FROM VAGRANCY TO MENTAL ILLNESS - THE ACTS OF PARLIAMENT

THE CHANGING PERCEPTION OF SOCIETY AND ITS CONSEQUENT LEGISLATION OVER THE LAST THREE CENTURIES
 
VAGRANCY ACT 1744
(could confine the furiously and dangerously mad)
 
COUNTY ASYLUMS ACT 1808
(As lunatics were being recognised as a separate group from vagrants, this Act legistated for 'airy and healthy locations' for the protection of lunatics)
 
MADHOUSES ACT 1828
(provided for a medical officer and patients who recovered could be discharged)
 
LUNATICS ACT 1845
(National system of inspection formed, i.e. The Lunacy Commission)
 
LUNACY ACT 1890
(this brought in judicial and medical 'certification' of patients)
 
MENTAL TREATMENT ACT 1930
(after the 1st world war`s shock victims and the work of Freud and Jung on the subconscious, this led to more specialism in Psychiatry and recognised `lunacy` as an illness. The terms 'lunacy' and 'asylum' were abandoned)
 
1948 NHS FORMED
(but still debate about whether mental illness should be included in general health)
 
1950s PSYCHOTROPIC REVOLUTION
(medical model came to the fore and mental illness seen as a disease that could be treated)
 
MENTAL HEALTH ACT 1959
(provided a framework for the treatment of the mentally ill. 'Certification' was replaced with 'Sectioning' whereby an application could be made to a hospital to admit someone compulsorily. 3 types -1 for observation, 2 for emergency observation, 3 for treatment)
 
1960s
(A big swing towards Human Rights and Autonomy in society and a revolution against the establishment which saw legislation as a way to control people. Now more of a move towards deinsitutionalisation)
 
MENTAL HEALTH ACT 1983
(This Act merely updated aspects of the 1959 Act, mainly because of safeguards ruled by The European Commission for Human Rights and abuses exposed in psychiatric hospitals. There was now a wider access to review by tribunals and re-establishment of a national inspection in the form of the Mental Health Act Commission, which the 1959 Act had abolished. Health and Social Services were now duty bound to provide after care).
 
Since 1983 the following revisions have occurred :-
 
1. Mandatory external enquiries for all murders committed by people who had been in contact with the mental health services in the year preceding introduced
 
2. Home Office discussion paper in 1999 about Managing Dangerous People with a Severe Personality Disorder.
 
3. The Deputy Prime Minister set up Social Exlusion Unit to combat the stigma of mental illness.
 
4. The Care Programme Approach introduced
 
5. Supervised Discharge introduced
 
HUMAN RIGHTS ACT 1998
(Incorporated the European Commission for Human Rights into UK law and there have been many cases testing the provisions of the 1983 Act against the duty in the Human Rights Act 1998 - this acknowledged that many aspects of the 1983 Act needed urgent change, in particular regard to Mental Illness -
 
Article 5 states that no one shall be deprived of liberty except the lawful detention of persons of unsound mind, alcoholics, drug addicts or vagrants`. It also states that everyone has a right to security. But everyone who is deprived of liberty shall be entitled to take proceedings to prove the detention is lawful. Objective medical evidence, the mental disorder must warrant confinement, there must be periodic reviews of the need to detain and detention must be a proportionate response.
 
Article 3 prevents torture or degrading treatment and it has been acknowledged that treatment without consent can breach this Article if its not a therapeutic necessity.
 
Article 8 is the right to respect for private and family life which confirms that there shall be no interference by a public authority except as is in accordance with the law for the prevention of disorder or crime, for the protection of health or morals and for the protection of the rights and freedoms of others. This right to respect for private life includes the right to self determination and so compulsory treatment can only be c arried out in accordance with the law. This means that the law must be clear so people know the grounds on which they can be treated without consent.
 
Article 14 is the prohibition of discrimination on any ground such as sex, race, colour, language, religion, political or other opinion, national or social origin, association with a national minority, property, birth or other status.
 
Since the 1983 Act, the pendulum has swung towards Human Rights, Autonomy and Community Care. This has brought problems with a minority of dangerous people in the community committing murders, which has done little to reduce the stigma of mental illness. The 1983 Act only permitted detention if there is a likelihood that medical treatment would alleviate the dangerous person`s condition and it was consquently recognised that this was a get out clause for patients with a personality disorder (DSPD - Dangerous People with Severe Personality Disorders). This has become an issue for the reform of mental health legislation.
 
MENTAL HEALTH ALLIANCE FORMED IN 1999
(which was service users, carers, voluntary and professional organisations grouping to influence the government)
 
2002
THE GOVERNMENT BROUGHT OUT A GREEN PAPER THEN A WHITE PAPER AND THIS WAS WIDELY CRITICISED
 
2004
THE GOVERNMENT BROUGHT OUT THE DRAFT MENTAL HEALTH BILL
 
MARCH 2005
EXAMINING COMMITTEE REPORTED ON THE DRAFT MENTAL HEALTH BILL
 
JUNE 2005
THE GOVERNMENT RESPONDED TO THE COMMITTEE`S REPORT
 

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