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From The Socialist newspaper, 31 May 2017

Fight the Tory cuts and changes that take mental health back to Bedlam

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photo amenclinicsphotos/CC, photo amenclinicsphotos/CC   (Click to enlarge)

The Tories' manifesto pledges changes to the Mental Health Act to "tackle unnecessary detention". NHS mental health nurse 'Harriet Ryman' responds.

Mental illness has always been present in society but what has differed throughout the ages is how sufferers were treated.

In 'The History of Madness' Michel Foucault describes how in the 14th century the 'lunatic' was banished to the outskirts of towns. In 1815 a House of Commons report revealed that the Bethlem hospital "showed its lunatics every Sunday for one penny" and it received up to 96,000 visitors each year.

Thankfully these barbaric practices have long since been kicked into the dustbin of history. Understanding of mental illness is slowly increasing and the development of treatments, changes in the law and the 'recovery model' devised by pioneering researchers Boardman, Slade et al guides mental health professionals towards enabling those with mental illness to manage their conditions themselves and live full lives as valued members of society.

Most mental health workers would concede that the system is far from perfect. But there can be no denying that advances have been made in the care and treatment of those suffering from mental illness. However, cuts to services are the biggest threat in rolling back the advances that have been made.

The Mental Health Act 1983 was brought into being with the specific notion of protecting the dignity and safety of those whose mental health relapse causes them to pose a risk to themselves or others.

No mental health professional would wish to admit someone to hospital against their will, but there are occasions when such an admission - or 'sectioning' - can literally be a life-saving measure.

The public duty to provide access to appropriate treatment and care is a mainstay of the act. In other words a person cannot be sectioned unless a hospital bed is identified and there is a plan in place to provide care and treatment.

The act cannot be applied to anyone unless three highly trained and experienced mental health professionals agree, and the least restrictive option, like treatment in the community, is always considered where this is safe to do so.

All sectioned patients have the right of appeal and to legal representation. Social services currently have a legal duty to provide money for community care to any patient who has been detained.

While the Mental Health Act has its flaws, Theresa May's claim that unnecessary detentions take place is ignorant and ill-founded.

Strict criteria are applied by highly skilled professionals before a person can be subjected to mental health legislation and it is insulting to psychiatrists and mental health professionals to suggest that they are not carrying out their functions correctly.

It is important to highlight that the rise in detentions is occurring against the backdrop of swingeing austerity policies which are placing more pressure on the health and wellbeing of people than ever before.

The suggestions that 'funding the Samaritans' and 'talking to children in schools' will somehow replace the current legislation underpinning the care and treatment of the seriously mentally ill, highlights that the Tory party is not competent to meddle with the Mental Health Act.

Tory claims

The discrimination that the Tories claim they are concerned about is a feature of capitalist society itself and does not just occur in the mental health system.

Tory party cash perks for big business while cutting vital public services ensure that the richest in society are always treated more favourably than workers. The redistribution of wealth and resources in society would go a long way towards tackling the discrimination that May speaks of.

Although mental illness can strike anyone from any class, those of us who work within mental health services note that the majority of our patients comprise the poorest in society and that poverty and lack of access to basic decent resources perpetuate mental ill health and lead to repeated admissions to hospital.

The Tories have no plans to address the poverty and material hardship that impede recovery from mental illness. In fact, the rates of mental illness and other social ills are likely to increase under a government delivering policies that widen inequality in society.

The need for service users, carers and trade unionists working in mental health services to unite against the Tories is more pressing than ever.

No one should be fooled into believing that Tory plans to meddle with the Mental Health Act are progressive. These plans will only be utilised to support and accelerate the drive to slash and burn services for the mentally ill.

We should be in no doubt that if mental health legislation is eroded, the legal duty of the state to provide funding, care and treatment for seriously mentally ill people will be eroded also.

If someone suffering from mental illness is lucky enough to have a carer, this person will be left carrying the sole responsibility to treat and contain the risks inherent in mental health crises.

In the absence of a carer, the police or prison cell will become the method of choice to contain the person suffering a relapse of their mental condition.

Mental health workers are united with service users and carers in seeking genuine progressive changes within the mental health system. We must fight together to stop the Tory cuts and privatisation that risk driving mental health provision back to the dark days of Bedlam.

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