II. A Psychiatrist's View
| Date | 01 July 1960 |
| DOI | http://doi.org/10.1111/j.1468-2230.1960.tb00615.x |
| Author | T. C. N. Gibbens |
| Published date | 01 July 1960 |
416
THE
MODERN
LAW
REVIEW
VOL.
23
likely to be a large number of appeals, and points of law and policy
of great practical importance will arise from the attempt to apply
these possibly over-elaborate definitions. Some of these will
no
doubt be referred to the High Court, where
it
will be interesting to
see the results.
J.
E.
HALL
WILLIAMS.
11.
A
Psychiatrist’s
View
In providing for the treatment of mental disorder with as few
distinctions as possible from other forms of illness, the Act confirms
a trend which has been going on for some time. With advances in
psychiatric treatment, and the change in the attitude of public
opinion towards mental illness,
it
has become possible to treat
an
ever-increasing proportion of patients without the use of compulsion.
Moreover, a larger proportion can be treated as out-patients and,
within the institutions, locked doors and close restraints have been
gradually reduced
or
abandoned, whatever the patients’ legal status.
In
the international field the Expert Committee of the World Health
Organisation recently reported that
(‘
most existing legislation is
misdirected in
its
aim.
It
is concerned too much with placing
checks on the mental patient and his physician, and too little with
the public’s responsibility for providing services for the mentally
ill.” The Act places us in the forefront of countries with good
legislation.
In the new conditions, the patient who shows a persistent
behaviour disorder is not only increasingly conspicuous and
troublesome, but tends to approximate more closely to the asocial
and antisocial person in the wider community. The recognition of
a new group of psychopathic disorders arises in part from this
experience as well as a wider knowledge of disorders in the com-
munity; in this respect the Act is a courageous blueprint for future
developments.
In
this new field, however, the attitude
of
the public
is as full of fear and ambivalence as
it
was towards mental illness
thirty years ago. A large section of the public would be willing
to see sex deviants and others segregated semi-permanently, out of
sight and out of mind; a small and sometimes embarrassing minority
calls
for
the medical
((
treatment” of almost
all
antisocial
behaviour. The new mental health review tribunals will have an
important function in protecting the doctor from these varied
pressures.
Less conspicuously, the Act bears witness to the coming
of
age
of psychiatry as a medical speciality. From the medical superinten-
dent who was the solely-responsible custodian of a number of
inmates, subject to the decision of
a
lay magistrate, we have evolved
*
W.H.O.
Technical
Rf,prt,
Series
No.
98,
1955, “Legislation
affecting
Peychiatric Treatment.
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