New Medicalism and the Mental Health Act

Description

Ten years have passed since the Mental Health Act (MHA) 2007 came into force in England. An amending statute, the Act reformed the MHA 1983 and reshaped the law governing the compulsory care and treatment of people suffering from mental disorders. Primarily driven by concerns about risk, it sought to remove legalistic obstacles to civil commitment and extend the law’s coercive reach into the community. At the time of its introduction, the 2007 Act was written off as a retrograde step and a missed opportunity for radical, rights focused reform. Despite this, little attention has been paid to its impact in the years since. Published to coincide with the tenth anniversary of the 2007 Act, this book offers a timely evaluation of mental health law and policy in England. It argues that the current MHA defies easy categorisation within any of the descriptive models which have customarily narrated the mechanics of civil commitment, namely ‘legalism’, ‘new legalism’, and ‘medicalism’. It therefore makes the case for a new model—new medicalism—to account for the 2007 Act’s enhancement of the discretion of mental health professionals for the express purposes of facilitating the management of situations of risk. In doing so, the book: critically examines the problems inherent in civil commitment frameworks organised around the concept of risk; explores the theoretical foundations of new medicalism; considers the challenges facing proponents of future reform in the era of the UN Convention on the Rights of Persons with Disabilities; and, reflects on the 2007 Act’s practical impact. Preface Acknowledgements Contents Table of Cases Table of Legislation Introduction 1. The Mechanics of Mental Health Law in England Introduction Voluntary Patients Informal Patients Formal Patients Conclusions 2. The Centrality of Risk in the Mental Health Act and its Consequences Introduction 'Immediately Befogged': The Difficulties of Defining 'Risk' Unlocking the Compulsory Powers: The Panoply of Risk 'Risk' and the Courts Tacit Knowledge, Risk and the Mental Health Act Conclusions 3. New Medicalism and the Mental Health Act 2007 Introduction Legalism, Medicalism and the Recent History of Mental Health Law in England The Renewed Prominence of Risk: The Policy Behind the 2007 Act The Reforms of the Mental Health Act 2007 Evaluating the Mental Health Act 2007: The Case for New Medicalism Conclusions 4. Theorising New Medicalism Introduction The Risk of Mental Illness The Risks of Harm Associated with Mental Illness Conclusions 5. New Medicalism and Human Rights Introduction New Medicalism and the European Convention on Human Rights (ECHR) New Medicalism and the UN Convention on the Rights of Persons with Disabilities (CRPD) Conclusions 6. Evaluating the Impact of the Mental Health Act 2007 Introduction Assessing the Impact of the 2007 Act Assessing the Determinative Potential of Legislation Governing the Compulsory Care and Treatment of Persons with Mental Disorder Conclusions 7. Reflections on New Medicalism Introduction The New Medicalist Moment After the Mental Health Act: Where Next? Conclusions Conclusions Bibliography Index