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Mental Health

Volume 455: debated on Tuesday 9 January 2007

2. What assessment she has made of the effect of the introduction of supervised community treatment on the care of patients with mental health problems. (113226)

We are introducing supervised community treatment for patients who have been detained in hospital under the Mental Health Act 1983. That is an important change, which brings legislation into line with modern service delivery and follows the example of modern practice in other countries around the world.

I am sure my right hon. Friend is aware of the fear expressed by some in the mental health world that people could continue to be given supervised community treatment for lengthy periods without the introduction of adequate safeguards. Can she assure me that that will not happen?

My hon. Friend is right that such concerns have been expressed, but I hope that I can reassure her that patients receiving supervised community treatment will be entitled to a comprehensive package of safeguards that are just the same as those for patients detained in hospital. The need for SCT will be subject to regular review in exactly the same way, and patients will have the right to apply for discharge to a tribunal and the hospital managers of their responsible hospital.

The Minister mentioned countries around the world, so presumably the Department of Health has access to information that proves that supervised community treatments are successful around the world. When will that information be released for general consumption?

A number of studies have been carried out into SCT. As I have said, it is available in countries around the world—including Scotland, now—to bring them in line with modern service provision. One of the published studies is from New Zealand; it shows that SCT not only worked for carers and patients’ families, but that patients also liked it because it meant that they could return home instead of having to be detained in hospital. The Department is also carrying out some research; it is currently being peer-reviewed, and it will be published fairly shortly.

Hackney, South and Shoreditch has a higher than average incidence of mental health issues, and I have received a lot of correspondence from people about community treatment orders; psychiatrists have raised the issue of holding people against their will in the community. Although I think that community treatment can be better than hospital treatment, how can my right hon. Friend reassure those with concerns that people will not be held against their will but will receive the treatment that they need and that their lives and their community will be made better?

First, it is important to emphasise that clinicians will decide whether supervised community treatment is appropriate for individual patients. We all know that there are instances of patients being released from hospital who then go into the community and who, perhaps, do not take their medication or stay in touch with health services, and whose condition deteriorates to such an extent that they become a danger to themselves or to other people. That is an example of where SCT could apply. It is important to remember that that often puts patients back into the care of their families, instead of their having to remain in hospital. That will be good for patients and for public safety.

The Minister acknowledges that community treatment orders are a contentious provision in the Mental Health Bill, so will she now confirm that her Department commissioned a report entitled “International experiences of using community treatment orders”, which was delivered to her last autumn, and which concluded, from a survey of 50 countries, that CTOs have been found to have no clear effect on patient outcomes or risk reduction, and that these psychiatric ASBOs have been described as discriminatory by many patient groups, not least those representing BME—black and minority ethnic—patients who have suffered disproportionately? Why has she failed to publish this report, after my parliamentary questions and my freedom of information request, given its relevance to the Mental Health Bill which is currently under scrutiny in Parliament?

As I have said, the report is being peer-reviewed, and it will be published. Frankly, the Opposition must decide whether they will support a Bill that will introduce supervised community treatment so that high-risk patients get the treatment that they need to keep them well after they are discharged from hospital, and that will lead to people who have potentially serious and dangerous personality disorders getting the treatment that they need. That is the issue.

The hon. Gentleman has called these measures the Government’s latest attack on civil liberties. He needs to think very carefully about the civil liberties of people who go in and out of hospital three or four times a year because we cannot get treatment to them, and the civil liberties of patients, victims and their families who have suffered because we do not have the powers to treat people in the community.