In July 2007, the government made amendments to the Mental Health Act 1983 and the Mental Capacity Act 2005. The government intended to modernise and improve the old legislation. A large part of the act remains the same; nevertheless, the new act presented very significant changes which include the introduction of the Supervised Community Treatment. This is the new supervision procedure for patients who are discharged from hospital and put back in the community. Another change is the redefining of the professional roles, which simply means that there are more mental health professionals treating and being responsible for one patient. Another change is the independent mental health advocacy. This gives mental health patients an opportunity to acquire a mental health advocate if they qualify.
The changes of the new mental health act seem to be very good and beneficial to mental health patients. It appears to be that the government really does care a lot about the nation’s well-being and mental health. However, by critically assessing these changes and looking behind the picture, we may find some weaknesses on how these services are being offered.
Let us talk about the Supervised Community Treatment, which appear to be really beneficial. A mental health patient who has been discharged from hospital will have someone in the community, normally a mental health practitioner, to regularly check if the patient is taking their medications. The practitioner has the power to return the patient to hospital, where the person may be forcibly medicated, if the medication regime is not being complied within the community (www.dh.gov.uk/en/Healthcare/Mentalhealth). I believe that the supervised community treatment has a number of strengths.
One big strength is that it ensures that patients receive medical treatment. Secondly, we all know that some mental health illnesses need to be regularly monitored, for example, schizophrenia and severe depression. These patients can suffer psychotic episodes if they do not regularly take medications. This endangers the patient and the people around the patient. By having someone from the community to regularly check if a patient is taking medications, this can be prevented. Another strength is that it can help in the treatment of problematic patients who have a history of stopping medication. The problematic patient will be aware that someone will be checking whether they are taking their medication. This may encourage the patient to take their medications properly.
However, I also think that the Supervised Community Treatment is not perfect. One big weakness that I found out in my research is that most patients do not like it. According to a survey by Mind, most mental health patients have very negative feelings towards the supervised community treatment (www.mind.org.uk/help/rights_and_legislation). Most patients do not like the fact that someone comes regularly in their homes to check if they have been good at taking their medications. Most patients feel that they are not trusted in taking their medications and they have very negative feelings about that.
It is hard for me to imagine how some of these vulnerable patients may feel when they are regularly checked by a stranger about their medication. Although they are out of the hospital, they may constantly feel that they are still inside. They may also feel that they are constantly reminded that are mentally ill, or different than the rest of the community. Another weakness is the fact that a patient may be forcibly medicated if they are not taking their medications. It just seems that they are scaring the patients to take their medications or else the patient will be force fed their drugs. I do believe that sometimes it is necessary, but under what conditions? Some psychiatrists say that force feeding drugs to the mentally ill is a necessary but safe process (www.siteslab.org/pitjournal). However, I cannot find any source that shows the patient’s point of view in this topic. As I found out in my research, there are many information about mental health in the point of view of psychiatrists, doctors, even campaigners. However, there is very little information out there on the mental health patient’s point of view, which may mean that they are not heard and not taken seriously because of their illness.
Over-reliance on drug treatment is another weakness. Research has already found out that the effectiveness of psychiatric medications is only short term, and it may also be harmful in the long run (www.nimh.nih.gov/health/publications/mental-health-medications). Obviously, if someone regularly checks up if a patient is taking their medication, it may encourage that patient to rely on drug treatments. Lastly, it may also be problematic with some mental health illnesses. For example, patients who has suffered trauma because they have been “forced” to do something. I just imagine how much fear they may feel if they are forced to take their medication.
If I have to put in a recommendation, I would consider adding holistic ways of treatment, such as counselling, CBT, etc. to the medication of mental health patients. I believe that these patients are very vulnerable and their treatment should promote therapeutic relationships to establish trust. This also reduces the chances of drug reliance. Another recommendation is that we should see these patients as individuals. Although, most patients can benefit from the supervised community treatment (eg. Severe depression, schizophrenia), some patients may be terrified with the idea (trauma patients).
Redefining professional roles is another change in the mental health act. It is the “broadening of the range of mental health professionals who can be responsible for the treatment of patients” (www.dh.gov.uk/en/Healthcare/Mentalhealth). This can be good as more professionals looking after and being responsible to one patient may mean more skills and expertise on offer. However, I have found out in my research that this is without the patient’s consent. I believe that this can be a weakness because it opens up too many avenues for too many professionals to do what they want with the patient, without consent. As I said before, these are vulnerable people and they may feel scared with the fact that a lot of doctors, psychiatrists, etc. are looking at their illness and being responsible for them. Lastly, I do not see how trust can be built with a patient this way. If I have to put in a recommendation, I would get the consent of the patient, or their nearest relative if they have no issue with more professionals looking after them.
The act also newly introduced the independent mental health advocacy. This gives mental health patients an opportunity to acquire a mental health advocate. This can be good because the advocate will be there to support the patient with their everyday lives. The patient will also have someone to look to for help. However, this service is only being offered to qualifying patients. In addition, the criteria for qualification are somewhat strict (www.afmh.org.uk). Only patients who are detained, have been detained, or are under the community treatment order are allowed to have an advocate (ibid.). A patient who does not qualify may be desperate for an advocate, and is not given an opportunity to acquire one because of the legislation. My recommendation would be that any patient can have an opportunity to acquire an advocate. I would remove the criterias and instead look at a patient’s case more thoroughly to find out if they need an advocate.
I will now talk about recent changes in policies that impact on people suffering with mental health illnesses. On February 2011, the government proposed a new mental health strategy called “No Health Without Mental Health” (www.dh.gov.uk/en/Healthcare/Mentalhealth). The strategy is very wide and diverse. Basically, it is a strategy to improve the nation’s mental health and well-being. The new strategy promises many improvements such as heightened awareness of mental health needs, Liaison Psychiatric Services in all general hospitals and improved quality of standards in mental health wards. The strategy also offers further enhanced training and education to all mental health professionals. One thing that strikes me the most is that the government also committed to £400 million funding over the next 4 years for the improvement of psychological therapies.
This is good news for everybody, especially people who are suffering with mental health illnesses. It seems that the government really does care about the nation’s mental health and well-being. However, mental health campaigners do not believe that the new strategy will work (www.psychotherapy.org.uk/ukcps_reaction_to_no_health_without_mental_health). This is because they do not see how the strategy will work while massive cuts on services are being done and carrying on (ibid.). Furthermore, on April 2011, the government has admitted that it risks undermining its plans to fund £400m because of massive cuts in civil service expertise (Dunning, 2011, socialcare.co.uk). I personally do not see how this new strategy will work with massive cuts that are carrying on. It also hard for me to be hopeful because even our government admitted that they may undermine their plans due to massive cuts.
Department of Health (2011) The Mental Health Act 2007 [internet] Available from: www.dh.gov.uk/en/Healthcare/Mentalhealth [Accessed April 2011]
Mind (2011) Supervised Community Treatment [internet] Available from: www.mind.org.uk/help/rights_and_legislation [Accessed April 2011]
SiteLab, Is Force Feeding of Drugs to Mental Patients Safe? [internet] Available from: www.siteslab.org/pitjournal [Accessed April 2011]
National Institute for Mental Health (2009) The Harmful Long Term Effects of Drug Treatment in Mental Patients [internet] Available from: www.nimh.nih.gov/health/publications/mental-health-medications [Accessed May 2011]
Advocacy for Mental Health (2011) Independent Mental Health Advocate [internet] Available from: www.afmh.org.uk [Accessed May 2011]
Psychotherapy UK (2011) Reaction to the New Mental Health Strategy [internet] Available from: www.psychotherapy.org.uk/ukcps_reaction_to_no_health_without_mental_health [Accessed May 2011]
Dunning J. (2011) Civil Service Cuts Puts Mental Health Strategy At Risk [internet] Available from: http://www.communitycare.co.uk/Articles/2011/02/02/116215/civil-service-cuts-put-mental-health-strategy-at-risk.htm [Accessed May 2011]