Mind Says No More Coercion To 'No Secrets' Consultation, UK

Main Category: Mental Health
Also Included In: Psychology / Psychiatry
Article Date: 01 Feb 2009 - 3:00 PDT

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As the Government's consultation on the review of the 'No Secrets' guidance came to a close, leading mental health charity Mind warns against more intervention by care staff into the lives of mental health service users.

Mind's new research 'Keeping safe from abuse' (1) consulted service users about their experiences of abuse, we found that:

-- 57% want the right to refuse interference by the authorities
-- 46% did not want police to have greater powers to enter their home without their permission
-- 86% felt they were responsible for their own safety
-- 89% would feel safer if they were able to choose who provides their care

Mind believes that extending the powers of care workers to give them access to people's homes against their wishes is a step too far. It takes away people's basic right to privacy and undermines their ability to make decisions for themselves.

It is inappropriate to label everyone with a mental health problem 'vulnerable' because of their diagnosis as an individual's mental health can fluctuate. A far better approach would be to involve people in decision making by encouraging the use of advance statements where they can set out what they would like to happen in the event they are at risk of abuse.

One service user told us: "I wouldn't want someone making the assumption that I am always vulnerable because I have mental health problems. If I have a breakdown, then yes I am 'vulnerable', but not when I feel strong. I am only vulnerable at certain times and in certain circumstances." Mind's research highlights that for many, the mental health system itself is seen as the abuser. It is difficult for a system that promotes compulsory treatment regimes, detention and control of behaviour to be the same system that is given responsibility for protecting safety. Appalling levels of abuse still exist in institutional settings which reduces people's trust in the system as a protector. A further barrier is the enduring stigma that surrounds mental health. It prevents people seeking help, allows abuse to occur and stops people from being believed.

Mind's Policy and Campaigns Manager Anna Bird said: "The people we spoke to felt very strongly that they needed to take responsibility for their own safety. The language around vulnerability and protection disempowers people, it suggests they are passive and takes away their fundamental right to have control of their own lives."

"The last thing that is needed is the expansion of powers of coercion. Giving social workers powers of entry blurs the line between law enforcement and care provision. It will erode trust and damage therapeutic relationships. Social workers are advisors not enforcers."

"There will of course be times when it is necessary for the authorities to override an individual's wishes in order to keep them from serious harm but the legal framework already exists for assessing this risk. Instead, the focus should be on ensuring the tools for intervention we already have works properly."

"The Government must acknowledge the specific issues relating to safeguarding adults with mental health problems and take radical steps to address this problem."

(1) Keeping safe from abuse, Mind (2008). Based on a survey of 84 service users and the results of two focus groups.

Mind is the leading mental health charity in England and Wales. We work to create a better life for everyone with experience of mental distress. www.mind.org.uk

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