Representing Clinical Psychologists at Meeting of All Party Parliamentary Group to Review the Mental Health Act: Report by Mike Wang, Chair of ACP-UK
Prof. Mike Wang, Chair or ACP-UK, representing clinical psychologists at meeting of All Party Parliamentary Group to review the Mental Health Act
All Party Parliamentary Group on the Mental Health Act Review Committee
Room 9 House of Commons, Westminster, 9th July 2019
Chaired by Johnny Mercer MP
Keynote speeches by Georgie Lopez (Service User); Sir Simon Wessley (Chair of independent review); Alan Kennedy (Rethink) ; Jackie Doyle-Price MP Minister for Mental Health
Dr Joe Ryan kindly organised my attendance at this event on behalf of ACP-UK. There were about 30 others in attendance including two Lords and some MPs.
Georgie (age 23) described her history of anorexia nervosa from the age of 15 and how she was sectioned for 5 years resulting in her having to leave school. The years of being sectioned including forced feeding and drug administration against her will were in her view extremely damaging and harmful to her and her parents. The hospital environments and staff where she was detained were not therapeutic and compounded her problems. She argued that the use of the MHA was abusive, contravened human rights and desperately needed reform.
Sir Simon (former President of the Royal College of Psychiatrists) explained that he had not practised as a psychiatrist for 25 years but was chosen to lead the independent review as an unprejudiced observer by the Prime Minister. He described how much society and mental health services had changed since the 1983 MHA 25 years ago when 95% of patients were admitted to in-patient units and only 5% were seen as out-patients or in the community. This statistic had now reversed with 95% of patients being treated in the community and only 5% as in-patients. He also highlighted the change in social attitudes to mental health with much more tolerance and less belief in the “dangerousness” of mental health service users. This meant the argument for a major revision of the MHA was unarguable. The independent panel had included a number of service users and so a major thrust of the recommendations for reform was to reinforce the human rights of service users and to incorporate patient choice wherever possible.
Sir Simon was asked when the recommendations might be implemented had he responded that he expected a White Paper would be published incorporating the Review’s recommendations, but the present political crisis was delaying matters. He hoped it would be published by the end of the year.
Alan Kennedy (Rethink) and Jackie Doyle-Price MP (Health Minister) both made supportive and general comments in their speeches.
I said that ACP-UK welcomes the emphasis on human rights and service user choice in the Review that Sir Simon has led and chaired.
I commented that given the longstanding and chronic shortage of consultant psychiatrists (which served to worsen defensive and risk averse over-use of the MHA because of severe pressure on existing hard-pressed psychiatrists), shouldn’t Sir Simon and the Royal College of Psychiatrists be campaigning for more clinical psychologist Responsible Clinicians, not least to ease the burden and therefore to improve the implementation of the MHA. Sir Simon responded that he welcomed the advent of Clinical Psychologist RCs which he acknowledged had been possible for the last 10 years, but that the problem was with a lack of enthusiasm on the part of clinical psychologists. I said that this was not my experience and that I was aware of some trusts where MHA trained and Approved Clinicians had stepped forward but had been blocked by the trusts’ psychiatrists. Sir Simon had previously commented that he thought interest in a psychiatric career amongst junior doctors had increased and he expressed optimism about future recruitment. I expressed my pessimism in this regard having witnessed the shortage for the last 40 years of my own career.
I was pleased I was able to make these comments in the presence of the Minister for Mental Health, an audience of interested parliamentarians, service users and representatives of related groups such as MIND, the Royal College of Psychiatrists and the BPS.