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This House would detain people on grounds of mental health
This House would detain people on grounds of mental health
Detention on the grounds of mental health aims to provide treatment and safety for those who are deemed unable to make an informed decision about their situation due to their mental state. The current process in the UK means that two doctors or a doctor and a social worker have to declare that it would be in the interest of the patient and society for the patient to be 'sectioned' (meaning detained in hospital). This usually lasts for 72 hours, but can be extended by the doctor for up to 28 days (full details in scrapbook). A similar process is carried out in countries such as Australia, the USA (although the specifics vary between States) and the Netherlands. In other countries such as Germany, detention is only carried out if a guardian wishes it. Yet historically, such a method of detention has been abused by governments such as Soviet Russia using these mental health laws to detain political prisoners1. Many mental health awareness groups oppose this policy. This debate aims to discuss the positive and negative aspects and effects of detention on the grounds of mental illness, with particular reference to DSPD (dangerous severe personality disorder).
|Points For||Points Against|
|It will ensure people are receiving the correct treatment||It is a waste of public resources.|
|It is important for the protection of the public.||Detention on the grounds of mental health is negative discrimination.|
|We have a duty to the patient's best interest.||It would increase already damaging stigmas surrounding mental health issues.|
|Any detention bill will have to be in line with human rights.||It would deter people suffering from mental illness to seek help.|
|Detaining a person who has committed no crime is an unacceptable restriction on liberty.|
|Danger to minority groups.|
Remember to choose a winning argument!
It will ensure people are receiving the correct treatment
As a society we should put effort into helping those suffering from mental illness and detention is one way of being sure that they are receiving and maintain treatment. This also means that doctors are able to keep an eye on patients so that if the patient is no longer a risk, they can be let out. If patients are detained then doctors will have a better idea of their patient's usual behaviour and therefore be better at reading their symptoms.Improve this
This could lead to doctors who diagnose certain psychiatric disorders effectively becoming jailers, and this is not their job or responsibility. Some doctors may refuse to be and many medical professionals will avoid identifying a patient as having DSPD if they know that this may result in their patient being detained. This could result in people with dangerous mental health problems going entirely unidentified– far worse than the current situation.Improve this
It is important for the protection of the public.
The public is at risk from people with known dangerous mental health problems. Two people are killed every month by Care in the Community patients in the UK (Care in the community described in Scrapbook). Jonathan Zito was stabbed to death by Christopher Clunis in 1992; Jason Mitchell beheaded his father and strangled two pensioners in 1994; Stephen Laudat killed his grandfather in 1994, believing him to be the gang leader Ronnie Kray; John Rous stabbed care worker Jonathan Newby to death in 1995; Michael Stone killed Lin and Megan Russell in a field near their home in 1996. All of these killers had diagnosed mental illnesses but could not be detained under UK law, yet if they had been detained many lives would have been saved. Currently, people with mental health problems who have not committed an offence may only be detained for the purposes of treatment, and may avoid treatment if they can argue that they will receive no benefit from it. There is no known effective treatment for Dangerous Severe Personality Disorder (DSPD). This means that people with DSPD fall through a gap between the criminal justice system and the healthcare system– they cannot be treated, so they never get less dangerous, but they cannot be detained, so the public cannot be protected from them. Furthermore it seems it is not unreasonable to detain people who you have good grounds to suspect could be dangerous as we already detain potentially dangerous people who do not have mental health problems anyway, if authorities believe they may be terrorists. 1Improve this
DSPD is not a psychiatric diagnosis, but a legal category therefore it is not surprising that it cannot be treated. It is a convenient label, however, for people whom the government fears and would like to have an excuse to detain, and who are unlikely to generate strong public sympathy. Rather than demonising and detaining people, the government should be providing mental health services which work in partnership with the people they are supposed to be helping.Improve this
We have a duty to the patient's best interest.
People who are mentally ill are significantly more of a danger to themselves than to others with only 5% of homicides being committed by people with mental illness.1 Detention is one way of preventing people suffering from mental illness to harm themselves or anyone else, and this must be in the best interest of the patient. Some people who are mentally unwell may attempt to commit suicide or get caught up in a cycle of self deprecating thoughts. However, patients in detention can be monitored; therefore similarly to the issue of Argument One, it seems important to detain patients in order to save them from themselves.Improve this
Detention can never truly be in the patient's interest. Detention has been known to have damaging effects on mental health1 and thus is perhaps the worst thing that could be done for the individual. The fact that DSPD is not a treatable condition means that people described as having it will, once detained, effectively be abandoned– they will not be able to be offered alternative treatment which might improve their condition and make their release more likely. Unlike other detained psychiatric patients, their detention has no clear goal and it is difficult to see how anyone could argue for their release on the grounds of improvement.Improve this
Any detention bill will have to be in line with human rights.
The 2007 British mental health act1 was actually created partly in order to update the Mental Health Act 1983 so that it conforms to current human rights law. The process of sectioning ensures this by having two separate doctors diagnose the patient as both mentally ill and a threat to themselves or others; these diagnoses are then presented to an independent AMP (approved medical practitioner) who makes the decision about whether or not the individual can be detained. If a doctor or AMP believes this should be extended to 28 days, then the process is repeated again independently. Therefore they should be no concerns about these detentions violating anyone's human rights.Improve this
Pre-emptive indefinite detention is potentially in breach of the ECHR and the Human Rights Act. Article 5 (Right to liberty and security), Article 6 (Right to a fair trial) and Article 8 (Right to respect for private and family life) are all threatened by the proposals1. It is best to avoid making legislation which the European Court of Human Rights will rule to be illegal; it is best to avoid making legislation which breaches human rights in any case.
1 Directgov. (n.d.). Human Rights Act. Retrieved August 30, 2011, from Directgov:
European Court of Human Rights. (n.d.). The European Convention on Human Rights. Retrieved August 30, 2011, from European Court of Human Rights:
It is a waste of public resources.
The NHS and the prison system are already underfunded and overcrowded. We already have insufficient resources to deal with those psychiatric patients1 who want to be treated, let alone those who want to be left alone. We should not add people who are being detained indefinitely without their consent, and who are therefore likely to be difficult and resource-intensive to manage, to the list of people our health system has to deal with.Improve this
The financial and human cost of assaults and killings by people with DSPD is enormous, and measures to prevent such suffering, and to protect the public, are worth paying for. All sorts of important public policy initiatives cost money: this does not mean they should not go ahead.Improve this
Detention on the grounds of mental health is negative discrimination.
People with mental illnesses are no more dangerous than other sectors of the population. Most people with mental health problems commit no crimes at all. There are other, far more accurate, predictors of criminal behaviour which nobody would consider to be sufficient to justify detention. The vast majority of crimes are committed by young men; 51% of violent crime and well over two-thirds of homicides are committed by people under the influence of alcohol1. Yet, rightly, the law does not permit the pre-emptive detention of young men, or of alcoholics. Why should people who have mental illnesses be treated differently?Improve this
If people have an infectious disease that could be dangerous to others, they are put in quarantine. If we think that people are a danger to their own personal safety they are put on 'suicide watch'. In both these cases the subject has done nothing wrong, yet they are often detained in order to protect the public. Detention on the grounds of mental illness can be seen to fit into this category, it is unfortunate but necessary for the public good.Improve this
It would increase already damaging stigmas surrounding mental health issues.
There is a strong stigma attached to mental illness, with a widespread public perception that people with mental health problems are "dangerous nutters" or other detrimental and unfounded assumptions1. Australian research has shown that the most problematic type of news coverage about mental illness results from information collected at court or from the police.
Many of these stories focus on violence and relate to specific and relatively rare circumstances. Audiences, however, are likely to make generalisations about people with a mental illness as a result2. A German study found that students who read negative articles about mental
illness express more negative attitudes toward people with a mental illness3, this is all in spite the fact that 1 in 6 people will experience mental health problems (mentalhealth.org.uk), almost always without exhibiting violent or dangerous behaviour. Detaining people with such problems will help to feed this false perception, and will be detrimental to efforts to improve the public understanding of mental illness.
2Dare A., Pirkis J., Blood R.W., Rankin B., Williamson S., Burgess P. &Jolley D. The Media Monitoring Project: Changes in Media Reporting of Suicideand Mental Health and Illness in Australia, 2000/01 - 2006/07. Centre for Health Policy, Programs and Economics, (Melbourne: The University of Melbourne Press, 2011)
3Dietrich, S., Heider, D., Matschinger, H., Angermeyer, M. C. (2006). Influence of newspaper reporting on adolescents' attitudes toward people with mental illness. Social Psychology and Psychiatric Epidemiology, 41, 318-322Improve this
The stigma attached to mental illness is unfortunate, and efforts should be made to combat it – but it is unlikely to be helped by continuing to permit a tiny minority of potentially dangerous individuals to continue to roam the streets unsupervised. When people with dangerous mental health problems commit murder, this tends to generate unfavourable headlines of the “violent loony” variety: stop the murders, stop the headlines.Improve this
It would deter people suffering from mental illness to seek help.
The knowledge that certain diagnoses may result in indefinite detention is likely to deter people who know they have a mental health problem from seeking diagnosis and treatment– a survey by the mental health charity Mind in 2002 found that more than 1 in 3 members of the public would be deterred from seeking help from their GP for depression if this proposal was passed. This would mean that medical professionals would not be able to help them. It would also mean that if they really are dangerous, the public would receive absolutely no protection from them.Improve this
These proposals will not affect the overwhelming majority of people with mental health problems, and there is no good reason for anyone to avoid seeking help.Improve this
Detaining a person who has committed no crime is an unacceptable restriction on liberty.
It is absolutely unacceptable to restrict the basic human right of an individual's liberty by detaining people indefinitely against their will when they have committed no crime. This is made worse when the detention will not do anything to help them with their condition (as would be the case with DSPD). We should be treating illness rather than locking them away. Assessing the risk that someone may be dangerous is an extremely difficult process, and has to be balanced against the harms they would be subjected to within indefinite detention – for example, loss of employment and family contact, loss of dignity and self-esteem, institutionalisation 1. Detention in this way is merely prioritising the general public’s concern over the individual liberty of those suffering from mental illness, and it appears unjust that someone has the right to enforce that the individuals with mental health issues are less important.Improve this
Public safety has to be the first concern. If these people are detained on the grounds that they are a danger to the public, and their condition never changes, of course they should not be released. This does not mean that conditions in the secure institutions in which they are housed should not be as comfortable or supportive as possible, or that regular assessments should not be made to see if there is a possibility that they should be released.Improve this
Danger to minority groups.
These proposals will have racist consequences. People from minority or ethnic groups, and Afro-Caribbean men in particular, are already disproportionately likely to be mistakenly diagnosed (mind.org.uk; mentalhealthalliance.org.uk) with mental illnesses compared with the population as a whole – this will put them at risk of being wrongly imprisoned as well.Improve this
These proposals neither increase nor reduce alleged structural problems which may lead to racial injustices in psychiatric diagnosis. Racial inequality in mental health treatment should be investigated and combated, regardless of this proposal or if any other change in mental health policy takes place. Therefore the racism argument is not directly related to this issue.Improve this
Dare A., Pirkis J., Blood R.W., Rankin B., Williamson S., Burgess P. &Jolley D. The Media Monitoring Project: Changes in Media Reporting of Suicide and Mental Health and Illness in Australia, 2000/01 - 2006/07. Centre for Health Policy, Programs and Economics, (Melbourne: The University of Melbourne Press, 2011)
Dietrich, S., Heider, D., Matschinger, H., Angermeyer, M. C. (2006). Influence of newspaper reporting on adolescents' attitudes toward people with mental illness. Social Psychology and Psychiatric Epidemiology, 41, 318-322
Deller, Robert et al, Mad Pride: A Celebration of Mad Culture, (Spare Change Books, 2001)
Jones, Richard, Mental Health Act Manual, (Sweet & Maxwell; 8th edition, 2002)
Lauance, Jeremy, Pure Madness: How Fear Drives the Mental Health System, (London: Routledge, 2003)
Richard, Stephens, Working With the Mental Health Act, (Matrix Training Associates; 2nd edition, 2008)
SANE Australia. (2005). Make it real! A report on consumer impressions of and responses to film and television portrayals of mental illness and suicide. Aconsultation project conducted by SANE Australia for the National Media andMental Health Working Group