I survived mental illness

I Survived Mental Illness

BBC News Online June 25, 2002

The government plans to give doctors in England and Wales the power to lock up people with severe mental illness and force them to receive treatment against their will. Rufus May, 33, is a clinical psychologist working with people with mental illnesses in Bradford. He has also been treated for schizophrenia himself. This is his reaction to the government's new tough approach to mental health.

I was diagnosed with schizophrenia in 1986. I was 18 years old.

I would have loved people to have negotiated my care with me - worked with me rather than doing treatment to me.

Instead they were not able to treat me as an equal and it felt like I was subhuman.

It filled me with despair.

The only way I could have power was to be mad and be difficult and challenging.

Of course, I was very confused. But no-one tried to help me make sense of what was happening.

I was put into hospital three times against my will

I've learnt through my work that even when people are at their most distressed you can still work with them.

You need to give them clear feedback about what's going on and involve them in their treatment.

If you don't, you break their spirit.

'Doctor knows best'

It definitely made me worse.

I was put into hospital three times against my will. And when I got on with the medication, I tried to work with my psychiatrist.

I was 19 and at college studying art but I couldn't draw a straight line so I wrote to him and asked for my medication to be reduced. He refused point blank.

So I moved away and managed my schizophrenia on my own. I finished my degree and then did a doctorate in clinical psychology.

Under this new legislation, that psychiatrist could have had me detained and forcibly drugged. The emphasis is the 'doctor knows best'.

If you treat people like children that is all they will become.

If I had listened to the doctors, I wouldn't be a psychologist now. I wouldn't have been able to do this on the medication.

It would have been a liquid strait jacket.

I'm not anti-drugs but I think all treatment should be individual and give patients a choice.

All the research from recovered people like me shows that people need to be given responsibility.

If you treat people like children that is all they will become.

It's very easy to become institutionalised and a permanent, dependent psychiatric patient.

'Marginalised group'

Usually young people don't get out of the system because they've got no other way of defining themselves.

I think the government is exaggerating the link between mental health problem and violence.

Violence by people with alcohol or drugs problems is far worse but you don't see them being institutionalised. There would be an outcry.

This is a group which is already marginalised and is an easy target.

I can't see this making any difference to my job or to the people I work with who have mental health problems, except to make them trust us less.

Source: http://news.bbc.co.uk/hi/english/health/newsid_2066000/2066378.stm

Tough new approach to care of mentally ill draws criticism
Patrick Wintour Monday June 24, 2002 The Guardian

Tough rules requiring some mentally ill patients to be locked away in secure hospitals for long periods are due to be outlined today in a draft mental health bill published by the Department of Health.

Mentally ill people living in the community who fail to take prescribed medication could be forcibly detained and taken to hospital for prolonged treatment.

The bill, the biggest reform to mental health policy since the second world war, marks a partial shift away from the now discredited care in the community programme.

The NHS plan claimed to make improvements in mental health one of its top priorities. The government had promised legislation as long ago as 1999, amid claims that it was determined to reform and improve a neglected part of the NHS.

In July 1999 a consultation paper was published and pilot projects to develop services for people suffering from severe personality disorders were started.

In December 2000 a white paper to reform the Mental Health Act again promised an indeterminate sentence, but the overhaul was not part of the Queen's speech after Labour won the election.

Despite a £300m boost in funding, the sector is largely underfunded.

Recent figures show suicides increasing by 1%, or 200 a year, despite the target of a 20% reduction.

Some of the moves were challenged yesterday by Lord Bragg, the Labour peer who is president of the mental health charity Mind.

He called for an overhaul of special hospitals, saying: "If people are not dangerous, they should be brought back into the community. We cannot just lock them up and forget about them."

Lord Bragg said that, at its simplest, mental illness needed to be seen like a physical disability.

"The whole benefits system must be open to people with mental disabilities as it is to other people, so they have some support while they beat their illness."

He added: "If you have a mental illness you should be looked after by the state and the company you work for, like everyone else."

The draft legislation comes as the Conservative health spokesman, Liam Fox, prepares to shift strategy towards a more liberal approach.

The move is part of the Conservative party's drive to show that it is committed to helping the vulnerable in society. Dr Fox is likely to claim that the government is not meeting its targets and that hospital beds are running at hugely over-capacity.

There has been persistent criticism that funds marked for mental health tend to be sidetracked into higher profile areas.

Source: Guardian

Britain Plans Tough New Powers for Mentally Ill
By Mike Peacock June 25, 2002

LONDON (Reuters) - Britain published plans on Tuesday allowing severely mentally ill people to be locked up indefinitely, even if they have not committed a crime.

Billed as the biggest shake-up of mental health services in 40 years, the draft Mental Health Bill will also make treatment for the seriously ill compulsory, closing a legal loophole which allows people with personality disorders to refuse care on the grounds that they are untreatable.

The Department of Health said there were a small number of patients who need to be detained for their own safety and that of the public.

"Most people with mental health problems are not a risk to themselves or others and most will never need compulsory treatment," health minister Jacqui Smith said in a statement.

"Some, however...can be a danger to themselves, whilst very few can pose a risk to others. In these cases government has a responsibility to ensure that treatment can be provided to these patients in the most appropriate way, to protect them, their families and the wider public."

There have been a number of notable high profile cases in recent years of people with acute mental problems attacking, even killing members of the public.

Most famously, the late Beatle George Harrison was nearly stabbed to death in 1999 by a man who thought he was "an alien from hell."

Michael Abram, a former drug addict and paranoid schizophrenic attacked Harrison and his wife at their mansion outside London.

The conviction of Michael Stone for the murder of Lyn Russell and her daughter Megan in 1996 sparked public alarm at the placing of potentially violent patients in the community and put pressure on the government to review mental health services.

Stone could not be sectioned because his personality disorder, diagnosed years before, was deemed untreatable.

"In the past, too many people with mental health problems were rightly moved from crumbling acute hospitals, but wrongly placed in the community with little support and poor treatment," Smith said. "Some lost touch with services with tragic results."

Since the 1960s, there has been a significant drop in the number of psychiatric patients in hospitals or long-stay asylums in Britain and a bias toward "Care in the Community" schemes, whereby patients are treated in their home environment.

The Bill introduces a single definition of mental disorder which means that people with personality disorders will no longer be excluded from compulsory treatment on the grounds that they are "untreatable," provided they meet a strict set of criteria governing the use of compulsory powers.

Current rules allow compulsory treatment only in hospital. The bill enables doctors to administer treatment plans in the community. If patients do not stick to these orders, they could be held in secure hospitals.

Source: Yahoo News

U.K. Gov't Reforms Mental Health Law
By ED JOHNSON, Associated Press Writer June 25, 2002

LONDON (AP) - In a major overhaul of Britain's mental health laws, the government said it wanted the power to detain people with dangerous personality disorders and force them to undergo treatment.

In a draft of its Mental Health Bill published Tuesday, the government proposed establishing a new tribunal that would decide if such patients could be forced to undergo treatment in secure mental hospitals.

"We understand that any use of compulsory powers is a very serious matter," said Health Minister Jacqui Smith.

"This bill will ensure that there is a proper focus on patients' assessed needs and the risk they pose to themselves and to others," she added.

Smith said there were up to 2,400 people in the United Kingdom with severe personality disorders.

Of those, the vast majority were in prison or in a secure mental hospital. But, due to the current law, as many as 600 were in the community, she said.

Under current law, authorities cannot detain people diagnosed with a dangerous personality disorder who pose a risk to others, if doctors are unsure whether treatment will alleviate their condition or stop it deteriorating — a consideration known as the treatability test.

The problem was exposed in the high-profile trial last year of Michael Stone, who was diagnosed with a severe personality disorder but was not detained years before he attacked and killed Lin Russell and her 6-year-old daughter, Megan with a hammer in 1996.

Under the draft bill, that treatability test will be removed, thus allowing patients to be detained even if doctors are unsure whether treatment will help.

Under the proposals, two doctors and a mental health professional will decide if someone needs compulsory treatment.

After 28 days, that decision will be reviewed by a tribunal, which can decide whether to impose a treatment order for up to six months. After that, subsequent treatment orders can be made for periods of up to a year.

The Royal College of Psychiatrists and the Law Society issued a joint statement saying the government's proposals were "fundamentally flawed in principle and practical reality."

A consultation period for the bill will run for 12 weeks.

Source: Yahoo news

Patients will be compelled to take medication

http://news.bbc.co.uk/hi/english/health/newsid_2065000/2065561.stm

Tough new plans to detain mentally ill people in hospital if they do not take the treatment prescribed to them by doctors have provoked concern among campaigners and politicians.

Marjorie Wallace, chief executive of the mental health charity Sane:

Mrs. Wallace said the Mental Health Act was in serious need of a revamp. She said the number of people detained against their will in psychiatric hospitals over the last 10 years - during a period when community care has become more common - had increased by threefold. However, she said: "This bill is not going to address the fundamental problems, which are the erosion of services over the years, the lack of beds, and the lack of risk assessment and fast-track to hospital care when people need it.

“People are already very alarmed about coercion in the psychiatric services and if it has the effect of engendering more fear then people might be turned away from services altogether.

"A lot of explanation will have to be done to reassure people that these new powers will only apply to very few people under very certain criteria.

“The safeguards have got to be strong enough that people don't fear that they are going to get a jab on the kitchen table, and just be left there."

Carolyn Kirby, vice president of the Law Society:

Ms Kirby called the new measures "draconian". Despite the promised safeguards, the scope for injustice in this situation remains alarming:

"The vast majority of people who have a serious personality disorder are already detained in secure units.

“The government admits itself that it is a very small number of people it is attempting to catch by this legislation. "But unfortunately it's going to have an impact on many thousands of other people who shouldn't be caught by it."

John Wadham, director of Liberty:

"People should not be locked up on the basis of what some expert thinks they might do in the future.

“People should be detained only because they have committed an offence, or because it is necessary for treatment of a mental illness.

"There is a real risk of people being detained on dubious grounds, having done nothing wrong, and with no treatment in prospect. Despite the promised safeguards, the scope for injustice in this situation remains alarming. This also risks turning our psychiatrists and mental health nurses into prison warders. This can't be a sensible way forward.

“Medical opinion on the nature of severe personality disorder remains so divided; and assessing dangerousness remains an inexact science.

“While that remains the case, this power creates too high a risk of serious injustice."

Dr Evan Harris, Liberal Democrat health spokesman expressed grave concerns about the new Bill.

He said: "It is damaging and disappointing that the government has merged the much-needed updating of the Mental Health Acts with repressive legislation to lock up people with untreatable personality disorders.”

We should be discussing a health Act for vulnerable people in need rather than a public safety bill. Dr Evan Harris is concerned about civil liberties:

“The public must be protected from the risk of attack. But the best way to do this is to ensure that there are adequate resources for inpatient and community care: psychiatrists, community psychiatric nurses, community care managers, drug therapies and counseling treatments."

Dr Harris said the public - and to a much greater extent the mentally ill themselves - were at more risk from under-resourcing than from the absence of detention powers or compulsory community treatment orders.

“There has to be a debate on compulsory treatment in the community. The biggest problem is that patients who need or want inpatient treatment simply can’t get into a hospital bed or access the modern drugs that they can take to control their symptoms.

“Until this blatant rationing of care for the most vulnerable in society is tackled, enforced medication in the community will be obscenely premature."

See "Tough new mental health laws proposed"
http://news.bbc.co.uk/hi/english/health/newsid_2065000/2065248.stm