Mental health review 'ignores real issues': Virginia Bottomley hints that she is considering emergency legislation to enforce compulsory treatment of patients in the community

GOVERNMENT plans to strengthen powers to force treatment on mentally ill people have been rejected by the Mental Health Act Commission as unnecessary and likely to divert attention from the 'fundamental difficulties' of providing adequate services to them.

Virginia Bottomley, Secretary of State for Health, hinted yesterday that she was considering emergency legislation, despite growing concern among charity workers and health professionals at her suggestion last weekend of new compulsory community treatment orders.

She believes that such measures are necessary to tackle the problem of people who have been discharged from psychiatric hospital, suffer mental health problems again but refuse continuing treatment in the community. At present, only those people who have been detained in hospital under the Mental Health Act can be compulsorily treated.

Mrs Bottomley spent yesterday discussing the possible terms of amending legislation with leaders of voluntary mental health agencies. Interviewed on Sky News, she said: 'We do really fairly urgently want to move to further action for this particular and vulnerable group of patients.' She said that the case of Ben Silcock, the man with schizophrenia mauled by a lion at London Zoo, had highlighted the need for action.

Department of Health sources suggested that ministers might seek to secure an amendment to the Mental Health Act of 1983 by means of a Private Member's Bill, although they are aware of the potential pitfalls of choosing such a route.

However, several organisations expressed concern that the Government was in danger of neglecting wider problems concerning the care of the mentally ill. William Bingley, chief executive of the Mental Health Act Commission, said: 'The commission's current view is that there is insufficient evidence to suggest that the creation of such a legal power would result in the needs of the patients for whom it is advocated being better addressed.

'Indeed, it may serve to distract attention from a number of fundamental difficulties in relation to profesional attitudes and adequacy of service organisation which, many would argue, are the real problem,' he said.

In its most recent report to Parliament, the commission suggested more use of guardianship orders, where local authorities or a relative or friend of the mentally ill person are given powers to control aspects of their behaviour.

The commission's call for a wide-ranging review of the Mental Health Act was echoed by the mental health charity, Mind. Ian Bynoe, its legal director, said there were several aspects of the legislation that required updating. 'We need more extensive rights to aftercare. Only a very small number of people, detained for a long time, have a statutory right to aftercare. The majority of mental health patients should have this right.'

It would be an 'unacceptable' breach of basic civil liberties if existing powers were strengthened against people who simply refused to take medication rather than those suffering a demonstrable mental disorder, he added.

The National Schizophrenia Fellowship said the main problem facing professionals seeking to treat those with serious mental illness was a chronic lack of resources. Martin Eede, its chief executive, said the closure of long-stay institutions for the mentally ill meant people being dumped into the community. 'The Government plans to close a further 49 hospitals within the next few years. Community care facilities just won't be there. Unless we have far greater resources, we will have the abandonment of people who are severely mentally ill.'

The Association of Metropolitan Authorities estimated last autumn that councils would face a pounds 200m shortfall in the resources they were given by central government to implement its community care policies. From next April, local authorities will take on prime responsibility for assessing the needs of elderly needy, handicapped and mentally ill people in their areas.

Leading article, letters, page 16