Mental Health Act: why not learn from devolution?

BMJ 2006; 333 doi: https://doi.org/10.1136/bmj.39051.722755.3A (Published 07 December 2006) Cite this as: BMJ 2006;333:1221
  1. Richard Simpson, consultant psychiatrist
  1. 1Lothian NHS, Livingston, West Lothian EH54 6QF richard.simpson@hushmail.com

    The UK government's third attempt to introduce an amended Mental Health Act is already meeting the same resistance as its previous attempts.1 The reasonable concerns of ministers in the Home Office about protecting citizens from violent people, who are likely to offend, have been interpreted in such a way in the proposed bill as to achieve a degree of unity in opposition from those in the mental health field that would have seemed improbable 10 years ago. Moreover they have done so not once or twice but now three times.

    At the same time, the Scottish government, when I was deputy justice minister, successfully introduced a new act that not only protects our citizens but also met with broad agreement and now support a similar alliance in Scotland that condemns the English government's approach. The two previous acts in the 20th century were passed first in the UK parliament applying to England and Wales and were subsequently amended marginally to become law in Scotland.

    My question is a simple one. Why not use the benefits of devolution and adopt the Scottish Act amended to suit English needs?2 Psychiatrists in the former Soviet Union were condemned for acting on behalf of the state to incarcerate citizens who did not suffer from a treatable illness. English and Welsh psychiatrists should not be forced to put themselves in a similar position. Are we to be the only signatory out of 45 nations to reserve the right not to comply with the Council of Europe's Recommendation 3on protecting the human rights and dignity of people with mental disorders?

    As Dyer has put it so concisely, if people who do not have a treatable mental illness are deemed a danger to others then criminal proceedings need to be implemented, if appropriate.


    • Competing interests: None declared.


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