defeat government over plans to extend compulsory plans of treatment
over mentally ill
by Angela Hussain
plans to extend compulsory plans of treatment over the mentally
ill have suffered a series of blows in the House of Lords.
Peers voted on Monday that compulsory community treatment - primarily
to ensure patients take their medication when living in the community
- should only be used on people who would otherwise be in and out
of hospital, so-called revolving door patients.
The government’s mental health bill stipulates that such forms
of compulsory treatment – known as community treatment orders
(CTOs) – could apply to anyone who had been sectioned.
Earlier this month peers voted for three other fundamental amendments
to the bill.
The first was that all forms of
compulsory mental health treatment should only be applied if there
is a therapeutic benefit. This is known as the “treatability
The House of Lords backed by 186 votes to 115 an amendment ensuring
that a person could only be detained if the treatment would be “likely
to alleviate or prevent a deterioration in his condition”.
The bill proposes abolishing the need for there being a condition
of therapeutic benefit. Ministers argue this would allow dangerous
people diagnosed with personality disorder – who some clinicians
regard as untreatable –
could be detained.
Peers also voted overwhelmingly to back an amendment preventing
people from being sectioned solely on the basis of their substance
misuse, sexual orientation or cultural beliefs.
And a third amendment, requiring that renewal of a detention be
agreed by a psychiatrist and responsible clinician, was agreed by
147 votes to 108.
Peer Baroness Meacher suggested the bill as it stood could allow
“the rather ludicrous possibility” that an occupational
therapist or nurse could renew a detention against the advice of
In January peers also voted that mental health patients should have
an impairment of decision-making ability before being compulsory
treated. The bill does not include such a condition.
Peers have also backed an amendment stating that children detained
under mental health legislation be placed in age-appropriate accommodation.
The government argues the new
law for England and Wales would both improve care for patients and
protect the public by preventing some of the 50-60 annual homicides
committed by those diagnosed with a mental illness.
The bill is likely to reach the House of Commons after Easter.
mental health bill (amendments to the 1983 Mental Health Act (pdf))
Jan 12: Government set to win bid to extend compulsion powers over
mentally ill, says MP
- "I do not think there will be a major Labour rebellion,"
says Lynne Jones of group of MPs with previous "misgivings”
over mental health bill.
Dec 12: CTOs do not work...and
that's according to the evidence base - Community treatment
orders will help protect the public from mentally people who kill,
says the government. But what of the evidence for such a claim?
1: Government presses ahead to force some psychiatric patients to
take medication in community - plans in new mental health bill
Nov 9, 2006:
Are homicides by people with mental health problems preventable?
Tony Maden believes recommendations he submitted to the government
could result in a cut in homicide rate by psychiatric patients of
10 per cent in five years. Is he realistic?
23, 2006: Government drops key proposals of draft mental health
bill - new "streamlined” bill will be an amendment
to the present mental health act, says mental health minister Rosie
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