Remember Maggies Care in the Community??

#2
Care in the Community introduced by Virginia Bottomly shen she was Secretary of State for Health under the Tories. A cost-saving exercise for what was widely regarded as the 'Cinderalla' service of the NHS.

The Tories later admitted that the exercise had been a complete disaster.

It is the Prison System which is now routinely used as the social dumping ground for the mentally ill. - they are easier to convict and thus inflate the 'clear up' rates for recorded crime.
 
#3
The government has been promising new legislation for the past seven years but, until the publication last month of a mental health bill, has failed to implement any reforms.
Whilst the previous Tory Government can hold there hands up to this policy, the present regime has had 9 years to sort it out and has done squat!!!

Implementing 4000 plus pieces of new legislation and imposing draconian restrictive laws will not fix flawed policies.

Ministers will now push ahead with plans to introduce new community treatment orders — so-called mental-health Asbos — to force mental patients to take drugs after being released from hospital. Those refusing to do so risk being sectioned. The system for checking up on patients in the community will also be strengthened in the new year.
I wonder if these Mental Health ASBOs will echo the failings of the current ABSOs. I feel the answer will be yes, unfortunately it will be on the back of another inquiry on some poor souls demise at the hands of another lunatic, inadequately treated, released early with a complete lack of monitoring and aftercare due to a lack of resources/money.

And these Ministers have the arrogance to try to give themselves a 66% payrise. (Oops, another thread!). God give me strength.
 
#4
A good deal of the current problem - which the Times article does not seem to highlight - is that those with even severe personality disorders/illnesses cannot be legally be detained if their condition is untreatable. This led to the release of, for example, Michael Stone (killed Megan and Lin Russell).

Is the answer just to lock up all of those people with such disorders? It's tempting to say yes, but we then have to overturn a presumption of innocence (bit of a slippery slope) due to the presence of illnesses which only cause violence in a small handful of cases.
 
#5
GM_1000 said:
A good deal of the current problem - which the Times article does not seem to highlight - is that those with even severe personality disorders/illnesses cannot be legally be detained if their condition is untreatable. This led to the release of, for example, Michael Stone (killed Megan and Lin Russell).

Is the answer just to lock up all of those people with such disorders? It's tempting to say yes, but we then have to overturn a presumption of innocence (bit of a slippery slope) due to the presence of illnesses which only cause violence in a small handful of cases.
It's amazing he still finds time for his loyalist paramilitary activities.
 
#6
Whilst the previous Tory Government can hold there hands up to this policy, the present regime has had 9 years to sort it out and has done squat!!!

Implementing 4000 plus pieces of new legislation and imposing draconian restrictive laws will not fix flawed policies.
. . . but they did save the lives of four foxes
 
#7
Random_Task said:
GM_1000 said:
A good deal of the current problem - which the Times article does not seem to highlight - is that those with even severe personality disorders/illnesses cannot be legally be detained if their condition is untreatable. This led to the release of, for example, Michael Stone (killed Megan and Lin Russell).

Is the answer just to lock up all of those people with such disorders? It's tempting to say yes, but we then have to overturn a presumption of innocence (bit of a slippery slope) due to the presence of illnesses which only cause violence in a small handful of cases.
It's amazing he still finds time for his loyalist paramilitary activities.
Shock! Two b*stards have same name! Stop Press!
 
#8
GM_1000 said:
Is the answer just to lock up all of those people with such disorders? It's tempting to say yes, but we then have to overturn a presumption of innocence (bit of a slippery slope) due to the presence of illnesses which only cause violence in a small handful of cases.
The presumption of innocence is all but eroded as it stands. Constant surveillance, huge Governmental databases all but pervade a presumption of guilt until eliminated. Lets not kid ourselves that the presumption of innocence is the keystone to modern judicial practices and law. This ceased to be a few years ago.

If someone is deemed an unacceptable risk, no matter how slight, then they should not be placed into society. Isn`t the prison process designed to rehabilitate individuals into becoming functional responsible members of society? Thus the "secure hospital" should work on the same principles.
 
#9
midnight said:
My Mother used to work in a Mental Hospital in the ´40s and ´50s,and often complained about the miss-uses of the Legal System to lock up people who where deffinatley NOT mentaly ill.............however,

http://www.timesonline.co.uk/article/0,,2087-2484061,00.html


Watch your backs!! :evil:
And in the last 8 years approximately 5000 people have been murdered by people who WEREN'T mentally ill....!

Just another ill-informed and journalistically lazy article that socially stigmatises the metally ill yet again.

The problem with the Compulsory Treatment Order (incidentally I now commission mental health services and I have NEVER heard a CTO called a 'mental health ASBO' before. I think the journalist may have invented that one!) is that I can't think of many CPN's who would be willing to forcibly medicate someone in their own home. If we set up clinics to provide the medication then the client still has to turn up. If they don't you are left with the prospect of nurses turning up mob-handed to forcibly remove someone to a place where their medication can be administered. That is not going to fill mental health professionals (or their clients) with joy....

It's very difficult to enforce this as it means basically baby sitting the seriously mentally ill, and services don't exist to do that. All that will happen is that if people don't take their medication they will become unwell again and be re-admitted that way, the same as happens now.
 
#10
psychobabble said:
If we set up clinics to provide the medication then the client still has to turn up. If they don't you are left with the prospect of nurses turning up mob-handed to forcibly remove someone to a place where their medication can be administered. That is not going to fill mental health professionals (or their clients) with joy....
Isn`t this where the famous "the men in the white coats are coming", saying comes from? Forcibly "sectioning" someone is a necessary evil as they are hardly likely to "section" themselves. If there is a degree of danger to the "white coats" then perhaps police assistance will be required to detain under the Mental Health Act.

I can`t see too many people hand wringing, seeing nurses forcing medication upon those clearly in need of it. Doctors carry it out on terminally ill patients, sometimes against their wishes. Sounds like a medico-ethical debate :lol:

I would rather see the individual "sectioned" for his own and societies safety, than be left within the community for him and his 30 alter egos to run amok whilsting shouting it is his Human Right to do so.
 
#11
mad_mac said:
The presumption of innocence is all but eroded as it stands. Constant surveillance, huge Governmental databases all but pervade a presumption of guilt until eliminated. Lets not kid ourselves that the presumption of innocence is the keystone to modern judicial practices and law. This ceased to be a few years ago.
Agreed - should have said "further eroded". With the propsed abolition of trials by jury in some cases, things really are going further and further down the pan.

mad_mac said:
If someone is deemed an unacceptable risk, no matter how slight, then they should not be placed into society.
However, surely we don't want to reduce such an important right still further unless absolutely necessary? You might say that it is in these cases: I'm not convinced that the "however slight" formulation is at all sensible, though. Do we really want to lock up - indefinately - anyone who poses even a slight risk to others? We would have to lock up a hell of a lot of people, many of whom don't pose a significant risk.

mad_mac said:
Isn`t the prison process designed to rehabilitate individuals into becoming functional responsible members of society? Thus the "secure hospital" should work on the same principles.
The point about those with certain mental illnesses is that they are deemed untreatable. So secure hospitals can't work on the same principles. They can't be rehabilitated. Yet the majority do not pose a risk. Do we really want to start locking up and criminalising an entire group of people on the grounds that a very small number pose a risk? The parallels from history are obvious and concerning, IMO.
 
#12
psychobabble said:
midnight said:
My Mother used to work in a Mental Hospital in the ´40s and ´50s,and often complained about the miss-uses of the Legal System to lock up people who where deffinatley NOT mentaly ill.............however,

http://www.timesonline.co.uk/article/0,,2087-2484061,00.html


Watch your backs!! :evil:
And in the last 8 years approximately 5000 people have been murdered by people who WEREN'T mentally ill....!

Just another ill-informed and journalistically lazy article that socially stigmatises the metally ill yet again.

The problem with the Compulsory Treatment Order (incidentally I now commission mental health services and I have NEVER heard a CTO called a 'mental health ASBO' before. I think the journalist may have invented that one!) is that I can't think of many CPN's who would be willing to forcibly medicate someone in their own home. If we set up clinics to provide the medication then the client still has to turn up. If they don't you are left with the prospect of nurses turning up mob-handed to forcibly remove someone to a place where their medication can be administered. That is not going to fill mental health professionals (or their clients) with joy....

It's very difficult to enforce this as it means basically baby sitting the seriously mentally ill, and services don't exist to do that. All that will happen is that if people don't take their medication they will become unwell again and be re-admitted that way, the same as happens now.
I find it almost unbelievable that a teenager who doesn´t want to return home gets a 24/7 `nursery´ care in a flat or house;But a mentally unstable patient doesn´t?

I know this as a cousin of mine used to earn lots of money to finance her Doctor in Social Studies,or some such rubbish;She left after becoming totally dissolusioned by the whole system,and is now a nurse.

It stinks of ´saving resources´ in that somebody that is `untreatable`,is not locked up or cared for and is simply set onto the streets to fend for themselves,and are free to kill or maim others knowing that they cannot be convicted when they´re caught.

A few months/years of treatment and they´re back out again,maybe we should lock up the `Doctors`that set them free on an unsuspecting public,and then say that they´re sorry that they couldn´t force somebody to take their tablets :x
 
#13
[
GM_1000 said:
[However, surely we don't want to reduce such an important right still further unless absolutely necessary? You might say that it is in these cases: I'm not convinced that the "however slight" formulation is at all sensible, though. Do we really want to lock up - indefinately - anyone who poses even a slight risk to others? We would have to lock up a hell of a lot of people, many of whom don't pose a significant risk.
This is a difficult dilemma, "devil and the deep blue sea" stuff. What constitutes an acceptable risk? Would you be prepared to explain it to Mrs Miggins who has just lost her husband after "Hannibal" has breakfasted on him?

I appreciate it is a quandary, and someone may get it wrong and there will be a human price to pay for it.

The point about those with certain mental illnesses is that they are deemed untreatable. So secure hospitals can't work on the same principles. They can't be rehabilitated. Yet the majority do not pose a risk. Do we really want to start locking up and criminalising an entire group of people on the grounds that a very small number pose a risk? The parallels from history are obvious and concerning, IMO.
If these people are untreatable and do pose a risk then they should be "contained". I would certainly not want to see a prisoner parolled committing further criminal offences. If this does occur the risk assessment has failed and further rehabilitation is required. If the individual is beyond rehabilitation and would pose a risk to society he/she should be detained at Her Majesties Pleasure indefinately.

When technology advances sufficiently to allow suitable treatment, these individuals will be re assessed accordingly. Not an ideal solution, but we do not live in an ideal world. The fundamental virtue of a society is the ability to function together. When this is threatened the perpetrator is excluded from that society. If I had a better solution I would be a rich man.
 
#15
Neuroleptic said:
Do facts help or hinder arguments?

http://news.bbc.co.uk/1/low/health/248841.stm

http://news.bbc.co.uk/1/hi/health/1721156.stm

As one of these articles notes, it's drugs and booze that seriously increase the risk of violence, not necessarily mental illness.
Looking at both articles one describes the chances of being murdered by a mentally insane person.

The second article refers to the chances of a mentally insane person being murdered.

Not quite the contradiction indicated. :wink:
 
#16
mad_mac said:
Neuroleptic said:
Do facts help or hinder arguments?

http://news.bbc.co.uk/1/low/health/248841.stm

http://news.bbc.co.uk/1/hi/health/1721156.stm

As one of these articles notes, it's drugs and booze that seriously increase the risk of violence, not necessarily mental illness.
Looking at both articles one describes the chances of being murdered by a mentally insane person.

The second article refers to the chances of a mentally insane person being murdered.

Not quite the contradiction indicated. :wink:
Not sure I follow you either.

One article points out that the risk of being murdered by someone with a mental health problem is really rather low, as it has been historically. The "care in the community made things worse" argument just doesn't stand up in the face of those facts.

The second one illustrates the fact that the mentally ill are far more vulnerable e.g. to suicide, rather than they are dangerous to others. But that doesn't seem to fit the agenda of hype that the press/ media have created around this issue. Appleby and the others on the National Confidential Inquiry have consistently pointed out that this is the main reason why more resources are needed for mental health care, although that would also help address the first issue as well.

Alcohol is a major factor in much violence, including murder, but no one seems to be suggesting we lock up all those who get drunk, just in case.
 
#17
Care in the Community was a left liberal idea taken up by the Tories, it had ALL party support.

It shows how far from reality all MPs were and are still .
 
#18
Just to give you an idea how the system works a freind of my wife has suffered mental health problems for a few years now. Last year she was discharged into care in the community and got no support what so ever, a care worker called once a week and if they got no answer did nothing. The person was eventually re-admitted when they were so sick they would have died from malnutrition if they had not been admitted although they had been trying to get re-admitted for some time. they were 'released' again.

The person then broke her leg and was admitted to a medical ward and got 'proper treatment and is now back out again and coping, with good 'medical' support in the community.

Whilst the pain of people affected by the dangerous ones let out is bad enough the suffering of the friends and famillies of the non dangerous ones is immense and just not addressed by the level of mental health care provided.

Peter
 
#19
Just a historical note on the ‘Care in the Community’ issue. The term was first used by a Conservative Minister of Health who had 2 concerns. The first was that many large Asylums and Workhouses (later to became the Mental Hospitals of the NHS) most of which had been built during the mid to late Victorian era were soon to be coming to the end of their lives. So too would many of the county infirmaries, which prior to the creation of the NHS had been run by either local councils or charitable trusts. Britain was faced with a massive hospital building programme. Replacing them would be costly and they believed that it would require significant additional tax revenue to pay for them. Being a Conservative government the Minister was not too keen on this idea so they looked for an easy target, something they could get away without replacing. The mental health services were an easy target. It also meant they would not have to get into the massive NIMBY disputes about where to build these things - when was the last time you heard of a local community demonstrating that their local loony bin was going to be closed or nor replaced. So they came up with the idea of ‘Community Care’ and as this coincided with the arrival of new drug therapies which it was hoped would significantly reduce the number of long-stay beds for the chronically mentally ill it was able to dress the idea up as enlightened social policy. However, this politician also had a second concern. The NHS was at that time becoming increasingly militant with significant pockets of left wing trade unionism emerging amongst groups who had not been particularly active. This was particularly strong in the mental health and learning disabilities hospitals (where for example most of the nurses chose to join TUC affiliated trade unions such as the them COHSE and NUPE rather than the non-affiliated Royal College of Nursing – a union by any other name) and the Secretary feared that this malaise may spread to other parts of the NHS. Thus there were both economic and political drivers for developing this policy as well as perhaps some genuine belief that it may be a better method for caring for the mentally ill. In the end, the government of which this politician was a member fell before the policy could be implemented, any decision on replacing mental hospital was delayed and delayed until many became unspeakable slums – both major political parties were to blame. In the end the policy became almost inevitable as no one wanted to meet the costs of building new mental hospitals and no one wanted to face the inevitable NIMBY disputes that would be so politically damaging. The policy, pretty well as originally espoused and for the same motivation was adopted by a Conservative and continues to be implemented by a Labour government. The one person who seems never to get a mention these days when politicians try to tell us what a great idea this is was the man who had the original idea of, the Minister of Health from 1960-1962, one John Enoch Powell; whatever happened to him!
 
#20
Neuroleptic said:
mad_mac said:
Neuroleptic said:
Do facts help or hinder arguments?

http://news.bbc.co.uk/1/low/health/248841.stm

http://news.bbc.co.uk/1/hi/health/1721156.stm

As one of these articles notes, it's drugs and booze that seriously increase the risk of violence, not necessarily mental illness.
Looking at both articles one describes the chances of being murdered by a mentally insane person.

The second article refers to the chances of a mentally insane person being murdered.

Not quite the contradiction indicated. :wink:
Not sure I follow you either.

One article points out that the risk of being murdered by someone with a mental health problem is really rather low, as it has been historically. The "care in the community made things worse" argument just doesn't stand up in the face of those facts.

The second one illustrates the fact that the mentally ill are far more vulnerable e.g. to suicide, rather than they are dangerous to others. But that doesn't seem to fit the agenda of hype that the press/ media have created around this issue. Appleby and the others on the National Confidential Inquiry have consistently pointed out that this is the main reason why more resources are needed for mental health care, although that would also help address the first issue as well.

Alcohol is a major factor in much violence, including murder, but no one seems to be suggesting we lock up all those who get drunk, just in case.
Or to stay even more safe don't have relationships or a family, as that's the source of most homicides in this country!
 

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