Caring for Patients in the Community

Publication Date01 May 1996
AuthorAlan Parkin
DOIhttp://doi.org/10.1111/j.1468-2230.1996.tb02088.x
LEGISLATION
Caring for Patients in the Community
Alan
Parkin*
The Mental Health (Patients in the Community) Act
1995
is an attempt to
reconcile opposing views’ about the provision of care for people with mental
disorder returning to the community.
Is
it appropriate that people who are
no
longer ill enough to require treatment in hospital should
be
made subject to
a
legal
regime which restricts their movements and activities, or is the policy of
community care failing patients because of a lack of staff and resources? The Act
comes down firmly in favour of a new legal regime, intended as a response to
widespread concern fuelled by a number of incidents, that some disordered people
in the community
are
a danger either to others or to themselves. Such incidents
include the case of Christopher Clunis who stabbed
a
stranger, Jonathan Zito, at
Finsbury Park underground station* and the
case
of Ben Silcock who was severely
mauled when he entered the lions’ den at London
The main purpose of the Act is to introduce the legal state of ‘supervised
discharge’ into England and Wales. It also extends the maximum period for which
leave can
be
granted from
6
to
12
months and makes
a
heavy handed change to the
provision in the Mental Health Act
1983
which allows discharge by operation
of
law following unauthorised absence from hospital. Thus, the major objectives of
the Act are to extend the
period
in which treatment in the community can
be
administered
as
part of the conditions attached to leave and, at the end of the
period
of
detention, to make available a legal status which can
be
attached to
selected
cases
on discharge in an attempt to make members of the limited group of
patients to whom it
is
intended to apply more amenable to supervision.
In
doing
so,
attempts have been made to steer an uneasy course between, on the one hand,
placing restrictions on those who are discharged
as
ostensibly well and, on the
other, leaving the provision of community care purely as a matter
of
persuasion.
Remarkably, the Act appears to have succeeded in introducing a legal duty with
no
immediately apparent sanction and is therefore described in the accompanying
memorandum
as
‘providing a legislative framework for existing good practice.’ It
is intended here to concentrate in the main on the consequent changes to the
Mental Health Act
1983
which implement the new concept of ‘supervised
discharge,’ and to attempt to explain the circumstances in which new legislation
appeared to the government to
be
desirable. It will
be
argued that the legislation,
perhaps inevitably, falls between two stools in attempting, on the one hand, to
avoid falling foul of the European Convention on Human Rights (although even
*Law School, University of Hull.
1
The opposing views are held within disciplines
as
well
as
across disciplinary boundaries.
It
is clear
from the contributions
to
Parliamentary debates that there is also a
clear
divergence in the views of the
various pressure groups in the area.
See the
Report
of
the Enquiry into the Care
and
Trearment
of
Christopher Chis
(London: HMSO,
1994).
See
A.
Parkin, ‘Into the Lion’s Den’ (1993) 143 NLJ
50.
2
3
414
0
The
Modem
Law
Review Limited
1996
(MLR 593, May). Published by Blackwell Publishers,
108 Cowley Road, Oxford
OX4
IJF
and 238 Main
Street,
Cambridge, MA
02142,
USA.

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