SUN International Protest

Mental Health Bill

From: David Harper

The Mental Health Bill has now been published and looks like it will go through the House of Lords first in the next few days.

http://news.bbc.co.uk/1/hi/health/6157736.stm

Mental Health Alliance lobby is on 28 November (see below).

I don't really send out many circular emails these days but I've attached a couple of things people have sent me in the last couple of weeks since I was sending this out.

Dave
Mental Health Alliance

- STOP PRESS - STOP PRESS-

The Mental Health Bill has been published

It is now more important than ever to show your support for the Mental Health Alliance's campaign to secure a better Mental Health legislation

The Mental Health Alliance is staging a mass lobby of Parliament on Tuesday 28th November 2006 and we need you to be there

A lobby of Parliament gives ordinary people the opportunity to speak to their MP about an issue they are concerned about. We want to tell MPs that we oppose the Government's plans to amend the Mental Health Act and what we would like to see in its place: a law that's fit for the twenty-first century.

The more people who can come to Parliament and talk to their MPs, the stronger our message will be. We will provide you with all the information you will need to make the most out of the lobby. It is also a good idea to keep checking the website for updates and information.

To join our lobby, please;

Come to: St Stephen's Entrance, Parliament, Westminster, London

On Tuesday 28th November 2006

Between 1:30pm and 5:00pm.

Please see http://www.parliament.uk/about/visiting/directions/maps.cfm for a map of the area.

The nearest tube station to Parliament is Westminster (Jubilee line, Circle and District lines) and there are a number of bus stops nearby. If you are travelling to the lobby by coach, you can park at Victoria coach station and either walk to Parliament or take a bus (numbers 11 and 211). Further information can be found at www.tfl.gov.uk

If possible, please come at the time for your region (shown below). This way, people from the same area with the same MP can see him or her together. When you arrive at Parliament (St Stephen's entrance) you will be met by our stewards who will take you into Parliament to be organised into groups and briefed. We will then guide you to Central Lobby where you will ask to meet your MP.

Please note this legislation only affects England and Wales.

Region

Arrive for briefing Lobby your MP

Wales 1.30pm 2.30pm

North of England (including the North east, North west, Yorkshire and the Humber) 2.00pm 3.00pm

South West England 2.30pm 3.30pm

East and West Midlands 3.00pm 4.00pm

East and South East of England 3.30pm 4.30pm

London 4.00pm 5.00pm

Not sure what region you're in? See the map at: http://www.statistics.gov.uk/geography/downloads/uk_gor_cty_1.pdf

If possible, we would like you to contact your MP in advance to make sure they're available to see you. Please send the attached letter to your MP or send an email via www.mentalhealthalliance.org.uk

If you are not sure who your MP is then please refer to www.locata.co.uk/commons

Please let us know if you are coming by emailing Katharine Boaden Katharine.boaden@scmh.org.uk .

If you have any questions or will require any assistance on the day of the lobby then please contact Katharine or see www.mentalhealthalliance.org.uk We regret that the Mental Health Alliance will be unable to provide any refreshments during the lobby. Please bring your own refreshments if you think you will require them.

We will need people who are coming to the lobby to speak to people in the media both before and afterwards about why they are coming. We may also want to take some photos of people who have attended the lobby. If you would be willing to speak to the media or have your photo taken, please let Katharine know.

Thank you for your support, Andy Bell Chair, Mental Health Alliance

Draft Bill dropped and 1983 Act to be amended
23 March 2006: The draft Mental Health Bill has been dropped in favour of making amendments to the 1983 Mental Health Act.

The new proposals include:

a broad definition of mental disorder which excludes drug and alcohol dependency and learning disabilities;
replacing the current treatability test with an appropriate treatment test (for all patients)
; supervised treatment in the community for patients who have been discharged from compulsory treatment in hospital;
automatic referrals to the Mental Health Review Tribunal, initially at 6 months and brought forward as resources allow;
patients will be given greater powers to displace a nearest relative they 'are not happy with
'
; provisions from the Civil Partnership Act 2004 for the choice of the nearest relative
; The Registered Medical Officer will be replaced by the clinical supervisor (which will be open to other professions);
The Approved Social Worker replaced by the Approved Mental Health Professional;
The Bill will include Bournewood safeguards (no details given about content) which will amend the Mental Capacity Act;
There will be no right to advocacy and this will be pursued via other means;
The children's safeguards will not be in the Bill but will be introduced via different legislation;
No guiding principles on the face of the Bill;
There will not be much consultation on the Bill and the main discussions will be about the Code of Practice;
There will be a Race Equality Impact Assessment;

Enactment expected in 2008.

Who's saying what ? From both sides
What do you think and why? Email your views about the bill

JOINT COMMITTEE SEEKS EVIDENCE ON DRAFT MENTAL HEALTH BILL
Session 2003-04, 16 September 2004

The two Houses of Parliament have established a Joint Committee on the Draft Mental Health Bill which was published by the Government on 8 September 2004.
The Committee will consider the draft bill and report on it to both Houses by 31 March 2005.
The Committee is currently inviting organisations and individuals to submit written evidence by Monday 1 November 2004 (see attached Call for Evidence for further details). The Committee plans to hold oral evidence sessions from mid October.
Membership
Mrs Liz Blackman, MP Erewash Labour
Mrs Angela Browning, MP Tiverton and Honiton Conservative
Mr David Hinchliffe, MP Wakefield Labour
Mr George Howarth, MP Knowsley North and Sefton East Labour
Tim Loughton, MP East Worthing and Shoreham Conservative
Mr Paul Marsden, MP Shrewsbury and Atcham Liberal Democrats
Laura Moffatt, MP Crawley Labour
Ms Meg Munn, MP Sheffield Heeley Labour
Dr Doug Naysmith, MP Bristol North West Labour
Mr Gwyn Prosser, MP Dover Labour
Dr Howard Stoate, MP Dartford Labour
Hywel Williams, MP Caernarfon Plaid Cymru
Baroness Barker Liberal Democrats
Lord Carlile of Berriew (Chairman) Liberal Democrats
Lord Carter Labour
Baroness Cumberlege Conservative
Baroness Eccles of Moulton Conservative
Baroness Finlay of Llandaff Cross Bench
Baroness Flather Conservative
Lord Mayhew of Twysden Conservative
Baroness McIntosh of Hudnall Labour
Baroness Pitkeathley Labour
Lord Rix Cross Bench
Lord Turnberg Labour
Members' declared interests will soon be available on the Committee's webpages, along with other information about the inquiry:
http://www.parliament.uk/parliamentary_committees/jcdmhb.cfm
At its first meeting on 15 September 2004, the Committee elected the Lord Carlile of Berriew as Chairman.
CALL FOR EVIDENCE
The Joint Committee invites interested organisations and individuals to submit written evidence as part of its inquiry into the Draft Mental Health Bill. Submissions, reflecting the guidance on written evidence given in this press notice, should reach the Committee as soon as possible and no later than Monday, 1 November 2004.
Scope of the Committee's inquiry
In particular, the Committee invites evidence on the following themes:
1. Is the Draft Mental Health Bill rooted in a set of unambiguous basic principles? Are these principles appropriate and desirable?
2. Is the definition of Mental Disorder appropriate and unambiguous? Are the conditions for treatment and care under compulsion sufficiently stringent? Are the provisions for assessment and treatment in the Community adequate and sufficient?
3. Does the draft bill achieve the right balance between protecting the personal and human rights of the mentally ill on one hand, and concerns for public and personal safety on the other?
4. Are the proposals contained in the Draft Mental Health Bill necessary, workable, efficient, and clear? Are there any important omissions in the Bill?
5. Is the proposed institutional framework appropriate and sufficient for the enforcement of measures contained in the draft bill?
6. Are the safeguards against abuse adequate? Are the safeguards in respect of particularly vulnerable groups, for example children, sufficient? Are there enough safeguards against misuse of aggressive procedures such as ECT and psychosurgery?
7. Is the balance struck between what has been included on the face of the draft bill, and what goes into Regulations and the Code of Practices right?
8. Is the Draft Mental Health Bill adequately integrated with the Mental Capacity Bill (as introduced in the House of Commons on 17 July 2004)?
9. Is the Draft Mental Health Bill in full compliance with the Human Rights Act?
10. What are likely to be the human and financial resource implications of the draft bill? What will be the effect on the roles of professionals? Has the Government analysed the effects of the Bill adequately, and will sufficient resources be available to cover any costs arising from implementation of the Bill?
Written evidence
All written evidence should be submitted to the Joint Committee no later than Monday, 1 November 2004. Given the limited time available for the submission of evidence and for the completion of the Committee's work, written evidence should be short and should concentrate on the major issues arising from the draft bill. Witnesses should feel free to cover only those aspects of the draft bill in which they are particularly interested. The Committee cannot investigate the treatment of individuals, evidence should address the general points listed.
Written evidence should contain, if appropriate, a brief introduction to the persons or organisations submitting it. Submissions should take the form of a memorandum and should have numbered paragraphs. They should not exceed 1,500 words in length. Unless submissions are very short, they should be accompanied by a summary.. Submissions may be accompanied by background material (perhaps already published elsewhere), which will not be reprinted by the Joint Committee.
We wish to receive written evidence, if possible, in MS Word or rich text format, by e-mail to scrutiny@parliament.uk. A single hard copy (single-sided, unbound) should also be sent to Richard Dawson (Draft Mental Health Bill), Committee Office Scrutiny Unit, House of Commons, London, SW1P 3JA.
Once written evidence has been submitted it becomes the property of the Committee. Those who have submitted written evidence to the Joint Committee are welcome to publish their evidence themselves (for example, by placing it on their own website), provided that it is not published until after the Joint Committee has acknowledged receipt of the evidence and that it is made clear that the document was prepared as evidence to the Joint Committee. Written submissions from those giving oral evidence will be available at the relevant hearing. Written evidence will, wherever possible, be posted on the Committee's web pages, and then either be published by the Committee with its final Report or placed in the public domain when that Report is published. Individuals and organisations considering submitting information to the Committee that they would wish the Committee to treat as confidential should consult the Clerks in advance, initially by sending an e-mail to the address given above.
To follow the progress of the inquiry, you may visit the Committee's website:
http://www.parliament.uk/parliamentary_committees/jcdmhb.cfm
If you wish to be added to the mailing list for future press notices from the Committee, please contact:
Richard Dawson
Committee Office Scrutiny Unit
House of Commons
London SW1P 3JA
E-mail: scrutiny@parliament.uk (Please put Mental Health in the subject box).
Tel: 020 7219 8363
Fax 020 7219 8381

Mental health Bill
The government has watered down its plans to allow the enforced treatment of potentially dangerous mental health patients.
The long-awaited re-draft of the Mental Health Bill, released on Wednesday, sets stricter criteria on which patients can be detained.
Government Response: Department of Health
Rosie Winterton, health minister, said: "The revised Bill represents the first major overhaul of the legislation since the 1950s and is an integral part of the government's wider strategy to improve mental health services for all; reflecting developments in human rights law and providing a legal framework in line with modern services and treatments.
"We have held extensive discussions with stakeholders since we published a draft Bill for consultation in 2002 and we believe that we now have a Bill that puts a new focus on the individual, allowing compulsory powers to be used in ways that fit with patients' changing needs.
"One of the fundamental aims of the Bill is to help make community care work for the people who need it most. Patients in the community who are ill and vulnerable or at risk will now be able to get the treatment they need.
"Safeguards for patients will also be greatly strengthened with choice of representative, access to advocacy and all use of compulsory treatment beyond 28 days having to be authorised by a new independent Mental Health Tribunal.
"People will only be subject to treatment under the Bill if they are at risk of harm to themselves or others.
"The bill means that the small minority of people with mental health problems who need to be treated against their wishes, normally for their protection but occasionally to protect the public, will get the right treatment at the right time.
"To make sure we get the legislation right we have asked a Joint Parliamentary Committee to scrutinise the draft Bill, and we look forward to receiving their report."
Party Response: Liberal Democrats
Paul Burstow MP, Liberal Democrat health spokesman, said: "For the Mental Health Bill to work, the government must have made changes to their earlier extreme and draconian Draft Bill.
"A new Mental Health Act is desperately needed, but it must be a law to protect and improve services for patients, not a means to demonise those with mental health problems."
Party Response: Conservative
Tim Loughton, shadow health minister said: "Everyone's liberty is still at risk by the way the legislation is framed. The government have still failed to grasp that mental illness is a medical condition requiring treatment like any other physical problem rather than a criminal offence demanding incarceration.
"Compulsion should be a means of last resort, and we fear that many people with mental health problems will still be deterred from seeking treatment for fear of being subjected to compulsory treatment or detention."
Stakeholder Response: SANE
Marjorie Wallace SANE's chief executive, , said: "We have long campaigned for reforms to mental health laws so that they better protect both the individual who experiences mental illness and the interests of the families, professionals and the public.
"But our mental health services in many places appear to be facing breakdown, with a chronic shortage of doctors, nurses and skilled front-line staff, squalid and overcrowded wards, and too few supervised places in the community.
"Despite all the government's recent efforts, we will not be able to provide the essential care and treatment for those whose freedoms we may limit.
"The emphasis on compulsion should be on the government to fund the 'safe, sound and supportive' mental health services they promised when they came to power and made mental health a priority. Only if new laws are backed by improved services can they lead to compassionate care rather than increased fear and stigma.
"A major concern remains that in situations of crisis, families and carers may still be left to take responsibility without being given rights to vital information that could prevent unnecessary suffering or tragedy."

Stakeholder Response: Depression Alliance
Jim Thomson, chief executive of the Depression Alliance, said: "The new Draft Mental Health Bill is a piece of public order legislation - feeding on largely media-generated fear and prejudice about people with mental health problems 'at large', instead of a piece of legislation providing the framework for services for the tens of thousands of people experiencing the nightmare of mental health service provision in the NHS.
"It is yet another piece of public order legislation dressed-up as health legislation, with a few token concessions to the 2,000 damning indictments of the original draft, which does not begin to address the issues.
"For example, a definition of what is meant by "psychological dysfunction arising from any disorder of the mind or brain" might be a start, if government plans to defend the wholesale locking-up and enforced treatment of individuals on the say-so of (also unspecified) 'health professionals'.
"Left undefined, that defence will be mounted in the Courts, at the taxpayer' s expense. In the coming days we will be working in partnership with other organisations and members of the Mental Health Alliance to discuss a formal response to the bill."

A time for treatment

The biggest challenge facing the mentally ill is the lack of access to urgently needed treatment. It is supposed to be one of the government's top three medical priorities. Rightly so. No other disease affects so many: an estimated one in six people of working age suffers some form of mental condition ranging from depression through disabling anxiety disorders to schizophrenia. And yet mental health funds still get diverted to more powerful medical specialties, leaving community mental health teams over-stretched and undermanned. No wonder the mental health lobby talks about the government's draft bill as a "once-in-a-generation opportunity to drive mental health up the political and social agenda". So why this week was there so much opposition from the lobby to the newly redrafted bill?
guardian.co.uk 11 Sept
Simple. The main driver behind the bill is not the needs of the mentally ill but a desire to appease a media-misinspired public concern with the risks that mental patients pose. Statistically you are 20 times more likely to be killed by a sane person than an insane one. By far the biggest threat posed by mentally ill patients is to themselves, with more than 1,000 committing suicide every year. Yet public fears over the threat posed by a tiny number of people with dangerous and severe personality disorder (DSPD), formally known as psychopaths, still prompts ministers to respond. It is six years since they promised to close the loophole exposed by Michael Stone's murderous attack on the Russell family. He had not been detained earlier because his DSPD was deemed untreatable.
An earlier version of the bill published in 2002 was withdrawn following opposition of the Mental Health Alliance, a powerful 60-strong group of professional and patient bodies concerned by its civil rights implications. It allowed detention of DPSD patients even if they had not committed an offence and had no prospect of cure. If it is right to detain dangerous people who are treatable, why is it wrong to detain them when they are untreatable? There is an important difference. For the first, rehabilitation and release offers hope, where there is none for the second. Indeterminate detention could not be more serious, but ministers have belatedly recognised this principle in their redrafting. Time for the lobby to reciprocate. It opposes compulsory community treatment orders, yet we have moved a long way down the "hospital without walls" road since the idea was first raised 20 years ago. Ministers have made concessions here too. Time for MPs to require the lobby to justify itself.

Rights and responsibilities in mental health

With the tragic death of Denis Finnegan in Richmond Park last week, we have what looks like yet another homicide committed by someone in the care of our mental health services. After the trial, there will be another independent inquiry, adding to the 150 or so since 1994, and the victim's family will be left to grieve for a loved one who was simply cycling through the park in the late summer sunshine.
guardian.co.uk 10 Sept
Mr Finnegan will join the list of all those who have lost their lives pointlessly, and in brutal circumstances, because we are unable to make the right decisions about people who are ill and at risk. These failures lead to 40 homicides and 1,000 suicides a year in this country. In addition, the mentally disordered offenders who have been let down by mental health services lose their liberty and their families suffer accordingly.
The price for carrying on as we are is high, which is why the Zito Trust supports the new draft mental health bill (Psychiatrists condemn mental health bill, September 9) and why it calls upon the Mental Health Alliance, the Royal College of Psychiatrists and other vocal critics of the bill to think carefully about the thousands of victims in this country who have suffered enough, without having to listen to criticisms that have not been well thought through and that never consider their interests.
This bill will deliver the government's promise to provide mental health services that balance patients' rights and public safety. It has every chance of protecting those at risk of losing their liberty, and saving those at risk of losing their lives.
Jayne Zito
Michael Howlett
Zito Trust

The mental capacity bill will not only affect people who may be subjected to euthanasia practices (Letters, September 7). The bill creates an imbalance of power between decision-maker and person without capacity. For the first time, informal carers, such as parents, will be given almost unlimited power to make decisions about the care and treatment of people lacking capacity. In practice, the decision-maker will be able to control their lives.
The bill does not give the same legal rights for people lacking capacity to receive support to make their own decisions, by the provision of facilitated communication, communication aids and training, and advocacy. Additionally, people lacking capacity would have no legal redress if a decision-maker held a reasonable belief that they can't make decisions because of impairment or disturbance of mind. In practice, this would mean that many people with learning difficulties who are thought to have an intellectual impairment would have no right to seek an injunction against a decision-maker.
The bill threatens the gains made by civil rights legislation and our right to make decisions for ourselves. Changing Perspectives is a member of I Decide, a coalition of disabled people's organisations campaigning against the bill.
Simone Aspis
Changing Perspectives
Liberty at risk under new mental health plan

Shadow Health Minister Tim Loughton has warned that the Government's new draft mental health legislation will prove widely unacceptable, and remain a threat to individual liberty.
Despite minor changes made to earlier legislation, he said new proposals just published still focus too much on the dangers to the public rather than the medical needs of the patients, he said.
Although ministers have accepted call for stricter criteria for detaining patients suffering from mental illness, Mr Loughton declared: "Everyone's liberty is still at risk by the way the legislation is framed. The Government have still failed to grasp that mental illness is a medical condition requiring treatment like any other physical problem rather than a criminal offence demanding incarceration. Compulsion should be a means of last resort, and we fear that many people with mental health problems will still be deterred from seeking treatment for fear of being subjected to compulsory treatment or detention."
The Conservatives have promised to produce alternative proposals, which take the beneficial parts of the draft Bill but remove the unacceptable coercion measures.
"This will form part of our election manifesto with a commitment to legislate early in the next Conservative Government. We have waited too long already to update our mental health laws, which mainly hark back to the 1950's and it is a disgrace that the Government have fudged this once in a generation opportunity to update this vital legislation," Mr Loughton told conservatives.com.

Prejudice, ignorance and fear

Rethink's reaction to plans for new Mental Health Bill

Rethink severe mental illness today (September 8) condemned plans for a new mental health Act as a wasted chance to reduce compulsion and complete the government's reform programme.
Chief executive Cliff Prior said: "When this long drawn out process began in 1999, the government's stated aim was to reduce compulsion (see notes to editors below). It was told that its plans would do just the opposite. Despite a few concessions, nothing has been done to address this fundamental flaw.
"We are being thrown back to an age where mental health law is based on prejudice, ignorance and fear rather than hope and recovery.
"Families will have reduced rights and fewer opportunities to press for the best care and treatment for the person they care for."

Mental Health Bill to 'protect patients and public'

From number-10.gov.uk
The government has unveiled the biggest reform of mental health legislation since the 1950's.
The new draft Mental Health Bill, published today, provides better safeguards and treatment for patients who may harm themselves and others.
Significant changes have been made to the 2002 draft following consultation with stakeholders and the public. They include changing the definition of mental disorder, and increasing the maximum sentence for people convicted of ill treatment or neglect of patients.
The Bill will be subject to pre-legislative scrutiny by a parliamentary committee, which has been asked to present its report by the end of March 2005.
Health Minister Rosie Winterton said the revised Bill puts a new focus on the individual, allowing compulsory powers to be used in ways that fit with patients' changing needs.
She said people would only be subject to treatment under the Bill if they pose a risk to themselves or others.
"Patients in the community who are ill and vulnerable or at risk will now be able to get the treatment they need.
"To make sure we get the legislation right we have asked a Joint Parliamentary Committee to scrutinise the draft Bill, and we look forward to receiving their report."
Home Office Minister Paul Goggins said public safety would not be compromised.
"If we are to protect the public we must ensure that those with a mental disorder who are a risk to others receive the high quality mental health treatment they need. The Bill will help to achieve this."
Liberty at risk under new mental health plan

Redrafted government plans on compulsory treatment for potentially dangerous mental health patients will alienate them from healthcare staff, according to the mental health charity Mind.

The original 2002 version of the legislation prompted consternation in the field by proposing new powers to impose compulsory treatment on severely affected patients.
Mental health charities and practitioners also condemned plans to detain those suffering from severe personality disorders even if they have not committed a crime.
Thousands of objections prompted a reworking of the bill, but the chief executive of Mind Richard Brook has expressed disappointment that the government "has not adequately addressed the profound misgivings of both service users and medical practitioners."
While more palatable than the original, the bill is still "fundamentally flawed" according to Mind. The retention of proposals on compulsory treatment in the community risks introducing fear and mistrust into the doctor-patient relationship and may discourage patients from seeking help, the charity warns.
Mr Brook adds: "Compulsion must be a means of last resort - the government must understand that what a person in crisis needs above all else, is care and compassion."
The Royal College of Psychiatrists is also anxious about the revised proposals, describing the bill as "unfair, stigmatising and dangerous".
While acknowledging some welcome changes have been made to the bill, the RCP's president Dr Mike Shooter warns that extending the use of compulsory powers to a larger group of patients will infringe human rights and exert greater pressure on psychiatric services.
"This proposed legislation would further distance the practice of psychiatry from the rest of medicine and ensure that people with mental health problems have less rights than people with physical illnesses."
The government has defended the proposals. Health Minister Rosie Winterton told the BBC: "We believe that we now have a Bill that puts a new focus on the individual, allowing compulsory powers to be used in ways that fit with patients' changing needs."

Revised mental health bill must not waste opportunity, UK

Revised mental health bill must not waste opportunity to improve services for people with mental health problems, says King's Fund.
Responding to the publication of the Government's revised draft Mental Health Bill, the King's Fund today warned Ministers not to squander an historic opportunity to come up with workable legislation that truly supports people with mental health problems while taking account of legitimate public safety issues.
King's Fund chief executive Niall Dickson said: "We have all waited too long for this legislation. Let us hope that this is not another wasted opportunity - this time politicians really must listen to those who use these services as well as the nurses, doctors, psychologists and all the other professionals who provide them."
But the King's Fund did welcome the Government's decision to put the draft Bill to a cross-party pre-legislative scrutiny committee before introducing a Bill to Parliament.
Simon Lawton-Smith, the King's Fund's senior policy adviser in mental health, said: "This is a welcome opportunity to debate the key issues and we will be looking carefully at the revised draft to see whether the concerns of many organisations in this field have been taken on board."
The King's Fund is part of the Mental Health Alliance, a coalition of over 60 service user and carer groups, charities and professional bodies.

MENTAL HEALTH BILL MUST PROTECT PATIENTS, NOT DEMONISE THEM - BURSTOW

Commenting on the re-draft of the Mental Health Bill, Liberal Democrat Shadow Health Secretary Paul Burstow MP, said:

"For the Mental Health Bill to work, the Government must have made changes to their earlier extreme and draconian Draft Bill.
"A new Mental Health Act is desperately needed, but it must be a law to protect and improve services for patients, not a means to demonise those with mental health problems."
libdems.org.uk

Q&A: Mental health laws
The government has re-drafted plans to change mental health laws after criticisms about earlier proposals for the enforced treatment of potentially dangerous mental health patients.
BBC News Online looks at what is in the new Bill.
What are the main changes being proposed by the government?
Doctors treating patients in the community who they believe should be forced to undergo treatment will be able to obtain a Mental Health Act Order.
The Act removes the need for patients to be sectioned - confined to hospital - in order to make them take their medication.
A new broader definition of mental disorder includes people with severe personality disorders. This will make it easier to force them to undergo treatment or to detain them, whether or not they have committed a crime, if there's a substantial risk that they will be a danger to themselves or to others.
But doctors would have to be able to justify that the planned treatment was clinically sound to a tribunal.
If treatment cannot be justified, but the person is deemed a danger to others, they should be referred to another appropriate agency, such as the police.
Why are they being proposed?
Ministers believe the current legislation doesn't go far enough to protect the public, or to provide safeguards for individual patients.
Existing legislation is out of date they argue, when the vast majority of people with mental illness are treated in the community rather than in hospital.
How do ministers believe these changes will improve on the current system?
Ministers say the proposals for new mental health tribunals and a new healthcare audit and inspectorate body will ensure that there are better safeguards in place than at present to ensure patients' rights are protected.
The argue the new powers will provide better protection to the public from those who are deemed a risk to others, by ensuring they receive the treatment they need.
It will also stop the so called 'revolving door' problem where patients in the community go in and out of psychiatric units because that's the only way to compel them to take their medication, according to ministers.
What concerns do mental health groups have about the proposals?
The Mental Health Alliance which represents around 50 of the largest mental health groups in the UK is gravely concerned about the proposals to extend compulsory treatment.
It says many people will be too frightened to seek help from mental health professionals because of the risk they'll be forced to take medication which would mean more people wandering the streets without help.
It also risks placing many hundreds of people under compulsory powers which could overwhelm mental health services, according to the Alliance.
It says new mental health legislation should have enshrined a right to treatment rather than broadening the sweep of compulsory treatment.
It pledged to use the Pre-Legislative Scrutiny process to present its own proposals for examination by the committee of MPs and Peers.
What happens now before they become law?
A committee of MPs will review the new draft.

Law Society condemns mental health bill

The Law Society today condemned government proposals for a new mental health bill. Chief executive Janet Paraskeva said that the bill does not help people suffering from mental health problems, instead concentrating on the perceived danger posed by those people. The society also says that the bill's definition of mental health is too broad, and that it could lead to a denial of human rights. As it stands, there is potential for epilepsy or even being drunk to be counted as mental disorders.
As part of the Mental Health Alliance, the Law Society believes care and treatment are the best ways to deal with mental illness.
thelawyer.com

Draft mental health bill explained
What is the draft mental health bill?
The bill sets out the government's proposed reforms of the 1983 mental health act, which campaigners have long argued is out of date. The first draft bill, published in 2002, proposed removing a legal loophole that allows up to 600 dangerous people with severe mental disorders to avoid treatment by arguing that they gain no benefit from it. It also set out plans to extend compulsory treatment, so it could be imposed on people being cared for in the community as well as hospital patients. These proposals were overwhelmingly opposed by mental health campaigners, charities, service users, carers and professionals, who believed they were draconian and would reinforce the misconception that people with mental health problems are dangerous. Ministers claim that a revised version of the bill, published yesterday, addresses these concerns.
guardian.co.uk 9 Sept
Why does the government want to reform the current law?
Ministers believe the current legislation neither provides enough protection to the public, nor sufficient safeguards for individual patients. The existing act was drawn up when most people with mental health problems were treated in hospital, whereas now the vast majority are treated in the community.
How does the bill change the definition of mental disorder?
The bill revises the definition of "mental disorder" to cover "a disturbance in the functioning of the mind or brain resulting from any disability or disorder of the mind or brain. Examples of a mental disorder include schizophrenia, depression or a learning disability". The 1983 act's condition of "treatability" would also be removed so that there would be no exclusion of people who have a sole diagnosis of mental impairment or psychopathic disorder, as well as sexual deviants and those hooked on drugs or alcohol.
Why do ministers want to remove the treatability clause?
The government first announced plans to detain psychopaths who have not committed a crime following the public outrage at the murder by Michael Stone of Lin Russell and her six-year-old daughter Megan in Kent in 1996. Stone had been left free to commit the crime because his severe personality disorder was considered untreatable and he could not be detained under the mental health act. Ministers estimated there were up to 2,400 similar people in the UK, which they described as having dangerous and severe personality disorder (DSPD). Although the vast majority are held in prison or a secure mental hospital, 300-600 live in the community.
However, official estimates of how many people have DSPD have gone up and down since the first draft bill was published. Some experts - including the vice-president of the Royal College of Psychiatrists (RCP), Dr Tony Zigmond, believe that there could be as few as a dozen people who meet the criteria in the community. He criticised the government for drawing up a new mental health law designed to deal with a dozen people that would affect 50,000.
Why does the government want to extend compulsory treatment?
The government says that allowing the compulsory treatment of patients in the community will help those caught in a "revolving door" of relapse and readmission because they fail to take their medication. Ministers claim that the revised bill will limit these extended powers, so that only patients assessed in hospital can be forcibly treated in the community. But Dr Zigmond says that the wording of the bill means that the assessment could have been carried out years ago.
How will the proposals better protect patients?
Patients will be allowed to choose their own representative, who until now has always been their closest relative. The use of compulsory treatment beyond 28 days will have to be authorised by a new independent mental health tribunal. At present this happens only if the patient lodges an appeal. The bill will also introduce a right to independent advocacy to ensure that detained patients' interests are properly represented. It also proposes new safeguards to balance the rights of the child and the rights of their parents, by giving young people aged 16 or 17 the right to refuse treatment. Their decision could not be overruled by their parents.
Why has the bill proved so controversial?
Both professionals and services users wanted a new bill to enshrine the right to assessment and treatment for people who wanted it and to reduce the amount of compulsion that already exists in the system. But the draft bill is regarded as widely extending powers to enforce treatment and/or detain people with mental illness or personality disorder.
Who was consulted about the bill?
In 1998 the government commissioned an expert review of the mental health act under Genevra Richardson, professor of law at Queen Mary and Westfield College, London, which recommended that any extension of compulsion should be balanced by improvement of rights and safeguards for the individual.
Although there are such improvements in the draft bill, professionals and service users say they go nowhere near far enough. Critics argue that the services provided to an individual would be determined by the level of risk they pose to others rather than as Prof Richardson proposed, the level of their mental capacity.
Which groups are opposed to the bill?
The bill has succeeded in uniting mental health professionals, charities and service users in condemnation of its proposals. Campaigners have set up the Mental Health Alliance (MHA), a coalition of more than 60 organisations including the mental health charities Mind, Sane and Rethink, the Law Society and the RCP. The MHA is opposed to the bill's "draconian new powers of compulsion". It was unimpressed with the revised proposals which it said risked bringing mental health services to their knees as hundreds more people were brought under compulsory powers.
What impact might the bill have on attitudes towards mental illness?
Campaigners fear that the bill's emphasis on managing risk will reinforce the public misconception that mentally ill people are dangerous. Richard Brook, chief executive of the charity Mind, said the proposed legislation would not deliver an effective and compassionate 21st century mental health service. He said: "It risks introducing fear and coercion into what should be a purely therapeutic relationship. It risks driving those who most need care and treatment away from seeking help as and when they need it most."
What happens next?
The bill will be subject to pre-legislative scrutiny by an expert parliamentary committee, which is due to report its findings by March 2005. This means the bill itself is unlikely to be introduced in parliament before the next general election.

BASW Press Release: THE MENTAL HEALTH BILL - BETTER BUT NOT NEARLY GOOD ENOUGH

The new version of the Mental Health Bill is an improvement on the 2002 draft, but despite the government's claim that it has listened to and learnt from the avalanche of criticism which greeted that draft, there is no evidence that it has been prepared to shift its ground significantly on the major issues of principle, and it remains a profoundly unsatisfactory measure which is still out of step with the rest of government policy on mental health.
In particular, BASW is concerned that:
· although the conditions for compulsion have been tightened, the examiners still lack the discretion not to detain when the conditions are met, and this is bound to result in the detention of a great many people who would not be detained under the present Act. In particular, it would force them to detain people who were neglecting their own health, for instance as a result of chronic alcohol or drug use, but who retained the capacity to make their own judgement about the risks of this; and there are of course tens of thousands of such people. At present, the Approved Social Worker (ASW) can take capacity into account as part of "all the circumstances of the case" but although this phrase has now been included in the Bill, it applies only to "the availability of appropriate medical treatment."
· although there is a promise that tighter entry criteria for non-resident assessment will be set out in Regulations, these are unlikely to be enough to satisfy BASW's concerns that this provision will be abused in places where there are not enough assessment beds for those who need them. BASW's view remains that compulsory non-resident assessment is both unnecessary and impracticable and that it ought to be deleted entirely from the Bill.
· although the government claims to have noted the concern of BASW that powers in respect of Tribunal applications and the operation of non-resident orders are entirely in the hands of clinical supervisors, and that other members of the multi-disciplinary team may therefore find themselves in a position where they are expected to implement decisions about which they have not been consulted or to which they are opposed, they have effectively brushed these concerns aside. BASW's position is that social workers should never allow themselves to be put in a situation where they are effectively forced to follow the directions of a member of another profession against their own professional judgement, and it will advise its members accordingly.

In respect of the Approved Mental Health Professional (AMHP),which is intended to replace the ASW, BASW is pleased that the local authorities will continue to be responsible for training and approval. However, there is no provision, once approval has been awarded, for the AMHPs to be legally accountable to the local authorities for their statutory work or for the authorities to have operational management control over them as they do over ASWs at present, nor is there any requirement in the Bill for them to ensure that a sufficient number of AMHPs is made available to carry out the duties laid down. Without these provisions, and given that most AMHPs will be NHS employees and that at least a high minority may well be from health professions, it is difficult to see how the local authorities will be able to influence practice after approval and to ensure that standards and quality of service will be maintained, let alone for them to guarantee the independent standing which is the most crucial element of the role.
BASW is also concerned that the government appears to have taken no heed of the repeated warnings that the present ASW role is becoming unviable, leading to a steady loss of practitioners which may soon result in the service breaking down in some areas, and that this problem will not be solved simply by opening-up the role to other professionals, who are unlikely to be any more keen than social workers to take it on in its present form. Nor has it addressed the difficulty of finding second doctors, which has been a chronic problem since 1959, is one of the factors which makes the ASW's job unnecessarily difficult, and is now about to get much worse due to the withdrawal of GP s from out-of-hours cover. Three years ago, BASW put forward proposals which would have gone a long way to resolving all these problems, but once again they have been ignored in favour of perpetuating the present unworkable system.
The government has at least recognised that its handling of the AMHP proposal in 2002 had a disastrous effect on ASW morale which has contributed to the loss of experienced staff, and it is now at pains to emphasise that it wants to retain both the ASWs themselves and their accumulated expertise. However, even if it can persuade them that they are still valued and wanted, it is unrealistic to expect that experienced ASWs, who have a wide variety of other employment opportunities and many of whom are within sight of retirement, will want to stay on to implement an Act with which they are not in sympathy and which they regard as flawed and impracticable, nor for the same reasons will newly-qualified social workers see it as a good career option. In view of the absence of discretion, it is still questionable whether the role of AMHP-examiner is compatible with social work's codes of ethics, and in this and many other respects, the government has a great deal more to do if it wishes to convince social workers that this is a role which is consistent with their professional values and aspirations.

Redrafted government plans on compulsory treatment for potentially dangerous mental health patients will alienate them from healthcare staff, according to the mental health charity Mind.

Scotland
Early-warning system for mental illness to pre-empt violence
FRONT-LINE medical staff are using a new method to spot people with mental health problems and offer treatment before they can become a danger to the public or themselves.
The early-warning system in Scotland has been introduced after a series of disturbing cases, including violent murders, involving people whose psychiatric difficulties were either not diagnosed or not dealt with properly.
theherald.co.uk 30 Aug
Information over a person's state of mind could be shared with the police if the patient agreed. Depending on the level of risk revealed in assessments, patients may be admitted for treatment. The system includes questions about sleep patterns, what makes people lose their temper, and how they have shown anger in the past.
One in four people in Scotland is thought to suffer from mental health problems at some point.
Practitioners say murderers such as Michael Stone and Christopher Clunis, who both carried out killings after being released following treatment for mental illness, could have been stopped if such assessments had taken place and information passed to other agencies, including the police.
A pilot project covering almost 1000 patients last year in the Argyll and Clyde area was deemed a success, and now doctors and nurses nationwide have agreed to implement the new assessment.
It is hoped that by encouraging more staff in GP surgeries and hospital casualty departments to look beyond a patient's physical state and employ the pre-emptive mental test, there will be a long-term reduction in violent assaults, killings, and suicides.
The process is voluntary, but it is hoped most patients would not resist help if a need were identified. Until now, dealing with mental health has tended to rely on extreme measures such as sectioning a patient who is obviously ill.
In the case of Stone, he was left free to murder Lin Russell and her six-year-old daughter, Megan, in Kent in 1996 because his severe personality disorder was considered untreatable and he could not be detained under the Mental Health Act.
Clunis, a schizophrenic, stabbed Jonathan Zito, 27, in the eye outside Finsbury Park tube station in London in 1992. The victim's wife, Jayne, founded the Zito Trust mental health charity after her husband, who was a musician, died. The results of the Argyll and Clyde pilot will be presented to an international conference in Edinburgh this week.
In his submission to the conference, Bill Stein, senior lecturer in the division of risk at Glasgow Caledonian University, says many violent offenders progress to criminal violence in stages and if caught at an early stage they can be helped.
Dr Stein said the pilot was very successful, but he believes front-line staff should become even more aware of symptoms and tools available to assess people. "One of the problems of violence prediction is that it was traditionally only done on those who have already fallen into crime. But there is a whole spectrum of conditions which really need some help. Apart from trying to help and cure them we need to think about the risk of suicide, neglect or violence and this may be harder to predict in a population who have not committed crime before."
Professor Kevin Gournay, of King's College London, who is also speaking at the conference, said: "Patients with a modest level of risk are often not picked up, but there is the potential to do so and tackle criminal behaviour much earlier. We have done reports on homicides by mentally ill people and the problem, time and time again, is that information has not been passed on to the relevant agencies."
The Scottish Executive said: "It is important that a patient's mental health needs are identified as early as possible so they can get the appropriate treatment and support."
But Dr Michael Smith, of the Royal College of Psychiatry, warned that violence should not be seen as a symptom of mental illness. "Alcohol and drugs are far more effective indicators of violent behaviour."

Reforming Mental Health Law
Scottish Executive Newsletter 4 - July 2004
Welcome to the fourth edition of the Scottish Executive's newsletter, 'Reforming Mental Health Law'.
There are now less than 9 months to the implementation of the Act in April 2005 and 3 months to the introduction of the provisions allowing people to appoint a Named Person and draw up an Advance Statement.
This newsletter tells you about the work which the Scottish Executive is undertaking to implement the Act and to establish the new Mental Health Tribunal. It also includes an update on the development of the Joint Local Implementation Plans.
News in Brief
· The consultation on Volume 1 of the draft code of practice ended at the start of July with over 70 responses. These were from a wide range of groups and we would like to offer our thanks to all for their constructive input.
· The consultation on Volumes 2 and 3 of the code of practice is now underway, more details inside. We look forward to your continued support in the development of the code. If you would like to take part in this consultation exercise please e-mail or telephone the Mental Health Law team, contact details on the back page.
· The appointment process for the Tribunal President is now underway with the first advertisement appearing in the Sunday press on 27th June. We hope that the successful candidate will take up the position in early 2005.
· The announcement on the location of the headquarters of the Mental Health Tribunal was made on 26th March. The headquarters are to be sited in South Lanarkshire.
· There was a successful event at Tynecastle Stadium on 27th May on the Joint Local Implementation Plans, attended by the Minister for Health and Community Care Malcolm Chisholm. This provided a valuable opportunity to share progress to date as well as challenges.
·
Implementing the new Act
Communications
In addition to continuing these newsletters, the Scottish Executive is working with the Mental Welfare Commission (MWC), Scottish Association for Mental Health (SAMH), and others to develop further communications on the Act. This will include guides to particular topics - such as Named Person, Advance Statement - as well as ensuring that information is in an accessible format for those whom English is not their first language or who would prefer the information in another format, for instance, on a tape. Materials are also being developed to help people who will be required to attend Tribunal hearings to understand the process and how the Tribunal hearing will proceed on the day.
The Code of Practice
The first volume of the Code of Practice which covered the civil compulsion procedures was issued for consultation early in April. Responses to this consultation were required to be with the Executive by 2nd July. Volume 2 of the Code of Practice will cover the remaining civil provisions and Volume 3 of the Code, which will cover criminal procedures and offenders in the mental health system, will both be published in early July.
Two months will be allowed for consultation with responses to be returned to the Executive by the end of August. We will be consulting on the Regulations which relate to each part of the Code at the same time, as with the first part of the Code. Our plan is still to have a final draft version of the Code available for training purposes in the autumn. The Code itself must be laid before the Scottish Parliament after which it can be published in its final form. We will be looking to see how we can help make the final Code as easy to navigate as possible.
Future work of the team includes looking at the transition of orders under the 1984 Act to orders under the 2003 Act.
Training on the Act
MHOs
Directions to be made under section 32 of the Act will specify the registration, education and training experience and competencies which are required of someone appointed as a Mental Health Officer (MHO) to carry out functions under this Act and the Adults with Incapacity (Scotland) 2000 Act. We will shortly be consulting on the content of these directions.
Early in 2004 the Scottish Executive commissioned The Robert Gordon University to produce material for a 5-day training course for mental health officers. The development of these training materials is almost complete and in early June The Robert Gordon University and the Scottish Executive hosted a 2-day pilot walk through of the training materials with potential training providers and MHOs. The material will be revised as a result of this work.
AMPs
Under section 22 of the Act directions will also be made specifying the qualifications, experience and training required by Approved Medical Practitioners (AMPs) before they can be included on a Health Board's list of AMPs. We are currently consulting on the content of these. With the support of the Royal College of Psychiatrists, Dr Mark Taylor and Dr Judith Halford are being seconded to the Scottish Executive on a part-time basis. They will work with colleagues in NHS Education Scotland (NES) to develop training material for a 2-day course for AMPs. At present it seems likely that this will consist of one day self-directed reading and a one day on-site training course. General Training

Earlier this year NES, with the help of Carol Dobson, carried out a scoping study to inform the production of training materials for health professionals and others. These materials are currently being developed by NES. It is planned that they will be available on the NES website and in other formats. These materials will be freely available for health and other organisations to use in training their staff and will be designed to be used in self-directed learning. NES are currently recruiting a new training co-ordinator to promote these materials and to support local areas (through the JLIP Team) in delivering training and awareness on the new Act.
Tribunal Service
Since the last newsletter update a lot of work has being going on behind the scenes to put the necessary processes, people and facilities in place to enable the new Tribunal to work effectively from day 1 of operation.
The Minister for Health and Community Care has announced that the Tribunal Headquarters will be in South Lanarkshire and we are in the final stages of selecting suitable office accommodation. The President and about 35 staff of the administration arm of the Tribunal will be based at the new office which should be ready by December. In addition to the staff based at the central HQ, we will be recruiting around 15 staff to be based across Scotland providing local support to participants at the hearings venues provided by Health Boards and Local Authorities.
We are sizing the new organisation on an estimate of 3,500-5,000 cases per year, and have taken account of the effort that will be needed in the first year to support the volume of cases moving over from the 1984 Act.
Regulations on the President's and Legal members' minimum qualifications have been laid before the Scottish Parliament. The process for appointing the first President of the MHTS started with the advertisement appearing in major newspapers at the end of June. The President's commitment in the early years of the Tribunal's establishment is essential, and we are therefore seeking someone who can accept the appointment on a full-time basis.
The implementation date for the Tribunal is April 2005 and we hope the new President will be able to take on duties, at least on a limited part-time basis, very soon after the appointment is confirmed - ideally no later than January 2005.
Advertising for Legal members is scheduled for later in the summer. We are currently consulting on the Medical and General members regulations and plan to have these laid after the Parliament's summer recess, allowing us to advertise for these member groups later in September. We need to recruit around 300 members in total. As with the President, members will be public appointments. Tribunal members will need to be available for hearings work at least 2 days a month and be flexible as to where they may have to travel. In some areas we may require higher number of days commitment, depending on the response to our advertising campaign.
If you are interested in finding out more about the new Mental Health Tribunal for Scotland watch out for the new website due to be launched later in the summer. In the meantime we can be contacted by email: mhts@scotland.gsi.gov.uk
Mental Health Law Research Programme
The analysis of the responses to the consultation exercise on the Mental Health Research Programme was published in hard copy and on the Scottish Executive website in February 2004. The analysis of responses has helped to identify the priorities for research and the action matrix, which was included in the document, allows stakeholders to see how the Scottish Executive intends to address their broader concerns and requests for information. Building on this momentum the pre-enactment research programme is already underway, gathering reliable information on how current mental health law is working. With this evidence, it will be easier to measure whether and how the changes brought by the new Act are benefiting all stakeholder groups.
· A Research Literature Review is gathering together what is already known about the workings of mental health law in Scotland, the rest of the UK and internationally on important relevant issues. This builds on and updates earlier reviews.
· A second project will analyse the views of stakeholders on the draft Code of Practice (and the accompanying Regulations) invited through the consultation exercise presently underway. This piece of research will allow the Scottish Executive to fine-tune the Code of Practice before enactment in April 2005.
Future work will focus on a deeper analysis of monitoring figures routinely collected. Bringing together information presently held in different databases to allow a more complete picture of the usage of mental health law across Scotland, and trends over time. Work will also focus on the experiences of all stakeholder groups and their expectations of the new Act.
Coming months will also see the publication of the Mental Health Law Research Programme Strategy which will provide information about all research planned both pre- and post-enactment of the new Act (although the programme will remain flexible to allow changing priorities to be addressed). A research programme advisory board (including representatives of all stakeholder groups) will be set-up to provide guidance and advice to the research programme as it develops. We welcome any comments or queries on the research programme and if you would like to get involved in any aspect of research please e-mail rosemary.rushmer@scotland.gsi.gov.uk
Mental Health Law Team
Scottish Executive Health Department
St Andrew's House, 3EN
EDINBURGH
EH1 3DG
e-mail: mentalhealthlaw@scotland.gsi.gov.uk .
website: www.scotland.gov.uk/health/mentalhealthlaw
To order paper copies of this newsletter, please contact us by e-mail at mentalhealthlaw@scotland.gsi.gov.uk or phone 0131 244 2591.

Mental health patients at risk from new legal rights

FEARS that shortages of staff and secure units will threaten new legal rights for mental health patients have been raised by one of Scotland's leading experts on the issue.
Dr Sandra Grant, former chief executive of the Scottish Health Advisory Service, has spoken out after investigating Scotland's preparation for the new legislation.
Solicitors have warned that the Scottish Executive could face compensation claims if patients are denied rights they should receive under the measures due to arrive in stages.
One potential problem is patients being held in the State Hospital at Carstairs, even though doctors have said they are well enough for lower security units. A shortages of psychiatrists also has been highlighted as a possible problem.
Patients will have new rights of appeal from April 2006, but at least two of the new medium secure units planned for Scotland - one in Tayside and one in Paisley - will not be ready. Psychiatrists are understood to have declared that 44 patients are ready to leave Carstairs.
Dr Grant said: "It is unfair if someone is well but continues to be detained . . . Potentially, if the same offence had been committed and they were not ill then they would be released.
"I think there will be a clear legal interest in supporting people. We are talking about human rights."
Under the new act, described by Dr Grant as one of the most forward-thinking in the developed world, mental health patients compulsorily detained in hospital (known as sectioning) will be entitled to a tribunal where a plan for their treatment will be put before a panel. Psychiatrists will be needed to staff the panel and to outline treatment proposals at the tribunals, from next April.
However, it is understood there are 45 vacancies for consultant psychiatrists in Scotland, and the Royal College of Psychiatrists has suggested an extra 30 staff are needed to cope with the new act, and laws restricting staff working hours. Dr Grant has warned in her report for the executive that the shortage is likely to worsen.
Dr Michael Smith, a consultant psychiatrist, also warned that patients who are not being detained could miss out under the new laws. He said: "It is a real, real worry for us. We could spend all our time doing detentions." He said he recently had to cancel a clinic because he had to attend a sheriff court for a day and a half to present the case for detaining a patient.
With the new system occupying double the number of psychiatrists, the fear is even more patients may lose out.
Dr Grant said: "The reality is there are not enough psychiatrists, there are not enough mental health officers, and there are not enough advocates (for patients). That's where service redesign comes in."
However, she added later: "I do not think service redesign can do everything."
Dr Grant said: "Implementing the act is going to be really quite difficult and that needs to be acknowledged . . .
"Part of the difficulty is there are so many initiatives going on, the European working time directive on working hours, service reorganisation, I think there is a worry the mental health side will lose prominence, go on the back burner."
Shona Neil, chief executive of the Scottish Association for Mental Health, said Dr Grant's report presented a "catalogue of non-delivery for service users and carers".
She said: "My fear is if people are not ready to enact this legislation seriously on April 1, those principles will be stuck to the wall . . . we owe our cousins, our family members, our lovers who have mental health problems, and ourselves, more than sticking the principles to the wall."
A spokeswoman for the executive said they were working with psychiatrists to raise capacity in the profession. She added that local level plans were in place covering the arrangements required "for a successful and timely implementation of the new act".
theherald.co.uk 23 Aug
Newsletter for Mental Health Officers in Scotland

From the Association of Directors of Social Work, the Social Work Services Inspectorate and Community Care Works. Issue 6 Summer 2004
Featuring:
Minister's statement to Parliament calls for national and local action to ensure the protection of vulnerable adults.
Medical treatment under the Mental Health (Care and Treatment) (Scotland) Act 1984 and the Adults with Incapacity (Scotland) Act
2000 Direct payments, independent living and mental health
Opposed guardianship application
Reviewing mental health officer services to meet increasing legislative demand
A user's view of the mental health act
Interaction between the law and codes of practice

MENTAL WARDS 'NOT FOR KIDS'

Jul 8 2004

AN MSP is calling for a stop to children being placed in adult psychiatric wards.
This week, Scottish Socialist MSP Rosemary Byrne lashed out during a parliamentary debate and said youngsters were at risk.
She said: "The news that young people continue to be placed in adult psychiatric wards is to say the least extremely disturbing.
"Recent reports have revealed that, over the past year, 144 under 18s, including 28 under 16s have been placed in wards where many have been subjected to "verbal aggression, violence and inappropriate sexual behaviour."
"This is extremely worrying with major implications for young people with mental health or other social problems.
"During the progress of the Additional Support for Learning Bill in the Scottish Parliament I made clear my concerns over the shortage of clinical psychologists and mental health workers in child and adult mental health services.
"The number of suitable in-patient beds in Scotland for children with psychiatric illnesses has fallen from 58 to nine over the past nine years with the beds concentrated in just one hospital. The number of beds for adolescents has fallen from 67 to 48 over the same period. This trend must be reversed.
"Mental health services for young people must be increased in every health board area or the expectations implicit in the Additional Support for Learning Bill will not be fulfilled and our children will continue to suffer."

Prejudice against mentally ill still common in Scotland

NEW research has shown that three in five Scots believe that someone with a mental health problem would be unable to look after children.
Previously unpublished re search by the anti-stigmatisation See Me campaign also reveals that more than half of those polled say someone with an illness such as depression could not hold down a job as a bank manager; 47% say the person would be unable to work as a managing director; and 43% believe he or she would be unable to be a nurse.
The same research showed that only 5% disputed that people with a mental illness could be cleaners or labourers, and just 10% said they would not be able to be checkout assistants.
The survey, carried out during May, is the most up-to-date investigation of the public's views on mental health and the workplace in the UK.
In all areas of employment, women were perceived to be able to cope better than men in a job if they suffered from mental health problems. However, in the job of childminder the majority of Scots believed that men and women with mental health problems would be unlikely or very unlikely to be able to look after children.
Linda Dunion, director of the See Me campaign, said the results highlighted the stigma that still surrounds the issue of mental health in Scotland. She said: "The findings reinforce the fact that the public's attitude towards mental ill-health and people who experience it are negative.
"When you examine the kinds of jobs the public expects people with mental health problems to do, it shows that people have low expectations of them. The reality is that people who have illnesses such as depression or schizophrenia are perfectly capable of holding down jobs."
The research aims to expose the myths that surround mental health problems. Research ers involved with the study say that despite one in four Scots suffering mental ill-health at some point in their life, stereotypes about people with problems being unable to cope prevail.
News of the study comes as a campaign to overturn prejudice against mental illness at work is launched tomorrow. A radio advertising campaign by See Me, an alliance of five mental health groups, will run across the UK, with materials to discourage discrimination in the workplace distributed to businesses.
Separate research carried out by the group last week revealed a catalogue of abuse and intimidation at work experienced by 38% of Scots with mental health problems.
Of those, 67% said their bosses were responsible for the abuse and 32% said their colleagues had behaved badly towards them.
Dunion added that most managers would be "horrified" to discover such behaviour among their staff. She urged employers in Scotland to ask themselves if they could be sure it couldn't happen in their workplace.
Dunion said: "Many managers don't encourage their staff to be open about their mental health problems because it's seen as too much of a risk to the employee if they do. But that means the safeguards are not in place, so they are abused, patronised and ridiculed by their colleagues.
"People should not be written off just because they have a mental health problem. We know that 70% to 80% of people do recover, and come back to their old jobs and carry on with them successfully."
Julie Mackay, an assistant clinical nurse manager in NHS Grampian, said she managed to come back to work and secure promotion after going off sick for six months with severe depression and post-traumatic stress disorder.
The 31-year-old, who was then a community psychiatric nurse, became ill with anxiety and depression after her parents split up, she was assaulted in the street and her own relationship ended, all around the same time in her life. She says her illness was so bad that in the end she was "in a worse state than the people I was treating".
She said: "I would take panic attacks that would immobilise me, and because I was a nurse I knew exactly what was happening to me. My colleagues knew I was struggling and they sent me to the occupational health service.
"After treatment for six months I came back and got a job managing nursing services in the Moray area. Having a mental health problem does not alter your professional abilities. It may stop you from carrying out your duties at the time of the illness, but so would a physical injury like a broken leg. I've not had a day off since I've been back."
See Me's campaign will include roadside billboards as well as posters at commuter thoroughfares. It will also be working with organisations such as Scotland's Health At Work and the Federation Of Small Businesses to educate managers and recruiters about how to help staff with mental health problems.
CRIMINALLY INSANE TO GO TO REGIONAL MENTAL UNITS
More than half of the mentally-ill inmates detained at Carstairs State Hospital are to be sent back to their home regions to be cared for.
Sites in Perth and Aberdeen are being proposed to receive all north and north-east prisoners eligible for a transfer from the 250-bed high-security unit.
But there are serious concerns that the new medium secure facilities for northern Scotland will not be ready in time. Health chiefs will then be open to legal action from the offenders, who could claim up to £30,000 each if a place is not found for them after spring, 2006.
While classed as medium security, many of the offenders may well be a danger to themselves and the public, according to the consultant leading Tayside's part of the project.
The Scottish Executive has failed to provide an explanation of what security will be available at the units, and which prisoners will be eligible to be based there.
It is understood mentally-ill patients from the region could end up sharing a ward with offenders, as currently happens at Carstairs.
Mental health campaigners welcomed the move towards medium secure units yesterday saying it would help improve the treatment of the mentally ill.
The transfer of medium secure prisoners was sanctioned by the Scottish Executive last year. In their new mental health legislation they ruled that by May 2006, all prisoners with mental problems should not be detained at institutions with excessive security.
Four new medium secure units are to be built across the country to house the offenders.
Tayside, Grampian, Highland, Orkney, Shetland and the Western Isles have been told to work together to build facilities to take their offenders. Fife has also joined forces with the region.
Under the new legislation, mentally disordered offenders remanded by the courts, and those currently in mainstream prisons, will also have to be provided for.
Board members of NHS Tayside yesterday heard that it was estimated 50 beds would be needed for the north and east.
But female offenders with mental problems and all offenders with learning disabilities at Carstairs have not yet been taken into account, though they too will have to be provided for.
While having the highest demand for beds in Scotland, the north and east are the furthest behind in their preparations. While Edinburgh has already built its unit and the other two regions are not far behind, the north and east are only at the beginning of their decision making process about their facilities.
The report before the board yesterday, stated: "It is almost certain that a regional service will not be commissioned by May, 2006."
The earliest estimate it will be ready by is December, 2007. This will leave the region's health boards open to legal action.
Currently the favourite options being discussed are Aberdeen's Royal Cornhill Hospital and Perth's Murray Royal Hospital.
Health chiefs could choose one or other of the sites, but also have the option of choosing both with offenders shared between the two locations.
The health board also agreed to consider private provision of the service.
The unit would cost up to £11.5million to build, with each bed costing the board and local authority £100,000 a year to run.
Speaking about the kind of offenders who will be housed at the facilities, Dr Helen Kirk, the consultant psychiatrist with NHS Tayside leading their part of the project, said: "Although for shorthand purposes they are known as mentally disordered offenders, they are in fact extremely mentally ill people who, either because they haven't come to the attention of mainstream services, or their needs haven't been met, end up in the criminal justice system. It is our job to extract such people from the criminal justice system."
Commenting on the risk such patients pose the doctor said: "They may be a danger to others as well as a danger to themselves."
The Scottish Association for Mental Health yesterday backed the setting up of the medium secure units.
Director of policy Richard Norris said: "We completely support the strategy. This will provide the best environment for the mentally ill to get better and will be best for everyone all round."
NHS Tayside have now approved the initial proposals as have NHS Highland and Orkney.
NHS Grampian will vote on the initial proposals on July 6.
thisisnorthscotland.co.uk 25 June

Action needed to improve care for people with schizophrenia

A searching three-year inquiry into the performance of services for people with schizophrenia in Scotland has found that there continues to be far too much variation in the standard of care offered across the country.
Many people with schizophrenia will experience symptoms of varying degrees for many years and will require help from a range of different agencies, often at the same time. Good co-ordination and continuity of care lie at the heart of an effective service but this is failing to happen in too many places in Scotland.
The national review carried out by NHS Quality Improvement Scotland (NHS QIS) found that some progress is being made in improving services and there are many examples of good practice and innovative developments across Scotland. However, service development continues to be hampered in many places by a lack of accurate record keeping, poor continuity of care, incomplete care planning and insufficient support for patients and carers.
The report found wide variations across Scotland in the composition of community based mental health teams. Only a few of these teams included staff such as occupational therapists, psychologists and social workers who are important in helping people with schizophrenia.
Concern is also expressed at shortcomings in the system of identifying and recording who has the illness and who is looking after them. The review found there are 12,000 people in contact with services. However, no NHS organisation has a system to record all those with a diagnosis of schizophrenia and the actual number of people with the condition is likely to be higher than this figure. The report expresses concern that people who could benefit from services may not be getting the help they need.
Schizophrenia is a serious and common mental illness which affects not only those diagnosed, but their carers and families as well. There are an estimated 1000 new cases in Scotland expected every year. It affects people in different ways and it is difficult to predict the course the illness will take. There is no known cure but the illness can be managed with a combination of medication and psychological and social therapies. The illness is one of the most costly conditions for the NHS to treat.
The report marks the culmination of a three-year inquiry into the performance of services for people with schizophrenia in Scotland. It has been conducted in two phases - the first report of performance against six agreed care standards was completed in March 2002. The report published today (June 14) examines performance against the remaining five standards and provides an update on the progress of the recommendations made in the earlier report.
It highlights the importance of developing a local, co-ordinated approach through a system known as an Integrated Care Pathway which uses standardised methods to assess need and plan care. To date, ICPs have only been developed by a minority of mental health services in Scotland. Similarly, little progress has been made in extending the use of psychological interventions, and offering life and social skills training to people with schizophrenia.
The report found five key areas that require action:
o There needs to be a greater multi-disciplinary approach to documentation
o NHS Boards need to develop and implement ICPs
o Mental health teams need to be multi-disciplinary with a full range of skills
o Comprehensive assessments are required to identify the needs of people with schizophrenia and their carers.
o Continuous data collection systems need to be introduced across Scotland
It calls on NHS Boards to review the make-up of mental health teams and to develop ICPs. It recommends that a new mental health data collection system be introduced in Scotland covering both hospital and community services. It also urges the Scottish Executive to review the progress made in addressing the problems identified in the report.
Dr Linda Watt, Divisional Medical Director for Mental Health and Learning Disabilities in Greater Glasgow, who chaired the review group, said:
"Good information is fundamental to the effective care of people with schizophrenia. Knowing who needs which services and monitoring whether their needs are met offers a real opportunity to improve the quality of life and care for people with schizophrenia and those who care for them.
"This report, together with its predecessor, has given us an unprecedented amount of information about how services are performing. It shows that some progress is being made but that much remains to be done. It can now act as the spur to introducing further improvements throughout Scotland for this important group of patients and their carers."

The chairman of the NHS Quality Improvement Scotland Lord Naren Patel said:
"This is a very important piece of work which has highlighted where services need to improve. It is very disappointing that recommendations made in 2002 have still to be implemented in many parts of Scotland. The same key messages are repeated in these latest findings. It is vital that action is taken now by those responsible for mental health services to improve the care of people with schizophrenia. NHS Quality Improvement Scotland intends to target efforts on mental health services and will continue to monitor progress across Scotland to ensure that services improve."
First Summary of a National Overview:
NHS QIS has taken the opportunity with the review of services for people with schizophrenia to produce our first shortened summary of a national overview. The booklet has been designed to communicate our findings to a wider audience. Schizophrenia: a review of schizophrenia services in Scotland, will be available to a broad range of healthcare professionals, service users and carers to let them know about the work being done on the care and treatment of schizophrenia in Scotland.

Mental Health Tribunal for Scotland
26/03/2004
South Lanarkshire will be the location for the headquarters of the Mental Health Tribunal for Scotland.

The new body was established under the Mental Health (Care and Treatment) (Scotland) Act 2003 to make and review decisions on the care and treatment of people with a mental disorder.

Health Minister Malcolm Chisholm announced today that the new headquarters will carry out the administrative support for the Tribunal, such as handling applications to the Tribunal and arranging dates and locations for each hearing.
The Tribunal system is scheduled to begin hearings in April 2005.

Health Minister Malcolm Chisholm said:
"I am pleased to announce today that the headquarters will be based in South Lanarkshire and that with this decision we have taken another step forward on the road to implementing this ground-breaking Act.

"Under the new legislation, hearings for those with mental health disorders will take place in a tribunal setting specifically designed to deal with these cases rather than in Sheriff Courts as in the past.
"This is a fundamental change and provides for a more inclusive process for patients, carers and the health professionals involved, with hearings in the hospital where the person is a patient or as near as possible to the patient's home."

The new office will create, initially, 20 new jobs with the majority of the new workforce expected to be recruited locally.

The siting of the office in South Lanarkshire is in line with the Scottish Executive policy of dispersing jobs throughout Scotland.
Deputy Finance Minister Tavish Scott, who has responsibility for the dispersal policy, said:

"I welcome the choice of South Lanarkshire as the location for the Mental Health Tribunal for Scotland. It is further evidence of the Executive's determination to ensure that public sector posts and the benefits they bring are spread throughout the country."
A suitable property will be identified in South Lanarkshire over the next few months

PROTEST AGAINST THE GOVERMENTS MENTAL HEALTH PROPOSALS:
SEND A MESSAGE IN A BOTTLE……………

We're asking people to take their empty psychiatric medication boxes and bottles and hand them back to the government. WHY!!!!

As you may or may not know, this government is currently pushing for controversial and draconian plans to reform the Mental Health Act of 1983. Concerned about the proposed changes and sick of being ignored, a number of psychiatric users and survivors have decided to get together and organise a direct, peaceful protest. As a part of this ongoing effort, they are asking people to send a message in a bottle- to take part in a firm rejection of the government's wish to impose yet more forced drugging and compulsion. If you would like to contribute towards this protest, simply collect together as many EMPTY psychiatric medication boxes and bottles you have lying around, write a message of protest on the back or on a note placed inside and then send them to;

REF; BOX COLLECTION (PROTEST MHB)
C/O LTTV
P.O. BOX 472
LONDON WCIX 9NB
( *Please see disclaimer under more information)

General guidelines on how to do this;

1) Use a biro to obscure your name from the pharmacy label/s (for reasons of privacy)
2) If you wish, write a message of protest on the back of the medication container, or write a note and place it inside the medication box or bottle.
3) Place everything in an envelope and send to the above address
4) You can send them just one psychiatric medication box/bottle, or as many as you like. If sending bottles please ensure they are well wrapped in newspaper to avoid breakages.

Once they have collected enough bottles and boxes, they will then present them to the government as a firm rejection of their move towards yet more forced drugging and compulsion of people with severe mental stress. WE WANT TO SYMBOLICALLY "GIVE BACK" what they impose upon us, and send a powerful message to the government that forced medication in the community is NOT the answer.

For more information on the above please contact the following;

On the web; http://groups.yahoo.com/group/protestagainstthementalhealthbill/
OR/Telephone symon on 07792 064974

* Disclaimer LTTV does not necessarily support or promo