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Mental health U-turn

The Government has agreed to back down on controversial elements of its planned Mental Health Bill after opposition from GPs and psychiatrists.

Its plans had been widely criticised for their confusing definition of mental illness and for attempts to rescind the treatability clause governing who can be sectioned for avoiding treatment.

Ministers have now agreed to alter their proposals after doctors warned patients who were not currently defined as mentally ill might otherwise be compulsorily treated.Health minister Rosie Winterton announced the climbdown over treatability last week, proposing instead a compromise that would permit enforced treatment only in situations where it was 'intended to alleviate a condition or prevent if from getting worse'.

Ms Winterton said: 'We have had productive discussions with members of the House of Lords, House of Commons and with stakeholders, and have listened to their views and concerns. 'We have worked closely together to strengthen the bill, and with these amendments I feel we have got the balance right.'

The amendments also include changes to new supervised community treatment orders – designed to encourage treatment of patients in the community after release from hospital or offenders' units.

The Government is persevering with community treatment orders despite fresh research, presented at the Royal College of Psychiatrists annual meeting in Edinburgh last week, that suggested it would take 100 orders to prevent a single psychiatric readmission, and that they did little to address the problem of 'revolving-door care'.

Professor Mayur Lakhani, chair of the RCGP, welcomed the clarification on how community treatment orders were to be used, but added that he was concerned about the practicalities of implementing them and their impact on general practice.

He also said the college had been disappointed by the lack of proactive dialogue with GP organisations about the Mental Health Bill – and said GPs would need more support in managing patients with complex mental health issues.

Amendments to the bill
• Supervised community treatment – an order can only be placed to ensure patients receive treatment to prevent the risk of harm to their health or safety, or to protect other people. Doctors will not be able to 'ban' patients from certain places or activities.
• Patients' rights – advocates will be appointed to support mental health patients, to help patients understand the treatment they are being given and how to exercise their right.
• Children and young people – young people must receive treatment in an environment that is suitable for their age and geared to meet their needs.
• Mental Capacity Act – statutory access to be provided to advocacy for people deprived of their liberty under the MCA, with changes to regulations when advocates are unavailable.

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