Select Committee on Home Affairs First Report


APPENDIX 13

Supplementary note by the Royal College of Nursing

  In addition to our written and oral evidence, the Royal College of Nursing would be grateful if the Committee could note the following points:

  1.  We wish to draw your attention to the suggestion by the Deputy Home Secretary that trials of assessment procedures will take place in prison settings. We recommend that pilots of assessment and treatment models also take place in special hospitals and especially in community settings. We refer you to our answer to Question 204, in relation to taking a "whole systems" approach.

  2.  We would also like to draw the Committee's attention to the potential role of mental health nurses in working preventatively with people with severe personality disorders. Assertive Outreach services aim to make contact, establish trusting relationships, encourage people to maintain contact and work with professionals and provide supportive and other interventions with this group. Nurses are at the core of these services. Mental health nurses also work with people with chaotic drug and alcohol use in various settings. Many of these patients have personality disorders and may exhibit anti-social behaviour including violence. Nurses are therefore in a position to work proactively and preventatively with people who may fall into the category identified by the Government in these proposals.

  3.  The Deputy Home Secretary stated (in his answer to Question No. 120) that persons with personality disorders sometimes present themselves at hospitals and police stations asking for help, stating that they believe that they are likely to harm someone. He said that nothing within the existing law can be done unless the personality disorder is deemed to be treatable. This is incorrect and seriously misleading. Unfortunately, we did not have the opportunity when giving oral evidence to correct this error.

  When persons with personality disorders ask for help, there is no legal barrier to providing help.

    —  The "treatability" requirement does not apply unless it is proposed to admit the patient compulsorily, under a section of the Mental Health Act. Persons asking for help do not need to be sectioned but can be admitted voluntarily.

    —  In any event, the "treatability" test is interpreted widely by the courts. A patient in this position would probably benefit from hospital admission and would therefore be deemed "treatable".

  If adequate help is not always provided, this is not because of lack of legal powers. It is more likely to be the result of lack of resources.

  We note that this part of the Minister's evidence was selected by the BBC for broadcasting on "Today in Parliament".

December 1999


 
previous page contents

House of Commons home page Parliament home page House of Lords home page search page enquiries

© Parliamentary copyright 2000
Prepared 14 March 2000