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You can find the current article at its original source at https://www.theguardian.com/society/2018/jan/25/psychiatric-services-need-better-support-not-more-legal-scrutiny
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| Psychiatric services need better support, not more legal scrutiny | Psychiatric services need better support, not more legal scrutiny |
| (about 4 hours later) | |
| Letters | Letters |
| Thu 25 Jan 2018 18.00 GMT | Thu 25 Jan 2018 18.00 GMT |
| Last modified on Thu 25 Jan 2018 22.00 GMT | |
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| Christina Blacklaws of the Law Society is wrong to say that patients detained under the Mental Health Act have to wait six months to challenge their treatment (Lawyers seek end to forced treatment of psychiatric inpatients, 24 January). There is an automatic review at six months, but they can lodge a challenge via the mental health tribunal or the hospital managers (or both) from day one. It is misleading to talk of the act giving “the state” the power to detain. The act empowers clinicians to do this, and two professionals have to agree. One must be a trained psychiatrist, the other an “approved mental health professional” (usually a social worker) charged with exploring alternatives and safeguarding the patient’s rights. The law already requires compulsion to be used only as a last resort and only when there is obvious risk. The section papers require an explanation of why effective treatment cannot be achieved without it. | Christina Blacklaws of the Law Society is wrong to say that patients detained under the Mental Health Act have to wait six months to challenge their treatment (Lawyers seek end to forced treatment of psychiatric inpatients, 24 January). There is an automatic review at six months, but they can lodge a challenge via the mental health tribunal or the hospital managers (or both) from day one. It is misleading to talk of the act giving “the state” the power to detain. The act empowers clinicians to do this, and two professionals have to agree. One must be a trained psychiatrist, the other an “approved mental health professional” (usually a social worker) charged with exploring alternatives and safeguarding the patient’s rights. The law already requires compulsion to be used only as a last resort and only when there is obvious risk. The section papers require an explanation of why effective treatment cannot be achieved without it. |
| Community treatment orders are not linked to payment. Whether the current 5,000 per year are justified is highly questionable, given that all three published randomised controlled trials find them ineffective. There is, however, no doubt that we do not have enough beds. No mental health act is perfect. My experience of those in countries with front-loaded legal scrutiny is of rubber-stamping. Currently a third of UK adult admissions are on section and a further third are placed on section while in hospital. These are very distressed individuals, struggling with terrible illnesses. What they need and deserve are vastly improved services. They do not need a cosmetic revision of an act that was thoroughly rewritten only a decade ago.Tom BurnsProfessor emeritus of social psychiatry, University of Oxford. Psychiatric adviser to the 2007 parliamentary review of the MHA | Community treatment orders are not linked to payment. Whether the current 5,000 per year are justified is highly questionable, given that all three published randomised controlled trials find them ineffective. There is, however, no doubt that we do not have enough beds. No mental health act is perfect. My experience of those in countries with front-loaded legal scrutiny is of rubber-stamping. Currently a third of UK adult admissions are on section and a further third are placed on section while in hospital. These are very distressed individuals, struggling with terrible illnesses. What they need and deserve are vastly improved services. They do not need a cosmetic revision of an act that was thoroughly rewritten only a decade ago.Tom BurnsProfessor emeritus of social psychiatry, University of Oxford. Psychiatric adviser to the 2007 parliamentary review of the MHA |
| • Things are different in Scotland. Indeed, the Law Society would do well to look at the provisions of the Mental Health (Care and Treatment) (Scotland) Act 2003, which allows for an initial short-term detention of up to 28 days, which can be appealed, and any subsequent compulsory treatment order for up to six months can also be appealed, by adults and children. And legal aid is available for these appeals.Sally CheseldineEdinburgh | • Things are different in Scotland. Indeed, the Law Society would do well to look at the provisions of the Mental Health (Care and Treatment) (Scotland) Act 2003, which allows for an initial short-term detention of up to 28 days, which can be appealed, and any subsequent compulsory treatment order for up to six months can also be appealed, by adults and children. And legal aid is available for these appeals.Sally CheseldineEdinburgh |
| • The proportion of people with suicidal thoughts who go on to complete suicide is less than one in 200. While it is not possible to identify that one person, it’s worth remembering that the other 199 are at high risk of many other problems too: repeated self-harm, depression, anxiety, low self-esteem, and poor educational and work progression. It makes no sense to be told that a person who self-harms “doesn’t meet the threshold for treatment unless it’s life-threatening” (Children as young as three self-harming, say teachers, Education, 23 January). All need care, understanding and support.Brendan KellyProfessor of psychiatry, Trinity College Dublin | • The proportion of people with suicidal thoughts who go on to complete suicide is less than one in 200. While it is not possible to identify that one person, it’s worth remembering that the other 199 are at high risk of many other problems too: repeated self-harm, depression, anxiety, low self-esteem, and poor educational and work progression. It makes no sense to be told that a person who self-harms “doesn’t meet the threshold for treatment unless it’s life-threatening” (Children as young as three self-harming, say teachers, Education, 23 January). All need care, understanding and support.Brendan KellyProfessor of psychiatry, Trinity College Dublin |
| • Join the debate – email guardian.letters@theguardian.com | • Join the debate – email guardian.letters@theguardian.com |
| • Read more Guardian letters – click here to visit gu.com/letters | • Read more Guardian letters – click here to visit gu.com/letters |
| Mental health | Mental health |
| Health | Health |
| Suicide rates | Suicide rates |
| Scotland | Scotland |
| Legal aid | Legal aid |
| UK criminal justice | UK criminal justice |
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