View source for Anselm Eldergill, 'Is it Madness?' (5 February 2025)

{{Resource
|Title=Is it Madness?
|Author=Eldergill, Anselm
|Date=2025-02-05
|URL=https://www.linkedin.com/posts/anselm-eldergill-53146142_eldergill-mental-health-bill-activity-7292911062792765440-Kd4E
|Type=Article
|Sentence=Criticism of Mental Health Bill
|Abstract=This article by the chairman of the Patient Safeguards and Mental Health Tribunals Working Group, which formed part of the Wessely review, is critical of the failure of the Mental Health Bill to act on its recommendations. Liberal reforms of mental health legislation (the 1959 and 1983 Acts and initiating this review) have been initiated by Conservative administrations whereas Labour has focussed on structures and systems more than individual freedom, with unfortunate results. Care homes are the new long-stay wards and there are now far more people detained outside psychiatric hospitals than in them, so a single, fused statute is needed. Lack of intervention prior to psychiatric homicides is not due to lack of legal powers, and no amount of new legislation can improve foresight. An unanswered question is whether statutory grounds for detention actually fetter professional decision-making, or whether doctors make their decisions on other grounds and squeeze that decision into whatever legal framework is provided. In relation to the four protective pillars of the MHA 1983: (1) Tribunal discharge rates have fallen from 20-25% in the mid-1990s to around 6% (3% for CTOs), partly because of defensive decision-making after well-publicised incidents, JAC procedures and judicial culture, and inadequate legal representation following the decimation of Legal Aid. It was disturbing that the tribunal’s representations to the working group proposed curtailing rather than expanding some of the legal rights of detained patients, and placed less emphasis on individual liberty than the old 1959 Act. The proposals to empower the tribunal to authorise deprivation of liberty in the community means it will come to be seen by some as part of the state apparatus that imposes compulsion rather than as a court that exists solely to review and terminate infringements of liberty that are not justified. (2) The nearest relative's removal is for essentially Kafkaesque equality reasons, and is to be replaced by a ridiculously complicated and bureaucratic scheme which involves the citizen or a professional selecting a 'nominated person'. (3) Labour's abolition of the MHAC and its amalgamation into the CQC super-quango led to the predicted increased institutional abuse. What is needed is a multi-disciplinary legally-led Mental Health and Human Rights Commission that is responsible for monitoring and ensuring compliance with the MHA, MCA and ECHR, and which to ensure independence from Ministerial pressure should be accountable to and funded by Parliament, not the DHSC. (4) The hospital managers' focus needs to be on seclusion, restraint, investigating complaints and reporting allegations of ill-treatment or non-compliance with the law to the new Commission. The author is critical of the review for overreliance on civil servants and academic input and insufficient practitioner input: "The consequence is that a legal system that was deficient will remain deficient. ... These Bills are once in a generation events and we shall now have to wait another generation for necessary reforms. Pure madness."
|Saved=No
|Download=2025-02-05 Eldergill Is it Madness.pdf
|News=Yes
|RSS pubdate=2025-02-06 05:06:28 PM
}}