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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 . – PowerPoint PPT presentation

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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
  • Need for transformation of mental health services
    from being primarily hospital based to community
    focused to be reflected in legislative framework.

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  • Current Act out of date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

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
  • Frank Dobson

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

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

Report of Expert Committee
Published July 99 Two Fundamental Underlying
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).
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.
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
Mental Health Alliance
  • Areas of concern
  • Definition of mental disorder over-inclusive
  • Breaking of link with treatability
  • Compulsory treatment in the community

(No Transcript)
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

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
  • miscellaneous matters to do with resources,
    implementation and monitoring, including the
    abandonment of the successor body to the MHAC as
    a separate entity.

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, victims right to
    information, abolition of finite restriction