Politics
Patients should be treated and not turned into pre-criminals
Published 15 January 2007
Legislating is the easy option. The real scandal in mental health lies in the lack of psychiatrists and hospital beds
In Steven Spielberg's Minority Report, such is the omniscience of the authorities that people are hunted down for "pre-crimes": simply for thinking of doing something wrong. The film was a fictional account of life 50 years hence, but it is not too far removed from life as it is now. This Labour government has acquired a penchant for locking people up even before they have done anything wrong. Control orders, as part of anti-terrorism legislation, marked an important departure in pre-crime detention. There will be more, as threats to public order are deemed to increase all around us.
In recent days parliament has begun to consider the latest attempts by ministers to amend the Mental Health Act for England and Wales. (New measures for Scotland have been far less contentious.) Mental health professionals and politicians agree that the legislation requires updating. Some of the bill's minor provisions appear reasonable; others could be argued either way. But in several crucial areas the legislation is dangerous, particularly where it seeks to deal with what is known as "revolving-door patients" - mentally ill patients who do well in hospital but stop taking their drugs after being discharged, and then relapse.
Under the proposals, community treatment orders will compel patients to take their treatment after discharge on threat of being readmitted to hospital. In countries where such orders are applied, the effect is minimal and hugely outweighed by infringement of liberties. The definition of the kind of treatment that requires a patient's detention is also being broadened. Psychiatrists say this will turn them into potential jailers.
When they made their first attempts in the late 1990s to introduce legislation, ministers declared they wanted to prevent "another Michael Stone". A drug addict suffering from paranoid schizophrenia, Stone was convicted of the 1996 murder of Lin Russell and her six-year-old daughter, Megan. It was a crime that left a particular mark on the public consciousness. The desperate urge to be seen to do something was understandable. The only problem was that the recent report into the murders came to more complex conclusions about a complex case. The inquiry could find no evidence to show that tougher treatment could have prevented the killings.
More often than not - as the hubristic John Reid is discovering - crises in criminal justice are the result of professional mistakes. These are harder to pinpoint and correct, and produce fewer political benefits. Legislating is the easy option. This applies similarly in the crossover between mental health and law and order.
The real scandal lies elsewhere, in the shortage of psychiatrists and hospital beds for the mentally ill. The government refuses to accept evidence, produced by a number of reports, showing that spending in this area has been disproportionately affected by the recent attempts to cut costs across the NHS. Mental health has long been the Cinderella service, and yet it is vital. One in six people suffers at any one point from problems ranging from anxiety and depression to dementia and schizophrenia. Half of all women and a quarter of all men will be affected by depression in their life. Members of ethnic minorities are three times more likely to be admitted to hospital with a mental illness than whites.
Only a quarter of people with long-term problems are at work. The number of incapacity benefit claimants suffering from mental health issues has almost doubled to 850,000. There is, therefore, an economic as well as a social and moral rationale to devoting more sustained resources.
Yet ministers take the headline-grabbing route, pandering to public safety concerns rather than seeking to distinguish between legitimate and whipped-up fears. It should be remembered that, of the 900 or so murders a year, fewer than 5 per cent are committed by people with a severe mental illness. We in Britain are 20 times more likely to be killed by a sane person than an insane one. Almost the whole profession sees the Mental Health Bill as bad law, and the NS supports those in both houses of parliament seeking to change it.
The responsible face of politics
Tony Blair's staunch defence of the right of British travellers to cheap flights has been read by the press as a rebuke to the environment minister Ian Pearson. It probably was. Pearson labelled Ryanair "the irresponsible face of capitalism" and said a future Labour government would take action against airlines over climate change. The Ryanair boss, Michael O'Leary, took offence. The Prime Minister defended having a "good time".
Yet there was nothing very outspoken about Pearson's comments, which is possibly why they initially received little media attention. His remarks were in line with EU policy on carbon emissions (which his boss David Miliband has backed with enthusiasm and Ryanair, unsurprisingly, has opposed). Broadly, this states that, from 2011, all flights within Europe will be covered by a carbon-trading scheme, limiting the CO2 that can be emitted by major polluters. Eventually, such a scheme would cover all international flights.
Though he has now backtracked, Blair ("everybody else is going to be having . . . cheap air travel") spoke as if this important piece of policy had slipped his mind. We could speculate about his intentions, his relationship with O'Leary, Miliband's with Pearson, Gordon Brown's with all of them.
Instead, let us make it clear that if ministers are going to start speaking plainly and honestly about their policies and the likely consequences of these, this magazine will be delighted. Keep talking, Mr Pearson.
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