Draft mental health bill needs major overhaul, says committee
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《英国医生杂志》
Government plans to reform mental health services will force too many people into compulsory treatment and erode their civil liberties, a committee of MPs and peers appointed to scrutinise the legislation has warned.
The draft mental health bill is "fundamentally flawed" and needs a major overhaul, concludes the joint parliamentary committee, which was appointed to scrutinise the bill and recommend improvements before a final version is put before parliament.
The draft mental health bill places too much emphasis on protecting the public, say MPs. Pictured are Lee Jar vis (left), who attacked a 79 year old man with a hammer in 2004 and was detained in hospital indefinitely, and Pet er Bryan (right), who was given two life sentences in March for killing a man and eating his brain
Credit: PA/EMPICS
Credit: METROPOLITAN POLICE/PA/EMPICS
The committee says the bill places too much emphasis on protecting the public from a small minority of dangerous mentally ill people at the expense of the civil rights of the majority who pose no risk to others.
It warns that the powers granted by the bill could be used as the equivalent of a "mental health antisocial behaviour order," forcing treatment on people who might be a nuisance but who pose no major risk to the public.
The committee concludes that compulsory treatment is warranted only if there is a significant risk of serious harm to others. Patients should never be treated under compulsion unless their decision making is impaired, it says, and any compulsory treatment must be of therapeutic benefit.
The wide definition of treatment in the bill means people with a diagnosis of a personality disorder or learning disability could be detained on the grounds of public safety rather than to benefit their health, say the MPs and peers.
People who cannot benefit from treatment, including those with dangerous and severe personality disorders, should be dealt with by separate legislation, the committee recommends.
It says the primary purpose of mental health legislation should be to improve services and safeguards for patients and to reduce the stigma of mental disorder. These fundamental principles must be set out clearly in the legislation, it says.
Although the committee supports compulsory treatment in the community, it believes it should be more restricted than is currently proposed, with clear criteria setting out who can be treated at home and time limits on the length of treatment.
The committee has "major concerns" about the resources needed to implement the legislation. "We lack confidence in the government's models and underlying assumptions used to predict the funding and staff required to make the new provisions work," it says.
"The bill is fundamentally flawed. Far too many people could be forced into treatment unnecessarily," said the committee's chairman, Lord Carlile of Berriew. The bill "is too focused on addressing public misconception about violence and mental illness and does not do enough to protect patients' rights," he added.
Mental health charities and the Royal College of Psychiatrists have welcomed the report. The health minister Rosie Winterton said the government would look at the report in detail.(Clare Dyer, legal correspondent)
The draft mental health bill is "fundamentally flawed" and needs a major overhaul, concludes the joint parliamentary committee, which was appointed to scrutinise the bill and recommend improvements before a final version is put before parliament.
The draft mental health bill places too much emphasis on protecting the public, say MPs. Pictured are Lee Jar vis (left), who attacked a 79 year old man with a hammer in 2004 and was detained in hospital indefinitely, and Pet er Bryan (right), who was given two life sentences in March for killing a man and eating his brain
Credit: PA/EMPICS
Credit: METROPOLITAN POLICE/PA/EMPICS
The committee says the bill places too much emphasis on protecting the public from a small minority of dangerous mentally ill people at the expense of the civil rights of the majority who pose no risk to others.
It warns that the powers granted by the bill could be used as the equivalent of a "mental health antisocial behaviour order," forcing treatment on people who might be a nuisance but who pose no major risk to the public.
The committee concludes that compulsory treatment is warranted only if there is a significant risk of serious harm to others. Patients should never be treated under compulsion unless their decision making is impaired, it says, and any compulsory treatment must be of therapeutic benefit.
The wide definition of treatment in the bill means people with a diagnosis of a personality disorder or learning disability could be detained on the grounds of public safety rather than to benefit their health, say the MPs and peers.
People who cannot benefit from treatment, including those with dangerous and severe personality disorders, should be dealt with by separate legislation, the committee recommends.
It says the primary purpose of mental health legislation should be to improve services and safeguards for patients and to reduce the stigma of mental disorder. These fundamental principles must be set out clearly in the legislation, it says.
Although the committee supports compulsory treatment in the community, it believes it should be more restricted than is currently proposed, with clear criteria setting out who can be treated at home and time limits on the length of treatment.
The committee has "major concerns" about the resources needed to implement the legislation. "We lack confidence in the government's models and underlying assumptions used to predict the funding and staff required to make the new provisions work," it says.
"The bill is fundamentally flawed. Far too many people could be forced into treatment unnecessarily," said the committee's chairman, Lord Carlile of Berriew. The bill "is too focused on addressing public misconception about violence and mental illness and does not do enough to protect patients' rights," he added.
Mental health charities and the Royal College of Psychiatrists have welcomed the report. The health minister Rosie Winterton said the government would look at the report in detail.(Clare Dyer, legal correspondent)