The Mental Health Bill & sectioning
The recently proposed changes to the Mental Health Bill has shown me a different set of opinions: in my experience people are more for the so-called ‘protection of the public’ than the rights of the person in question. However, the Lords have shown their worth this week by saying no, and it now winds its way through the legislative system, to be debated by the Commons this week. I believe that there are bigger, fundamental issues of our justice system that are undermined by effective imprisonment by the NHS. Yes, one of the purposes of imprisoning people at all is to protect those outside, but this is not the be all and end all.
To summarise the facts, as the law stands at the moment, doctors are able to ‘section‘ patients against their will and, aside from a few exceptions, apply treatment without the patients consent. The argument is that the patient is unable to make a rational decision against treatment in their mentally inhibited state. The key change with the new bill is that a wider range of conditions will be sectionable, notably untreatable ones, which under the current rules patients cannot be detained for. For any of these the requirement is that several (in emergencies however this can be reduced to one) medical professionals must sign to say that the sectioning should go ahead, and appeals can be made to a mental health tribunal. Indefinite confinement has long been possible (giving rise to the ‘loony bin’ concept).
This of course leaves the power to hold people against their will in the hands of doctors and psychiatrists, which is something that I do not believe they should have the power to do – notably, the patient is not allowed an advocate as they are in all court affairs. I can understand situations where a deranged person could cause damage to people, but again believe that doctors are not the people to make this decision. Additionally, the final point of appeal of the tribunal is again medical professionals.
I would propose a legal way forward, requiring a hearing before a court of law, with a judge and possibly jury, with the NHS prosecuting of a sort. It has been said that legal professionals cannot deal with this kind of situation because they are not qualified in medicine to understand the patient’s condition, but this is exactly my point – if the doctors had a truly strong and decent case, they would convince the judge/jury, allowing a second opinion to be had on the entire proceedings. In any case, compulsory treatment is not something that I think the state ought to be able to impose – mental illness, unlike something like a broken leg, is almost impossible to pin down (with exceptions where neurological changes are visible) and it is only someone’s opinion that someone is mentally ill. What if it’s just that they don’t fit the normal standards of behaviour? Who are we to deny that in a liberal society?
A further argument is that sectioning undermines one of the cornerstones of British justice: innocence until proof of guilt, which I think is incredibly important to sustain a fair system. Interestingly, this also contradicts the theory of the seperation of powers, as doctors are part of the executive, rather than the judiciary and therefore the power to imprison is in the wrong hands. I think that it would be all too easy for those high up to abuse this (despite the fact that the secret services already do). To conclude, I believe that the new bill is going in the wrong direction by adding power rather than taking it away as sectioning is an infringement of human rights that undermines key concepts of this country’s legal system.