|
|
Mental Health Alliance's Common Concerns SANE is a member of the Mental Health Alliance, a grouping of voluntary organisations, service user groups, service providers, professional organisations and trade unions sharing the following common concerns about the reform of the Mental Health Act: 1. The aim of the new legislation should be to reduce the need for using compulsory powers. 2. The new legislation should offer people an individual enforceable right to a comprehensive assessment of their needs; and to have their identified needs met with good quality and effective services. 3. A free independent advocate should be available to everyone at all times, from the point of assessment; and the Government should provide adequate resources for this on a national basis. 4. The current law takes insufficient account of people's capacity to make their own treatment decisions and leaves those deemed to lack capacity without proper protection. New legislation must address both these issues in conjunction with wider incapacity legislation. Incapacity must not be equated with disagreeing with your doctor and must be sensitive to cultural differences. 5. Capacity to take treatment decisions should be part of any formal mental health assessment. In relation to longer-term criteria, compulsion on grounds of benefit to health should be more readily available for those who lack capacity in the absence of incapacity legislation. The forum for resolving any disputes over capacity should be the Tribunal. 6. People with mental health problems should have the right to draw up advance statements on their care and those they want involved in such are. Such statements should be legally enforceable such that a person who has lost capacity (whether detained or not) has the same rights as someone who has retained capacity. 7. There should be a duty for full information to be provided on any proposed treatment and for informed consent to be sought in every case. Special safeguards should continue to apply to psychosurgery, ECT and long-term drug treatment and should be extended to polypharmacy1, prescribing above BNF levels1 and force feeding. Where treatment is without consent it should be subject to independent review including a second medical opinion and involving consultation with patients and their representatives. 8. We support the formation of new independent tribunals as long as they reflect the community they serve, comprise a breadth of experience (including that of service users) and receive appropriate training. There should be an independent appeals procedure against the Tribunal's initial decision. 9. High Risk Patients: whilst recognising the Government's concern about public protection we continue to have doubts about the need for such sweeping powers as are proposed. (a) We have considerable difficulties with the suggestion that non-offenders would be detained under the proposed system regardless of whether or not they can be treated. (b) There are significant problems with risk assessment which we do not feel is sufficiently accurate to ensure that only people who pose an unacceptable danger would be incarcerated under the proposals. (c) New powers are being proposed to cover people with a personality disorder before there is an adequate evidence base and without the existing pilots being fully evaluated. (d) These powers will impact disproportionately on oppressed people such as black and minority ethnic communities and reinforce the discrimination which already exists in the mental health system. 1The British National Formulary (BNF) is a guide for general practitioners setting out recommended dose levels for medication. We accept the Richardson Committee's definition of polypharmacy as the concurrent administration of more than two drugs for mental disorder from the same BNF class.
|
