The implications of mental health law reform for service development and workforce planning

DOIhttps://doi.org/10.1108/17556228200600004
Publication Date01 May 2006
Pages22-29
Date01 May 2006
AuthorPeter Kinderman
SubjectHealth & social care
22
The implications of mental health law
reform for service development and
workforce planning
Abstract
The UK Government has been planning changes to
mental health legislation for at least eight years. On
23 March 2006, the Department of Health
announced that many of these plans would proceed
although through amendments to the 1983
Mental Health Act rather than a substantive Bill.
These proposed reforms are significant but
controversial. This paper sets out some of the
reasons for welcoming the proposed changes. It is
argued that the proposals to replace the responsible
medical officer with a clinical supervisor arein
keeping with best quality mental health care, and
allow for proper multidisciplinary practice. Such an
approach explicitly permits proper use of the skills
and competencies of the workforce – including
psychologists. A second controversial aspect of the
proposed reforms – supervised community
treatment orders, permitting compulsorycare
outside of hospitals – represent not a violation of
human rights, but a specific defence of ‘Article 8’
rights to protection of family and personal life.
Finally,it is argued that the proposed amendments
are important because mental health legislation
dominates mental health care and the present 1983
Mental Health Act inappropriately consolidates the
status of the medical model and the role of the
responsible medical officer (and hence psychiatry). It
is argued that the proposed changes are imperfect;
in particular they lack inclusion of an ‘impaired
judgement’ criterion, but it is suggested that
necessary role and service redesign needs such
amendments to allow the new ways of working
programme to ‘bite’.
Key words
mental health law reform; mental health legislation;
service development; workforce planning
Plans for reform
Most workers in the mental health services will now be
aware of the general thrust of the Government’splans for
reform of the 1983 Mental Health Act. On 23 March 2006,
the Department of Health announced that many of the
Government’splans for mental health law reform would
proceed – although through amendments to the 1983
Mental Health Act rather than a substantive Bill. These
proposed amendments retain many of the key elements of
the 2004 draft Mental Health Bill, and include (but are not
limited to):
‘To introduce supervised treatment in the community
for suitable patients following an initial period of
detention and treatment in hospital’,
‘Toexpand the skill base of professionals who are
responsible for the treatment of patients treated
without their consent’,
‘Tointroduce a new, simplified single definition of
mental disorder’,
‘To replace the “treatability test” (which currently
results in some people with personality disorder being
inappropriately excluded from the treatment they need)’,
‘To keep the exclusion for drug and alcohol
dependency, and preserve the effect of the Act as
it relates to people with learning disabilities’.
The reforms are wide-ranging and significant, but also
controversial. Although this paper will focus on the
implications of the proposed reforms for workforce
development, it is fair to say that much of the criticism
has been couched not in terms of new statutory roles (for
psychologists, for other professionals and hence for
mental health generally), but because many people have
criticised the reforms themselves on ethical and human
rights grounds.
Peter Kinderman
Division of Clinical Psychology, University of Liverpool
The Journal of Mental Health Workforce Development Volume 1 Issue 1 May 2006 © Pavilion

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