Sunday, April 22, 2007

Community Treatment Orders: the psychiatric ASBO

“The Bill is not about service provision. It is about the legal processes for bringing people under compulsion.” (Department of Health, 2005).

This week saw the second reading of the controversial Mental Health Bill. The Bill has faced a rocky read in getting this far and New Labour and the Lords are locked in a battle over Community Treatment Orders (CTOs) which the Lords in January this year amended and New Labour want to block when it gets to committee stage. As Patricia Hewitt argues:

"We are not prepared to accept the amendments that have been made there restricting the use of community treatment orders to patients who have been detained as compulsory patients at least twice. I believe that would be a wholly unacceptable restriction on clinicians."

One of the amendments from the Lords that New Labour wants to see gone: “Ensure that people with full decision making ability cannot be forced to have treatment imposed upon them against their will”.
Bizarrely, Hewitt goes onto argue that the Bill strikes a right balance between improving patient safeguards and protecting more people. Who is she trying to kid as there aren't no safeguards?! The first so-called safeguards were the substantial amendments by the Lords. And the amendments include safeguards for children which, again, New Labour want to scupper!

A CTO removes the right of a service user to choose whether or not to continue receiving their medication once they have been discharged from hospital. As Tony Zigmond, Royal College of Psychiatrists argues:

"Furthermore, there is the ethical issue of whether CTOs are fair. Should any person who is capable of making a decision about their treatment be forced to accept medical treatment they don't want solely to benefit their health?

New Labour are on their lonesome with this Bill as even that bastion of radical ideas, The Royal College of Psychiatrists oppose much of this draconian Bill along with over 80 organisations/individuals (though the voices of the service users has been drowned out by the of professionals and the carers. The mental health user movement is pretty much in a weak state).
The government claim that around 1,450 will be placed on CTOs yet according to research by the King’s Fund it is estimated that there will be a gradual year on increase of numbers. They believe it is more likely that between 7,000-13,000 service users could be placed on CTOs over the next 10-15 years....

The Bill also resembles CTOs currently used in Australia and New Zealand. CTOs are a way, New Labour claims, of reducing psychiatric admissions yet studies have shown in Australia, that CTO placement, aboriginal ethnicity, younger age, personality disorder and previous health service use were all associated with increased admission rates. The authors conclusion stated that we “should question the rationale for CTOs and advocate more effective treatments” (British Journal of Psychiatry, 2004).

The Institute Of Psychiatry’s “International experiences of using CTOs” (March 2007) noted as well that ethnicity data from Israel, USA, New Zealand and Australia,“indicate that relative to the proportion of the general population comprised by their ethnic group, most ethnic groups might be over-represented amongst CTO recipients.”

At the moment young Black men are 38% more likely than the average to be sectioned under the current Mental Health Act and with the lack of safeguards this disproportionate number of Black people being forced onto CTOs will remain.

The psychiatric system reflects the sexism, racism and homophobia that exists in this society and without any kind of anti-discrimination this will continue (though there is an amendment regarding this but New Labour want to see it ditched).

The Mental Health Bill can be reduced to the 3 C’s of New Labour (compulsion, coercion, containment). It is a retrograde act and will terrify mental health service users. It will destroy trust between service user and professional. Instead of support service users will feel policed. If a person can live in the community then they should be trusted in whether they take their medication. It is about choice. And surely the service user is the best person to know whether medication works or doesn’t work? And if the service user is experiencing dire side-effects are they expected to keep taking it?

The emphasis being on that panacea known as medication and alternatives aren’t given any credence. The voice and the rights of the mental health user will be lost to ever growing concerns about “protecting the public”. And during the past week there has been debate over “predicting behaviour” in light of the shootings in Virginia.

Mental health service users already, for good reason, feel stigmatised and victimised and this Bill only increases that fear. One of the biggest criticisms from mental health service users (and from my own personal experience I echo it) is not being listened to and your needs, demands, concerns regularly ignored by professionals this will indeed create more powerlessness and lack of control over your surroundings. This will add to the distress and will in no way increase better mental health.

Professionals will err on the side caution as they will be worried about the “what ifs” and these CTO’s will be handed out on a regular basis. How long will service users be expected to on CTOs? There is nothing in the Bill which explains length so in theory you could be put on one indefinitely.
A cross-party of over 100 MPs have signed motions expressing their concerns about this Bill.

This Bill, along with agenda of New Labour, attacks civil liberties and will instil fear, stigma, mistrust and create a tightly controlled passive society.....
The umbrella group which is campaigning against the Bill is the Mental Health Alliance ( Their website seems to be down at the moment.

: Spending my Sunday afternoon trawling through the Mental Health Bill specifically the CTOs section I was unable (though correct me if I am wrong) to find any provision which gives the user right of an appeal against the decision for a CTO, implementation, review, right of service user to look at the information the CTO is based on and/or monitoring decisions on a regular basis i.e. discrimination. These important safeguards make professionals accountable for their decisions are conspicuous by their absence. Shows that New Labour don't give a damn for basic human rights.

(Have tried to upload suitable pic but Blogger is playing havoc maybe a suitable dose of cyber medication will resolve the problem).


AN said...

There is a fourth C: conformity.

I think you have done a good job at raising awareness of this issue, which has been largely overlooked elsewhere I think.

It seesm to me that care and support to the service users is not even part of the agenda, there is an assuption that the role of the state is to "protect" society from the ill, rather than help them: as if the mentaly ill are in Thatcher's words, not "people like us"

newsflash said...

Michael Meacher claims '200 nominations in the bag'

Michael Meacher promised one of the biggest upsets in modern British political history when he claimed to have received the nominations of around 200 MPs.

"I can confirm that at least 200 MPs at last count have agreed to nominate me," he told reporters. "John McDonnell, on the other hand, has minus 5 nominations. If that."

If confirmed, the claims will spark panic among Gordon Brown's leadership team who had themselves claimed to have over 200 Labour MPs signed up this week. It will also spell disaster for John McDonnell's campaign.

However, doubts were raised over the claims when it became clear that Meacher was unaware that only members of the Parliamentary Labour Party were able to nominate candidates for the Labour leadership.

One journalist who was shown the list claimed that 197 of the names were members of the Opposition. Among them were David Cameron, George Osborne, Oliver Letwin and Kenneth Clarke.

Interviewed at one of his country retreats, Meacher struck back at suggestions that Tory MPs were not eligible to nominate candidates for Labour leader.

"Believe me, I've spent months reading over the rules and nowhere does it say that Tory MPs cannot nominate me," he responded. "It would be flagrantly undemocratic to prevent members of other parties from nominating candidates. That so many Tory MPs wish to nominate me simply reflects how much respect there is for my unparallelled experience."

"I'm always seen myself as a cross between Winston Churchill and Clement Atlee," he added.

He also repeated controversial claims that the CIA could have been responsible for the Norman invasion of England in 1066.

"They could have scrambled fighter jets, couldn't they? Why didn't they? We're a NATO ally, aren't we? I'm not saying that they were behind it - I'm just asking questions. The families of the victims of the invasion have a right to answers."

Meanwhile, police have revealed that 123 Labour MPs have taken injunction orders against Michael Meacher.

"If he f*cking rings me again, I'm going to f*cking lamp the stupid w*anker," said one MP.

neprimerimye said...

One cannot but note that this legislation will be of very direct concern to considerable sections of the far left......

In which case it may well be of direct ebenfit to those section of the far left untouched by its affects.