14:37, May 08 323 0 theguardian.com

2017-05-08 14:37:03
Mental health needs resources, not tinkering with the law

The theme of this Mental Health Awareness Week (8–14 May), hosted by the Mental Health Foundation, is “Surviving or Thriving”. Rather than asking why so many people are living with mental health problems (Report, 8 May), we need to uncover why too few of us are thriving with good mental health.

It is crucial to remember that three children in every classroom will experience mental health problems by the time they are 16, and half of adult mental health problems start before the age of 14. While the Scottish government and society as a whole has begun to treat mental health and physical health equally, we still have a long way to go.

If we are going to truly develop a mentally healthy society, we must begin with a renewed focus on prevention and early intervention, so that our children and young people get the support they need, where and when they need it.

As members of the Scottish Children’s Services Coalition we have long campaigned for mental health and wellbeing education to be expanded in schools, to equip our young people with emotional resilience and coping skills required to thrive in the modern world (Five priorities for improving children’s mental health, theguardian.com, 5 May).

Tom McGhee Managing director, Spark of Genius, Duncan Dunlop Chief executive, Who Cares? Scotland, Sophie Pilgrim Director, Kindred Scotland, Stuart Jacob Director, Falkland House school, Niall Kelly Managing director, Young Foundations, Liz May National coordinator, Action for Sick Children Scotland

As psychiatrists carrying out a study of the implementation of the Mental Health Act 2007, we are concerned by the Conservative party’s undertaking to replace the current legislation, apparently in order to tackle “unnecessary detention”. The legislation was introduced following an extensive and lengthy review in which many alternative options were considered and which eventually decided to keep much of the Mental Health Act 1983 intact, with some new measures introduced by the 2007 Act and complemented by the Mental Capacity Act of 2005.

The most recent report on the use of the Mental Health Act by the Care Quality Commission does not call for changes in legislation but urges better compliance with the accompanying code of practice, and draws attention to problems due to lack of resources. All detentions under the act are subject to review by an external, independent tribunal, which can order discharge but for 94% of detentions this does not happen, strongly suggesting that in most cases detention is appropriate. There is no evidence for widespread unnecessary detention.

We consider that the rise in the proportion of patients who are detained and disparities between ethnic groups likely reflect the scarcity of resources for informal treatment and differences in need, access and engagement between groups. We can see no reason at all to consider major changes in legislation so soon after the last review.

Dr Susham Gupta, Professor David Curtis, Dr Toby Baldwin and Dr Elvan U Akyuz

London

Periodically politicians go after the 1983 Mental Health Act – Labour did in 2007. Not because it is a bad act, it isn’t, but under pretexts that it doesn’t address the problems of today. The truth is it does cover almost all contingencies, but it has not lived up to expectations because there have never been the resources to match the aspirations.

Mental health first aid, cognitive behaviour therapy, group work and peer support programmes are great but they can only work if statutory mental health services are functioning as the act intended.

John Byrne

Berkhamsted, Hertfordshire

This weekend saw another example of Tory proposals fitting Menken’s view that ‘For every complex problem there is an answer that is clear, simple, and wrong’. Growing numbers of mentally ill people are being inappropriately held in police cells. Contributory factors to this appalling situation include the growth in mental health problems caused or exacerbated by poverty, a parlous lack of appropriate hospital places, cuts to voluntary and statutory services working in preventative care, a lack of police resources/training in ways of working with people in mental health crises and staff shortages in all relevant public services – health, policing and social care.

The Tory solution? Scrap the Mental Health Act 1983. Simple! And oh so wrong!

Dr Karen Postle

Titchfield, Hampshire

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