Clause 4
Mental Health Bill [Lords]
1:30 pm
John Pugh (Shadow Minister, Health; Southport, Liberal Democrat)
Clearly, the Government and the Mental Health Alliance think that there is an important issue, as there are two conditions in the 1983 Act for the detention of a mentally ill person. One, obviously, is having a severe mental disorder; the other is to be seen or judged to constitute a risk to oneself or others. Essentially, the amendment would add a third condition—that the individual has impaired judgment about his medical treatment.
The Government want to insist that it is perfectly safe to leave just the two conditions in place. They argue that to add the other condition would make matters worse because mentally ill patients whoare judged at risk will be left free to commit suicide and, less commonly, to harm others.
The key question is who we are talking about here. Could there be people who are judged to be a serious danger to themselves and others who are diagnosedas mentally ill and who are possessed of unimpaired judgment? I wanted to define where people stood on that issue, so I wrote to a number of the bodies that contacted me and asked if there were such people and what they were like—we explored some differences in the debate this morning.
Mind wrote back to me saying that it was hard to imagine that there were such people; the British Medical Association said that it was entirely possible that there are such people. The Royal College said not in most cases, although there will be some dangerous people who coincidentally will have mental problems. Lewis Appleby at the Department of Health said yes, there definitely were such people. The Law Society, in submission MH20 said that it was axiomatic that if one is dangerous and disordered one is mentally impaired.
The British Association of Social Workers in submission MH25 said:
“If a person’s judgement is not impaired, they cannot be suffering from a serious mental disorder”.
Baroness Murphy said that
“many if not all”—
of the people who pass on the first two criteria—
“will have impaired decision making”.