Tough new controls on violent and `untreatable' patients

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TOUGH NEW controls on potentially dangerous patients discharged from psychiatric hospitals are to be announced tomorrow in the biggest shake-up of mental health legislation for 40 years.

Alan Milburn, the Secretary of State for Health, will publish proposals for a radical reform of the Mental Health Act 1993, which was an updated version of the 1959 Act. The proposals are the third plank of his strategy to modernise the NHS, after his announcement last month of new targets for tackling cancer and heart disease. At present, 99 per cent of mental patients are looked after in the community.

A spokesman from the Department of Health said the new proposals were designed not to abandon community care but to end the "couldn't care less" approach, in which "dangerous patients were left to get on with it". Ministers believe there is a third way between asylums and community care.

Under the Green Paper's proposals, patients discharged from hospital will be given an order specifying where they will live and a care plan similar to a statement of special needs for a child at school. Patients who disregard their plan will be returned to hospital for compulsory treatment.

But pressure groups for the mentally ill say compulsory treatment outside hospital is an unacceptable breach of civil liberties. Marjorie Wallace, of Sane, a mental health charity, said: "We are not in favour of treatment outside hospital or a clinical setting, mainly on the grounds that these are pretty heroic drugs and patients given them against their will need monitoring for side-effects. Our view is that two or three months in hospital can stabilise a person much better than making them come for injections in the community."