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Mental Health Act reform

Should psychiatrists go on being responsible?

Published online by Cambridge University Press:  02 January 2018

Trevor Turner ,
Mark Salter  and
Martin Deahl
Trevor Turner
Affiliation:
Department of Psychiatry, East Wing, Homerton Hospital, Homerton Row, London E9 6SR
Mark Salter
Affiliation:
Department of Psychiatry, East Wing, Homerton Hospital, Homerton Row, London E9 6SR
Martin Deahl
Affiliation:
Department of Psychiatry, East Wing, Homerton Hospital, Homerton Row, London E9 6SR
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Psychiatrists have been complaining about mental health legislation for over a century (Smith, 1891), usually in terms of the delays engendered, paperwork and bureaucracy, and the impositions on clinical practice. As a result they have gained more powers, and perhaps much-needed status within the medical profession, to the concern of some commentators (e.g. Fennell, 1996). Thus, the ‘triumph of legalism’ (Jones, 1993) of the Lunacy Act 1890 was modified by the Mental Treatment Act 1930, whereby outpatients and voluntary patients were encouraged and ‘asylums' became ‘mental hospitals'. Then came the radical change of the Mental Health Act (MHA) 1959, making compulsory detention an essentially medical decision and removing the routine of the courts, but retaining a theme of requiring ‘treatment in hospital’. The Mental Health Act 1983, however, was a touch anti-medical, since it strengthened the role of the approved social worker (ASW) and enhanced the importance of a patient's consent to treatment. “The primacy of the medical model and the paramountcy of the psychiatrist are certainly subject to greater limitations and external review”, was the opinion of William Bingley, then Mind's Legal Director, now Chief Executive of the Mental Health Act Commission – reviewing the Act in its early days (Bingley, 1985).

Type
Review Articles
Information
Psychiatric Bulletin , Volume 23 , Issue 10: The Journal of Trends in Psychiatric Practice , October 1999 , pp. 578 - 581
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution (CC-BY) license (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © 1999 The Royal College of Psychiatrists

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