"Mental health patients complain of 'zombification'", is an article by Mark Gould which appeared in “The Guardian” on the 15 March 2011, and which is worth a read. It is of course always refreshing to see “Service Users” portrayed in the media relatively sympathetically, rather than as a menace to society. Although a very common complaint of my clients is indeed the sedating effects of medication, this article does not actually focus on the “zombification” of mental health patients as the strapline suggests. Rather the focus is on the increase in the number of people being “sectioned” under the Mental Health Act 1983, and in particular the huge numbers who find themselves under a “Community Treatment Order” (or “CTO”).
Statistics released in January reveal a huge 17.5% rise in the number of people being “sectioned” - up from 32,649 in 2008-09 to 38,369 in 2009-10. The courts are using the Mental Health Act 1983 more often as well - there was a hefty increase of 85% in the number of women who find themselves subject to the Mental Health Act 1983 via the courts, and a rise of 48% in the numbers of men following that route into hospital. This is not surprising and perhaps should be welcomed given that on the HM Prison Services website it is acknowledged: “Up to 80% of women in prison have diagnosable mental health problems.” The statistics provided by the Prison Reform Trust are that, “72% of male and 70% of female sentenced prisoners suffer from two or more mental health disorders. One in five prisoners have four of the five major mental health disorders.” Clearly, those who are suffering from major mental disorders are better placed in hospitals rather than prisons. The rise of the CTO is rather different, however.
One of the biggest surprises following the introduction of CTOs in 2008 was just how popular they would prove to be - with Psychiatrists of course, rather than patients. When they came into force in 2008, the government expected 350-450 CTOs to be issued in England and Wales in the first year; however from November 2008 until March 2009 a staggering 2,134 CTOs where made, and now it seems that more than 6200 have been issued. Not surprisingly, experience is showing that these orders may be easy to make, but it is nowhere near as easy for someone to get their CTO discharged. Tony Zigmond, lead on mental health law for the Royal College of Psychiatrists, advocates a more consensual approach to treatment. He is quoted in the article as describing detention under the Mental Health Act 1983 as “a lobster pot - easy to get into but hard to get out of,” and stating “The top line is that CTOs have increased the number of detentions...in effect they are prisons without walls so that numbers on them could be limitless.” Stirring words indeed, but with the current culture of fear, with an overemphasis on risk and “back covering”, I can only see even more use of compulsion and coercion in the future. I hope I am wrong.