Hostname: page-component-78c5997874-xbtfd Total loading time: 0 Render date: 2024-11-18T01:22:22.618Z Has data issue: false hasContentIssue false
  • English
  • Français

Lessons from the Mental Health Act Commission for England and Wales: The Limitations of Legalism-Plus-Safeguards

Published online by Cambridge University Press:  08 August 2011

DAVID PILGRIM
DAVID PILGRIM*
Affiliation:
School of Social Work, University of Central Lancashire, Preston PR1 2HE email: [email protected]
Get access Rights & Permissions [Opens in a new window]

Abstract

In 2009, the Mental Health Act Commission for England and Wales was closed down and its functions subsumed in separate organisations in the two countries. Its final biennial report, issued that year, focused on coercion and consent. This article uses some aspects of the report to discuss the implications of lawful psychiatric coercion being predicted by social group membership (correlated with race, age and gender). The work of the Commission furnished useful information in this regard, but its framework for data collection could not, and so did not, illuminate a more established picture of the class gradient in mental health problems. With the latter literature in mind, material adversity may explain the racial patterning of psychiatric populations coercively detained. However, normative aspects of risk-taking in the community and in hospital may better predict the findings on age and gender. The article concludes by querying the ameliorative impact of government appointed ‘visitorial’ bodies. Legalism-plus-safeguards is a questionable basis for meaningfully bringing discriminatory powers to book, or for reversing the differential impact of pathogenic social forces.

Type
Articles
Information
Journal of Social Policy , Volume 41 , Issue 1 , January 2012 , pp. 61 - 81
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Abbotts, J., Williams, R. and Ford, G. (2001), ‘Morbidity and Irish Catholic descent in Britain: relating health disadvantage to socio-economic position’, Social Science & Medicine, 52: 7, 999–1005.CrossRefGoogle ScholarPubMed
Baldwin, R. and Cave, M. (1999), Understanding Regulation: Theory, Strategy and Practice, Oxford: Oxford University Press.Google Scholar
Barnes, M., Bowl, R. and Fisher, M. (1990), Sectioned: Social Services and the 1983 Mental Health Act, London: Routledge.Google Scholar
Bean, P. (1986), Mental Disorder and Legal Control, Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Bean, P. (1980), Compulsory Admissions to Mental Hospitals, Chichester: Wiley.Google Scholar
Berry, H. L. (2008), ‘Social capital elites, excluded participators, busy working parents and aging: types of community participators and their mental health’, Social Psychiatry and Psychiatric Epidemiology, 43: 527–37.CrossRefGoogle ScholarPubMed
Blom-Cooper, L., Brown, M., Dolan, R. and Murphy, E. (1992), Report of the Committee of Inquiry into Complaints about Ashworth Hospital, Cm 2028, London: HMSO.Google Scholar
Boydell, J., van Os, J., McKenzie, J., Allardyce, J., Goel, R., McCreadie, R. G. and Murray, R. M. (2001), ‘Incidence of schizophrenia in ethnic minorities in London: ecological study into interactions with environment’, British Medical Journal, 323: 1–4.CrossRefGoogle ScholarPubMed
Boyes, S. and Gunn, M. J. (2007), ‘Law, regulation and the Mental Health Act Commission’, in Shaw, I., Middleton, H. and Cohen, J. (eds.), Understanding Treatment without Consent: An Analysis of the Work of the Mental Health Act Commission, London: Ashgate.Google Scholar
Boynton Report (1980), Report of the Review of Rampton Hospital, Cmnd 8073, London: DHSS.Google Scholar
Breggin, P. (1993), Toxic Psychiatry, London: HarperCollins.Google Scholar
Brown, P. and Funk, S. C. (1986), ‘Tardive dyskinesia: barriers to the professional recognition of iatrogenic disease’, Journal of Health and Social Behaviour, 27: 116–32.CrossRefGoogle Scholar
Campbell, T. and Heginbotham, C. (1991), Mental Illness, Prejudice, Discrimination and the Law, Dartmouth: Aldershot.Google Scholar
Cohen, J. (2007), ‘The reform of the Mental Health Act’, in Shaw, I., Middleton, H. and Cohen, J. (eds.), Understanding Treatment Without Consent: An Analysis of the Work of the Mental Health Act Commission, London: Ashgate.Google Scholar
Commander, M., Odell, S., Surlees, P. and Sashidharan, S. (2003), ‘Characteristics of patients and patterns of psychiatric service user in ethnic minorities’, International Journal of Social Psychiatry, 49: 216–24.CrossRefGoogle Scholar
Coulter, J. (1973), Approaches to Insanity, New York: Wiley.Google Scholar
Council of Europe (1966), European Convention on Human Rights and Its Five Protocols, Strasbourg: Council of Europe.Google Scholar
Fennell, P. (1996), Treatment without Consent Law, Psychiatry and the Treatment of Mentally Disordered People Since 1845, London: Routledge.Google Scholar
Fisher, S. and Greenberg, R. P. (eds.) (1997), From Placebo to Panacea: Putting Psychiatric Drugs to the Test, New York: Wiley.Google Scholar
Ford, T., Goodman, R. and Meltzer, H. (2003), ‘The British Child and Adolescent Mental Health Survey 1999: the prevalence of DSM-IV disorders’, Journal of the American Academy of Child and Adolescent Psychiatry, 42: 1208–11.Google ScholarPubMed
Gourney, K., Ward, M., Thornicroft, G. and Wright, S. (1998), ‘Crisis in the capital:inpatient care in inner London’, Mental Health Practice, 1: 5, 10–18.CrossRefGoogle Scholar
Gove, W. R. (1970), ‘Societal reaction as an explanation of mental illness: an Evaluation’, American Sociological Review, 35: 873–84.CrossRefGoogle ScholarPubMed
Hiday, V. (1995), ‘The social context of mental illness and violence’, Journal of Health and Social Behaviour, 36: 122–37.CrossRefGoogle ScholarPubMed
Illich, I. (1978), Limits to Medicine, Harmondsworth: Penguin.Google Scholar
Johnson, S., Bingham, , Billings, C., Pilling, J., Morant, S., Bebbington, N., McNicholas, P., Dalton, S., , J. (2004), ‘Women's experience of admission to a crisis house and to acute hospital wards: a qualitative study’, Journal of Mental Health, 13: 3, 247–62.CrossRefGoogle Scholar
Kellam, A. M. P. (1987), ‘The neuroleptic syndrome so called: a review of the literature’, British Journal of Psychiatry, 150: 752–9.CrossRefGoogle Scholar
Knapp, M. (2001), ‘The costs of mental disorder’, in Thornicroft, G. and Szmukler, G. (eds.), Textbook of Community Psychiatry, Oxford: Oxford University Press.Google Scholar
Leavey, G., Rozmovits, L., Ryan, L. and King, M. (2007), ‘Explanations of depression among Irish migrants in Britain’, Social Science & Medicine, 65: 2, 231–44.CrossRefGoogle ScholarPubMed
Link, B. and Phelan, J. (1995), ‘Social conditions as fundamental causes of disease’, Journal of Health and Social Behavior, special issue, 80–94.CrossRefGoogle Scholar
Martin, J. P. (1984), Hospitals in Trouble, Oxford: Blackwell.Google ScholarPubMed
Meltzer, H., Gatward, R., Goodman, R. and Ford, T. (2003), ‘Mental health of children and adolescents in Great Britain’, International Review of Psychiatry, 15: 185–7.CrossRefGoogle ScholarPubMed
MHAC (1991), Fourth Biennial Report (1989–1991), London: HMSO.Google Scholar
MHAC (2009), Coercion and Consent: Monitoring the Mental Health Act 2007–2009, 13th Biennial Report, London: HMSO.Google Scholar
Nazroo, J. (2003), ‘The structuring of ethnic inequalities in health: economic position, racial discrimination and racism’, American Journal of Public Health, 93: 2, 277–84.CrossRefGoogle ScholarPubMed
Nazroo, J. Y. and Williams, D. R. (2005), ‘The social determination of ethnic/racial inequalities in health’, in Marmot, M. and Wilkinson, R. G. (eds.), Social Determinants of Health, 2nd edn, Oxford: Oxford University Press.Google Scholar
Padgett, D. K., Henwood, B., Abrams, C. and Drake, R. E. (2008), ‘Social relationships among persons who have experienced serious mental illness, substance abuse, and homelessness: implications for recovery’, American Journal of Orthopsychiatry, 78: 333–9.CrossRefGoogle ScholarPubMed
Pescosolido, B. A. and Wright, E. R. (2004), ‘The view from two worlds: the convergence of social network reports between mental health clients and their ties’, Social Science & Medicine, 58: 1795–806.CrossRefGoogle ScholarPubMed
Pilgrim, D. and Rogers, A. (2005), ‘Psychiatrists as social engineers: a study of an anti-stigma campaign’, Social Science & Medicine, 61: 12, 2546–56.CrossRefGoogle ScholarPubMed
Pilgrim, D. and Vassilev, I. (2007), ‘Risk, trust and mental health services’, Journal of Mental Health, 16: 3, 347–57.Google Scholar
Pols, J. (2001), ‘Enforcing patients’ rights or improving care: the interference of two modes of doing good in mental health care’, Sociology of Health and Illness, 25: 4, 325–47.Google Scholar
Rogers, A. and Pilgrim, D. (2003), Mental Health and Inequality, Basingstoke: Palgrave/Macmillan.CrossRefGoogle Scholar
Rogers, A. and Pilgrim, D. (2010), A Sociology of Mental Health and Illness, 4th edn, Buckingham: Open University Press.Google Scholar
Rosenfeld, S. and Wenzel, S. (1997), ‘Social networks and chronic mental illness: a test of four perspectives’, Social Problems, 44: 200–16.CrossRefGoogle Scholar
Sainsbury Centre for Mental Health (1998), Acute Problems: A Survey of the Quality of Care in Acute Psychiatric Wards, London: Sainsbury Centre for Mental Health.Google Scholar
Scull, A. (1985), ‘Humanitarianism or control? Some observations on the historiography of Anglo-American psychiatry’, Cohen, S. and Scull, A. (eds.), Social Control and the State, Oxford: Basil Blackwell.Google Scholar
Shaw, I., Middleton, H. and Cohen, J. (2007) (eds.), Understanding Treatment Without Consent: An Analysis of the Work of the Mental Health Act Commission, London: Ashgate.Google Scholar
Silver, E., Mulvey, E. P. and Monahan, J. (1999), ‘Assessing violence risk among discharged psychiatric patients: towards an ecological approach’, Law and Human Behavior, 23: 237–55.CrossRefGoogle Scholar
Soyka, M. (2000), ‘Substance misuse, psychiatric disorder and violent and disturbed behaviour’, British Journal of Psychiatry, 176: 345–50.CrossRefGoogle ScholarPubMed
Staunch, M. (1995), ‘Rationality and the refusal of medical treatment: a critique of approaches in the English courts’, Journal of Medical Ethics, 21: 162–5.CrossRefGoogle Scholar
Stockdale, S. E., Wells, K. B., Tang, L., Belin, T. R., Zhang, L. and Sherbourne, C. D. (2007), ‘The importance of social context: neighbourhood stressors, stress buffering mechanisms and alcohol, drugs and mental disorders’, Social Science & Medicine, 65: 1867–81.CrossRefGoogle Scholar
Szasz, T. S. (1963), Law, Liberty and Psychiatry, New York: Macmillan.Google Scholar
Szmukler, G. and Appelbaum, P. (2001), ‘Treatment pressures, coercion and compulsion’, in Thornicroft, G. and Szmukler, G. (eds.), Textbook of Community Psychiatry, Oxford: Oxford University Press.Google Scholar
Tudor-Hart, J. (1971), ‘The inverse care law’, Lancet, 27 February, 1 (7696): 405–12.CrossRefGoogle Scholar
Velling, W., Susser, E., van Os, J., Mackenbach, J. P., Selten, J. P. and Hoek, H. W. (2008), ‘Ethnic density of neighborhoods and incidence of psychotic disorders among immigrants’, American Journal of Psychiatry, 165: 66–73.Google Scholar
Wexler, D. (1992), ‘Putting mental health into mental health law: therapeutic jurisprudence’, Law and Human Behaviour, 16: 1, 27–38.CrossRefGoogle Scholar
World Health Organization (2002), 25 Questions and Answers on Health and Human Rights, Geneva: World Health Organization.Google Scholar
World Health Organization (2005), Assessment Instrument for Mental Health Systems, Geneva: World Health Organization.Google Scholar