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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 April 14; 334(7597): 761.
PMCID: PMC1852040
New Mental Health Bill

Bill aims to protect people at times of high risk

Louis Appleby, national clinical director for mental health

Crichton and Darjee claim that the new mental health bill is insufficiently concerned with care and treatment.1 The bill's aim is to ensure that people with mental disorder receive the treatment they need at times of high risk. This will benefit patient and public safety—14% of the 1300 patient suicides that occur annually in England and Wales and 25% of the 52 patient homicides are preceded by refusal to take medication—but the starting point will be better care.

The bill introduces supervised community treatment. A similar power exists in many countries, including Scotland (where the authors work). Patients will be eligible for this treatment only if they are already detained in hospital for treatment—a safeguard that goes beyond what is in the Scottish legislation. The bill also removes the “treatability test” that currently acts as an impediment to care for some people with personality disorder.

Crichton and Darjee claim, without evidence, that an overemphasis on public safety will be counterproductive. But whose overemphasis are they referring to? The House of Lords has amended the bill so that supervised community treatment cannot be used for the suicidal patient, and the Mental Health Alliance, described by the authors as a “remarkable coalition,” has asked the government not to reverse this change. Protection for the violent patient but not the suicidal patient? Remarkable indeed.


Competing interests: LA advises the government on mental health policy.


1. Crichton J, Darjee R. New mental health legislation. BMJ 2007;334:596-7. (24 March.) [PMC free article] [PubMed]

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