New powers to compel mental patients cared for in the community to submit to treatment were unveiled by ministers yesterday in a packageaimed at tightening control over people with mental disorders. The powers, set out in a Green Paper, are the centrepiece of what Alan Milburn, the Health Secretary, described as the biggest shake-up of mental health legislation in 40 years.

New powers to compel mental patients cared for in the community to submit to treatment were unveiled by ministers yesterday in a packageaimed at tightening control over people with mental disorders. The powers, set out in a Green Paper, are the centrepiece of what Alan Milburn, the Health Secretary, described as the biggest shake-up of mental health legislation in 40 years.

The measures, which include 100 extra crisis teams to provide services for 10,000 patients in the next two years, aim to improve protection for the public and for mental patients who pose a risk to themselves and others. They follow cases in recent years in which mentally ill patients have attacked or killed strangers, although studies show they are more likely to harm themselves.

Research published by the Department of Health in May showed that three murders and 80 suicides are committed each month by mentally ill patients who had recently received treatment. Many had not continued with medication and lost contact with care services.

The proposals, which are going out for consultation, were condemned by mental health campaigners. They warned that compulsion would undermine the trust between mental patients and their carers and could drive patients away.

The plans amount to an overhaul of the Mental Health Act 1983, itself an updated version of the 1959 Act, when most patients were cared for in hospital. Now 99 per cent of mental patients are treated in the community. Ministers say the Act must change to reflect that.

Detained patients can be forcibly given injections or ECT (electro-convulsive therapy) in hospital, but this power does not extend beyond the hospital.

Mr Milburn said: "The current mental health laws have failed. They have failed to properly protect the public, patients or staff...It is the community as well as these patients who have paid a very heavy price. The tragic toll of homicides and suicides graphically illustrates the failure of the old system."

Patients subject to compulsory treatment orders will be given a care plan they must follow and be told where they can live. If they fail to comply they can be returned to hospital for treatment. A duty will be imposed on health and local authorities to provide the services they need. As a safeguard for patients, a new mental illness tribunal is proposed.

The Green Paper follows ministerial announcements of an extra £700m for mental health services over three years, and a national service framework setting out service benchmarks.

Mental health groups criticised the move to compulsion. Cliff Pryor, chief executive of the National Schizophrenia Fellowship, described the Green Paper as a missed opportunity. "The Government is harking back to compulsion as a first resort rather than raising the standard of modernisation, quality and choice. Compulsion should be the last resort."

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