UK's New Mental Health Bill
http://politics.guardian.co.uk/columnist/story/0,9321,817397,00.html
_The Guardian_ - Oct. 23, 2002
Comment
Stop this madness
The new mental health bill is so bad, psychiatrists and 'mad pride'
activists have joined forces to fight it
Jonathan Freedland
You are in hospital with, say, appendicitis. Suddenly the patient in the next
bed makes an insulting, racist remark. You complain and yet it is not your
abusive neighbour who is moved off the ward but you. You complain about that
too, but you are shouted down. You feel your rage rising and you lash out,
hitting a nurse. Suddenly five members of staff are tackling you to the
ground, holding you face down on the floor: a nurse for each arm, two more
across your lower body and another holding your ankles. They are waiting for a
doctor to inject you with a sedative, but no doctor comes and all you can feel
is the crushing weight of five people on top of you. You can hardly breathe.
You cry out, warning that they are going to kill you. But still they hold you.
You begin to turn blue. Eventually, after 25 minutes, they need restrain you
no longer. You are not struggling now, but are perfectly still. You are dead.
Remember, you were not a mass murderer who had to
be restrained lest you kill again. You had committed no crime. You were merely
a patient in a hospital, seeking medical treatment. That's what you came in
for - what you got was a violent and terrifying death.
And that, more or less, is the story of David Bennett. He was known since
infancy as Rocky by his parents, because he'd always been such a resilient
baby. But he got ill, and that's how he ended up in the Norvic Clinic in
Norwich. There's one more crucial fact about Rocky: he wasn't in for
appendicitis. He was in for a mental health problem.
And that, I'm afraid, is the heart of the matter. Different rules, it seems,
apply to the mentally ill: in the most literal sense, liberties can be taken
from them that we would fight to protect for everyone else. People are denied
basic human rights - control over one's body, freedom of movement, free
expression - simply on the grounds that illness has struck them in the head
rather than the body.
This week an independent inquiry has begun examining Rocky's death. It will
attempt to explain why it is that mental patients, especially black ones, keep
getting killed while being "restrained" by medical staff. But hopefully it
will do something more: reminding us that there is something badly wrong with
the way society treats the mentally ill. Not that "us" and "them" are so
separate: one in four of us will experience a mental health problem at some
point in our life.
So we should all have our ears open today, when hundreds of representatives of
the Mental Health Alliance descend on parliament to lobby against the
government's new plans for those who have trouble in the head. It is a tribute
to Labour's ineptitude that it has managed to unite every one of the normally
warring factions of the mental health world in angry disapproval of its new
bill. The Royal College of Psychiatrists will today walk hand-in-hand with the
"mad pride" activists who usually rage against the medical establishment. What
brought together this rarest of coalitions? "The fact that the bill's so
terrible," says alliance chairman Paul Farmer. Campaigners call it the
Dangerous Men Act, because that's how the new legislation sees all those with
mental problems. It's a good nickname, because it neatly recalls the notorious
Dangerous Dogs Act - a law so ill-thought-through, it had to be put down.
The new bill seems designed, above all, to solve the Michael Stone problem. He
was the man who murdered Lin Russell and her daughter, Megan, in 1996; he was
at large because he had a personality order that was untreatable, and so could
not be detained. The new legislation would seek to close that loophole, giving
the government preemptive powers to lock up people who have committed no act
of violence, but who seem likely to in the future.
That may chill civil liberties purists, who see it as a step on the way to a
dystopic, Minority Report world where criminals are arrested in advance, but
that is not the mental health activists' complaint. If there is a case for
preemptive action, they say, it should apply to the people statistics show are
most likely to commit murder: namely alcoholics, serious drug-abusers or
compulsive wife-beaters. If the government wants to redesign the criminal
justice system to allow the arrest of people statistically bound to kill, go
ahead - just don't single out the mentally ill. "Otherwise, it's
discrimination, pure and simple," says David Crepaz-Keay of the Mental Health
Media pressure group and himself a "survivor" of the psychiatric system.
He has a similarly dim view of the second key thrust of the new bill, which
seeks to increase doctors' powers to force patients to take medication. This
too is a response to a widely publicised death - that of young musician
Jonathan Zito, who was stabbed in 1992 by the schizophrenic Christopher Clunis.
In the run-up to the killing, Clunis had stopped taking his drugs.
It sounds like an obvious move to make, requiring the ill to do what is both
for their own good and in the interest of public safety. Except it's not quite
as simple as that. "This legislation assumes that doctors always know best and
that drugs are a magic wand that makes everything better," says Crepaz-Keay.
Drugs work well for about a third of patients, he says, and have some effect
on another third. But for the rest they have no effect at all. "I was part of
that final third. Not a single drug stopped me seeing and hearing things."
But they do have side-effects, whether it's damage to the liver, heart and
respiratory systems, symptoms of Parkinson's disease or impotence, weight gain
and even lactation in men. It's no wonder so many patients go to extreme
lengths to avoid taking their medication: they find the cure much worse than
the disease. Indeed, it's only once off the drugs that they can start living:
Crepaz-Keay is now married and successfully employed. If he was still taking
the pills, "there's no way I'd have the life I do now". Besides, for every
Clunis there are cases of homicides committed by patients who had faithfully
taken their medicine.
Of course, there are times when compulsion is essential - the only way to stop
someone in acute distress from hurting themselves or others. In those moments,
say campaigners, force can and should be used. But that should not be a
licence to deprive the patient of autonomy and liberty ever after. Instead
when the mentally ill are in a lucid period they could draw up "advance
directives", detailing how they want to be treated when they are next in
distress and in no position to speak: it could work on the same principle as a
living will.
There is no shortage of solutions here, most of them generated by those who
know the psychiatric system best: the people who have used it. There are
630,000 Britons in that situation today. To draw up legislation for all those
people by looking only at the handful who commit acts of violence would be a
terrible injustice. That's why we should see today's demonstration for what it
is - not merely a lobby by a disadvantaged group, but a protest in what is
shaping up to be the last great struggle for civil rights.
e-mail: <j.freedland@guardian.co.uk>
- in the U.S. -
Note more information on this topic is available from the Conservative Caucus
Foundation website:
http://www.conservativeusa.org/psych-fraud.htm
Last Updated on
04/08/04
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