Clinical psychologists will not provide more humane mental health service if given extra powers

August 22, 2005
by Adam James

Clinical psychologists have been warned they should not be misled into believing they can help deliver a more humane mental health service if granted extra powers as outlined in the draft mental health bill.

The warning came from five clinical psychologists themselves in a letter in the latest edition of Clinical Psychology Forum.

The five also demanded that, because of the "momentous" implications of becoming clinical supervisors for compulsory detained psychiatric patients, clinical psychologists should be balloted on whether their professional body, the British Psychological Society (BPS), should support the plans.

As outlined in the government's draft bill, clinical supervisors would have the authority to draw up multi-disciplinary care plans for detained patients, to implement such plans and to decide whether or not to continue detaining patients. At present psychiatrists hold such responsibilities, while clinical psychologists do not.

In April, Professor Peter Kinderman, then chair of the BPS's division of clinical psychology, wrote at psychminded.co.uk that clinical psychologists "relish" becoming clinical supervisors as it would give them greater leadership, influence and power. Prof Kinderman said psychologists could, for example, prevent the use of ECT or the over-medication of patients.

However, in their letter, clinical psychologists Bob Diamond, Guy Holmes, John Hanna, Dave Harper and Rufus May argue clinical psychologists are unlikely to work more "philanthropically" than psychiatrists.

They wrote: "Those in our profession assenting to the development of clinical supervisors appear to see it as an opportunity to have direct influence in the delivery of care and exercise power comparatively benignly, despite ample psychological research (e.g. Stanford Prison Experiment) that shows roles people take are crucial in determining their (sometimes oppressive) behaviour.

"We do not believe psychologists will somehow act more philanthropically and benignly than our psychiatric colleagues once we hold the clinical supervisor status."

The five say they fear the division of clinical psychology is supporting plans for the new clinical supervisor role without proper consultation.

"We would like to see an official ballot on whether we take up the role - in short the decision should be a democratic one not an executive one," wrote the five psychologists.

"Although a ballot would be unusual, we feel that the changes to the profession that will occur as result of us being clinical supervisors are so momentous it warrants this. And who would argue against democracy?"

They point out that the only consultation clinical psychologists participated in was a "brief questionnaire" in 2001 with a 16 per cent response rate. Two thirds of respondents supported having a CS role.

The five also argue that because the BPS itself has called the draft mental health bill "fundamentally flawed", it would be inconsistent for the society to support the CS role.

The government's draft mental health bill (pdf)

See also:
July 13, 2005: Ministers refuse to add "treatability" condition to draft mental health bill - fears that more people will be compulsory treated is fuelled by government response to parliamentary committee
Clinical psychology comment
April 11, 2005: We can do a power of good - Many clinical psychologists welcome the draft mental health bill because it would give them extra powers, such as preventing the use of ECT or the over-medication of patients. Moreover, argues Peter Kinderman, it's time clinical psychologists stopped clinging to the myth that, at present, they have no power.

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