Mental Health Bill - Assignment Example

1.0: Introduction Mental disorder and its effects upon the general public due to the mentally affected people are increasing tremendously causing concern across the UK on the need for a stronger regulation. The amendment draft to the Mental Health Act of 1983 that is currently under scrutiny in the parliament is examined in this report. The analysis focuses upon the benefits of this bill and the response received in order to justify its approval in the parliament. 2.0: Policy Overview The selected policy (i.e.) the Mental Health Bill - an amendment to the Mental Health Act in the UK is put forth by the government on emphasizing the protection of the public. This is naturally because of the steep increase in the crime rates since the dawn of twenty-first Century that have roots to some form of mental disorder as argued by Linda Nazarko (2004)1. The three principal objectives with on analysing the amendment draft to the Mental Health Act is presented below Broaden the definition of Mental Health Disorder: The amendment aims to ease the treatment of people with personality disorders from the perspective of the doctor (i.e.) the draft supports the treatment of an individual forcibly in case of potential mental health disorder identified by a medical practitioner. Allow for the compulsory treatment of the patients cared for in the community: Under this category, the draft aims to eliminate the confinement of the patients to the hospital through sectioning and using force to provide medication. Tighten the criteria for detaining a patient and enforce safeguards: Under this objective, the draft not only provides rigid regulations on detaining a patient under the grounds that he/she will be a potential danger to the society or to themselves but also avoid the abuse of this provision through enforcing the safeguards. The aforementioned three objectives are critically analysed using the secondary research data form the reports, journals and white papers on the aforementioned topic. This report not only presents an analysis but also investigates the justifiability of the draft in the light of the aforementioned three objectives. The increasing need for a robust mental health regulation act to protect the public as well as prevent its abuse affecting vulnerable patients is the primary reason for the choice of the topic on policy tracking in this report. Furthermore, the increase in the crime rate with higher number of criminals under the mental disorder category makes it clear that the mental health act should be able to respond to the growing needs of the present situation in the society and protect the public. 3.0: Broaden the Definition of Mental Health Disorder The Mental Health Act Commission (2006)2 argues that the mental disorder is loosely defined in the Mental Health Act of the UK when compared to those of other countries like Australia and Canada. The Mental Health Act of 1983 defines the Mental disorder as "mental illness, arrested or incomplete development of mind, psychopathic disorder and any other disorder or disability of mind." The aforementioned definition makes it clear that the legislation is targeting on an exceptional segment of the public leaving a broad segment of the people untouched. The increase in the crime due to mental disorder especially child abuse in the recent years has increased the need to redefine the mental disorder itself in such a manner that it targets on a broader segment thus reducing the possibility of loosing a criminal. The Ian Huntley case of the year 2004 where the Humberside police failed to spot the personality disorder of the accused has led to the death of two innocent school girls as well as the sexual abuse of many other under age girls (BBC News, 22/06/043). The aforementioned argument justifies that the definition of the mental disorder itself should be redefined in order to include those in the general public with specific personality disorders to be treated under mental health disorder as argued by Linda Nazarko (2004). Furthermore, the amendment draft to the Mental Health Act also argues that the broadening the definition of the mental health disorder in the UK general public will provide room to help those with personality disorder to recover and lead a normal life without affecting the general public. Alongside the recommendation to broaden the definition of medical treatment to mental disorder for people with personality disorders further makes it clear that the government is striving to reduce the crime due to mental disorder and thus protect the public. Although this measure is perceived to be a viable method to address the mental disorder issues and the treatment of individuals with mental health disorder, the threat of the compulsory treatment is very broad as argued by Tony Zigmond (2006)4. This is naturally because of the fact that the broadening of the definition especially in terms of the medical treatment increases the vulnerability of individuals although with some personality disorder but harmless to the society to be retained in the hospital for intensive treatment. This approach is against the human rights as it infringes the basic rights of an individual through forcing for treatment. The forced treatment is also under the allegation of personality disorder and not due the crime committed due to the disorder. The government's argument that this approach can eliminate people with personality disorder from being potential threat to the society is opposed by many authors including Theodore Dalrymple (2004)5. The author argues that the increase in the detention of patients under the suspicion of potential threat to the community due to mental disorder will increase the resources dedicated to such cases, which can be effectively used by the National Health Service effectively to reduce costs without loosing jobs. Although the aforementioned argument is commendable the personality disorder that is predominantly focused by the amendment draft is defined as 'a class of mental disorders that are characterized by long-lasting rigid patterns of thought and behaviour. Because of the inflexibility and pervasiveness of these patterns, they can cause serious problems and impairment of functioning for the persons who are afflicted with these disorders' (Mental Health Act Commission, 2006). The aforementioned definition makes it clear that the personality disorder is a critical mental illness state that can not only endanger the members of the public but also the patients themselves in most cases as argued by Michael Cavadino (1995)6. This makes it clear that the broadening of the definition as well as the tight regulations in the definition of the mental disorder is itself an important element to reduce the potential threat due to individuals that fall under this category. The withdrawal of the protest march by mental health campaigners in September 2004 when the personality disorder of Ian Huntley was revealed as the key element instigating the crime justifies the aforementioned argument (Zosia Kmietowicz, 20047) This is naturally because of the fact that the public response to the move by the Mental Health campaigners against the proposal to force the individuals with personality disorder to treatment, will not be positive to the campaign. Alongside, the increasing awareness that the sex offenders especially those under the child abuse category have certain personality disorder to be categorised as a paedophile which puts the public under risk when deprived of treatment (force or otherwise). The aforementioned argument further justifies that the broadening of the definition of the mental disorder is focused upon the welfare of those who suffer from personality disorders in order to protect the society as well as provide an opportunity for the individual through treatment. Although this is debatable, the increase in the staffing pressure at the National Health Service (NHS) will further worsen with the increase in the patients under this category. The increasing the stress upon the staff members in the NHS will not only increase but also increase the demand for psychiatrists and mental disorder specialists to cater the increase in the number of people identified with personality disorder. This situation further increases the threat of loosing the medical practitioners to the treatment of the mental disorder instead of treating the patients in the general public. The above arguments on the broadening of the definition for treatment and the mental disorder makes it clear that the amendments draft to the Mental Health Act is essential to identify individuals with personality disorders to prevent them from being a threat to the society and to themselves. Furthermore, the increase in the awareness among the general public on the threat of the people with mental disorder has further increased the need to treat such individuals in order to prevent them from being vulnerable in the eyes of the public. Alongside, the public anger in case of many sex offence cases like that of Ian Huntley where the failure of the government authorities to effectively track the personality disorders is a critical element that needs to be considered prior to opposing the proposal. 4.0: Allow for the compulsory treatment of the patients cared for in the community: Community care and the public safety being the critical elements of the Mental Health Act of 1983 as well as the focal point of the draft for amendments in the Mental Health Bill that is under scrutiny in the parliament, it is clear that the treatment of the personality disorders if required by force can effectively reduce the crimes due to mental disorders as well as increase the protection in the public. Although the aforementioned is a palpable statement, Mental Health Alliance (2006)8 argues that the civil rights of the patients are at risk with the enforcement of the bill. The fact that the rights of the patient is violated once he/she is forced to medical treatment and detained in a hospital for potential mental disorder makes it clear that the personality disorders although a critical element contributing to the public danger, should not be forcefully treated. Alongside, the increasing number in the crimes due to mental disorders along with the need for a safer environment to protect the public especially children from sex offenders is equally important which is a justifying element for the approval of treating patients even by force for personality disorders. From the contrasting arguments above it is clear that the compulsory treatment of the patients is not only a sensitive issue but also a matter that should be addressed in order to eliminate criminals from escaping the law whilst protecting the vulnerable patients who suffer from personality disorder. Since the existing Mental Health legislation is not robust enough to categorise personality disorders as a potential danger to the society, people with such traits who can involve in crimes even serial killings tend to escape until the law enforcement mines enough evidence to arrest such criminals. Under the aforementioned circumstances, it is clear that the compulsory treatment of the patients and especially the use of force to treat patients with personality disorder is an essential element as part of the mental health act to enforce efficient monitoring of psychopaths and mental disorder criminals in the society. Alongside, the written evidence filed by Keith Kinsella (DMH 14, 2006)9 states that the exercise of compulsory treatment is detrimental in certain cases not only in the legal perspective but also affecting the patient's health itself. Alongside, the fact that it is essential to provide care and protection to these patients as argued by the Keith Kinsella stating that the draft should try to work by embracing the right to advanced directives whilst exercising the compulsory treatment of the patients even with the use of force. Although the aforementioned is a complex scenario, the fact that the advanced directives is the only element that protects the rights of such patients and encouraging them to have a certain amount of control over their treatment makes it clear that it is necessary to enforce the regulation embracing the advanced directives. In the light of the aforementioned arguments it is further interesting to note that although the treatment of patients can be accomplished with force, the drugs so given do not always have the desired effect as argued by the Mental Health Alliance (2006). This is not only because of the fact that the individual nature of the personality disorder but also because of the complex nature of mental disorder and that the there is not a universal treatment option. This not only makes the approach complex but also makes it clear that the compulsory treatment of identified personality disorder patients will not always be fruitful. Alongside, the treatment of the patients cared for in the community also encourages the elimination of the sectioning which provides the opportunity for the patients to lead a normal life in the society. This approach is indeed beneficial to many although the confinement to hospital can be a case in case of incurable disorders. This situation further makes it clear that the patients face the chances of ending up in a hospital care centre just because there is not a cure for their disorder reverts the causes of concern to civil rights violation and the advanced directives. Apart from the aforementioned arguments, the compulsory treatment of the patients in a broader perspective will provide the government or the legal authorities the list of potential suspects with regards to a specific crime or personality disorder. This record will not only help the law enforcement to keep track of the patients and their activities but also provide the ability to quickly eliminate them from the suspects list in case of a crime enquiry. This makes it clear that the compulsory treatment of the patients for community care has the inherent advantage of quickly eliminating suspects from a potential crime investigation. Although this has negative effect on the personal information and data protection act, the fact that this information is being used by the legal authorities and is stored in high level of confidentiality justifies the aforementioned. 5.0: Tighten the criteria for detaining a patient and enforce safeguards The detention of the patients is a far critical and sensitive area in the draft for amendments to the Mental Health Act of 1983. The draft empowers the law to detain a patient in hospital or keep an individual under observation for as long as the law deems necessary. This makes it clear that the patients face the threat of being detained in the hospitals for observation against their interests, which infringes the civil rights of the individual. The arguments of Leslie Carr (DMH 15, 2006) that the detention of the patients in the hospitals and especially the tightening of the criteria for detention have not only increased the ability to effectively use the resources but also provide the necessary care to the patients in need. The Acquired Brain Injury Rehabilitation Unit that faced high density of patients can be effectively controlled under this act. This is because not only the amendment proposes the detention of the necessary patients but also tightened the criteria under which a patient should be detained. The aforementioned makes it clear that the detainment of a patient can be exercised under exceptional circumstances making it clear that the National Health Service can effectively use its staff to meet the increase in the patient density in the psychiatric unit. The arguments in the earlier section 3 that the broadening of the definition will increase the number of patients in the hospitals has been addressed by the bill in this section where the norms to detain a patient have been tightened making it clear that a patient cannot be detained just because he/she suffers from a personality disorder. Furthermore, the staff efficiency can be increased through the effective deployment of the detaining rules whereby the company NHS gains control over the patient density thus reducing its costs whilst retaining most of the jobs. Furthermore, the tight regulations in the detaining of the patients will also increase the ability to effectively utilize the staff members involved in the care and protection of such patients since the personality disorder is not a common disease to be treated with a stereotype treatment. Although the tightening of the detaining rules are beneficial in nature and prevents the abuse of the mental health Bill provision, it is clear that the improper exercise of the rules will result in the infringement of not only the Mental Health Act but also other laws like the civil rights of the patients. This is naturally because of the fact that an improper use can result out of the wrong judgement of the psychiatrist or the diagnosing medical practitioner. This makes it clear that the even though the rules to detain a patient are tightened, its exercise should be effective in order to efficiently control the crime due to mental health disorders and reduce the unwanted treatment of a personality disorder in cases of its harmless nature. The introduction of safeguards in the detention of the patients in the hospitals adds strength to the policy especially because of the fact that the hospitals should provide justification on the detention of a patient for a longer duration that uses the resources. This approach to the detaining of the patients further increases the ability to effectively control the number of patients being detained in the hospitals thus eliminating the queuing up of the NHS counters with the patients in need of care. The introduction of independent tribunal to look at the care plans in place for patients held over twenty eight days in hospitals makes it clear that it is necessary to efficiently treat the patients as well as ensuring the fair treatment of the patients both admitted in a hospital as well as those awaiting treatment. This also makes it clear that the presence of the safeguards conforms to the civil rights of the patient to a certain extent although the detention of the patient up to 28 days before the tribunal is infringing the civil rights. The increasing demand in the NHS counters and the tremendous fall in the NHS staff is an issue of concern in the light of the aforementioned. This is because of the fact that although there are tight regulations and norms to detain a specific patient, the increasing density of the patients who fall under the broader definition of the mental disorder is very high. This increases the density of the patients at the NHS making the diagnosis a critical part of the equation. The introduction of the 'nominated person' whereby the patient is being monitored by an individual who can help the patient challenge the use of compulsory powers is more or less like the presence of a lawyer during the interrogation of a patient. The presence of the 'nominated person' actually provides the patient with the ability to decide upon a given situation on accepting a specific method of treatment. Although, the draft proposes the enforcement of the treatment through force, the 'nominated person's' presence will actually eliminate the abuse of the power vested among the authorities once the bill is passed in the parliament. Furthermore, the increasing demand for protecting the civil rights and the advanced directives of the patient which were provided by many in written evidence as part of the Draft for amendment to the Mental Health Act of 1983, has necessitated the need for a person to speak for the patient with personality disorder. The obvious reason that the patient won't have the mid state to judge and decide accordingly is the reason for the presence of the nominated person in the scene itself. From the aforementioned it is clear that the presence of the nominated person and the introduction of safeguards in the detainment of the patients in the NHS is beneficial to both the patients as well as the authorities involved. In the former case, the law provides room to protect the civil rights whilst the NHS resources are used efficiently in the latter case. Furthermore, it is also clear that the detaining of the patients cannot be abused or depends upon biased reasons of the psychiatrist with the presence of the strict time limits and the introduction of the tribunal to review the treatment after the first 28 days of detainment. 6.0: Conclusion The investigation into the Mental Health Act of 1983 and the amendment draft - Mental Health Bill has revealed that the need for a stronger method of enforcing regulation over mentally disordered individuals. The analysis has also revealed that the Mental Health Bill under scrutiny in the parliament is a robust approach to cover a broad area in categorising the personality disorder traits that are potentially dangerous to the society. The investigation on the broadening the definition has revealed that it is imperative to reach over a wider segment of the public to track personality disorder that are potentially dangerous to the society whilst protecting the civil rights of the patients. This is not only necessary in the case of identifying the patients and broadening the definition of medical treatment but also for enforcing compulsory treatment of disorders. Since the rights to patient as well as the advanced directives, which in certain cases are the only option for protecting the interests of the patients, it is essential to protect these rights whilst justifying the compulsory treatment. The introduction of the tribunal option and the 'nominated person' act as the protecting elements to the Mental Health Bill. Thus to conclude this report, the Mental Health Bill should be passed by the parliament in order to protect the wider public from mental disorders and people suffering from personality disorders. Read More