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A bad Bill has been dropped - but the battle to reform the system goes on

Sophie Goodchild,Chief Reporter
Sunday 30 October 2005 00:00 BST
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Dr May was diagnosed with schizophrenia at the age of 18, sent to hospital three times within 14 months and told he would have to take medication for the rest of his life. Instead, he found his own way out of his "madness" and no longer has to take drugs, which in his view should only be a short-term solution. His patients are offered acupuncture and tai chi to aid recovery, not locked up in psychiatric hospitals for years.

"What saved me was drama and dance, and people not giving up on me," said the clinical psychologist who works for the NHS in Bradford, West Yorkshire. "Unless we have a holistic approach then we are no better than drug dealers."

The remarkable story of Dr May's mission to change the health system from within was a catalyst for The Independent on Sunday's campaign to improve the rights of the mentally ill. It included demands for ministers to drop controversial measures that would have forced psychiatrists to detain more people against their will, even those who had never committed a crime.

Along with patients, lawyers and psychiatrists, Dr May has always been vehemently opposed to the draconian measures outlined in the draft mental health Bill. The news that the Bill has been quietly shelved by ministers is a victory for this newspaper and for campaigners who denounced it as unworkable because it was geared towards criminalising the mentally ill. Although reforms are still desperately needed, groups such as Mind and the Law Society argue that the emphasis must be placed on looking after patients, not locking more up.

Psychiatrists can already have patients locked up in mental health units on the grounds they may pose a threat to the public or for their own safety. But what provoked outrage was that the new laws were so broadly worded that even people with a mental disorder for which there is no official treatment could have been held on a secure ward.

Ministers saw the Bill as a way to appease the public in the wake of the horrific murders of Lin and Megan Russell by Michael Stone, a former psychiatric patient. David Blunkett, the former home secretary, demanded that civil servants find a way to close what he saw as a loophole preventing those with so-called severe dangerous personality disorders being incarcerated.

Mental health charities argue that the tiny minority of dangerous people in society should be dealt with under criminal laws. Of 900 homicides a year, only between 30 and 50 are committed by people suffering from severe mental illness, and that figure has remained static since records began. If the mental health Bill had become law in its current form, these rare attacks might have increased because desperate people would have shied away from seeking help for fear of being incarcerated in high-security hospitals.

Another measure in the Bill that attracted criticism was the introduction of special orders which would have meant that people risked being sectioned unless they agreed to take regular medication that often has adverse side-effects.

"There is a much more understanding approach now towards mentally ill people who are living in the community, but forcing people to take their medication just alienates them,' Dr May said.

The Bill may have been shelved, but the mental health system is still in urgent need of reform. Improvements have been made but progress is depressingly slow. Ministers have promised to invest £130m in psychiatric services. There have been real changes in the provision of crisis services and of new medicines thathave less debilitating side-effects than old-style psychiatric drugs.

Rethink, which offers support for people suffering from severe mental illness, said improvements were being made but that the biggest problems were still prejudice, ignorance and fear. Services are delivered against "a background of crisis and compulsion". "We have to make sure that improvements are rapid and sustained, and that the public recognises that investment in mental health must continue," said Paul Corry, a spokesman.

The treatment of women is a continuing concern for campaigners. New research reveals that nearly one in 10 of female patients on psychiatric wards report that they have been sexually assaulted while receiving therapy and more than half have been verbally or physically threatened.

One who responded to Mind's WardWatch survey wrote: "I once found a male patient in underpants in my bed. He wandered into the wrong room. I was very scared as I have been raped in the past." These shocking findings, published for the first time, highlight the woeful state of psychiatric wards.

Richard Brook, chief executive of Mind, said: "What we have is a system that is broken and was never going to be fixed by the new proposals [in the Bill]."

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