Mat Kinton

Placed Amongst Strangers – the Tenth Biennial Report (2001–2003) of the Mental Health Act Commission

The Mental Health Act Commission’s Tenth Biennial Report was laid before Parliament and published in December 2003. The report covers two years’ activity – financial years 2001 to 2003 – monitoring the operation of the Mental Health Act 1983 as it relates to the detention and treatment of patients. In twenty chapters it deals with a range of issues pertinent to the care of mental health patients subject to compulsory treatment. I will not attempt here to list systematically the points made by our report. Readers of this journal are likely already to have thumbed a copy of the report itself, or accessed it on the Commission website, and, if not, I hope that this article will encourage them to do so. Instead, I will seek to explain in more general terms the context and themes of the report, and what we would wish to see as its desired outcome.

A snap-shot of ‘long-term’ section 17 use in South-West England

The Mental Health Act Commission (MHAC) does not have a culture of visiting patients in the community, having a primary statutory duty of visiting detained patients in hospital, and no remit over patients placed under Guardianship or Supervised Discharge (s.25A). The MHAC’s statutory remit does, however, encompass patients who remain liable to be detained but are granted leave of absence from hospital, and will extend to patients who are subject to supervised community treatment upon the implementation of SCT powers in October 2008. In an attempt to get a better understanding of patient and process issues that are likely when visiting community-based patients, the MHAC has been running some exploratory visits to detained patients on long-term section 17 leave. These visits have been carried out under the MHAC’s statutory remit. This is a brief account of one such exercise in the South-West of England.

Mental Health Law for the 21st Century

Lord Shaftesbury complained that it took him ‘seventeen years of labour and anxiety’ to get the Lunacy Act 1845 onto the statute books. The revision of the Mental Health Act 1983 is also turning out to be a long and difficult process, both for Government and for those that it calls ‘stakeholders’ in mental health services. What follows does not seek to examine that process, although it relies heavily on the public sessions of the Joint Committee on the draft Mental Health Bill (hereafter ‘the Joint Committee’). Nor will I attempt to summarise the Mental Health Act Commission’s public comments on the draft Bill of 2004, which are readily available. My conclusions, especially insofar as they exhibit a certain pessimism over the future direction of mental health law, are a personal view rather than one which is necessarily held by the MHAC.

What Is To Be Done? MHAC Recommendations for Detained Patients' Services

he Mental Health Act Commission (MHAC) is a Special Health Authority charged with overseeing the operation of the Mental Health Act 1983 (‘the Act’) as it relates to the care and treatment of detained patients. We are fully independent of those with operational responsibilities for mental health services, whom we visit on a rolling programme. Over the last two years we averaged at least three visits to every facility that detains patients. We met with over 20,000 detained patients on these visits. We also talked with staff and looked at issues relating to the operation of the Act. Following each MHAC visit we provide a written report to the hospital managers detailing our observations and recommendations. We also publish guidance on issues relating to the operation of the Act. Every two years we publish and lay before parliament a biennial report detailing our activities and findings over that period.