I am writing with a few concerns about the above posts. I feel you are a sceptic of mental health law and appear to have very limited respect for people who work in the field of mental health. Although I am aware that there are problems with the system, there is also a lot of very good work which gets done (of course this is never commented upon). I also disagree with your comments about the perceived lack of qualifications of Social Workers, Occupational Therapists, Nurses and Psychologists. All of these professionals are educated to degree level, many also have studied at post graduate level. The current Approved Social Work course is definitely not superficial. It is an intensive course encompassing The Mental Health Act, The Human Rights Act, The Mental Capacity Act and the Children’s Act. It also covers anti discriminatory practice, treatments and social policy. It is marked using essays, exams, presentations and supervised practice. The supervised practice usually involves the ASW trainee completing on average 15 assessments.

The decision whether or not to detain is made by 2 doctors from different trusts and the ASW (soon to be AMHP). It is not a decision taken lightly and we definitely would not detain someone just because they are shouting loudly in the street. You are also not allowed to assess a person if they are under the influence of drugs or alcohol.

The issue of the large majority of black people receiving a mental health diagnosis is of particular interest to me. Studies show that African people are more likely to be diagnosed with a psychotic disorder, white people are more like to be given the diagnosis of personality disorder and people from the Indian subcontinent are more likely to be mentally well. The reasons for this are unclear, but there is a very strong link with cannabis use and psychosis and cannabis use and black people. There are also links between living in an inner city environment and psychosis. Again black people tend to live in cities in the UK. I work in London where there is a majority representation of black staff in health and social care, so I would hope cultural misunderstandings are a minimum. I would be concerned however in rural areas where there are few black staff and cultural differences may be more apparent.

I am very interested in mental health services in African countries and hope to return to Ghana to investigate the services, treatments, diagnoses and prognosis of people with MH problems. If anyone has any information, I would be grateful to have a look.