Friday, 10 December 2010
Am I the only one who's somewhat worried that the Mental Health Act 1983 revised in 2007 is illegal
The revisions of the Mental Health Act 1983 in 2007 have created what is potential a pre-crime punishment system. The widened the definition of mental disorder to include psychopathy. The also removed the treatability test, i.e. previously the mental illness had to be treatability otherwise a person couldn't be hospitalised. There are important defintions of what a mental illness is and how personality disorders fit in. This was ignored as was the general consensus of psychiatric thinking, certainly 10 years ago The reference for most of this information is this paper - http://bjp.rcpsych.org/cgi/content/full/180/2/110 and this one http://bjp.rcpsych.org/cgi/content/abstract/153/1/44?ijkey=d37a25014dd3a3864f92f4c7cf60a74e6979a35e&keytype2=tf_ipsecsha.
In the UK incarceration is the worst punishment handed out by society. People are no longer executed. They just have their freedom taken away. There is a huge and well funded criminal justice system that fundamentally believes in one thing: innocent until proven guilty. Hospitalisation without treatment nor what is classically defined as a mental illness is no different to incarceration except it is in a hospital full of very distressed people in crisis states. There is none of the judiciousness of the legal system: no adversarial lawyers, judge nor jury. As far as I am aware there is not a definition of a person with a dangerous personality disorder. The likely hood is it will commonly be persons with Antisocial Personality Disorder (one which relates to psychopathy - more here on the relationship between the two - http://www.psychiatrictimes.com/dsm-iv/content/article/10168/54831).
In theory this means an innocent person can be incarcerated by the NHS having committed no serious crime, held without treatment nor hope of treatment. I am unware of any cases however this is what the law seemed to have been inadvertently designed to create: a system of punishment the same as for a crime but having not actually committed the crime.
So there is a hole in the fundamental rights of free citizens. In fact, in my opinion, this is a significant area for all use of deprived liberty in mental healthcare. It's noteworthy that the deprivation of liberty is the worst punishment most developed world nations exact on the worse criminals. And yet in mental healthcare a person can have ECT used on them without their consent and a free person can lose their liberty without due process or treatment available. They are simply punished the same way a criminal would be for being different.
I guess other people can't see that the use of a Section of the Mental Health Act 1983 is akin to incarceration unless there is treatment involved. The onus should be to offer intensive treatment and the same freedoms as any other citizen so as not to punish the individual. The protocol of depriving liberty is justified on risk to self or someone else. However without mental healthcare treatment - and this is beyond drugging them up to a state of avolition by use of chemical restraint - it is punishment the same as is handed out to people who have committed serious crimes. As someone who's experienced this first hand it may be worse in some psychiatric wards.
There is an illogical situation where there are some psychiatric wards that have worse conditions than the best prisons. But no one gives a fuck about psychiatric patients and justice for them.
I think the law is also illegal but I don't know what law makes it illegal to punish people who've committed no serious crime.
It makes me think of a question. Who watches the watchers? In this context I suppose it's who legislates on the law? The only thing I can think of is the Human Rights Act however it too allows for incarceration without crime. It doesn't seem to note that deprivation of liberty is used as punishment.
The UK criminal justice system has many tenets such as the adversarial system, innocent until proven guilt and due legal process. Though the Human Rights Act sees any deprivation of liberty with the procedure defined by law it doesn't say that the theory of the law should be applied to any deprivation of liberty.
Black men are overrepresented in psychiatric hospital admissions and in the use of the diagnosis of schizophrenia. This happens in the US too. It doesn't happen in the Caribbean. Deprivation of liberty for mental illness is one of those things justified as a necessary evil but because they're to be fundamentally understood as mental illnesses. The privilege of medicine only applies to true illness.
Mental health problems - and I use this in the correct term to define this differences in behaviour, thought, emotion or personality rather than the politically correct euphimisation of mental illness - are different. People with mental health problems suffer social disability and some of them, for example people with a diagnosis of schizophrenia, suffer a severe social disability such that their difference in life outcomes is comparable to people with severe physical disabilities.
However their incarceration with treatment, legal right to expect treatment and denied the same liberty as a citizen who has not committed a serious crime nor apply a rigorous process with the same rigour as if offered to people who've committed a serious crime is totally fucking nuts, and not the sort of nuts that I like.
(In practice this means offering as much of their life outside the confines of a psychiatric ward as possible rather than putting people in conditions that are worst than the best prisons (places used to punish people). It means a system of judicary and solid, reliable evidence rather than conjecture and hearsay). It means the mandatory right to intensive treatment if the person wants it and their choice in options (but the whole choice in treatment thing is a whole 'nother kettle of fish).
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