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
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