The mentally ill deserve compassion, not compulsion

Wednesday 26 June 2002 00:00 BST
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If ever a government policy laboured under a misnomer, it was "care in the community", the label the Conservatives chose when it was decided to decant thousands of patients out of those vast Victorian mental institutions.

True, there was much wrong with those old homes and hospitals for "incurables" and the like. Those who had campaigned against them and the often abysmal, sometimes cruel conditions that obtained there were right. However, what awaited those who found themselves – with scant preparation – in the outside world was precious little care and not much in the way of community.

A rapid increase in the number of homeless was one consequence of the policy; rare but high-profile cases of assaults and murders by the mentally ill upon other members of the public was another. As is widely recognised now, even by Conservatives such as the shadow Health Secretary, Liam Fox, care in the community was given far too little funding for it to ever have had very much chance of success. So the whole policy fell into disrepute.

Now, however, the Government, with its new draft Mental Health Bill, is in danger of undoing what good did come out of care in the community and of returning to a regime that relies on rather too much detention and residential care. Of course we should try to close the loophole that allowed the murderer Michael Stone, who was diagnosed with an untreatable but severe personality disorder, to go free. However, that power should necessarily be used only in relation to the few people such as Stone who fall into that rare category. The more pressing need is for the Government to ensure that mental heath receives its fair share of the large projected increase in NHS spending over the next five years that the Chancellor announced in the Budget.

One in four of us is likely to have some form of mental health problem, ranging from mild depression through to Alzheimer's disease. It is encouraging that the Health Minister, Jacqui Smith, has stated so clearly that most people with mental health problems are no risk to themselves or others, and that most will never need compulsory treatment. Compassion and not compulsion has to be the keynote.

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