The Government


In 1997 when the current Government was elected into power one of their aims was to tackle the inequalities that existed within health and social care. Since then we have seen the publication of many policy documents which planned the way forward for health care, particularly in the way that care is delivered. Modern and Dependable (DOH, 1997), set out ways for national improvement in healthcare. Modernising Mental health Services (DOH, 1998a), set out the way on which mental health services would deliver care in the future. Safe, Sound and Supportive (DOH, 1998b), emphasized the involvement of service users in the planning and the delivery of care, offering choices and promoting independence for individuals. The National Service Framework for Mental Health (DOH, 1999), represented the first set of national standards for mental health, frameworks of how these standards would be achieved, standards which were based on up to date evidence of how to achieve the best possible care. It would be fair to say that all these policies were working towards social inclusion and better care for those with mental health problems.


However the same Government is now proposing changes within the Draft Mental Health Bill for England and Wales (DOH, 2002) which have serious implications for the human rights of those same individuals.


The Governments intentions throughout the policies previously mentioned were seen as a positive development within mental health services, developing services in a way that followed the morality of a caring society. Regrettably the Governments new proposals are seen as nothing more than the coercion and control of those with a mental illness. Compulsory treatment orders are one of the proposed developments. But are they really necessary in the context that has been proposed by the Government?


Through this piece of work the writer aims to explore the legislation which has, and still does, endeavour to provide an ethical framework to the unethical practice of the involuntary treatment of people with a mental illness. The fundamental dilemma is that of balancing the individual’s autonomy and civil liberty with the need to protect both the individual and the public from perceived risk. But how far should mental health services go in maintaining a function of social control? Morrall (2000), believes that when a nurse does not acknowledge their role as an agent of social control, that fuel the public’s misconceptions that surround mental illness. ( fear is real, so the public would feel more at ease knowing that the problem is being dealt with)


Mental health legislation is, and always has been an extremely controversial issue. Maintaining the necessary balance between care and control has always been problematic, even more so since the inclusion of the European Convention of Human Rights Act 1998 into the law of the United Kingdom (Bartlett & Sandland, 1999).


Compulsory treatment in the context now being proposed by the Government undermines civil liberties; this is an opinion which is shared by both the Royal College of Psychiatrists (2002), and the Law Society (2002), both of whom feel that the Governments proposals are unworkable and unethical. Thomas Szasz has argued since the 1950’s that compulsory psychiatry is incompatible with a free society (Roberts, A. 1996).


It is felt by the writer that the Draft Mental Health Legislation currently proposed by the Government is nothing more than an attempt to rid society of what many feel to be a social nuisance or an economic burden. It is hard to believe that these proposals are based truly upon altruistic motives. Through this work the writer will examine the current proposals and look at the implications of such to society, and more so to the impact it will have upon the individuals it concerns.


In order to fully understand the nature of the dilemma, it is felt that an understanding is needed of how mental health care and also the legislation that governs it, has evolved over the past forty years.


Since the 1960’s we have seen a move away from the old asylums, which had been at the heart of institutionalised and coercive mental health care, towards care in the community. Care in the community was seen by many to be a more humane treatment of those with mental health problems.


There were many changes around this time. Societal attitudes towards mental