief that the Bill is inappropriately concerned with public safety," it said

"Media coverage of homicides leads to a distorted view of the risk that is posed by mentally disordered people, the great majority of whom will never be a risk to anyone. But the fact remains that there are significant numbers of homicides by mentally disordered people each year - some of which are preventable.

"We believe that it is in patients' interests to bring them under compulsion if their mental disorder is so serious that they represent a serious risk to themselves or a risk to others – not only because treatment may be able to help them but also because we will never overcome the stigma associated with mental illness if the public is concerned that people with a mental disorder represent a risk to public safety.

"We must stress that we see no conflict between protection from harm and ensuring that patient rights are fully and appropriately promoted. The Bill does both. The Bill introduces a range of new safeguards, such as rights to advocacy and rights to choose a nominated person."