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Mental Health Bill [Lords]

I want to address some of the submissions about who would or would not get treatment. As I have said, it is important to admit that there are people who would not get treatment. I have received a letter, which I know the hon. Gentleman will reject, signed by a number of eminent psychiatrists. It states:"““It is not possible to say that because a patient has a particular condition, they necessarily will (or will not) have impaired decision-making. People differ. Their circumstances differ. Even the fact that two people are diagnosed as having the same mental disorder does not mean they will experience or be affected by it in the same way. While impaired thinking is a common feature of mental disorder, impairment of the ability to make treatment decisions specifically is not, of itself, a criterion for diagnosing mental disorder, or any particular mental disorder. For example:""Patients with a long-standing diagnosis of schizophrenia or severe depression, with a history of detention at times of acute illness resulting in high risk. These patients will usually have impaired decision making when in relapse but as they recover ""this may no longer be the case. They may, however, not be prepared to accept that they have been ill or to accept the need for treatment. As a result, if we had an impaired judgment test, the psychiatrist would be unable to use Mental Health Act powers to continue treatment—until a further relapse occurred.""Patients with borderline personality disorder who do not have impaired decision-making, but who have a high risk of serious self-harm at certain times, and for whom the psychiatrist may well think that hospitalisation is needed during a crisis. Those patients may well understand the treatment that is being offered and the consequences of refusing it, and they may talk in a clear-headed way about committing suicide. If we had an impaired judgment test, the psychiatrist would be unable to intervene.””" We know that young women with borderline personality disorders who have a history of abuse, whether sexual, physical or emotional, want to commit suicide at times of crisis, but they understand the options. The hon. Gentleman’s new clause means that we, as a society, would say, ““We are not going to treat you under the Mental Health Act.”” There is absolutely no doubt that that would happen. The British Psychological Society is in favour of an impaired decision-making test:"““We recognise that this approach may mean that a very small number of people believed to be at risk of self-harm or suicide would be permitted to refuse treatment if their decision-making was not considered to be significantly impaired.””" It has said that the new clause would allow some people to go out and commit suicide, which Labour Members find unacceptable.