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Mental Health Bill [Lords]

I return to the first principle that I articulated, namely that no psychiatric unit should be a prison by another name. However pleasantly it might be arranged, we cannot detain people just for the purpose of detaining them, and there must be some kind of therapeutic benefit. That is the purpose of the amendment. We also need to adhere to two other important principles. First, the public have a right to protection. Historically, mental health legislation has always allowed for the protection of the public. Originally, the legislation addressed the protection of the King, but it was subsequently extended to cover all members of the public. I know from personal experience in my family that families, friends and carers of those who have significant mental health problems sometimes want mental health services to have the right to detain and sometimes feel that mental health services were too hesitant in detaining somebody, because they consequently saw that person travel further and further down the route towards significant mental ill health in a way that they think is irretrievable. Having said that, it is important to bear in mind that I do not believe that the Bill will balance the rights of the patient, the rights of the public and the rights of families and friends on the security of society and the rights and freedoms of the individual without some kind of treatability test. The treatability test in section 3(2)(b) of the 1983 Act specifies that"““in the case of psychopathic disorder or mental impairment, such treatment is likely to alleviate or prevent a deterioration of his condition””." That is clear, but it refers only to those with a psychopathic disorder or mental impairment and not to those with other mental disorders. Because of the way in which we are changing the 1983 Act, any treatability test that we introduce tonight will apply to not only the historical definition of ““psychopathic disorder””, but anybody who might be detained for any mental disorder. As I am sure that all hon. Members know, the Lords insisted that there should be a treatability test and inserted one almost identical to that in the 1983 Act, before the Commons Committee—I see that most of its members are here this afternoon—removed it. However, I believe that there is a need to insert a form of treatability test if we are to get the balance right. The Lords version of the treatability test sets too high a hurdle because it insists on the word ““likely ””, as in a treatment being"““likely to alleviate or prevent a deterioration in his condition.””" Likelihood is a very high hurdle. Is it more than 50 per cent. likely—that is what ““likely”” means in most dictionary definitions—that the treatment will produce one of those two outcomes? That is difficult to argue. It is also difficult to argue at the beginning of an individual’s treatment under detention that their condition will be alleviated or will not deteriorate further, because the process of detention or of starting treatment may itself bring about a deterioration in the condition. On top of that, most medical treatment is not subject to a ““likelihood”” clause—that is not the hurdle that we set. Many treatments are provided where there is only a one in four or a one in three chance of alleviating the condition. That is why we should move towards the purpose of the treatment being the most important element.