Revised mental health bill fails to persuade patients or professionals
BMJ 2004; 329 doi: https://doi.org/10.1136/bmj.329.7467.640-a (Published 16 September 2004) Cite this as: BMJ 2004;329:640
All rapid responses
Rapid responses are electronic comments to the editor. They enable our users to debate issues raised in articles published on bmj.com. A rapid response is first posted online. If you need the URL (web address) of an individual response, simply click on the response headline and copy the URL from the browser window. A proportion of responses will, after editing, be published online and in the print journal as letters, which are indexed in PubMed. Rapid responses are not indexed in PubMed and they are not journal articles. The BMJ reserves the right to remove responses which are being wilfully misrepresented as published articles or when it is brought to our attention that a response spreads misinformation.
From March 2022, the word limit for rapid responses will be 600 words not including references and author details. We will no longer post responses that exceed this limit.
The word limit for letters selected from posted responses remains 300 words.
Rosie Winterton appears to have missed the point. There is a
fundamental flaw at the heart of the revised bill, carried over from the
last one. The current situation is flawed but basically ethical - if
someone is ill and at risk, either to themselves, others or through
neglect they can be sectioned and treated (for their psychiatric
problems). Being deprived of your liberty "for your own good" brings with
it certain rights, mainly to appeal and to be treated - this to me
suggests such treatment should be based on a degree of evidence,
experience etc. Detention is a means to allow treatment to be delivered
not an end in itself.
We should not be detaining people because they may at some point in
the future be dangerous. We are doctors not agents of social control. The
arguments have been made ad infinituum - we cannot accurately predict who
to lock up (600 to prevent one Michael Stone??), we don't know what to do
with them once we have. Who decides what is illness needing psychiatric
treatment and what is bad behaviour? The core of medical practice is
beneficence and non - maleficence - how do these values sit with the Bill?
As for the practicality aspect - perhaps proponents of the bill
should spend some time in the odd clinical setting, as well as the local
hospital's Mental Health Act office and the Human Resources department
Competing interests:
None declared
Competing interests: No competing interests
There is already so much workload for General Adult Psychiatrists and the
new bill will further add to the workload.How and from where we are going
to get more psychiatrist?A lot of psychiatrists who have been appointed
through NHS international fellowship scheme, are not able to join the
trusts because of rigid IELTS Requirement (for G.M.C. Registration) even
after getting the C.C.S.T. I believe language ability should be assessed
before awarding the C.C.S.T. by S.T.A. and people who have already studied
in English medium throughout their life including medical schooling (one
of the requirements for awarding C.C.S.T.) should have flexible IELTS
Requirement.Moreover their communication skill has also been assessed by
A.A.C. during the interview before offering the consultant post.In this
context IELTS Requirement for EEA candidate is more flexible even though
they have studied in other language than English throughout their
career.If the same IELTS Requirement can be applied to non EEA candidate
then it will be justified and we will be having more working hands who are
just waiting for this relaxation.U.K. Govt. has already spent lots of
money for their interviews and C.C.S.T. without any gain.We should wake-up
early before these people lose interest/motivation or migrate to some
other countries e.g. Australia/New Zealand.
Competing interests:
None declared
Competing interests: No competing interests
Politics of Mental Health Bill: individual patient's treatment needs and public safety.
Sir:
From political perspective, public at large should feel strongly safe
and secure from all threats and attacks that may emanate from general
"normal" people as well as mentally "abnormal" persons. The maintenance
of public safety and security is the solo responsibility of the
government. Surprisingly, normal people indulgence in violent fatal or
nonfatal activities does not cause much public hue and cry as comapred to
those of known mental patients with severe mental illness or personality
disorders. This is an absolute paradox and in fact public's such negative
attitudes against mental patients need overhauling by continuing global
campaigns.
The UK government in close collaboration with mental health
professionals and mental patients organizations attempted to strike a
balance between patients treatment needs and public safety through
drafting the Mental Health Bill, which gives considerably justified weight
to the assessment of each patient with psychiatric disorder including
personality disorder in hospital(after short term admission or possibly on
OPD basis), due to get follow-up treatment in the community. This policy
to which the community mental health teams have to adjust reflects double
safeguard, which will benefit to all involved partners-government health
policy makers, mental health professionals and most importantly patients.
To execute this policy successfully, the health policy makers would
require and hopefully they will recruit additional 130 psychiatric
consultants from any where in the world.
Arguably, no mental health bill is perfect and absolutely balanced
that is fully acceptable to all people and hence the criticisms by
Appleby, Farmer and Zigmond are not realistically well grounded.
Reference:
Lynn Eaton. Revised mental health bill fails to persuade patients or
professionals. BMJ 2004; 329: 640-a
Competing interests:
None declared
Competing interests: No competing interests