[Kunjufu]

The New Mental Health law and you!!!!

Amid the the news stories over recent days many I suspect many will have missed the fact that the 9 year wrangle over changes to the Mental Health Act, came to an end.. with cross European party agreement on significant changes to the Mental Health Act 1983….

The new Mental Health Act 2007, which has now received royal accent, will become law, so what are some of the key changes and what does it mean for AFRICANS in this country?

In all there are 14 significant changes that will have a fundamental effect of Africans who become unwell in this country….

1. Changes to the categories of mental illness; under the old act there were 4…mental illness, mental impairment, severe mental impairment and Psychopathetic disorder… Nw there is only one generic definition…. ‘any disorder of the mind or brain’..

So what does this mean for us [Africans] many complaint about misdiagnosis, well the good news [not] is that this will be reduced..the bad news is that under this broad definition, you could in theory and I suspect in practice make a case for practically anyone to be sectioned!!! If you’re stoned out of your mind on drugs, then that is a disorder of the mind, if you’re clinically depressed, you could be sectioned if you presented a risk of harm to self or others.. Hell you could sectioned if you become brain damaged after say a car crash…so for me this small change has massive implications…

2. in the old law, there was a requirement that a sections made, had to be underpinned with idea that the person could be treated or that treatment would alleviate their condition.. However under the new law, there is only an emphasis on ‘intent’ no requirement to prove or test that sectioning with ‘treat’ a patient…

Again for us [Africans] it provides a dangerous grey area, in conjunction with the abolition of the four criteria’s…there is now no safeguard of treatability.. therefore again in theory, if this is questioned a clinician only has to prove his/her ‘intent’ not that the treatment is likely to work or make better…hmmm

3. another key area is who can authorise your detention, remembering that you can potentially be locked up for up to 6 months and have that detention renewed on a 6 monthly basis… The new law now takes the power away from Psychiatrists to provide medical recommendations and now also gives it to Occupational therapists, Psychologists, Nurses and Social workers.

None of these four professions receives the SAME training, none of these professions share the same perspective.. therefore your freedom’s could be in the hands of a person who at most would have received a few months superficial training on mental health law and diagnosis of symptoms… Psychiatrists are in my experience an arrogant bunch..but at least they are trained to endth degree…would I really want to trust my life to a Social worker or a Nurse…**** no!!!

4. again the new Law does away with what called the ‘Approved Social Worker’ and introduces the title of the Approved Mental Health Practitioner… in effect it widen who can make an application to have you sectioned… again this can be Doctors, Nurses, OT’s and anyone who thinks they’re up to it..

Is this good..in my view no..the whole point of an ASW in the first place was to offset the medical bias of Psychiatrists, who are often seen as gods in the medical field, having medically trained people colluding with that will increase not decrease those who are detained..

5. The most controversial aspect of this new law is the introduction of the CTO’s..Community Treatment order…in effect this is akin to being sectioned to your house and being told how to live your life, with the treat of being locked up, if you don’t comply… So under the New law, if you are sectioned under this new order, you have to comply with the direction given to you.. ie where you live, what you do and to take your medication.. it is not unlike an ASBO… if you fail to comply..you will receive a visit and you will be taken by force if necessary to the local hospital…and either given your medication there or worse detained.

I don’t think I really need to outline the dangers of this order, or discuss how the watering down of who can practice in mental health will make us [Africans] more vulnerable.. because I think the initiative speaks for itself..

[more to come]

[An_Advanced_Spark]

You know what Kun this is a VERY valid post especially where apparently Africans are 3 times more likely to suffer mental health problems, I say apparently because there is a blurred boundary for me personally as to what defines a mental illness, as western definition may differ from an African one, with this new even loser definition, I feel it will get a whole lot worse. A lose example being a group of black people talking loudly may be seen by a European as an argument, does this mean they are arguing? Not necessarily. I also am also uncomfortable with the widening of who can decide who is to be section with as you have stated 'superficial' training; that is not say that some psychiatrists are not without prejudice but this could be more common place in diagnosis and that is a great concern.

[mike pain]

it's very scary....

[bennie2]

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.