British look at detaining dangerous mental patients

Apr 16 2007

Government ministers in Britain are in the midst of discussing controversial plans to allow mentally ill people to be detained against their will, even if they have not committed a crime.

However the Mental Health Bill, rejected by the House of Lords in February, is expected to come in for some heavy criticism in the House of Commons.

An attempt to change the laws in 1998 following a brutal murder, the bludgeoning to death of Lin Russell and her daughter Megan by Michael Stone, failed at the time in the face of widespread opposition.

Stone was regarded as a dangerous psychopath but, because his condition was untreatable, he could not be held under mental health powers.

Michael Stone's conviction spurred the government to suggest that it favoured the bolstering up of the power of medics preemptively to detain and attempt to treat those who, like Stone, suffered from severe personality disorders even where no treatment of proven effectiveness is available.

Ministers say the proposals will help to keep the public safe but many believe the plans will make it easier for people to be detained at a time when the NHS is being forced to close beds in mental health wards.

The public also needs to be assured that public safety and individual rights are balanced.

Experts fear that the plans could impact adversely on mentally ill people more widely and say many more of those with mental illness are more of a danger to themselves than to anyone else.

They also say tougher legislation might not prevent a repeat of the tragedy that originally provoked it, as it was a breakdown in communication between the agencies handling Stone, rather than specific loopholes in the rules governing mandatory treatment, which contributed to the tragedy.

Far more murders are committed by sane than by insane people, and many experience mental illness without being a danger to either themselves or anyone else and critics suggest that the government's latest plans will make it easier to have people sectioned and place increasing the pressure on a system already struggling to cope.

The bill would allow people with severe or violent personality disorders to be confined if they were judged to be a threat to themselves or others.

In February the Lords voted against the idea of compulsion, saying treatment should be given only if it was likely to help the patient.

Previous attempts to change the laws have been abandoned in the face of widespread opposition from both campaigners and doctors who have voiced concerns that government plans are too occupied with public safety, rather than the needs of patients.

The Lords introduced a number of amendments, which would strengthen legal powers and did not completely reject orders for compulsory treatment in the community.

They suggested it be restricted specifically to "revolving door patients" - people who have repeatedly failed to keep up with medication on release from hospital, and who pose a danger to others.

The Lords also proposed that treatment should not be imposed on those able to make up their own minds and that treatability should remain an essential condition.

The bill would affect an estimated 14,000 of the 600,000 people who use mental health services each year.