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Section 3 — Meaning of "mental Disorder" in the 1984 Act

Part of Mental Health (Public Safety and Appeals) (Scotland) Bill: Stage 2 – in the Scottish Parliament at 4:15 pm on 8th September 1999.

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Photo of Iain Gray Iain Gray Labour 4:15 pm, 8th September 1999

In debating stage 1 of the bill last week, we made it clear that this was emergency legislation and that it was about one thing and one thing only. It was and is about public safety. It was and is about ensuring that there are no further releases from detention of those patients whose diagnosis and condition is similar to that of Noel Ruddle. It is about closing that door-that is all. The bill is certainly not about reforming or modernising mental health legislation. That is why the insertion of "personality disorder" as a mental illness, which was always implicit in the Mental Health (Scotland) Act 1984, is made express in the bill. The amendments which we move, 37, 38 and 39, make it plainer still that "personality disorder" was included under mental illness-and it still is. It has been the aim not to change that, but to clarify it.

This is not the time or place to change that; this is about closing the door-that is all. It is not about, as some have implied, opening the doors of the state hospital to a cohort of new people with mental illnesses, whether they are currently in the community or in prison. The bill will not do that because hospital admission will still require section 17 of the 1984 act to be satisfied: it will still need to be shown that, if the mental disorder from which a patient suffers is persistent, manifested only by abnormally aggressive or seriously irresponsible conduct, treatment in hospital is likely to alleviate the condition or prevent it from deteriorating, and that it is necessary for the health or safety of the person, or for the protection of others, for him to receive such treatment in hospital. That is a very important sentence, although a particularly difficult one to read.

It is clearly for doctors to reach that view; in our view, the bill imposes no new responsibilities on doctors or psychiatrists in that respect. The bill affects those seeking to leave detention in hospital; it does not change the process of admission. I gave this assurance yesterday to the Royal College of Psychiatrists and I am happy to give it again in this chamber. We are closing a door; that is all. We are not opening new ones.

The Executive is in no doubt about the importance of mental health and the issues surrounding it. We well understand the complexity and difficulty of the definitions of mental disorder, and are conscious of the differing and deeply held convictions regarding such matters, even within the mental health community. That is why we will not open the door to that debate today. Involved in that debate is the MacLean committee, which is examining how to deal with serious offenders, including those with personality disorders. Also involved is the Millan committee, which is, as we asked, reviewing mental health legislation-a difficult job. We will not and must not burst in on those deliberations-they are too important. I acknowledge that even to think about such matters without beginning to stray into MacLean's and Millan's territory is extremely difficult, but to start tinkering with the definition of mental disorder now-which it may be tempting to do-would be irresponsible. Mr Millan's letter, which has been referred to and has been made available, made it very clear that he wishes us to stay out of his room for the moment.

The Minister for Health and Community Care and I will throw open the doors to the debate on modernising mental health when the time is right. We will examine all the issues fully in the light of all the experience and expertise available, but we will not do it today because this bill should do as little as possible, commensurate with its aim of improving public safety. As drafted, with the clarifying amendments, improving public safety is what the bill does, and it goes no further.

I say again: the bill does not seek to allow anyone to be admitted to hospital who could not be detained under the existing law. For those few-and it is a few-whom the bill affects, we give the assurance, as the Deputy First Minister has already done, that resources will be available for treatment which is considered to be appropriate by clinicians in the state hospital. However, we will not try to define that today, which is why Susan Deacon has asked the Mental Welfare Commission for Scotland to report on this matter properly and separately from the consideration of public safety, with which we are involved today. All around us are interesting and important doors that we need to open, but not today. Today, we have one door to close and these amendments will help us to do that. We all know what we have to do-let us close that door now.

I move amendment 37.