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Ethics briefings
  1. Veronica English,
  2. Danielle Hamm,
  3. Caroline Harrison,
  4. Julian Sheather,
  5. Ann Sommerville
  1. BMA Ethics Department;

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    Mental health legislation

    In March 2006,1 the UK Government announced its intention to replace the 2004 draft Mental Health Bill for England and Wales with a bill to amend the 1983 Mental Health Act. The government subsequently published a series of briefing notes outlining its plans in relation to major areas of policy covered by the amending legislation ( The main changes that the government intends to introduce are outlined below:

    • Compulsory treatment will now be permitted in the community. After an initial period of assessment or treatment in hospital, certain individuals will be eligible for treatment in the community. Supervised community treatment is designed for those patients who have been successfully stabilised in hospital but who risk relapsing on discharge following non-adherence to treatment regimens.

    • The group of practitioners who can take on the role of approved social worker and responsible medical officer under the Act is to be broadened to include appropriately qualified nurses and psychologists.

    • Patients will be given the right to make an application to displace their nearest relative and to enable county courts to displace the nearest relative when there are reasonable grounds for doing so.

    • The legislation will replace the current fourfold definition of mental disorder—mental illness, severe mental impairment, mental impairment and psychopathic disorders—with a single definition based on a broad understanding of mental disorders. The bill will also remove the current exclusions for compulsion in relation to promiscuity and other immoral conduct and sexual deviancy. It will retain the exclusion in relation to drugs and alcohol. People with learning disabilities will be eligible for compulsion only when their behaviour is associated with “abnormally aggressive or seriously irresponsible” conduct.

    • The “treatability test” is being removed. Under the current legislation, in the case of a psychopathic disorder or mental impairment, treatment can be provided only if …

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